Category Archives: nutrition

business, facts & data points, file note, healthy habits, musings, nutrition, policy, politics, quotes & aphorisms

“There is no freedom in addiction”

Michael Bloomberg was laughed at for suggesting that New York City businesses limit soda serving sizes. It was never a perfect plan, but his public shaming shows how closely we equate food with ‘freedom.’ The problem is, there is no freedom in addiction. As the Nature Neurosciencestudy showed above, rats and humans alike will overeat (or eat less healthy food options) even if they know better.

Hence the magic bullet at the center of McDonald’s letter: a precise combination of fat, sugar and salt that keeps us craving more. As NY Timesreporter and author of Salt Sugar Fat: How the Food Giants Hooked UsMichael Moss said in an interview

These are the pillars of processed foods, the three ingredients without which there would be no processed foods. Salt, sugar and fat drive consumption by adding flavor and allure. But surprisingly, they also mask bitter flavors that develop in the manufacturing process. They enable these foods to sit in warehouses or on the grocery shelf for months. And, most critically to the industry’s financial success, they are very inexpensive.

PN: The fallacy in the rump of this discussion is that cigarettes are not that more harmful than a big mac. I’m just as likely to die from smoking a single cigarette in front of you, as I am if I were to eat a big mac in front of you. The problems arise when you smoke/eat these products every day of your life.

http://bigthink.com/21st-century-spirituality/should-big-food-pay-for-our-rising-obesity-costs

Should Big Food Pay For Our Rising Obesity Costs?

FEBRUARY 25, 2014, 4:29 PM
Bt-big-food

Paul McDonald didn’t expect his letter to go public. The Valorem Law Group partner had queried sixteen states, asking leaders to consider investigating Big Food’s potential role in paying for a percentage of the health system’s skyrocketing obesity costs. The Chamber of Commerce got wind of this letter and made it public, setting off a national debate over food marketing, ingredient manipulation and personal responsibility.

McDonald’s premise is simple enough: if large food companies are purposefully creating addictive foods to ensure consumer loyalty, adding to the rising obesity levels in this country, they should be responsible for covering costs associated with treatment. The backlash was immediate and biting.

Comparisons to the Big Tobacco companies came first to mind. In the 1998 Tobacco Masters Settlement Agreement, major players in the tobacco industry agreed to pay $246 billion to offset health risks and diseases associated with its product. Critics of McDonald’s idea believe there is no link between tobacco and food.

Advertising

On the face of it, this would appear true: you don’t need to smoke, but eating is a necessity. Smoking is a choice, and therefore if you choose to smoke, you pay the consequences. Eating falls into an entirely different category.

Yet the neural mechanisms might be similar. A 2010 study in Nature Neuroscience found that rats consumed well past their limits when offered high-calorie foods such as bacon, sausage and cake, speculating that humans, when faced with an equivalent scenario, also choose to overeat.

Harvard University Professor of Medicine, Emeritus David Blumenthal’s study, Neurobiology of Food Addiction, found a similar link between food and drug abuse. In the summary he writes

Work presented in this review strongly supports the notion that food addiction is a real phenomenon…although food and drugs of abuse act on the same central networks, food consumption is also regulated by peripheral signaling systems, which adds to the complexity of understanding how the body regulates eating, and of treating pathological eating habits.

The argument against food addiction is a tough one, waged by industry insiders who want to keep 60,000 products on American shelves. The real question, however, is: are food companies purposefully producing addictive foods that change our neurobiology? If so, should they be held economically accountable?

American obesity costs are currently $147 billion per year. The CDC estimates that 35.7% of adults and 17% of children ages 2-19 are obese—a number that has risen dramatically over the last two decades. A joint report between Trust for America’s Health and the Robert Wood Johnson Foundation estimates that 44% of American adults will be obese by 2030. The report predicts that will add between $48-66 billion to our costs, some of which is paid for by taxpayers.

Yet food is such an emotional topic. For example, when informing someone that I’m vegan, they immediately let me know why they could never do such a thing (I didn’t ask) or that it’s ‘wrong’ for them, and sometimes by extension, me (last week’s annual blood work shows me in perfect shape).

Michael Bloomberg was laughed at for suggesting that New York City businesses limit soda serving sizes. It was never a perfect plan, but his public shaming shows how closely we equate food with ‘freedom.’ The problem is, there is no freedom in addiction. As the Nature Neurosciencestudy showed above, rats and humans alike will overeat (or eat less healthy food options) even if they know better.

Hence the magic bullet at the center of McDonald’s letter: a precise combination of fat, sugar and salt that keeps us craving more. As NY Timesreporter and author of Salt Sugar Fat: How the Food Giants Hooked UsMichael Moss said in an interview

These are the pillars of processed foods, the three ingredients without which there would be no processed foods. Salt, sugar and fat drive consumption by adding flavor and allure. But surprisingly, they also mask bitter flavors that develop in the manufacturing process. They enable these foods to sit in warehouses or on the grocery shelf for months. And, most critically to the industry’s financial success, they are very inexpensive.

Inexpensive to companies, not to consumers. Paul McDonald is striking an important nerve in how we manufacture, distribute and consume food in our country. There will be a lot of resistance and debate from both industry and citizens. But if we don’t begin this conversation now, our national and mental health is only going to continue to decline.

Image: Aliwak/shutterstock.com

healthy habits, nutrition, policy, rapid learning health systems

Too cool… Tetris is good for you???

  • Of the 119 people that participated, 80 reported craving something: 58 people wanted food or drink of some kind, 10 wanted caffeine, and 12 wanted nicotine.
  • Their mean craving levels were “reasonably high,” the researchers write. Playing Tetris reduced their cravings by about 24 percent.
  • The relationship between playing the game and craving reduction remained statistically significant, even when the researchers accounted for a general lessening of the craving over time, or removed the people who were only slightly craving something.

 

  • Potential confounder: doing nothing for three minutes could have resulted in an increase in cravings!????

http://www.theatlantic.com/health/archive/2014/02/playing-tetris-can-reduce-urges-to-eat-smoke-drink/284056/

Playing Tetris Can Reduce Urges to Eat, Smoke, Drink

Three minutes of the game reduced cravings by 24 percent in a recent study.
Richard Drew/AP

The never-ending falling blocks of Tetris have caused innumerable people untold amounts of frustration. YouTube star Hank Green even has a song memorializing the evil of “The Man Who Throws The Tetris Piece.” But a new study published in Appetite shows that the unwinnable game may be good for something other than wasting hours, days, lives—reducing cravings.

The Plymouth University researchers—graduate student Jessica Skorka-Brown and professors Jackie Andrade and Jon May—tested Elaborated Intrusion Theory, which says that cravings rely heavily on visual imagery. They write that this is the first test of that theory using naturally-occurring cravings. To capture the 119 participants’ natural cravings (rather than artificially inducing them in the lab by having them evaluate chocolates or something),  asked them when they came in for the experiment if they were currently craving something, and to rate their craving from 1 to 100. Participants completed the Craving Experience Questionnaire, which measured the “strength, imagery, vividness, and intrusiveness of their current craving.”

Then participants sat down in front of a computer, which either loaded Tetris for them to play, or looked like it was going to load Tetris but never actually did. They either played Tetris, or didn’t, for three minutes and then answered the same questions about their craving, describing what happened to the craving while they were playing the game (or, you know, sitting there).

(YouTube)

Of the 119 people that participated, 80 reported craving something: 58 people wanted food or drink of some kind, 10 wanted caffeine, and 12 wanted nicotine. Their mean craving levels were “reasonably high,” the researchers write. Playing Tetris reduced their cravings by about 24 percent. The relationship between playing the game and craving reduction remained statistically significant, even when the researchers accounted for a general lessening of the craving over time, or removed the people who were only slightly craving something.

Obviously a 24 percent reduction doesn’t mean the craving is gone, but neither is that nothing. “Tetris reduced the vividness and frequency of craving imagery, as well as craving intensity,” the study reads. Tetris is a very visual task, which the researchers posit may be why it seems to impede the strength of craving imagery.

Strange as it may seem, Tetris could actually be a helpful tool for those trying to quit smoking, or just avoid indulging in an unhealthy snack. Because despite its frustrations, Tetris is one of the most popular video games ever—people like playing it. And if three minutes of arranging colored blocks could help curb a craving, it might be worth logging onto FreeTetris.org the next time you feel one hit.

healthy habits, nutrition, policy

Better blooded vegans

  • Vegans have lowest blood pressure
  • Meat increases your blood pressure
  • Brocolli has 1g protein per spear
  • Vegan animals can be strong too
  • Interview with Neal Barnard – avid vegan
  • Nice pot shots from Katz

http://www.theatlantic.com/health/archive/2014/02/vegetarians-and-their-superior-blood/284036/

Vegetarians and Their Superior Blood

A plant-based diet can lower your blood pressure, according to research released today in a major medical journal. Should we really stop eating meat before starting medication?
Frozen oranges in California, December 2013 (Gary Kazanjian/AP)

“Let me be clear about this. A low carbohydrate diet is quackery,” Dr. Neal Barnard told me over the phone. “It is popular, bad science, it’s a mistake, it’s a fad. At some point we have to stand back and look at evidence.”

Note to self: Don’t ask Dr. Neal Barnard about limiting your carb intake.

“You look at the people across the world who are the thinnest, the healthiest, and live the longest; they are not following anything remotely like a low-carb diet,” he said. “Look at Japan. Japan has the longest-lived people. What is the dietary staple in Japan? They’re eating huge amounts of rice.”

Based on the fact that Barnard is the author of 15 books extolling the life-prolonging virtues of plant-based diets, I should have seen that coming. Apparently I’m one of few people in health media not familiar with his work, and his very clear perspective. I heard about Barnard because today he and his colleagues published a meta-analysis in the prestigious Journal of the American Medical Association: Internal Medicine that confirmed a very promising health benefit of being a vegetarian: an enviably lower blood pressure than your omnivorous friends.

The publicist for an organization called the Physician’s Committee on Responsible Medicine emailed me to ask if I’d like to talk with Barnard about the research, and I always do want to talk about food research, so I did. High blood pressure shortens lives and contributes to heart disease, kidney failure, dementia, and all sorts of bad things, so any reasonable dietary way to treat or prevent it is worth considering. We’ve known for years that vegetarianism and low blood pressure are bedfellows, but the reason for it hasn’t been clear.

“We looked at every published study, so it’s really undeniably true,” Barnard said at the outset of our conversation, in a manner that anticipated a denial I wasn’t prepared to offer. “People who follow vegetarian diets, they’ve got substantially lower blood pressures. [The effect] is about half as strong as taking a medication.”

In this case substantially means that when you look at all of the controlled research trials comparing any kind of vegetarian diet to an omnivorous diet, the average difference in systolic blood pressure (the top number in the standard “120 over 80” jive) is about five millimeters of mercury. In diastolic blood pressure decrease (the bottom number) the difference is two. Not nothing, but not earth-shattering.

There have been a number of blood pressure studies on vegetarian diets in recent years, most famously the U.S. National Institutes of Health’s 2006 DASH (Dietary Approaches to Stop Hypertension) studies. DASH was inspired by observations that “individuals who consume a vegetarian diet have markedly lower blood pressures than do non-vegetarians.” It ended up recommending a diet high in fruits and vegetables, nuts, and beans; though it did not tell us to go all-out vegetarian.

“What’s new here is that we were able to get a really good figure for an average blood pressure lowering effect,” Barnard said. “Meta-analysis is the best kind of science we do. Rather than just picking one study or another to look at, you go after every study that has been published that weighs in on this question.”

In addition to the seven controlled trials (where you bring in people and change their diets, then compare them with a control group eating everything), the researchers also reviewed 32 different observational studies. Those are less scientifically valid than controlled studies, but they showed even larger decreases in blood pressure between vegetarian and omnivorous diets (6.9 systolic, 4.7 diastolic).

“It’s not uncommon for us to see patients at our research center who come in and they’re taking four drugs for their blood pressure, and it’s still too high. So if a diet change can effectively lower blood pressure, or better still can prevent blood pressure problems, that’s great because it costs nothing, and all the side effects are ones that you want, like losing weight and lowering cholesterol.”

The research center to which Barnard refers is that of Physicians Committee for Responsible Medicine (PCRM). Barnard is president. Founded in 1985, PCRM describes itself as an “independent nonprofit research and advocacy organization.” The advocacy is for ethical human and animal experimentation. According to its website, PCRM “promote(s) alternatives to animal research and animal testing. We have worked to put a stop to gruesome experiments, such as the military’s cat-shooting studies, DEA narcotics experiments, and monkey self-mutilation projects.”

Unloading vegetables from a boat on a foggy January morning in Bangladesh (A.M. Ahad/AP)

“Neal is a good guy and does good work,” Dr. David Katz, Director of Yale University’s Prevention Research Center, told me, “but the name of the organization is entirely misleading. It is not about responsible medical practice. It is entirely and exclusively about promoting vegan eating. A laudable cause to be sure, but I prefer truth in advertising.”

The PCRM research group has another academic article published this week that found that a meat-based diet increases one’s risk of type-two diabetes and should be considered a risk factor. Barnard’s anti-meat orientation became pretty clear as I talked more with him about today’s study.

“One way of thinking about it is that a vegetarian diet lowers blood pressure,” he said, “But I like to switch it around: A meat-based diet raises blood pressure. We now know that, like cigarettes, if a person is eating meat, that raises their risk of health problems.”

Barnard’s blood-pressure study did not distinguish one type of vegetarianism from another. I asked what he thought of eggs and milk, at this point expecting that they wouldn’t be a good idea.

“A semi-vegetarian diet does help some. We might suspect that a vegan pattern is going to be the best simply because studies have shown that vegans are the thinnest,” he said. “People who add cheese and eggs tend to be a little heavier, although they’re always thinner than the meat eaters. We have suspected that when people go vegan their blood pressures will be a little bit lower, but so far the data don’t really show that.”

Weight gain aside, because that is a different variable, why do vegetarians have lower blood pressure? “Many people will say it’s because a plant-based diet is rich in potassium,” Barnard said. “That seems to lower blood pressure. However, I think there’s a more important factor: viscosity, how thick your blood is.”

Eating saturated fat has been linked to viscous blood and risk for high blood pressure, according to the World Health Organization, as compared to polyunsaturated fats. Barnard paints an image of bacon grease in a pan that cools and solidifies into a waxy solid. “Animal fat in your bloodstream has the same effect,” he says. “If you’re eating animal fat, your blood is actually thicker and has a hard time circulating. So the heart has to push harder to get the blood to flow. If you’re not eating meat, your blood viscosity drops and your blood pressure drops. We think that’s the more important reason.”

Unprompted and seemingly apropos of nothing, we move into one of my favorite topics, Thanksgiving.

“You know how on Thanksgiving everyone kind of dozes off? People say it’s the tryptophan in the turkey, but it’s not. It’s all the gravy and the grease that’s entered their bloodstream. It reduces the amount of oxygen that’s getting to their brain and they just fall asleep.”

“That’s terrifying.”

“And what else could be affected by blood flow? One thing might be athletic performance. Take the fastest animals, take a stallion, they don’t eat meat or cheese, so their blood is not viscous at all. Their blood flows well. As you know a lot of the top endurance athletes are vegan. Scott Jurek is the most amazing ultra-distance runner in the world. That’s why Jurek says a plant-based diet is the only diet he’ll ever follow. Serena Williams is going vegan, too. A lot of  endurance athletes are doing it. If you consider tennis an endurance sport.”

“I do,” I said. “It is.” Venus and Serena Williams have been outspoken in their raw veganism for years. “Where should we be getting the protein to rebuild our muscles after a 100-mile run,” I asked, “if there’s no meat on the table?”

“Well, the same place that a stallion or a bull or an elephant or a giraffe or a gorilla or any other vegan animal gets it. The most powerful animals eat plant-based diets. If you’re a human, you can eat grains, beans, and even green leafy vegetables. Broccoli doesn’t want to brag, but it’s about one-third protein.”

I can’t speak for broccoli, but I do think the broccoli-growers association could consider that as a slogan. (Though, if you Google “Broccoli doesn’t want to brag,” it turns out Barnard said the same thing during an appearance on The Dr. Oz Show, so maybe he already owns it.) Broccoli does have one gram of protein per five-inch spear. That means 56 broccoli spears would get an adult man to the CDC‘s recommended daily protein allowance. For an ultra-marathoner it would be two or three times that.

“As for the findings [in this meta-analysis],” Katz told me, “they are valid, and show yet again that we could be eating far better than we do. The potentially misleading message is that veganism (or, more generally, vegetarianism) is the only way to eat to lower blood pressure.”

The DASH diet studies showed that including dairy was more effective for lowering blood pressure than a strictly plant-based diet.

“That isn’t an argument for dairy,” Katz continued, “there are considerations other than blood pressure, of course. But it highlights the tendency for nutrition researchers with any given agenda to emphasize that portion of a larger truth in which they are personally invested. For what it’s worth, Mediterranean diet studies also show blood pressure reduction.”

healthcare, healthy habits, nutrition, policy

Vegetarian diet lowers blood pressure… derrrrr!

  • Japanese meta-analysis in JAMA Int Med shows lowered blood pressure on vegetables by 5mmHg
  • similar to low sodium diet, loss of 5kg, half the effect of meds

http://www.foodnavigator-usa.com/R-D/Vegetarian-diet-could-slash-blood-pressure-Meta-analysis/

Vegetarian diet could slash blood pressure: Meta-analysis

Post a comment25-Feb-2014

Related tags: Vegetarian, Diet, Meat, Blood pressure, Heart health

Related topics: R&D

Consuming a vegetarian diet may be associated with lower blood pressure, and as such could be used to reduce blood pressure and heart disease risk, say researchers.

RELATED NEWS:

Vegetarians have significantly lower mortality rates, reveals new study
Veg congress day one: The fact vegetarians are healthier than meat-eaters is ‘one of the most consistent findings of nutritional epidemiology’
Vegetarian diet could slash heart disease risk by a third, say EPIC researchers
Vegetarian meal sales to top £882M by 2016

The meta-analysis of seven clinical trials and 32 studies in which participants consumed a vegetarian diet, finds consumption of a vegetarian diet is associated with lower blood pressure (BP).

Led by Dr Yoko Yokoyama from the National Cerebral and Cardiovascular Center, Japan, the team behind the analysis pooled measurements on net differences in BP associated with eating a vegetarian diet from 311 clinical trial patients and more than 21,000 participants in observational studies.

Writing in the journal JAMA Internal Medicine, Yokoyama and his team said that their results suggest such diets could be a useful nonpharmacologic means for reducing blood pressure.

“The meta-analysis indicates an overall difference in systolic BP of −4.8 mm Hg in controlled trials and −6.9 mm Hg in observational studies,” revealed the research team.

“These effect sizes are similar to those observed with commonly recommended lifestyle modifications, such as adoption of a low-sodium diet or a weight reduction of 5 kg, and are approximately half the magnitude of those observed with pharmaceutical therapy, such as administration of angiotensin-converting enzyme inhibitors to individuals with hypertension,”they added.

Yokoyama and colleagues commented that further studies are now required to clarify which types of vegetarian diets are most strongly associated with lower blood pressure, adding that research into the implementation of such diets, either as public health initiatives aiming at prevention of hypertension or in clinical settings, “would also be of great potential value.”

Source: JAMA Internal Medicine
Published online ahead of print, doi: 10.1001/jamainternmed.2013.14547 
“Vegetarian Diets and Blood Pressure: A Meta-analysis”
Authors: Yoko Yokoyama, Kunihiro Nishimura, et al

complex adaptive systems, data saving lives, entrepreneurship, healthcare, healthy habits, meaning, nutrition, policy, politics, quantified self, rapid learning health systems, startup

Wellthcare

Lissanthea put me on to this project.

Sounds highly aligned to my own ambitions, similarly requiring more focus…

http://www.wellthcare.com/

Wellthcare is an exploration

It’s an attempt to find new ways to value and create health

Health care contributes only 20% to our health and yet it dominates the health discourse;
80% of our health comes from our genes, behaviours, social factors and the environment

Wellthcare is about the 80% 
It’s about finding new sources of health-related value
It’s about creating health

At Wellthcare we believe that much of this value resides in our networks and communities

We call this value Wellth

Recent Log posts 

Pernicious moralising: when public health fails
22 Feb 2014
Wellthcare receives its first grant 
6 Feb 2014
It’s time to prioritise health creation – not just care and prevention 
30 Jan 2014
How a talking pet can keep us healthy
15 Jan 2014
Angelina Jolie, the end of standard, confused value, and not enough failure: why 2013 mattered
30 Dec 2013

Despatches from the Wellthcare Explorers 

Despatches are detailed descriptions of the debates being had between the Wellthcare Explorers as they further discuss health creation. 

Is there a role for an ‘event’? (PDF)
Published February 28th 2014

Building Resilience: Understanding People’s Context and Assets (PDF)
Published December 11th 2013

Fragmenting Communities and the Wantified Self (PDF)
Published October 22nd 2013

Discovering Wellth (PDF)
Published September 26th 2013
Exploration timeline 

Wellthcare is being explored by its Pioneer, Pritpal S Tamber, and an eclectic group of thinkers and doers called the Wellthcare Explorers.

February 2014

  • The fourth debate between the Wellthcare Explorers on the aims of an international meeting on health creation (Despatch pending)

January 2014 

  • Grant from Guy’s and St Thomas’ Charity received to ascertain whether it is possible to hold an international meeting on health creation (see announcement)
  • Wellthcare Manifesto drafted (publication pending)

December 2013

  • Wellth definition changed to: ‘new, health-related value, defined by what people want to do, supported by their nano-networks and communities’

November 2013 

  • Third debate between Explorers followed by Despatch

October 2013

  • The idea of the ‘Wantified Self’ described
  • Second debate between Explorers followed by Despatch
  • Wellth definition changed to: ‘new, health-related value, defined by what people want to do, supported by their nano-networks’

September 2013 

  • First debate between Explorers followed by Despatch

June 2013

  • Website launched
  • Wellth defined as ‘reclaimed currencies of health, delivered through new technologies, nurtured and protected by intimate communities’

May 2013

Feb 2013

  • Work starts on Wellthcare
facts & data points, healthy habits, nutrition, policy, politics

Middle Eastern chronic disease

  • Bad, but not much worse than Australia… according to the report, 66-75% of the adult population (over 18) and 25-40% of children and adolescents (under 18) in the Middle East are estimated to be overweight or obese

http://www.foodnavigator.com/Regions/Middle-East/Overweight-Middle-East-struggles-with-heart-disease-and-diabetes/

Overweight Middle East struggles with heart disease and diabetes

Post a commentBy Ankush Chibber , 11-Feb-2014

Related tags: Heart disease, Diabetes, Obesity

Related topics: Middle East

The Middle East is grappling with a rise in non-communicable diseases such as heart disease and diabetes, the roots of which are in a rise in obesity among its populace, a new study has found. 

According to report, ischemic heart disease is now the leading cause of death in middle and high-income Arab nations – and it comes in at number 4 even in the lowest-income countries in the region.

Stroke is also a leading cause of death, and Kuwait, Lebanon, Qatar, Saudi Arabia, Bahrain and the UAE are now among the 10 nations with the highest global prevalence of type 2 diabetes, it said.

The study’s authors put most of the blame for this on the change in dietary habits among the region’s population.

Fat of the land

The report added that the prevalence of overweight and obesity has increased in both young and adult populations of GCC countries, including Kuwait, Qatar, Saudi Arabia, and Bahrain.

According to the report, 66-75% of the adult population (over 18) and 25-40% of children and adolescents (under 18) in the Middle East are estimated to be overweight or obese.

“The traditional Arab diet has changed from high-fibre and low-fat food with increased integration of the Arab world into the global market over the past four decades,” the study’s authors said.

“Unhealthy dietary habits are prevalent in children, adolescents, and adults, especially in the wealthy GCC countries where a wide variety of global fast-food chains are near ubiquitous,” they added.

According to the report, people in the Arab countries have a high intake of fast food and carbonated beverages and a low intake of milk, fruits, and vegetables, and frequently consume snacks rich in calories, salt, and fat between meals.

Pricing policies?

According to the report, national policies, programmes, and action plans to improve diet and increase physical activity are undeniably important for non-communicable disease prevention.

“But the realities of implementation are likely to be very different from the written policies,” the authors said.

According to the results of a review of diet and physical activity policies in low-income and middle-income countries, only Jordan had a policy that addressed all four risk factors: salt, fat, fruits and vegetables, and physical activity.

“In particular, the review reported that diet and physical activity policies tended not to be associated with specific action plans, timelines, and budgets, and they were also mostly focused on individual behavioural changes,” they said.

“Policies that link to specific budgets and priority actions, and involve a broader range of stakeholders, are needed. Importantly, pricing regulations are needed to ensure that fruits and vegetables are more affordable than processed foods, thus targeting both obesity and micronutrient deficiencies.”

Salt and trans fats need attention

According to the authors, even slight reductions in salt intake will result in substantial reductions in medical costs and cardiovascular events.

“Reduction in salt intake can be achieved with behaviour modification efforts (through advertising and health education campaigns) and reformulation of food products by industry. In the Arab world, bread is a big source of salt in the diet, and should be the first target for reformulation by gradual reduction,” they said.

The authors pointed out that in high-income and middle-income countries, reduction of trans-fat consumption has been addressed through mandatory labelling of the trans-fat content in foods and voluntary agreements.

“But little information about trans-fat intake in the Arab world is available. A recent study in Jordan showed a high and variable content of trans fat in both locally produced and imported foods,” they said.

“The WHO has proposed various policies to reduce trans-fat intake, including further studies on trans fat with respect to labelling, pricing regulations, and import restrictions. Health education campaigns are needed to educate consumers about trans fats,” they recommended.

Source: The Lancet

Non-communicable diseases in the Arab world

doi:10.1016/S0140-6736(13)62383-1

Authors: Dr. Hanan F Abdul Rahim. Prof Abla Sibai, Yoused Khader, Prof Nahla Hwalla, Ibtihal Fadhil, Huda Alsiyabi, Awad Mataria, Shanthi mendis, Prof Ali H Mokdad, Abdullatid Husseini

healthy habits, nutrition, policy, politics

Ban on junk food advertising to chindren

 

http://www.foodnavigator-asia.com/Policy/Academics-call-for-ban-on-child-facing-junk-food-advertising/

Academics call for ban on child-facing junk food advertising

Post a commentBy RJ Whitehead , 10-Feb-2014

Related tags: New Zealand, Junk food, Obesity, Advertising, Research

Related topics: Asian tastes, Policy, Convenience foods and snacks, Australia – New Zealand

A ban on manipulative junk food advertising to children is urgently needed to help fight increasing rates of childhood obesity, say University of Otago Wellington researchers.

RELATED NEWS:

Junk food industry should prepare for plain and graphic label debate
Junk food can junk your memory in a week, suggests new study
Indian schools to ban junk food in 2013
Minister slams NZ’s “Couch Potato” award for obesity

Free toys, gifts, discounts and competitions, promotional characters and celebrities, and appeals to taste and fun, are just some of the techniques used by marketers to promote junk food to kids, according to a recent systematic literature review.

The university’s Department of Public Health has for some time been on a drive to research the causes of obesity in a country where the obesity rate among children aged between five and 11 jumped from 8% to 11% in just six years. At least 20% of New Zealand’s children are considered overweight.

From Happy Meals to ‘open happiness’

Lead researcher Gabrielle Jenkin says most children and parents will be familiar with the offer of free toys at McDonalds, slogans such as “open happiness” with Coke, and the use of licensed characters such as Spiderman or Spongebob Squarepants to promote junk food to children.

Persuasive food marketing is manipulative, especially for children, Jenkin said, adding: “Such marketing has been proven to increase children’s requests for the advertised foods, their food preferences and ultimately their diets. For example, free toys, discounts and competitions promote brand loyalty and repeat purchases.”

Meanwhile, Jenkin’s colleague at UOW’s Department of Public Health, Louise Signal, has been researching the extent of junk food advertising on kids by equipping 200 schoolchildren with wearable cameras and recording the instances they come in contact with advertising from billboards, shops and the back of buses.

“Children tell us that they do see a lot of advertising, but we’ve never quantified it across the entire range of media,” said Signal. 

“As a parent myself, I’m very interested because parents aren’t with their older children all of the time, they don’t necessarily know where they go, and a lot of it slides under the radar anyway.”

Bringing legislation in line with other countries

Jenkin and her review team are now calling for an outright ban on junk food advertising to children under 16, as has been done in Norway.

In the absence of a ban, new rules would need to be added to the advertising codes around the use of persuasive techniques, as has been done in the UK, Australian and Ireland, they say.

The study claims to be the first of its kind to focus on common techniques used to promote food to children on television. The research has been published in the latest edition of the international journal, Obesity Reviews.

complex adaptive systems, facts & data points, healthcare, healthy habits, nutrition, policy, politics, rapid learning health systems

Overweight or obese now normal

Heart Foundation lays it all down… we need to lose a combined 120million KGs to return to normal healthy weight range… not as easy as it sounds.

http://www.medicalobserver.com.au/news/being-overweight-or-obese-now-the-norm

Being overweight or obese now the norm

AUSTRALIANS need to lose a combined 120 million kilograms to return to a healthy weight range.

The average Australian man now weighs 85.9kg – that’s 6.5kg heavier than he was in 1989 – according to a National Heart Foundation analysis on the severity of the nation’s weight problem.

A breakdown of Heart Foundation national health surveys and government data also revealed that the average woman has gained 5.7kg in the past 25 years and now tips the scales at 71.1kg.

The Heart Foundation’s national director of cardiovascular health, Dr Rob Grenfell, said two-thirds of Australians now fall outside the healthy weight range, with nearly half a million people morbidly obese (BMI > 40).

“To return to a healthy weight range, an average man would need to lose 8.9kg and a woman would need to lose 5.7kg,” Dr Grenfell said.

“The combined weight loss required is just short of 120 million kilograms across the nation.”

The analysis highlights that the average BMI for men is up from 25.3 to 27.9 since 1989, and the average for women is up from 24.3 to 27.2.

Obesity has increased from 8.4% of the population in 1980, to 28.3% in 2011–12.

“It’s scary that two in three Australians are now above the healthy weight range, making overweight and obese weight ranges more ‘normal’ than healthy,” he said.

“The healthiest BMI is relatively lean, at around 22.5–24.9, which is equivalent to a weight of 70–77kg for an Australian man of average height and 59–65kg for an Australian woman of average height.”

In comparison to 1980, the proportion of obese adult Australians has tripled, while the number of people in the healthy weight range has almost halved.

WA and Queensland now have the highest average male BMIs at 28.2, according to the Australian Health Survey of 2011/12, with the highest average female BMIs, 27.7, occurring in SA and Tasmania.

Victoria has the lowest average BMIs at 27.6 for men and 26.9 for women.

healthy habits, nutrition

Fasting Facts – Ramadan, Alternate Day, 5:2

  • fasting works
  • three types of fasting are analysed – ramadan, alternate day and 5:2
  • Reducing calories in any form assists with weight loss. 
  • If overweight/obese patients with cardiovascular risks are struggling to lose weight, Alternate Day or Intermittent Fasting may be dietary options worth exploring with medical and dietetic supervision.
  • Patients with diabetes may require assistance during Ramadan with glucose monitoring and drug dosage.

 

http://www.medicalobserver.com.au/news/a-fast-way-to-lose-weight

A fast way to lose weight

FASTING is not a new diet fad: the effects of three main regimes have been researched scientifically.

Not all fasting is the same: the amount and type of energy consumed, frequency of eating occasions in a day or number of fasting days per week may vary.

The three types of fasts below have been researched since the 1960s.1

Ramadan

During the month-long, religious obligation during the Islamic calendar, Muslims adhere to strict fasting (no food or fluids) from dawn to sunset, some 13—18 hours.

All adult Muslims fast, except those who are ill, travelling, pregnant, breastfeeding or menstruating. Those with chronic medical conditions such as diabetes are not expected to fast but many do.

Research has found Ramadan appears to have positive effects on blood pressure (BP) and blood lipids for those with stable cardiac conditions, metabolic syndrome, hyperlipidaemia and hypertension.2

However, in those with diabetes, daylight fasting increases blood lipids 2 and results in higher insulin levels,3 risk of hypoglycaemia 4 and deterioration of glycaemic control.5 HbA1c can improve after Ramadan ceases, however.5

Patients with diabetes need to monitor their condition during Ramadan and may require assistance with alteration of drug dosage and timing, and dietary counselling.6

A small weight loss, around 1kg, is seen in those observing Ramadan but it is normally regained the following month.7-9 Ulcers and epigastric pain may be more common during this time.10

Alternate Day Fasting (ADF)

ADF is a dietary pattern with a ‘feed day’ when food and fluids are consumed ad libitum alternated with a ‘fast day’ when only 25% of an individual’s energy requirement is consumed in a 24-hour period. A research group at the University of Illinois at Chicago has been testing the effect of this regime in overweight/obese people since 2009. Overall they have found:

  • After 8—12 weeks, around 0.6kg of weight is lost per week and fat mass significantly decreases. 11-14
  • Total and LDL cholesterol and BP are reduced while maintaining HDL. 11,12
  • LDL particle size increases. 12,14,15
  • These effects can be seen with an ADF low-fat (25% of energy), high-carbohydrate (60% of energy), high-fibre (27g) regime or an ADF high-fat (45% of energy), lower carbohydrate (40% of energy), high-fibre (27g) regime.16 Improvements in endothelial function are only seen with ADF low-fat regimes.17
  • Adipose tissue hormones change: adiponectin increases while leptin decreases. 18
  • Compliance with this eating plan is around 85—95%.11,15
  • While ADF is providing interesting results, longer and larger trials are needed to confirm these results.

Intermittent Fasting (IF)

IF is a modified version of ADF where, on two non-consecutive days a week, only 25% of energy requirements are consumed, leaving five days of ad libitum diet.

Made popular by the recent book The Fast Diet by UK journalists Dr Michael Mosley and Mimi Spencer, IF has been researched by the University Hospital of South Manchester.20

Over six months 53 obese, premenopausal women followed an IF regime with two days consuming ~2700kJ/day and five days their habitual diet with usual exercise, compared to 54 women on a chronic energy restriction (CER) diet of ~6276 kJ/day for seven days a week.

  • 34% of IF participants lost more than 10% of initial body weight compared to 22% in the CER group.
  • Both groups had comparable body fat loss and reductions in C-reactive protein, oxidative stress markers, total and LDL cholesterol, triglycerides and systolic and diastolic BP.
  • Both groups saw improvements in fasting insulin and insulin sensitivity but greatest in IF group and no differences in blood glucose.
  • As with most diets, compliance with the IF regime was high in the first month (70%) but decreased over time to 64% at six months compared to 55% at six months for the CER group.

Other researchers have studied similar IF patterns but only over 12 weeks with similar results for weight and insulin, cholesterol and glycaemic control.21-23

Although compliance was not as high, like ADF, IF may be an alternative dieting regime that may work for some patients.

Summary

  • Reducing calories in any form assists with weight loss.
  • If overweight/obese patients with cardiovascular risks are struggling to lose weight, Alternate Day or Intermittent Fasting may be dietary options worth exploring with medical and dietetic supervision.
  • Patients with diabetes may require assistance during Ramadan with glucose monitoring and drug dosage.