Most Adults Do Not Finish Their Peas, Shouldn't Get Dessert

When we were young, our parents decided what we ate. Example: "No dessert until you finish your peas!" As we got older, though, it was exciting to to make our own food decisions. Perhaps too exciting. Suddenly dessert came first, coffee became an acceptable breakfast, and Pop Tarts and Easy Mac constituted complete meals.

Some people never grow out of (what I'd refer to as) the "Student Diet". On a daily basis, sweets are consumed early and often and the later meals are usually fatty and convenient. For most of the people I know who adhere to this regimen, this routine evolved from the undergrad/grad mantra that all time must be spent studying. Time not spent studying should be used to either talk about studying, worry about studying, or engage in completely unproductive and/or illegal activities. This leaves zero time for thinking about food, let alone preparing your own meals.

As the study-obsessed student graduates and gets older, the "studying" gets replaced by other things. Work. Relationships. Hobbies. More work... and so on forever. Then one day, these adults procreate and pass their attitudes about food and nutrition onto the offspring, and new little crazy people are made. The point is, there are lots of adults who have pretty terrible eating habits, and I think it's because it is difficult to re-value food and nutrition if a person has neglected these things for a very long time.

Case in point: the CDC recently published a report on fruit and vegetable eating habits in the United States. Guess what?

• 33% of adults consume the recommended 2 or more servings of fruit every day.
• 27% of adults get the recommended 3 or more servings of vegetables.
  
• 14% of adults eat BOTH the recommended daily fruit and vegetable servings. (See map)

I bet you saw that coming.

The report, called State Indicator Report on Fruits and Vegetables, 2009, is the first to break down fruit and veggie consumption by state. It seems more reports with a national scope are doing this often, which makes a lot of sense. Since the U.S. is so incredibly huge and diverse, the state breakdown makes these statistics a bit more manageable. Also, we get a better idea of who's not eating their peas!

The fruit and veggie consumption data from the report was collected as part of a progress report for the Healthy People 2010 initiative, which aims for 75% of adults to eat the recommended fruit and 50% of adults to eat the recommended vegetables. Right, good luck with that.

The State Indicator Report does include 3 key policy recommendations to increase fruit and veggie consumption:

1. Healthier food retail, encouraging groceries and markets to stock fresh, affordable produce.
   
2. Make healthier foods more available in schools. (Because the "Student Diet" gets started early)
   
3. Increased food system support, primarily by increasing the number of local food councils that will "make recommendations about policies and programs such as farm–to–school programs, community gardens, farmers markets and availability of fresh produce in supermarkets."

These recommendations seem to be aimed more towards the state and local municipalities, and less towards individuals, but I'd thought it was important to mention.

Now, the percentages of people reporting they eat fruits and veggies are low, but I suspect the actual numbers are even lower. The data was collected through voluntary phone interviews, so we're dealing with self-report and selection biases probably. Who even participates in those interviews? And are people actually honest about how often they eat carrots? (Which was one of the questions.) I know these government-funded studies typically include thousands of participants which eliminates the margin of error and blah blah blah... but it still makes me wonder how accurate people are when reporting their food habits. I'm not sure even really sure how I would answer!

It's very noble to want to eat enough fruit and vegetables every day, but do you actually do it? I know that I make a good effort, but it doesn't always happen. And in truth, although the government recommends 2 servings of fruit and 3 servings of vegetables, it's unlikely that eating more will hurt you.

So what is there to do? Eat more salad? Ugh. This is the point in the conversation where a lot of the experts make vague allusions to steaming vegetables and eating less french fries, which always makes vegetables sound like they are something you have to choke down. The truth is vegetables can be delicious if you cook them properly, i.e. move beyond the lettuce-tomato-ranch salad. To start, here are a few examples the CDC gives for a single serving of fruits or vegetables:
Ok, now that we've established a possible list of ingredients and quantities, I wanted to share a few of my favorite veggie heavy recipes. Before the list, though, I want to emphasize that while this is not a food blog and I am not a foodie, I do appreciate good food. In my new job, I also do a lot of cooking (at least one meal a day for up to 20 people), so food is front and center on my radar nowadays.

• Garlic Ginger Tofu Stir Fry (via VegCooking)
• Vegetable Frittata (via Epicurious. A fantastic option for incorporating whatever is in the fridge.)
• Kale (or Spinach) and Olive Oil Mashed Potatoes (via 101cookbooks)
• Green Beans Amandine (almonds browned in a bit of butter over cooked beans, from my Better Homes & Gardens cookbook. easy peasy)
• Sweet Potato Fries (with an Avocado Dip) (via Food Network)

Also, I typically eat a lot of fajitas, veggie-heavy wraps/sandwiches, and anything sauteed with garlic. So there are a few ideas!

This is obviously not a very extensive list of dishes requiring 1-3 servings of vegetables, so please share yours in the comments! Or if you'd rather not write a novel, email me and I'll put together a few more recipes for a future post. For my own peace of mind, I just needed to break the trend of saying EAT MORE VEGETABLES and then providing no practical means for doing that.

Enjoy!

NY Times Reporter's File on Obesity: Could you BE more pessimistic?!

Dear Laura,

I received your email re: NYTimes.com: Reporter's File: Obesity. Per your comments concerning the content of said "file", I have responded below in an itemized fashion.

(I would like to note that I am NOT a medical professional, nor a professional of any kind (besides being on the Board of the North American Jackass Association, NAJA). Therefore, my comments are purely my own opinion and do not reflect the established opinion of the Western medical community. However, I would like to note that I have read widely on the subject of obesity in the United States because it is a curious problem and besides, everyone and their mom seems to have their own idea about why the U.S. is so fat, so why shouldn't I?!)

1. Let's start at the beginning, shall we? On the issue of genetics, Reporter's File says:

Diet and exercise do matter, they now know, but these environmental influences alone do not determine an individual’s weight. Body composition also is dictated by DNA and monitored by the brain. Bypassing these physical systems is not just a matter of willpower.

You already knew this. People look different and have different body types and are able to consume different foods to different effects. Some people are going to have an easier time gaining weight that losing it just as others will stay thin forever.

Is this an excuse for obese people? Should we all just get over the fatness because it's genetic?! It might sound like that at first, but I don't think it is. There are several factors at play here, and none of them reign supreme in determining weight. Genes, diet, exercise and willpower are all important parts of the equation here. They are clearly not EQUAL parts of the equation, but they are contributing factors nonetheless.

The article also completely seems to miss the influence of other factors like stress and sleep deprivation, not to mention the higher prevalence of obesity among people with low SES. Maybe those things are considered "weaker" or maybe just more boring. It's hard to say.

2. On the issue of diet, Reporter's File says:

The nation’s poor diet has long been the scapegoat... The recent rise in obesity may have more to do with our increasingly sedentary lifestyles than with the quality of our diets.

It seems there is evidence that we Americans have been eating a lot of crap for quite awhile now, but I would argue that the definition of "crap" has deteriorated to an even lower level of crappiness.

Case in point: The article points to the fact that in 1966, McDonald's had already sold about 2 billion hamburgers. What they don't say is that in 1966, people were washing down those hamburgers with a 10 ounce can of Coke, or more likely, a 6.5 ounce bottle. Today, it's more likely that people are eating Big Macs (not introduced until 1968) which weigh in at 540 calories, a large fries (500 calories) and drinking a 32 ounce Coke (310 calories). Can you do that math? It's 1350 calories. I SERIOUSLY doubt that a meal at McDonald's in 1966 was 1350 calories. Yes, we sit around on our asses a lot more, but there is no doubt in my mind that we are consuming a lot more calories to go along with it.

(Which is to offer no explicit comment on the increasing size of individual soda quantities. A year ago, a Pepsi spokesperson explained the reasoning behind the introduction of 26- and 16-oz bottles into convenience stores: "[It] is about giving consumers more choices, and if that leads to more frequent transactions and greater volume, it's also a win for our customers, our bottlers and us.")

3. On the issue of exercise, Reporter's File says:

The leisurely after-dinner walk may be pleasant, and it may be better than another night parked in front of the television. But modest exercise of this sort may not do much to reduce weight, evidence suggests.

The key word here is "modest." A meandering 20 minute walk will hardly get your heart pumping. Unless, of course, you are extremely overweight and you just ate the McDonald's Big Mac, fries and Coke for dinner and also the walk is uphill. This sort of modest exercise *might* help you maintain your weight so you don't gain any more, but it's not going to reduce weight.

The Reporter's File fails to mention exactly what type of exercise can aid weight loss, so it seems like exercise is worthless. Obviously that is not the case. Have you seen The Biggest Loser? Have you noted how hard they work out? So hard! And how long? Hours! A huge amount of effort is expended to lose all of that weight. And once they get to their "goal weight", whatever that may be, it's going to be more hard work to maintain that weight. This effort does not fall under the "modest" exercise category. It's hard f-ing work, but exercise can help.

However, for the average person, I think that if you only exercise to lose weight, you are going to be disappointed. It takes more than 30 minutes of cardio twice a week to see significant weight loss. Fortunately, the benefits of exercise are far-reaching! Exercising affects your muscles and bones--from your legs and arms to your heart and lungs--is incredibly important to your physical and mental health. The Reporter's File mentions nothing about this (since it has nothing to do with obesity) but it's useful to note that exercising isn't just about weight loss.

4. On the issue of the body's/brain's determination, Reporter File says:

Scientists now believe that each individual has a genetically determined weight range spanning perhaps 30 pounds.

I really don't know anything about this. It's the genetic thing again. Obviously, this 30 pound span is not a hard and fast rule. If that's true, then how does a person grow to be 40, 60, 100 pounds overweight?

I don't want to get touchy-feely, but if this "30ish pound span" idea is correct, there is clearly a pretty big disconnect between what we think our bodies want and what they actually need. People must be seriously ignoring the subtle signs they receive from their body in order to gain so much weight. Does your body really want a Big Mac or is your brain just mesmerized by the fluffy bun, the sizzling patty and the glistening cheese? (Yes, sometimes cheese glistens with delicious cheese sweat.)

5. On the issue of maternal diet and pregnancy, Reporter's File says:

According to several animal studies, conditions during pregnancy, including the mother’s diet, may determine how fat the offspring are as adults. Human studies have shown that women who eat little in pregnancy, surprisingly, more often have children who grow into fat adults. More than a dozen studies have found that children are more likely to be fat if their mothers smoke during pregnancy.

I believe this. This research is fairly new it seems, but it's pretty compelling and scary as hell. The Reporter's File was updated August 2007, and already there have been some new updates in the role of the maternal diet. In January, researchers found that a high-fat diet can lead to fatty liver disease in newborns, which sounds like a fantastic way to start a new life.

Overall, on the first read the Reporter's File comes across as hopelessly pessimistic. But after I read it a second, third, fourth time, there really isn't any content that you haven't heard before. The difference is that you usually hear bits of this information accompanied by tips and tactics to combat the somewhat depressing information. But the File lays the bad news on thick and without relief.

But that's the point. The title is "For the Overweight, Bad Advice by the Spoonful," not "I'm Going to Tell You a lot of Bad News, and Then Make You Feel Better About It." The facts are that it's hard to lose weight and there are a lot of factors stacked against the obese.

A little awhile ago I posted a quote from an editorial in the American Journal of Public Health. Essentially, people are starting to recognize that the epidemic of obesity (and yes, I'd call it an epidemic if 66% of Americans are overweight or obese, according to the File) is not just a personal problem shared by of millions of individuals. It's systemic. The way We eat, the way We teach our children, the way We do business, etc. is quickly becoming one giant, intertwined mess of misinformation.

The File makes it seem like there is no hope for the obese Individual, and maybe there isn't a lot. But I think there is hope for the obese Society, if we start making some difficult changes in the way we live our lives.

Love,
Chloe

The (Un)Fair Copyright in Research Works Act

The National Institutes of Health (NIH) is an agency of the US Department of Health and Human Services, and is primarily responsible for doling out funds for biomedical and health-related research. The recipients of this funding include it's own organizations that put the plural in Institutes (for a total of 20 institutes and 12 centers) and everyone else outside the NIH umbrella. But you probably knew all that already.

According to the NIH's Research Portfolio Online Reporting Tool, in 2008, NIH handed out 45,887 research grants to 2,538 institutions for a total of over $20 billion of government (i.e. taxpayer) funds. The total awards, which include training and construction grants, fellowships, etc., are upwards of $21 billion.

I know that the recent bailing out of several of our nation's major banking institutions makes $20 billion seem like chump change, but let's pretend like we don't have anything to compare it to. That is A LOT of money. And we're handing out to people who are doing really fantastic and cutting-edge research that will benefit all of mankind in the long run (hopefully). However, a bill introduced by US Rep. John Conyers, D-Mich, threatens to limit public access to the findings from all that research, unless you pay a fee.

HR 801, also known as The Fair Copyright in Research Works Act, would prohibit the government from requiring scholarly journals to make federally funded studies accessible to the public. Supporters of the bill include 5 cosponsors and obviously, the guys set to lose money, the publishers. Currently, the NIH has an "open access" policy for all manuscripts to be made available via PubMed Central.

The concept of open access seems obvious, but it's not. The NIH's policy was just put in place a mere 12 months ago! Seriously. Already people have been excited and the content on PubMed has increased substantially, according to this great article at Science Progress.

The NIH's open access policy is a good start, but it's not amazing. First, the policy states that manuscripts have to be submitted to PubMed no more than 12 months after being accepted for publication. Which means there will be a delay for many studies to be made available. Second, the nature of scientific study is such that only studies that get positive results are published. If some people do a study thinking they're going to find something fantastic, and then they get nothing or something very small, they're not required to make that public knowledge. I'm sure they report it to the NIH (all funds come with many strings attached), but since their non-results won't get published in a peer reviewed journal, we'll never find out about it. Maybe this isn't a huge deal, but I just hope someone somewhere is keeping track of money the NIH has spent on "statistically insignificant" research, aka crap.

But wait a second, you say. Maybe I don't care to know about current research, because I'm not a student. Maybe I prefer to get my scientific information from the local news at 11 and, I don't know, MY DOCTOR!

Well sure, your primary care physician is probably a great source of information. However, due to the VAST and VARIED amounts of research being conducted, it is virtually impossible for any one person (MD or not) to be 100% up to date on the latest and greatest research. Especially if your doctor is seeing upwards of 20 patients a day. When do you think he/she has time to peruse the last 10 studies regarding your weird foot fungus? And that is even assuming that he/she cares enough to do so. Ideally, doctors and specialists stay up to date with new findings, but they're only human and they only have 24 hours in the day, like the rest of us slackers.

So, you think this "Fair Copyright" Bill is BS too? What is one to do? There are several options.

1. Follow the progress of the bill here.
2. Check out the Alliance for Taxpayer Access here.
3. Look at this huge list for ways to promote open access for faculty, universities, foundations, journals, etc.
   

In any case, it's somewhat mind-boggling that open access is just now being achieved to some extent. The need for transparency and accountability in our nation's research centers should not be underestimated, as well as other areas of government. Clearly, we don't want people wasting time studying, oh I don't know, Moon Robots or something. Let's just leave that one to Japan.

Resources:
Research copyright bill would end access to free health info(3/5/09)
Open Access News blog
Open Access Overview by Peter Suber
Open Access Directory

Best USA Cities for Women & Men

The Women's Health Magazine published a report recently listing the BEST and WORST cities for women to live in.

Want to see if you're going to live a long life or die in a mushroom cloud of pollution? Look at the map. Actually, it doesn't give that information, and the city you live in probably isn't even on the rankings. I just like to look at these things.

FYI--the magazine goes into great detail about how fabulous and accurate their rankings are. If you care enough to be convinced, browse the preamble here.

Not to be outdone, Men's Health Magazine published their OWN MAP. Take that.

Obesity in the USA

From Jill Richardson on La Vida Locavore.

OBESITY TRENDS 1985-2007 shows a nice little animation of the percent of obese people by state. Watch as each state changes colors through the years, as the residents gain more and more weight.


An interesting way to represent the situation. And also disheartening.

FYI: "The Measure of America"

Madeline Drexler's op-ed in today's Boston Globe, The need to combine social and health policy, discusses a report by the Social Science Research Council called "The Measure of America". At $24.95, I was not about to order and read the entire thing, but information about the report can be found here.

Drexler explains that "The Measure of America" applies the United Nations human development model to the United States, which until now had never been done before... and for good reason. The results are less than flattering. Drexler says,

Underscoring how far we lag in our promise, the report documented how the roughly $5.2 billion we spend every day on healthcare yields a pitiable return on investment. For example, US life expectancy ranks below that of Chile, Costa Rica, and nearly every European and Nordic country. The US infant mortality rate is on par with that of Croatia, Cuba, Estonia, and Poland. Within the United States, stark health inequities persist along socioeconomic and racial/ethnic lines.

Yikes.
Drexler goes on to explain how most of the countries ranking above the USA provide universal health care, weighing the health consequences of policies in "taxation, business development, transportation, housing, agriculture, and so on". She considers a lack of health care the primary reason for the disparities.

The op-ed ends with this quote:

As Dr. Georges Benjamin, executive director of the American Public Health Association, told me during the group's annual meeting last month: "I would love Barack Obama to declare that he wants America to be the healthiest nation in the world - in a generation. Americans need to rally around the idea of grappling not only with healthcare, but with health."

Interesting point. Right now the health care industry is exactly that--an industry. As in, for profit. When you consider in that way, its no wonder that our national health sucks.

Last thing--Along with "The Measure of America" report, the website offers some "Tools" to play around with. One is called the Well-O-Meter. The introduction says,

The formula used to calculate the American HD Index for large population groups cannot be used for individuals. However, you can get a general sense of your own human development level by using our well-o-meter.

I answered the 25 questions, but the results mean very little to me. If you can't use the test for individuals, why are they using it for individuals? It makes no sense.