10 Tips for Reducing Sugar Intake

The average American eats more sugar in one day than our ancestors did during an entire lifetime. They prized sugary foods for their abundant calories and quick energy spike. Thus, now we are wired to reach for the cookie jar over and over and over – even though we have no lions to outrun.

Sugar has a very high caloric content and virtually no nutritional value. Besides causing weight gain, it also encourages inflammation and infection, compromises the immune system and raises insulin levels. Insulin encourages the storage of fat, elevates triglyceride levels and promotes cardiovascular disease, asthma, mood swings, diabetes, gallstones, hypertension and arthritis. Still want that piece of cake?

We all know that sugar can cause health problems, however our eating culture revolves around sugary, salty, fatty, unhealthy foods. Even those without a raging sweet tooth will find that it's almost impossible to avoid eating refined sugar these days, as grocery manufacturers routinely add it to everything from bread and pizza dough to spaghetti sauce and salad dressing.

Eating less sugar is one of the best actions you can take to improve your current and future health, but saying "no" to sweets isn't as easy as it seems. If you can't cut out sugar completely (who can?), then try the following tips to quickly and painlessly reduce your sugar intake. It seems this becomes increasingly handy during the holiday season...

1. Cut down on processed and packaged foods. Salad dressings, spaghetti sauces, soups and even pizza crusts contain sugar. If you make your own soup, you will unlikely be adding a cup of sugar to the stew pot, however this is exactly what manufacturers do. Try to purchase groceries with the least amount of packaging as possible.

2. Indulge in the highest-quality sweets that you can afford. You will get more satisfaction from enjoying one divine chocolate truffle than you will from six crappy little sandwich cookies. Resolve to only eat sweets that you really, really like. Forget the rest, and then don't beat up on yourself when you have a sugary treat that you really enjoy.

3. Free sweets aren't free. Many work sites, businesses or offices always have on hand candy, doughnuts or other sweets to snack on. It is human nature to grab these cheap calories and ingest them, however you will pay for the free treats later with poor health and a belly roll.

4. Banish the candy jar. Do you have a candy jar on your desk at work, school, or some other handy and convenient place? Remove it, and you will reduce your sugar intake. Even just moving a candy dish from your desk to a table across the room will drastically decrease the amount that you eat.

5. Know your sugars. Fructose, glucose, lactose, maltodextrin and dextrose are all types of sugar masquerading under their scientific names. Read grocery labels so that you know what you are putting into your body.

6. Don't drink liquid candy. Soda is basically that – liquid candy. Most Americans think of soda as a beverage, and most Americans are overweight. Think of soda as a special treat rather than a daily occurrence, and you will enjoy it even more and avoid all those empty calories. Besides, we've got the Top 10 Reason to Banish Soda. 

7. Watch your breakfast. Deep-fried dough topped with icing and candy sprinkles isn't anywhere near healthy, but doughnuts are a tried-and-true American breakfast. Just say no. Also passing as breakfast: giant muffins (muffins = cake), frappuccinos and smoothies – these are basically milkshakes. Starting your morning off with a sugar overload like this will offset your energy and unbalance your system for the rest of the day.
8. Indulge your sweet tooth naturally. Fruits, honey, maple syrup and molasses all contain natural sugars. Although these foods are no health superstars, they are a better option when the sweet tooth strikes and you are craving some sugary action. An apple will give you a sweet burst of flavor along with beneficial vitamins and fiber. Check out our Guide to 10 Natural Sweeteners. 

9. Go black and never go back. Resolve to drink your coffee and tea without sugar and milk; this small change of mind can save you several sweet teaspoons every single day, and you will most likely find that you do not miss it. And besides, ordering a straight-up black coffee or espresso is infinitely cooler (and cheaper!) than ordering the triple-no-fat half-caramel grande Flufficino with whip and chocolate drizzle. Don't let your daily caffeine requirements become an excuse to load up on sugar.

10. If you just have to have something sweet at the end of every meal, keep a pile of your favorite gum on hand and enjoy a piece for dessert. This will give your brain the sweet sensation it desires and will keep your mouth occupied from chewing other more high-calorie dessert options. Of course, conventional gum isn't healthy either, but you can find natural and even organic gums at your local health food store.

Waiting For Christmas

Waiting For Christmas :DDD

HIV/STD Update

World AIDS Day

December 1 is World AIDS Day. There are approximately 1,462 people estimated to be living in Maine with diagnosed HIV infection. In addition, Maine CDC estimates that about 388 people in Maine may be infected but unaware of their HIV status. Worldwide, more than 33 million people are estimated to be living with HIV. For more information on World AIDS Day: http://www.aids.gov/world-aids-day/ For more information on HIV/AIDS in Maine: www.mainepublichealth.gov/hivstdhep


Syphilis

Since mid-July, health care providers in Maine have diagnosed 19 cases of early syphilis, ages 19-56, in Cumberland, Penobscot, Waldo and York Counties. Eleven cases were primary syphilis, 5 cases were secondary syphilis, and 3 cases were early latent syphilis. All 19 cases were among men who have sex with men (MSM). Eight of the 19 individuals (42%) are known to be HIV positive. A total of 33 cases of early syphilis have been reported since the beginning of the calendar year. For more information, see this Health Alert: http://www.maine.gov/tools/whatsnew/index.php?topic=DHHS-HAN&id=152027&v=alert

PrEP

The National Institutes of Health (NIH) has announced the results of an international clinical trial, co-sponsored by the Bill and Melinda Gates Foundation, that examined whether a pill containing two drugs used to treat HIV can also help prevent HIV infection – an approach called pre-exposure prophylaxis, or PrEP. The trial found that daily oral use of Truvada ® provided an average of 44 percent additional protection to trial participants that included gay, bisexual, and other men who have sex with men (MSM), as well as transgendered women who have sex with men. These participants also received a comprehensive package of prevention services that included monthly HIV testing, condom provision, counseling, and management of other sexually transmitted infections.

US CDC will fully review the trial data and publish interim guidance in the coming weeks in the Morbidity and Mortality Weekly Report, to be followed in several months by formal U.S. Public Health Service guidelines. The agency urges individuals and their doctors to await those guidelines before use. For more information, please refer to the PrEP fact sheet: http://www.cdc.gov/nchhstp/newsroom/PrEPforHIVFactSheet.html

This blog has additional information from the White House.

Sixth Annual Comprehensive Sexuality Education Conference

Save the date for the sixth annual Comprehensive Sexuality Education Conference, which will be held April 7 at the Augusta Civic Center. It is sponsored by: Family Planning Association of Maine; Maine Department of Education, Maine CDC; New Beginnings; University of Maine at Farmington; and the Maine Association for Health, Physical Education, Recreation, and Dance.

The Benefits of Fruits and Vegetables

Nutritionists have long advised us to add color to our diet. In fact, they say the more colors we eat, the better balanced the meal. A new study in the Archives of Internal Medicine supports this belief.

Carotenoids are yellow, orange and red pigments made by plants that come into our body through fruits and vegetables. They're found in yellow-orange vegetables such as carrots and sweet potatoes, and dark green vegetables, like green beans.

There are two types of carotenoids, alpha- and beta-carotene, which both produce vitamin A in our bodies. More is known about beta-carotene because of its possible role in preventing chronic disease.

Now, in a new study of over 15-thousand adults, researchers measured the concentration of alpha-carotene in the blood. Over a 14 year period they found that the risk of death was lower for people with elevated levels of alpha-carotene.

The investigators think that the benefits of high alpha-carotene eventually flattens out - it's not an elixir of eternal life. But they conclude that increasing fruit and vegetable consumption may prevent premature death.

The science is still out on just how this works. But it further supports previous findings - and conventional wisdom - that fruit and vegetable consumption is beneficial to people's overall health.
For tips on how to boost fruits and vegetables in your diet...and to see the benefits each one provides, click on the American Heart Association website.

Source  http://www.wdio.com/article/stories/S1857838.shtml?cat=11803

Where's That Then? No 46

If you were on the other side of this summer house, then you'd think this was a one storey building. And behind you would be something much bigger. Clue: mid-southern England.

Choline and Fatty Liver

I've been writing about non-alcoholic fatty liver disorder (NAFLD) since the early days of this blog, because it's an alarmingly common disorder (roughly a quarter of Americans affected) that is typically undiagnosed. It often progresses into its more serious cousin non-alcoholic steatohepatitis (NASH), an inflammatory condition that causes liver damage and can progress to cancer. In a number of previous posts, I pinpointed excess sugar and seed oil consumption as culprits in NAFLD and NASH (1, 2, 3, 4, 5).

Chris Masterjohn recently published two very informative posts on NAFLD/NASH that add a major additional factor to the equation: choline (6, 7). Choline is an essential nutrient that's required for the transport of fat out of the liver (8). NAFLD can be caused, and cured, simply by removing or adding dietary choline, and it appears to be dominant over other dietary factors including fat, sugar and alcohol. Apparently, certain researchers have been aware of this for some time, but it hasn't entered into the mainstream consciousness.

Could that be because the richest dietary sources are liver and eggs*? Choline is also found in smaller amounts in a variety of whole animal and plant foods. Most people don't get the officially recommended amount. From a recent review article (9):
Mean choline intakes for older children, men, women, and pregnant women are far below the adequate intake level established by the [Institute of Medicine]. Given the importance of choline in a wide range of critical functions in the human body, coupled with less-than-optimal intakes among the population, dietary guidance should be developed to encourage the intake of choline-rich foods.
I've dubbed beef liver the Most Nutritious Food in the World, Nature's Multivitamin, and I'll probably invent other titles for it in the future. Add yours to the comments.

Head over to Chris's blog and read about the classic studies he unearthed. And add The Daily Lipid to your RSS reader, because there's more interesting material to come!

The Sweet Truth about Liver and Egg Yolks
Does Choline Deficiency Contribute to Fatty Liver in Humans?


* For the brave: brain is actually the richest source of choline.

Christmas Cookies

Update on Smart Meters

In October, the Office of the Public Advocate (OPA) requested that Maine CDC comment on health concerns related to the wireless communication technology, also known as smart meters, being installed by Central Maine Power (CMP). As a result, Maine CDC submitted a report on November 8 to OPA and the Public Utilities Commission (PUC) of our review of national and international government-affiliated organizations’ analyses on this subject.

Subsequently, Maine CDC and others received several correspondences from people expressing concerns about the review. In order to make sure OPA, PUC, and the correspondents have our responses in a concise format, we have grouped the concerns into eight topic areas and compiled our responses into a Frequently Asked Questions document.

It's Good to be Home

It's Good to be Home

The latest health tips on cell phone radiation

To date, I have written in this column thirteen (13) articles on health tips on the use of cell phones… as a public service to remind cell phone users of the harmful effects of the excessive use of cell phone because of radiation exposure.

Here are additional health tips on the use of cell phones that I got from the internet. Should you wish to confirm the information I am sharing with the readers of this column; or should you need further information to convince you of the health risks of cell phone radiation, please check the internet:-

• Do you know that different cell phones emit different amount of radiation? And do you know that cell phones are just complex two-way radios and that if one is talking on a cell phone, he/she is actually talking and listening to a two-way radio that is broadcasting a very, very high frequency signal right next to one’s head;
• Do you know that the San Francisco Board of Supervisors passed a law requiring retailers of cell phones to post notices on how much dangerous radiation is reportedly being emitted by the cell phone units being sold - for consumers’ information;
• Do you know that one of the latest warning on cell phone radiation is to keep your cell phone at least one inch away from your body at all times while it’s on? A big problem for male cell phone users is that they put their cell phones in their pockets – without bothering to check whether their cell phones are on off or on mode;
• Do you know that many parents give their children cell phones as playthings and/or sometimes to soothe them to sleep and place the cell phone under the pillow – without realizing that the skulls of their children are thinner than the skulls of adults and that thinner skulls admits more radiation. There are research studies that show that a young brain is more vulnerable to brain damage/cancer than a mature brain;
• Do you know that in 2008, researchers in the American Journal of Epidemiology found that individuals who kept their cell phones against one side of their heads for several hours a day were fifty percent (50%) more likely to develop parotid tumors;
• Do you know that cordless phone chargers also emit radio frequency power even when not in use. This being so, Wi-Fi and cordless phone chargers should be removed in the bedrooms.
• Do you also know that pulsed digital signals are more damaging than the analog signals and they should not be anywhere near the head of the bed. Also, baby monitors should not be placed closer than 6 feet to the cribs.

(The above information was taken from Internet sites re the book Zapped; Why Your Cell Phone Shouldn’t be Your Alarm Clock and 1,268 Ways to Outsmart the Hazards of Electronic Pollution, by Ann Louise Gittleman, an award winning New York Times best-selling author of over 30 books on health and healing. In 2005, Ann Louise Gittleman was diagnosed with a benign tumor of the parotid, one of the salivary glands located just below the earlobe. It’s a very rare tumor. Ms. Gittleman is a heavy cell phone user for years.)
• Do you know that the French National Assembly passed a new environmental bill last June that included the following health protection directives against possible risk to electromagnetic fields (EMF). The radiation emitted by cell phone is known as electronic radiation.
– A prohibition on the use of mobile phones at school by students in kindergartens, elementary schools, and colleges.
– A prohibition on advertising and marketing mobile phones to children under 14 years of age.
– Every mobile phone sold in France must provide Specific Absorption Rate (SAR) along with a recommendation to use a hands-free kit. The details of how the information is to be presented are not yet finalized.

Let us reduce our cell phone radiation exposure by practicing health care measures on the use of cell phones.
Have a joyful day!

Health Reform Update

Health Reform News

CDC Vital Signs highlight recent data on important health topics. November’s health topic is Access to Care: http://www.cdc.gov/vitalsigns/HealthcareAccess/ New estimates show that the number of Americans without health insurance is growing, affecting middle-income Americans as well as those living in poverty. Adults without consistent health insurance are more likely to skip medical care because of cost concerns, which can lead to poorer health, higher long-term health care costs, and early death.

People with Medicare can review their current coverage or choose a new Medicare plan that works for them through the Open Enrollment period that ends Dec. 31: http://www.medicare.gov/navigation/medicare-basics/open-enrollment.aspx?AspxAutoDetectCookieSupport=1

The Affordable Care Act provides important new benefits to most people with Medicare starting in January 2011, including a 50% discount on brand name drugs for people who fall into the coverage gap, free annual wellness visits, and free mammograms, colonoscopies, and other screenings. For more information: http://www.healthcare.gov/foryou/seniors/strengthening/index.html

HHS Secretary Kathleen Sebelius has announced the launch of the new application cycle for the National Health Service Corps (NHSC) Loan Repayment Program. The NHSC offers primary care medical, dental and mental health clinicians up to $60,000 to repay student loans in exchange for two years of service at health care facilities in medically underserved areas. This year’s investment in the program, which includes $290 million from the Affordable Care Act, seeks to address shortages in the primary health care workforce and translates into greater access to healthcare for those who might otherwise go without.

The Affordable Care Act also provides more flexibility in how the Corps administers the loan repayment program. In addition to monetary awards that are higher than previous years, the Corps will give members the option of working half-time to fulfill their service obligation and provide credit for some teaching hours.

For more information: http://www.hhs.gov/newss/press/2010pres/11/20101122b.html

Health Reform in Maine

Maine Primary Care Association has been awarded $86,434 in additional technical assistance and training funds through the Affordable Care Act. For more information: http://www.hhs.gov/news/press/2010pres/11/20101119b.html

For more information about Health Reform in Maine, visit the Governor’s Office of Health Policy and Finance’s web site: http://www.maine.gov/healthreform/

Thanksgiving and vaccinations: Turkeys aren’t the only ones who should get injections

Another Thanksgiving dinner has come and gone. The bird’s been picked clean, the dishes washed and tummies are full. (Maybe too full!)

Chances are you and your family are now wondering what to do with all that empty togetherness time. Sure, you can whip out the board games and the Wii, or slog out to the mall and bargain-hunt, but we’ve got some other ideas, and they’re better for your health.

The U.S. Department of Health and Human Services suggests that you use some of your holiday together time to talk with your relatives about your family health history. (As a matter of fact, Thanksgiving is officially National Family History Day.) That’s a great idea, and we here at the Get Ready campaign would like to expand on that to suggest you also take some time to talk about vaccinations. No matter their age, someone in your family probably needs a vaccination. Kids and teens need to stay up on their regular shots, adults need their boosters, and seniors especially need vaccinations for flu and pneumonia.

Take a second to think: Can you remember the last time you had a tetanus shot? They are only good for 10 years, so if you can’t recall, chances are you need one. What about pertussis, aka whooping cough? As recent outbreaks have shown, immunity can wane and your lack of protection can end up endangering those you care about. Come Monday, check with your doctor to see whether you are up to date on your vaccinations, and schedule an appointment if not.

And since you and your family are all together post-Thanksgiving anyway, how about taking a group trip to get your seasonal flu shots? The malls are going to be packed this weekend, but chances are the lines at the local pharmacy counter or in-store clinic will be wide open.

Everyone in your family — as long as they are older than 6 months of age — should get their flu shot this year, according to federal health officials. So give your drug or grocery store a call to see when they are giving flu vaccinations today. Then pile in the car and go do some good for your family health.

Since flu shots are an annual thing, use Thanksgiving as a reminder each year to double-check that everyone in your family is protected. (Who knows? It may even become a new tradition.) After all, it’s not just turkeys that benefit from injections.

Christmas feet

Happy Thanksgiving!

Happy Thanksgiving to all my American readers! I hope you all have a great dinner planned with friends and family.

I'm thankful for all the free resources you can find on the web.

Signs and Wonder posted some scans from "The Dedman Method of Basic and Advanced Hair Designing" on Flickr:
http://www.flickr.com/photos/23366371@N08/sets/72157617347576135/

According to the description, it is a 1953 self-published instruction manual on hair styling.

Red&White

Pilze (acufactum)

Alcohol and Public Health

US CDC has released two new reviews from The Guide to Community Preventive Services that assess the effectiveness of limiting the days and hours of alcohol sales for preventing excessive alcohol consumption and related harms. Excessive alcohol use, including binge and underage drinking, is the third-leading preventable cause of death in the United States; responsible for, on average, more than 79,000 deaths per year and 2.3 million years of potential life lost. For more information, review CDC’s October Vital Signs report on binge drinking.

The U.S. Food and Drug Administration (FDA) issued warning letters to four companies that had caffeine added to their malt alcoholic beverages. FDA's action follows a scientific review that examined the published peer-reviewed literature on the co-consumption of caffeine and alcohol, consultation with experts in the fields of toxicology, neuropharmacology, emergency medicine, and epidemiology, and a review of information provided by product manufacturers. FDA also performed its own independent laboratory analysis of these products. Experts have raised concerns that caffeine can mask some of the sensory cues individuals might normally rely on to determine their level of intoxication. The FDA said peer-reviewed studies suggest that the consumption of beverages containing added caffeine and alcohol is associated with risky behaviors that may lead to hazardous and life-threatening situations. All four Maine distributors of Joose alcoholic energy drink have agreed to stop selling it, in response to FDA’s findings.

For More Information:

Influenza Update

Surveillance

There was no flu activity reported in Maine for the week ending Nov. 20. Weekly updates on flu activity in Maine are available at http://www.maine.gov/dhhs/boh/influenza_surveillance_weekly_updates.shtml

Weekly updates for the US are available at http://www.cdc.gov/flu/weekly/summary.htm and international updates are available at http://www.cdc.gov/flu/international/activity.htm.

Update on state-supplied vaccine distribution

Most influenza vaccine arrives in Maine through private sector channels, but Maine CDC will be distributing a total of about 290,000 doses of flu vaccine this year; 92% of doses have already been shipped out to providers in the state. Almost 350 schools have received a total of more than 80,000 doses of state-supplied vaccine for school-based clinics.

Christmas Games

Health department offers food safety tips

Planning for holiday meals should include more than a delicious menu and invited guests. The McHenry County Department of Health wants residents to practice safe food handling, as well.
Keeping “hot things hot (more than 135 degrees) and cold things cold” can reduce your risk of a food-borne illness.

Other safety tips:

• Thaw frozen meats in the refrigerator (allow one day for each 5 pounds of weight plus an extra day or two).
• Wash hands thoroughly with warm water and soap before and after handling foods.
• Clean all kitchen surfaces before you begin cooking.
• Scrub cutting boards with hot soapy water after preparing food to avoid cross contamination.
• Use a metal-stemmed food thermometer to ensure that food is cooked to the proper temperature. Food is safely cooked when it reaches a high enough internal temperature to kill harmful bacteria. Poultry, stuffed pasta and reheated foods should reach an internal temperature of 165 degrees.
Ground meats, pork and eggs should reach an internal temperature of 155 degrees. Beef roasts, steaks and fish should reach an internal temperature of 145 degrees.
Insert the thermometer into the center of the thickest part (away from the bone) of the meat. When cooking casseroles and egg dishes, place the thermometer into the thickest portion, making sure that it does not touch the bottom of the pan. Metal-stemmed thermometers can be bought at grocery, hardware and department stores.
• It is recommended that leftovers be refrigerated within two hours of serving time.

Food-borne illness is preventable. If you suspect a food-borne illness, call the health department for an investigation.

The staff can be reached from 8 a.m. to 4:30 p.m. Monday through Friday at 815-334-4585. For after-hours emergencies, call 815-344-7421.

For more tips, visit www.foodsafety.gov.

Tips to Prevent Carbon Monoxide Poisoning

The Kansas Department of Health and Environments  wants to remind  Kansans that as cold weather approaches the dangers associated with Carbon Monoxide (CO) poisoning increase.   

Carbon monoxide is a colorless, odorless gas that is extremely poisonous and can kill within minutes. CO is found in combustion fumes, such as those made by automobiles,    portable generators, stoves, gas ranges and heating systems.  CO from these fumes can build up in places that do not have a good flow of fresh air and breathing high levels of CO can cause severe illness or death in a matter of minutes.

 KDHE reminds people to have their gas appliances inspected to insure they are not leaking and that they have the proper ventilation. 

For more information and tips about CO, visit www.kdheks.gov/beh/index.html or call the KDHE Bureau of Environmental Health, 785-296-5606.

Where's That Then? No 46

One of my favourite places, and a great adventure playground for my boys. And on top of all that, it's free. Any clues? Let's just say east.

Tips on how to avoid overeating during your family’s holiday feast

Cranberry sauce, sweet potatoes, turkey, mashed potatoes, green bean casserole — with Thanksgiving right around the corner, people watching their waistlines are hoping to keep them in check during the holidays.

Thomas Lemke, a registered dietitian and licensed with Intergris Bass Baptist Health Center, said stopping overeating begins in the morning.

“My basic recommendation is always start with breakfast,” he said. “I recommend you always eat breakfast on the day of a holiday. People who eat breakfast tend to be lighter overall because they don’t tend to overeat later in the day.”

Pamela Baggett, a registered dietitian and licensed dietitian with St. Mary’s Regional Medical Center, added skipping breakfast can lead to loss of self-control.

“What we need to think about is not skipping breakfast because by lunch I will be so ravenous that I have no self-control,” she said.

With many people hitting the road to visit friends and family during the holiday season, several end up arriving famished, Lamke said.

“If you are traveling for a holiday, try to eat something before you show up for the festivities,” he said. “It can be something small like a salad or carrots. Having something on your stomach can lessen the desire to eat as much when the smell of the turkey cooking hits your nose.”

If people are participating in providing food for the festivities, they can bring a favorite food they safely can eat a lot of.

“I tell my diabetics, ‘take something you can have a whole bunch of, a vegetable plate or a sugar-free Jell-O. Take something you can fill up on,’” Baggett said.

Lemke suggested bringing a healthy alternative to potluck holiday meals.

“If it is a potluck, bring a fruit tray or veggie tray, so if you have the munchies throughout the day, it is something you can default to throughout the day,” he said. “You can get some tomatoes and carrot sticks, maybe dipped them in some ranch, rather than keep going back to the dessert table.”

If you are participating in a strict diet and going to someone’s home to celebrate Thanksgiving, let the host know your restrictions beforehand, Baggett said.

“If I am on a strict diet for whatever reason and I am going to someone’s house, I need to let them know,” she said. “I can’t have salty dishes, I can’t have a lot of fat ... whatever my restrictions are.”

Portion control also is an important tool to help keep food consumption in check.

“My No. 1 recommendation for portion control when eating family-style is to go through the line once., Lemke said. “Don’t keep coming back all day long. If you want to pile your plate really high, that is fine, but limit it to what you can eat in one sitting. Once you eat that, you are done until the next meal.”

While eating, Baggett said slowing down can help your body realize when it truly is full, a process that can can take up to 20 minutes.

“Slow down. Eat slower. Put your fork down between bites,” she said.

She added limiting your eating to one plate only can help reduce overeating.

“Realize Thanksgiving is one meal, not a four-day holiday,” she said. “I am going to do one plate and pick what I like the best. Maybe I can do without the bread but love dressing, so I may just eat the dressing.”

Lemke also recommended choosing only one favorite dessert for the holiday.

“People tend to want to take a little bit of grandma’s cheesecake, Aunt Ethel’s pumpkin pie and Aunt Betty’s gingerbread cookies. Pick one dessert,” he said. “If your favorite dessert is Aunt Betty’s gingerbread cookies, eat them. When you are finished with the cookies, don’t go on to something else.

“Don’t eat everything just to make grandma happy. She will be just as unhappy with her grandchild suffering with obesity and health as you not eating her pumpkin pie.”

Baggett agreed.

“We have to realize Thanksgiving, Christmas, our birthday — they come every year,” she said. “If I feel I am feeling deprived, I may say, ‘what the heck’ and try everything. If Aunt Mabel makes the best whatever and it is here today and my wife makes the others every once in a while, I will choose Aunt Mabel’s dessert. If my favorite is, say apple pie, I will have one piece and eat it slowly and enjoy it so I don’t feel deprived.”

Baggett also suggested taking only half portions of dessert.

Lemke said moderation is key during the holiday when it comes to eating.

“It is individually based,” he said. “I know can’t keep myself away from my cousin’s fudge. My options are not start or take a handful and take it as far away from the tray as I can so I don’t keep eating them all afternoon. Know your habits and your limits.”

Once the food is put away and dishes are washed up, Baggett suggests getting active.

“One of the great things I do, once the dishes are done, is I go for a walk or work on Christmas lights or do an activity with the family,” she said. “I do something rather than plop down and take a nap.”

Hosts of the big family Thanksgiving day meal often can be stuck with the leftovers and feel obligated to eat them.

Lemke suggested trying to pawn off as many leftovers as you can to your guests.

“Some can take the pie and someone else can take the green bean casserole,” he said. Or, “if you get stuck with the leftovers, freeze them. You can pick at them over a longer time and it isn’t as overwhelming.

“If you are stuck with too much food and you can’t eat it all, throw it away. You gaining five or 10 pounds over the holidays isn’t going to help anyone.”

Lemke encourages his clients to enjoy the holidays, but not to go overboard.

“Holidays are a time for fun. Go ahead and indulge yourself a little bit,” he said. “Have a little bit of the pumpkin pie, but don’t also have the gingerbread cookies on top of that. It is about moderation.”

Glucose Tolerance in Non-industrial Cultures

Background

Glucose is the predominant blood sugar and one of the body's two main fuel sources (the other is fatty acids). Glucose, in one form or another, is also the main form of digestible dietary carbohydrate in nearly all human diets. Starch is made of long chains of glucose molecules, which are rapidly liberated and absorbed during digestion. Sucrose, or table sugar, is made of one glucose and one fructose molecule, which are separated before absorption.

Blood glucose is essential for life, but it can also be damaging if there is too much of it. Therefore, the body tries to keep it within a relatively tight range. Normal fasting glucose is roughly between 70 and 90 mg/dL*, but in the same individual it's usually within about 5 mg/dL on any given day. Sustained glucose above 160 mg/dL or so causes damage to multiple organ systems. Some people would put that number closer to 140 mg/dL.

The amount of glucose contained in a potato far exceeds the amount contained in the blood, so if all that glucose were to enter the blood at once, it would lead to a highly damaging blood glucose level. Fortunately, the body has a hormone designed to keep this from happening: insulin. Insulin tells cells to internalize glucose from the blood, and suppresses glucose release by the liver. It's released by the pancreas in response to eating carbohydrate, and protein to a lesser extent. The amount of insulin released is proportional to the amount of carbohydrate ingested, so that glucose entering the blood is cleared before it can accumulate.

Insulin doesn't clear all the glucose as it enters the bloodstream, however. Some of it does accumulate, leading to a spike in blood glucose. This usually doesn't exceed 130 mg/dL in a truly healthy person, and even if it approaches that level it's only briefly. However, diabetics have reduced insulin signaling, and eating a typical meal can cause their glucose to exceed 300 mg/dL due to reduced insulin action and/or insulin secretion. In affluent nations, this is typically due to type II diabetes, which begins as insulin resistance, a condition in which insulin is actually higher than normal but cells fail to respond to it.  The next step is the failure of insulin-secreting beta cells, which is what generally precipitates actual diabetes.

The precursor to diabetes is called glucose intolerance, or pre-diabetes. In someone with glucose intolerance, blood glucose after a typical meal will exceed that of a healthy person, but will not reach the diabetic range (a common definition of diabetes is 200 mg/dL or higher, 2 hours after ingesting 75g of glucose). Glucose tolerance refers to a person's ability to control blood glucose when challenged with dietary glucose, and can be used in some contexts as a useful predictor of diabetes risk and general metabolic health. Doctors use the oral glucose tolerance test (OGTT), which involves drinking 60-100g glucose and measuring blood glucose after one or two hours, to determine glucose tolerance.

Why do we care about glucose tolerance in non-industrial cultures?

One of the problems with modern medical research is that so many people in our culture are metabolically sick that it can be difficult to know if what we consider "normal" is really normal or healthy in the broader sense. Non-industrial cultures allow us to examine what the human metabolism is like in the absence of metabolic disease. I admit this rests on certain assumptions, particularly that these people aren't sick themselves. I don't think all non-industrial cultures are necessarily healthy, but I'm going to stick with those that research has shown have an exceptionally low prevalence of diabetes (by Western standards) and other "diseases of civilization" for the purposes of this post.

Here's the question I really want to answer in this post: do healthy non-industrial cultures with a very high carbohydrate intake have an excellent glucose tolerance, such that their blood glucose doesn't rise to a high level, or are they simply resistant to the damaging effects of high blood glucose?

The data

I'm going to start with an extreme example. In the 1960s, when it was fashionable to study non-industrial cultures, researchers investigated the diet and health of a culture in Tukisenta, in the highlands of Papua New Guinea. The eat practically nothing but sweet potatoes, and their typical daily fare is 94.6 percent carbohydrate. Whether or not you believe that exact number, their diet was clearly extraordinarily high in carbohydrate. They administered 100g OGTTs and measured blood glucose at one hour, which is a very stringent OGTT. They compared the results to those obtained in the 1965 Tecumseh study (US) obtained by the same method. Here's what they found (1):
Compared to Americans, in Tukisenta they had an extraordinary glucose tolerance at all ages. At one hour, their blood glucose was scarcely above normal fasting values, and glucose tolerance only decreased modestly with age. In contrast, in Americans over 50 years old, the average one-hour value was around 180 mg/dL!

Now let's take a look at the African Bantu in the Lobaye region of the Central African Republic. The Bantu are a large ethnic group who primarily subsist on a diverse array of starchy foods including grains, beans, plantains and root crops. One hour after a 100g OGTT, their blood glucose was 113 mg/dL, compared to 139 mg/dL in American controls (2). Those numbers are comparable to what investigators found in Tukisenta, and indicate an excellent glucose tolerance in the Bantu.

In South America, different investigators studied a group of native Americans in central Brazil that subsist primarily on cassava (a starchy root crop) and freshwater fish. Average blood glucose one hour after a 100g OGTT was 94 mg/dl, and only 2 out of 106 people tested had a reading over 160 mg/dL (both were older women) (Western Diseases: Their Emergence and Prevention, p. 149). Again, that indicates a phenomenal glucose tolerance by Western standards.

I have to conclude that high-carbohydrate non-industrial cultures probably don't experience damaging high blood glucose levels, because their glucose tolerance is up to the task of shuttling a huge amount of glucose out of the bloodstream before that happens.

Not so fast...

Now let's turn our attention to another study that may throw a wrench in the gears. A while back, I found a paper containing OGTT data for the !Kung San (also called the Bushmen), a hunter-gatherer group living in the Kalahari desert of Africa. I reported in an earlier post that they had a good glucose tolerance. When I revisited the paper recently, I realized I had misread it and in fact, their glucose tolerance was actually pretty poor.

Investigators administered a 50g OGTT, half what the other studies used. At one hour, the San had blood glucose readings of 169 mg/dL, compared to 142 mg/dL in Caucasian controls (3)! I suspect a 100g OGTT would have put them close to the diabetic range.

Wait a minute, these guys are hunter-gatherers living the ancestral lifestyle; aren't they supposed to be super healthy?? First of all, like many hunter-gatherer groups the San are very small people: the men in this study were only 46 kg (101 lbs).  The smaller you are, the more a given amount of carbohydrate will raise your blood glucose.  Also, while I was mulling this over, I recalled a discussion where non-diabetic people were discussing their 'diabetic' OGTT values while on a low-carbohydrate diet. Apparently, carbohydrate refeeding for a few days generally reverses this and allows a normal OGTT in most people. It turns out this effect has been known for the better part of a century.

So what were the San eating? The study was conducted in October of 1970. The San diet changes seasonally, however their main staple food is the mongongo nut, which is mostly fat and which is available year-round (according to The !Kung San: Men, Women and Work in a Foraging Society). Their carbohydrate intake is generally low by Western standards, and at times of the year it is very low. This varies by the availability of other foods, but they generally don't seem to relish the fibrous starchy root crops that are available in the area, as they mostly eat them when other food is scarce. Jean-Louis Tu has posted a nice analysis of the San diet on BeyondVeg (4). Here's a photo of a San man collecting mongongo nuts from The !Kung San: Men, Women and Work in a Foraging Society:

What did the authors of the OGTT study have to say about their diet? Acknowledging that prior carbohydrate intake may have played a role in the OGTT results of the San, they made the following remark:
a retrospective dietary history (M. J. Konner, personal communication, 1971) indicated that the [San], in fact, consumed fairly large amounts of carbohydrate-rich vegetable food during the week before testing.
However, the dietary history was not provided, nor has it been published, so we have no way to assess the statement's accuracy or what was meant by "fairly large amounts of carbohydrate-rich vegetable food." Given the fact that the San diet typically ranges from moderately low to very low in carbohydrate, I suspect they were not getting much carbohydrate as a percentage of calories. Looking at the nutritional value of the starchy root foods they typically eat in appendix D of The !Kung San: Men, Women and Work in a Foraging Society, they are fibrous and most contain a low concentration of starch compared to a potato for example. The investigators may have been misled by the volume of these foods eaten, not realizing that they are not as rich in carbohydrate as the starchy root crops they are more familiar with.

You can draw your own conclusions, but I think the high OGTT result of the San probably reflect a low habitual carbohydrate intake, and not pre-diabetes. I have a very hard time believing that this culture wasn't able to handle the moderate amount of carbohydrate in their diet effectively, as observers have never described diabetic complications among them.

Putting it all together

This brings me to my hypothesis. I think a healthy human body is extraordinarily flexible in its ability to adapt to a very broad range of carbohydrate intakes, and adjusts glucose tolerance accordingly to maintain carbohydrate handling in a healthy range. In the context of a healthy diet and lifestyle (from birth), I suspect that nearly anyone can adjust to a very high carbohydrate intake without getting dangerous blood glucose spikes. A low carbohydrate intake leads to impaired glucose handling and better fat handling, as one would expect. This can show up as impaired glucose tolerance or even 'diabetes' on an OGTT, but that does not necessarily reflect a pathological state in my opinion.

Every person is different based on lifestyle, diet, personal history and genetics. Not everyone in affluent nations has a good glucose tolerance, and some people will never be able to handle starch effectively under any circumstances. The best way to know how your body reacts to carbohydrate is to test your own post-meal blood glucose using a glucose meter. They are inexpensive and work well. For the most informative result, eat a relatively consistent amount of carbohydrate for a week to allow your body to adapt, then take a glucose measurement 1 and 2 hours after a meal. If you don't eat much carbohydrate, eating a potato might make you think you're diabetic, whereas after a week of adaptation you may find that a large potato does not spike your blood glucose beyond the healthy range.

Exercise is a powerful tool for combating glucose intolerance, as it increases the muscles' demand for glucose, causing them to transport it out of the blood greedily after a meal. Any exercise that depletes muscle glycogen should be effective.


* Assuming a typical carbohydrate intake. Chris Kresser recently argued, based on several studies, that true normal fasting glucose for a person eating a typical amount of carbohydrate is below 83 mg/dL. Low-carbohydrate eating may raise this number, but that doesn't necessarily indicate a pathological change. High-carbohydrate cultures such as the Kitavans, Aymara and New Guineans tend to have fasting values in the low 60s to low 70s. I suspect that a very high carbohydrate intake generally lowers fasting glucose in healthy people. That seems to be the case so far for Chris Voigt, on his diet of 20 potatoes a day. Stay tuned for an interview with Mr. Voigt in early December.

Protecting yourself from flu, infectious diseases at work

Has a coworker recently called in sick? Have others at work come down with the sniffles? If so, your workplace is not alone. Each year, 15 million U.S. workers get the flu, and with cold and flu season upon us, more illness may be on its way.

How can you protect yourself and others from getting sick at work? APHA’s Get Ready campaign has some tips:

• Wash your hands often, especially after touching workplace objects like copy machines, phones, keyboards and cash registers. Don’t forget to wash after handling other shared things like books, magazines or information binders. (Ever seen anyone lick their fingers to turn pages? Could have happened right before you got there.) If you work in a health care setting, frequent hand-washing is especially important.

• Avoid touching frequently used objects with your hands, if possible. The National Foundation for Infectious Diseases suggests using a tissue or your sleeve when touching door handles in offices, restrooms, cafeterias and other public places. Carry around your own pen or tools, and don’t lend them to others.

• Ask your employer to sponsor a workplace flu-vaccination campaign. Employer-sponsored flu vaccinations not only help protect employee health, but save businesses money. And getting vaccinated is your best protection from getting the flu.

• Stay home when sick. Rather than tough it out and go to work when you’re not feeling well, stay home. While many people feel pressured to go to work when sick, you may end up both annoying and infecting your coworkers — or your customers, if you work in a retail environment. Check with your manager or human resources department to find out what sick leave policies are now, before you get sick.

Play it safe and help keep your workplace healthy — and running smoothly — this flu season.

Prevent Carbon Monoxide Poisoning

Recent severe weather has caused power outages, which raises concern about carbon monoxide poisoning. To prevent carbon monoxide poisoning:

  • Have your heating system, water heater and any other gas, oil, or coal burning appliances serviced by a qualified technician every year.
  • Don't use a gas-powered generator, charcoal grill, camp stove, or other gas or charcoal-burning device inside your home, basement, or garage or near a window or door. Generators should be more than 15 feet from your home when running.
  • Don't run a car, truck or any other motor inside a garage or other enclosed space, even if you leave the door open.
  • Don't try to heat your house with a gas oven.
  • Make sure you have a CO detector with a battery back-up in your home near where people sleep. Check or replace the battery when you change the time on your clocks each spring and fall. You can buy an alarm at most hardware stores or stores that sell smoke detectors. By law, all rental units must have a CO alarm—talk to your landlord if you don’t have one in your apartment or rental house.
  • If your CO alarm goes off, get out of the house right away and call 911. Get prompt medical attention if you suspect CO poisoning and are feeling dizzy, light-headed, or nauseous.

For more information, see this Maine CDC press release: http://www.maine.gov/tools/whatsnew/index.php?topic=DHS+Press+Releases&id=151572&v=cdc_article

Use Your Scissors for Greater Permanent Wave Beauty



(Click on these images to see the larger versions.)
Source: Modern Beauty Shop, August 1938

Impressions from the Wise Traditions Conference

I spent last weekend at the Weston A. Price Foundation Wise Traditions conference in King of Prussia, PA. Here are some highlights:

Spending time with several people in the diet-health community who I’ve been wanting to meet in person, including Chris Masterjohn, Melissa McEwen and John Durant. John and Melissa are the public face of the New York city paleo movement. The four of us spent most of the weekend together tossing around ideas and making merry. I’ve been corresponding with Chris quite a bit lately and we’ve been thinking through some important diet-health questions together. He is brimming with good ideas. I also got to meet Sally Fallon Morell, the founder and president of the WAPF.

Attending talks. The highlight was Chris Masterjohn’s talk “Heart Disease and Molecular Degeneration: the New Paradigm”, in which he described his compelling theory on oxidative damage and cardiovascular disease, among other things. You can read some of his earlier ideas on the subject here. Another talk I really enjoyed was by Anore Jones, who lived with an isolated Inuit group in Alaska for 23 years and ate a mostly traditional hunter-gatherer diet. The food and preparation techniques they used were really interesting, including various techniques for extracting fats and preserving meats, berries and greens by fermentation. Jones has published books on the subject that I suspect would be very interesting, including Nauriat Niginaqtuat, Plants that We Eat, and Iqaluich Niginaqtuat, Fish that We Eat. The latter is freely available on the web here.

I attended a speech by Joel Salatin, the prolific Virginia farmer, writer and agricultural innovator, which was fun. I enjoyed Sally Fallon Morell’s talk on US school lunches and the politics surrounding them. I also attended a talk on food politics by Judith McGeary, a farmer, attorney and and activist, in which she described the reasons to oppose or modify senate bill 510. The gist is that it will be disproportionately hard on small farmers who are already disfavored by current regulations, making high quality food more difficult to obtain, more expensive or even illegal. It’s designed to improve food safety by targeting sources of food-borne pathogens, but how much are we going to have to cripple national food quality and farmer livelihood to achieve this, and will it even be effective? I don’t remember which speaker said this quote, and I’m paraphrasing, but it stuck with me: “I just want to be able to eat the same food my grandmother ate.” In 2010, that’s already difficult to achieve. Will it be impossible in 2030?

Giving my own talk. I thought it went well, although attendance was not as high as I had hoped. The talk was titled “Kakana Dina: Diet and Health in the Pacific Islands”, and in it I examined the relationship between diet and health in Pacific island cultures with different diets and at various stages of modernization. I’ve covered some of this material on my blog, in my posts on Kitava, Tokelau and sweet potato eating cultures in New Guinea, but other material was new and I went into greater detail on food habits and preparation methods. I also dug up a number of historical photos dating back as far as the 1870s.

The food. All the meat was pasture-raised, organic and locally sourced if possible. There was raw pasture-raised cheese, milk and butter. There was wild-caught fish. There were many fermented foods, including sauerkraut, kombucha and sourdough bread. I was really impressed that they were able to put this together for an entire conference.

The vendors. There was an assortment of wholesome and traditional foods, particularly fermented foods, quality dairy and pastured meats. There was an entire farmer’s market on-site on Saturday, with a number of Mennonite vendors selling traditional foods. I bought a bottle of beet kvass, a traditional Russian drink used for flavor and medicine, which was much better than the beet kvass I’ve made myself in the past. Beets are a remarkable food, in part due to their high nitrate content—beet juice has been shown to reduce high blood pressure substantially, possibly by increasing the important signaling molecule nitric oxide. I got to meet Sandeep Agarwal and his family, owners of the company Pure Indian Foods, which domestically produces top-quality pasture-fed ghee (Indian-style clarified butter). They now make tasty spiced ghee in addition to the plain flavor. Sandeep and family donated ghee for the big dinner on Saturday, which was used to cook delicious wild-caught salmon steaks donated by Vital Choice.

There were some elements of the conference that were not to my taste. But overall I’m glad I was able to go, meet some interesting people, give my talk and learn a thing or two.