Health for life

Is it too late to still be wishing happy new years? Well, it’s my first column of 2011, so I hope no one will mind if, two weeks into January, I’m still talking about it.

From Flickrs apocs

Two weeks into January, you say? And how many broken resolutions?

I’m not a huge fan of New Year’s Resolutions. I think January 1 is an arbitrary start date that might not match up with actual good timing. Take the chestnut of a resolution to eat better and work out more – why not time this with the time of year that’s actually conducive to activity and healthy eating? In the depths of winter our bodies want to store fat, its cold and snowy outside and, at least in the Northern Hemisphere, vegetables are wan and flavorless. You want to lose weight? Talk to me in June.

Waah, but I need to be bikini-ready already by then! Who exactly is telling you you’re not bikini-ready now? That’s another problem with New Year’s Resolutions – the outside pressure. We’re told it’s the time to make commitments, and so we leap in, and then berate ourselves for falling short. But what else should we expect when the drive to change hasn’t come from within ourselves?

Also it’s an easy way for gyms to sell more memberships.

On the other hand, though, sometimes we need an arbitrary impetus for change. Something that says, Hey, evaluate! And change what needs changing! One of my good friends made a resolution two years ago to set aside at least one night every week as a free night – no plans, no commitments. (This friend works in the music industry, where nighttime commitments are rampant, and is a generally popular guy.) Not only did he keep this resolution but it so improved his life that now, years later, the free night is a solid institution.

Don’t make resolutions for resolutions’ sake. But if the swooping tide of reevaluation and reinvention that comes with the new year inspires you, go for it! Just make sure you’re excited and inspired about your plans, and that your goals are not unattainable. Impossible or awful goals – to drop 20 pounds in a month, switching from a McDonalds diet to strict raw foodism – are just a set-up for disappointment and self-flagellation down the line.

In the spirit of positive, attainable change – and the spirit of this column! – I’ve put together what I hope will be a helpful and inspiring list. These aren’t commandments or edicts, just steps you can choose to take. You can choose a couple of items on the list as goals for yourself, or just keep them in mind next time you hit the supermarket (or farmers market). Figure out what’s important to you, what you might want to change, and how you can reasonably reach those goals.

1. Rethink Your Meat.
One of the strongest environmental impacts you can make with your food choices is what meat you eat, and how much. Conventional industrial meat production is, in a word, not-so-good. It’s not-so-good for the environment, it’s not-so-good for workers, and it’s not-so-good for animals. (I don’t think there’s anything morally wrong with killing animals for meat; I do think it’s horrible to make animals live miserable lives of suffering leading up to the slaughter.) And yes, human beings evolved to eat meat. But not miserable chickens that live immobile in cages, pecking out their own feathers, eating nothing but cornmeal and animal byproducts.

From Flickrs stickeresq

Industrial meat also has a markedly different nutritional profile than wild or pastured meat – the balance between Omega-3s and -6s swings way towards the 6s, which is not what your body wants – and animals who eat real food, rather than food-like sludge, taste better, too! Pastured, humanely-raised meat is, yes, more expensive. As it should be! Don’t skimp here. Buy less meat, and choose to spend your money on higher-quality, tastier, more ethical stuff. Dairy and eggs (also from happy-animal farms!) and plant proteins are cheap, good for you, and delicious.

2. Process Food Yourself.
Think about what goes into processing a processed food. All of the ingredients must be collected; any additives, preservatives, flavorings, or nutritional enrichments must be either derived or created themselves. The food is processed – mixed, cooked, prepared – in a factory. The food is packaged – plastic is made, trees are turned into cardboard, paints are applied to the label. The food has to be tested – the recipe was devised in a lab, and nutritional information has to be determined for the label. Odds are the food is marketed – someone designed its package and a marketing campaign; time is bought for television commercials, ad space is purchased in magazines, coupons are sent to you in the mail. Then the food is packed and driven – possibly in a rigerated truck – to a warehouse, and then to your supermarket. Now think about how much of the dollars you spend on that processed food is going toward quality ingredients, and how much of your money is going to… everything else.

There is no question that for a little more time in the kitchen, you get so much more bang for your buck with unprocessed foods. And I mean your literal buck, but also your nutritional buck and whatever metaphorical bucks this is all costing Earth. Unprocessed foods are closer to what our bodies evolved to eat. They are more nutritious, and their nutrients – naturally-occurring rather than added later on – are in better forms for our bodies to absorb. Also, who knows what undiscovered chemicals and compounds are in kale that haven’t been discovered yet and distilled into vitamins?

Eat real food and your body will thank you. You’ll notice a difference in your wallet, too. Even something as simple as shredding your own cheese rather than buying a bag already done – it’s cheaper per ounce and you skip the weird powdery coating that stops shredded cheese from sticking – makes a difference on every count.

3. Cook
So what do you do without processed food, just a pile of raw ingredients in your kitchen? Cook! There’s no better way to control what you eat than to cook your food yourself. Don’t trust the folks at Lean Cuisine to do it for you. Not only will you save money by starting with raw ingredients, but you’ll have way more control over exactly what you put in your body. Do you feel best eating a high-fat, grain-free diet? (Lots of people do!) Then pour on the coconut oil and enjoy! Would you rather focus on fresh fruits and vegetables? Bust out the blender and skip the Jamba Juice smoothies. You can decide if your home is powered with wind energy – no promises for the restaurant down the street. And how much salt did they put in your soup? When restaurants serve us giant portions, we’re inclined to finish them. Take responsibility here by taking control. And then have the satisfaction of knowing that you can make your own food.

From Flickrs Nataliemaynor

4. Eat with the Seasons.
I love shopping at the farmers market, but it’s not for everyone – it takes time, can be crowded, and seasonal eating can be limiting. (I’ll sing the greenmarket’s praises in August, but let’s talk about the onions, apples, and potatoes we’ll be seeing all winter.) Luckily, this is not an all-or-nothing deal. You can eat seasonally with supermarket produce and still do good for your bank account, body, and tastebuds. Compare a January tomato with one in July – even at ShopRite there’s a huge difference. And that taste (and color!) is indicative of more nutrients, too. If there’s no local food this time of year for you, consider just eating food from within your country, or your own hemisphere. Food’s cheaper and tastier in its proper season, and when it comes from closer by as well.

5. Enjoy!
Its frightfully easy to get so caught up in worrying if our food is healthy, cheap, and good for the planet that we forget what else food is supposed to be: delicious! A meal is more than calories and nutrients, more than a grocery store receipt. A meal is a sensory pleasure, and a social one as well. If your approach to cooking is pure drudgery, itll never last, and youll find yourself at the drive-through before you know it.

Figure out how to incorporate what makes you happy into your healthy eating plan. Once in a while, round out your healthy protein and veggies with some Doritos. Give yourself permission to enjoy that occasional Chinese food delivery, or splurge on a delicious meal out. Buy an avocado even if its come from halfway around the world.

Dont beat yourself up for failing to meet some lofty goal. Recognize and celebrate the ways youre good to yourself – do you nourish yourself with healthy food, are you conscious of spending, do you take responsibility for how your choices impact the environment? Awesome. Now make sure youre enjoying yourself – and your food – as you go.

~~~

If you liked this piece, youll surely dig:

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• Vintage Cookbook Hoedown: The Quick Cook Book (1961)

Every Saturday, we post a lovely piece from the CHG archives. This weeks comes from April 2009, when we were crazy hyper-literate. Since this, Ive read both Animal, Vegetable, Miracle, which was outstanding (read it now!), and Food Matters, which was all right. 

Sweet readers, this week’s a little out of whack with the ant situation. So, instead of today’s regular post, I thought I’d offer up a few of my favorite nonfiction food books. They’re fairly standard reads amongst chowhounds, and don’t concentrate specifically on healthy, low-budget cooking, but all have wonderful qualities nonetheless. I wouldn’t hesitate suggesting them to anyone. (Er, which is why theyre here.)

If you’ve ever perused these guys, or have any ideas for good reads, please go crazy in the comments section. After all, reading is FUN(damental).

In no particular order…

A Cook’s Tour by Anthony Bourdain
I never considered myself a particularly daring eater, or imagined cuisine as a huge part of any vacation. But Bourdain helped change that. Cook’s Tour is about food and culture – namely, how discovering one is key to understanding the other. He describes Vietnamese food in such a way that I can’t believe I’ve never been. There’s a reverence not present in Kitchen Confidential, too, which balances Tony’s occasional bouts with ennui and annoyance.

In Defense of Food by Michael Pollan
On its own, In Defense of Food is a really neat guide for everyday eating. As a companion to the more analytical Omnivore’s Dilemma, it’s invaluable. It counters OD’s occasionally relentless skepticism with optimistic solutions, as well as simple, vital messages. (“Eat food. Not too much. Mostly plants.”) Read it first if you can.

Fast Food Nation by Eric Schlosser
I plowed through this book years ago, and it’s a tribute to its effectiveness that I’ve rarely stepped into a fast food restaurant since. Having worked at both McDonald’s and Wendy’s, I knew about the food prep and employee relations, but the mass production methods used to keep prices down … great scott. (P.S. If you are parent to a socially concerned teen, this will absolutely rock his/her world.)

Heat by Bill Buford
Buford took a year off to learn how to cook under Mario Batali, Marco Pierre White, and various butchers and pasta-makers all over Europe. The result is Heat, which perfectly captures the fascination, frustration, and triumph facing novice denizens of the kitchen. Dude can really write, too, which helps.

I’m Just Here for the Food by Alton Brown
If you can imagine Good Eats in print, I’m Just Here for the Food is for you. Half cookbook, half science manual, you won’t find better explanations of the physical and chemical processes involved in getting a meal to the table. It’s Wired for foodies, or Cook’s Illustrated for nerds.


Also of note

Garlic and Sapphires by Ruth Reichl
Reichl’s kind of like an eccentric aunt who dresses up, goes to fancy restaurants, and ruminates on their merits for page after page. Funny, warm insiders look at big-city food criticism.

The Omnivore’s Dilemma by Michael Pollan
Though it can get a bit dry, OD’s a must-read for those interested in how our food industry can possibly function. Factory farms are scary, scary things.

Kitchen Confidential by Anthony Bourdain
Hilarious, hyperbolic behind-the-scenes glimpse into the everyday running of a restaurant, by the man himself.


Reading

Julie and Julia by Julie Powell
I’m about halfway through so far. It’s okay. Julie can definitely write, but the book seems more about her crappy apartment than the food. Still, I can relate to the crappy apartment parts. And I WILL be seeing the movie. Meryl Streep as Julia Child, yo.


Would like to read, but haven’t gotten around to yet

Animal, Vegetable, Miracle by Barbara Kingsolver

Food Matters by Mark Bittman

How to Pick a Peach: The Search for Flavor from Farm to Table by Russ Parsons


What about you guys? What are you reading? What are your opinions on the books mentioned? Do tell.

(Photos courtesty of Chrismasto, NY Bookworm, and Spill.)

An ovary almost completely replaced by cancer

As regular Disease Management Care Blog readers may have predicted, the controversial anti-cancer drug Avastin went bust again in two just-published studies (here and here).  This time it wasnt for the questionable treatment of breast cancer but ovarian cancer.  Yet, while the nations mainstream media has passed sentence on Avastins failure, the DMCB isnt quite ready to "short" the drug.

Very briefly, one randomized prospective trial involved women with high risk or disease that had spread.  Participants were randomly assigned to standard chemotherapy plus Avastin, while the other group got just the chemotherapy.  Women in the Avastin group went 24.1 months without progression of their disease versus 22.4 months in the non-Avastin group.  Death rates are still being analyzed.

The other trial involved women with cancer that had spread.  They were randomly assigned to one of three groups: just 1) chemotherapy or 2) chemo plus either Avastin in the earlier cycles of chemotherapy or 3) Avastin with all the cycles of chemotherapy.  The just chemo group went a median of 10.3 months before there was disease progression, while the Avastin groups went 11.2 and 14.1 months, respectively.

Even with the depressing results outlined above, the DMCB has several reasons for believing that weve not seen the last of Avastin for ovarian cancer.  Much of the DMCBs obstinacy has to do with the complexities of cancer treatment and how statistics are collected and interpreted:

1.  The trials involved patients with aggressive or advanced disease. Much like the logic of using a small extinguisher on a huge house fire, that doesnt mean that persons with limited or microscopic disease wouldnt be helped by Avastin.  The only way to find out is to perform the same sorts of randomized trials involving patients with less widespread or aggressive disease. 

2.  Its possible that some of the Avastin patients may have gotten much better, but their positive results were diluted by the majority of the patients who didnt benefit. In other words, the clinical trials report the average response rate.  That does little to answer the two questions that every individual cancer patient asks: 1) are there exceptions and 2) am I one of them?

3. Assuming exceptions exist, there may be a way to identify that small minority of patients who are more likely to derive a greater benefit from Avastin. Assuming ovarian cancer is a heterogeneous disease, there may be a blood test or an additional type of biopsy that can answer the two questions above.

4. "Disease progression" is just one of several cancer outcomes.  While its important, there are others that may have more meaning for patients and could simultaneously put Avastin in a better light.  As a reminder, death rates in one of the trials described above are still being compiled and have yet to be reported.  Stay tuned.

5. Last but not least, the most selectively generous interpretation of the data above is that Avastin helped patients go an additional 4 months before their disease started spreading again.  While that may not seem worth it, the DMCB has taken care of plenty of patients who would think its plenty worth it.  While commercial insurers will have every reason to question payment for a horrendously expensive drug with only 4 months of benefit, patients and their doctors will argue that hope is "medically necessary."

Image from Wikipedia