Health for life

Weve all been there with our parents – the same ol restaurant, with the same ol menu– because theyre reluctant to try something new, strange, or simply unappealing. And theres nothing intrinsically wrong with that, per se. People like what they like, and odds are, your parents eating habits have been pretty set for decades.

But wouldnt it be nice to try something else for a change?

Convincing your folks to move on to new cuisines and cultures can be a wonderful experience for all involved, and not just because kimchee is awesome. "Ethnic" foods, or foods found outside your traditional cuisine, are frequently:

• Less expensive: When HOTUS and I order Chinese takeout, we can turn $15 into dinner that night and lunch for the office the next day. While not as cheap as home cooking, its darn comparable.
• Healthier: Okay, so the ghee (clarified butter) in Chicken Korma wont put it on the happy side of the Eat This, Not That list, but non-traditional dishes can often pack in vegetables, lean cuts of meat, and healthy oils. Compared especially to most American-style restaurant meals, ethnic food is frequently a lighter choice.
• Educational: By eating foods outside of your customary cultural cuisine, youre exposing yourself to a new world of ingredients, flavor combinations, and styles of preparation, which you can then implement at home.
• Delicious: Mmm. Take two bites of baba ghanoush and call me in the morning.

But then again, were not talking about you here, are we? Were talking about your parents – wonderful people, to be sure, but not necessarily the most daring of eaters. So, how can you get your beloved Ma and Pa to dig into falafel, injera bread, and even sushi (or "bait," as a certain family member calls it)? Try five these strategies:

1) Pay for it. Sometimes, older folks (actually, any folks) simply dont want to blow money on something theyre not sure theyll like. So, pick an inexpensive restaurant and treat em. Think of it as an adventure you dont need hiking boots for.

2) Start at home. Prepping a meal for mom? Throw in a teriyaki side dish or a plate of pierogies. By surrounding a new food with ones she likes, it may seem more approachable.

3) Order a gateway food. Introducing your parents to a mild dish – one with a less-assertive flavor, similar to a recipe they might already love. Pad Thai is way Americanized, but its an effective tool for getting reluctant eaters into more daring Thai Food. For me, lassis and samosas were the gateway dishes to a lot of delicious Indian cuisine.

• SPECIAL NOTE: This can be a way effective strategy for people with an aversion to spice, which was probably the most-cited fear in yesterdays Ask the Internet comments. Feeding your parents a super-mild quesadilla proves to them that all Mexican food isnt a five-alarm chili, which could encourage them to attempt other dishes.

4) Embrace media. This might sound lame (I hope not), but for many folks, seeing a dish in a magazine, on a TV show, or at the movies – when its been styled and served in the best possible light by super-attractive people – can make it seem tremendously appealing. I wonder how many parents wanted an Italian meal after watching Julia Roberts slurp spaghetti in Eat Pray Love? Or how many folks decided Indian food could be super-awesome after 30 minutes of Aartis Party? Or how many moms and dads tried matzoh ball soup for the first time after seeing a glossy photo in Saveur? Probably a lot.

5) Know when to accept defeat. My dad will never, ever, ever develop a love of curry, no matter how many "mmm … slurp … ahhh" sounds I make while eating a big ol bowl of it. And that is totally, 100% fine. Not everyone has similar tastes, and pushing a loved one too hard can (seriously) get pretty annoying. Food should be a joy, not a struggle. Move on.

Opening parents - and anyone, really - up to new cuisines, and as a result, new cultures, is something from which we can all benefit. Happy eating.

Readers? Comments? Questions? Suggestions? Fire away.

~~~

If you enjoyed this read, you might also dig:

• Healthy Takeout on a Budget
• Learning to Love Foods You Hate: A How-To Guide for Frugal Eaters
• Serving Sizes and Portion Control: A Primer

Sweet readers! Today’s question is pretty self-centered, but what are blogs, if not digital representations of our desperate need for validation on a mass scale? Also, the winner gets a cookbook! Whee!

Q: A long, long time ago (37 days) in a galaxy far, far away (Lawn Guyland, Noo Yawk), I married a man of unparalleled awesomeness and beard-growing ability. Until that fateful evening, he was erred to on this blog as Husband-Elect. Now he has been … uh … sworn in (?) as my spouse, we need a new moniker.

What should we call The Artist Formerly Known as Husband-Elect?

A: Our favorite name will receive a copy of Giada De Laurentiis’ newest cookbook, Giada at Home: Family Recipes from Italy and California. (We went to Italy for our honeymoon, and I hear California is very nice, so its kind of fitting.)

As always with these kinds of things, there are a few rules:

• Entries must be in by this Thursday, October 14th, at 6pm. 
• One entry per person.
• Entries must include your idea and a name with which we can identify you. No anonymous comments, please.
• Winner will be announced in this Friday’s Top Ten Links post.
• In the case of a repeated idea, the commenter who mentioned it first will receive the cookbook.
• No family or friends of CHG bloggers can enter. Sorry, Ma.

Hope that makes sense, sweet readers. Can’t wait to see your ideas, and don’t forget to log on later for Jaime’s newest Green Kitchen column!

Want to ask the interweb a question? Post one in the comment section, or write to Cheaphealthygood@gmail.com. Then, tune in next Tuesday for an answer/several answers from the good people of the World Wide Net.

So Ive been thinking a lot lately about New Years Resolutions, and why they so often fail.  I see it every year in the gym... As soon as January 2nd hits, that place turns into a mad house, a clusterfuck if you will.  A clusterfuck full of everyday, hardworking people who have been neglecting their health all year long, especially over the recent holiday season, and are now determined to get in shape and lose weight.  But this clusterfuck never lasts.  It slowly ebbs away as the winter months go on, finally reaching a low in the Spring and Summer when the weather is nice and people return to their normal lives.  Hey, at least it gives people something to focus on other than the harshness of post-holiday Winter.

Of course not everyone fails in their New Years Resolutions; about 12% of us succeed, according to a 2007 study (1).  Thats right... just 12% succeed...  88% fail.  This year, 9 out of 10 of us will fail with our resolutions.  And what do we want?  No surprise, weight loss tops the list (2).

Why the horrible success rate?  Why do we fail at our goals to begin with?  And how can we be successful?  After some serious reading and thinking, Ive come up with the following:  three things you can do to succeed in your New Years resolution this year!

1.)  Set goals that are consistent with who you are.
Perhaps the most important thing you can do before you set a goal... know yourself and your values.  I cant stress this enough.  Sean Croxton wrote a great article about this topic here, I highly recommend it.  You need to do some soul searching.  If the things that you value most are your family, your business, education, religion, and the New York Giants... maybe you need to rethink your goal of losing 100 pounds this year.  I dont see health, nutrition, or exercise anywhere in that list, so unless you plan on denouncing football and God in the process, you wont find long-term success there.  Theres nothing wrong with not caring about health.  Everybody is different, everybody has different values.  Know yourself, be confident in what you stand for, and set goals that make sense for you.  

But just because you dont value health as much as other things in your life, that doesnt mean you cant have a successful health-related resolution this year.  Just gauge your resolution to the value you place on it.  If you only kinda-sorta care, theres nothing wrong with setting yourself a goal that lects that...  something relatively easy, like giving up soda.  You dont have to change the world here if youre not so inclined.  Just know who you are, and know the level of commitment youre willing to put into it.


2.)  Make sure youre doing it for the right reasons.
At the deepest level, behind every human action lies one of two emotions:  fear or love.  Setting a New Years resolution out of fear is a dead end street.  If your goal is to lose weight, ask yourself why you want to lose weight.  Is it because youre afraid of being unattractive?  Are you afraid of having a heart attack?  Afraid that you dont look like a Victorias Secret model?  If you set a resolution out of fear, then at the deepest level, you dont really want it.  Youll find that even if you do get there, the fear still remains. 

On the other hand, if you want to lose weight because you love the way you feel at that weight, because you love your life and you want to stick around for a while, or because you love being the best person you can be... then carry on.  If you do it from a place of love, you will get the return on investment youre looking for.  Recognizing whether you are coming from a place of love or a place of fear isnt easy; it requires a lot of self-lection.  Its a fine line, but its a crucial concept.  It could be the difference between success and failure.  Dont do it because youre afraid of what others think of you... fuck everyone else.  Do it for you.


3.)  Set goals that are realistic and attainable.
Now that youve got the first two covered, you need to set a goal that is realistic, and perhaps more importantly, it needs to be conducive to long-term success.  In other words, dont try to lose 50 pounds by February.  A.)  You wont.  B.)  Youll feel like a failure.  and C.)  You wont maintain it.  And if youve never weighed less than 150 pounds in your adult life, dont set your goal weight at 110 pounds.  It will not happen.  Accept it.

You would be wise to set both long-term and short-term goals.  Set a long-term, overarching goal youd like to achieve, and set short-term goals that get you there.  Lets say you want to lose 30 pounds by the end of the year.  Thats totally attainable.  Divide 30 by 12 and you get 2.5 pounds per month.  Shoot for 2-3 pounds of weight loss a month as your goal.  If you lose more than that, great.  But keep your goals modest and keep your long-term goal in sight.  The constant success will keep you motivated and you might even hit your goal before you planned to.  If you do, good for you!  I know I know... slow, gradual weight loss isnt sexy, but its the only way to go if you want to keep the weight off long-term.  Its far easier to implement a minor lifestyle modification than an intensive one, especially over the long haul.  If you set out to eat zero carbs, and exercise 2 hours every day, youll fail.  Quickly.  Take your time, dont get carried away, and keep your long-term goal in mind... theres no rush.


There you have it.  Three bits of advice to aid you this year in your New Years resolution.  I hope this helps someone out there.  Has anyone had success with their resolutions in the past?  How did you do it?  And what are people going for this year?  Id love to hear from you in the comments!

A diet high in omega-3 polyunsaturated fat lowers levels of problem enzyme

Columbia University Medical Center (CUMC) researchers have found that a diet high in saturated fat raises levels of endothelial lipase (EL), an enzyme associated with the development of atherosclerosis, and, conversely, that a diet high in omega-3 polyunsaturated fat lowers levels of this enzyme. The findings establish a "new" link between diet and atherosclerosis and suggest a novel way to prevent cardiovascular heart disease. In addition, the research may help to explain why the type 2 diabetes drug rosiglitazone (Avandia) has been linked to heart problems.

The study, conducted in mice, was published in the October 4 online edition of Atherosclerosis, Thrombosis, and Vascular Biology.

Like other lipases, EL plays a role in the metabolism of blood lipoproteins, which are complexes of lipids (fats) and proteins. EL, which is secreted by macrophages (a type of white blood cell) and other cells in arteries, was discovered in 1999. Studies have shown that elevated EL is associated with atherosclerosis and inflammation. Until now, however, little was known about how dietary fats might affect this enzyme, said study leader Richard Deckelbaum, MD, the Robert R. Williams Professor of Nutrition professor of pediatrics and of epidemiology and director of the Institute of Human Nutrition at CUMC.

In the current study, a strain of mice susceptible to atherosclerosis was fed a normal diet enriched with either palmitic acid (a common saturated fat) or eicosapentaenoic acid (an omega-3 fatty acid, or polyunsaturated fat, found in fish oil, among other foods). After 12 weeks, the mices aortas were examined for changes in the expression of EL and inflammatory factors. Aortas of mice fed the saturated fat diet showed a significant increase in EL and detrimental changes in inflammatory factors, while those of mice fed the polyunsaturated fat diet showed a significant decrease in EL and beneficial changes in inflammatory factors. Studies in cultured macrophages showed similar results.

"Our study identifies a new way in which the high-saturated-fat Western diet could lead to the development of atherosclerosis, though, of course, these results need to be confirmed in human studies," said Dr. Deckelbaum. "The findings might also explain some of the cardiovascular benefits that have been attributed to omega-3 fatty acids."

The researchers also found, in cell culture studies, that macrophages fed saturated fat showed increased expression of PPAR-gamma, a cell signaling molecule that plays a role in regulating lipid metabolism and inflammatory responses. This increase was blocked when the cells were fed an omega-3 fatty acid.

"These findings are intriguing, because we know that the diabetes drug rosiglitazone (sold under the brand name Avandia) is a strong PPAR-gamma activator and that it has been associated with an increased risk of heart disease," said Dr. Deckelbaum. "So we hypothesized that if rosiglitazone activates ppar-gamma, it might also activate EL, which would explain its effects on the heart."

In fact, when the macrophages were given rosiglitazone, the expression of EL increased markedly. The addition of omega-3 fatty acids to the cells blocked this increase. "This would suggest that besides raising LDL cholesterol levels, rosiglitazone can raise the risk of cardiovascular disease by increasing EL," said Dr. Deckelbaum. "In addition to its potential role in increasing arterial inflammatory responses, EL increases the anchoring of LDL to cell surfaces, which could be associated with increased LDL accumulation in coronary arteries."

Use of Avandia was severely restricted in 2010, when the drug was linked to the development of heart disease.

First study to report that proteins found in soybeans, could inhibit growth of colon, liver and lung cancers, published in Food Research International

Soybean meal is a bi-product following oil extraction from soybean seeds. It is rich in protein, which usually makes up around 40% of the nutritional components of the seeds and dependent on the line, and can also contain high oleic acid (a monounsaturated omega-9 fatty acid).

The study looked at the role soybeans could have in the prevention of cancer. Using a variety of soybean lines which were high in oleic acid and protein, the researchers looked to monitor bioactivity between the peptides derived from the meals of soybean and various types of human cancer cells.

The study showed that peptides derived from soybean meal significantly inhibited cell growth by 73% for colon cancer, 70% for liver cancer and 68% for lung cancer cells using human cell lines. This shows that the selected high oleic acid soybean lines could have a potential nutraceutical affect in helping to reduce the growth of several types of cancer cells.

Wheres Newt?

After watching the last Iowa Caucuses Republican Presidential debate, the Disease Management Care  Blog continues to be fascinated by The Newts repartee prowess.  Maybe its because the starstruck DMCB has seen the former Speaker in the flesh on a number of occasions.  National health policy conference organizers have known for years that the logorrheic and futuristic Newt Gingrich Big Idea Factory could be counted on to deliver the goods to any audience.

Yet, keynoting prowess is one thing, but being a contender for President an another.  Now that Newt has clawed is way into a leading position in the polls, greater visibility has prompted greater scrutiny. 

Thats why the DMCB likes this New York Times article on Newts unseemly mix of health advocacy and business ties.  Its not pretty, portraying Newt as a cynical political opportunist who has been brazenly willing to ally himself with popular "big-government" ideas.  Whats more, The Times darkly implies that consulting fees from big pharma and insurance companies caused him to promote their business interests.

So what, according to The New York Times, are Newts five sins?

1. While every other service industry relied on information technology, Newt had little patience for a health care system system that perpetuated reliance on pen and paper.  When HITECH passed, private citizen Newt had little problem taking some of the credit and collecting some fees while he was at it.

2. Newt repeatedly observed that ATMs could reconcile complex financial records and yield hard cash from any ATM in the world within seconds, yet Medicares payment systems were inaccurate, byzantine and highly vulnerable to fraud. He called for the orm of Medicare, which later also turned out to be one of the bedrock principles of the Democrats modernizing health orm agenda.

3. Then theres this 1995 "wither on the vine" quote in which he maps out the demise of Medicare because of orms leading Americans to "voluntarily [going to] leave it -- voluntarily."  Fast forward 15 years and Newt is supporting the Ryan-Wyden bipartisan compromise legislative proposal that is likewise based on voluntary choice and doesnt end Medicare as we know it.

4. Newt was also an ardent supporter of comparative effectiveness research (CER)  Newt specifically cited not-for-profit Cochrane as an example of the kind of CER he supported. He doesnt like this $1.1 billion boondoggle.

5. As for funding from insurers and pharma, Newts ideas on enhanced coverage of children and diabetes care attracted like-minded companies and allies.

"Big deal," says the yawning DMCB.  The Times concerns about Newts past lack substantive ballast.  If nothing else, Newts pugilistic skills will make Mitt Romney a stronger contender - assuming he makes it to the championship round .

While the DMCB is at it, it cant help but take a quick look at two other arenas of alleged Newty nuttiness:

1) That infamous criticism about his fellow conservatives dangerous "social engineering" in the Ryan Ver. 1.0 plan:

The DMCB thinks Newt personally liked the plan but disliked the prospect of having it pass over the objections of a leery electorate.  Its one thing to dream up a good plan, but its another to craft it behind closed doors and impose it on an unwilling citizenry.

By the way, that some logic seemed to underlie his recent debate commentary over abolishing "activist" federal courts.  Hes warning that in a divided powers representative democracy, the co-equal legislative and executive branches and grumpy voters could be pushed into neutralizing flashpoint judges at either end of the political spectrum with recalls, subpoenas, impeachment and defunding.  Hes not only consistent, he has a point. (A 12/22 addendum - A point which Newt is provocatively willing to to back up with U.S. Marshals.  Of course, he could just sandbang them during State of the Union Addresses.  Whats next: pieing?)

2)  Being too incendiary, zany and mercurial to be President

This was best portrayed by Peggy Noonans December 10 Wall Street Journal "Declarations"  description of Newt as a human "hand grenade" who delights in being to ready "watch this!" pull the pin at a moments notice. 

Good point, but there is also something stubbornly dysfunctional in many parts of the health care system.  If Obamacare doesnt work out as planned, there may be merit to the notion rejecting the Republican mainstream and applying a heavy dose of creative destruction.  Newt certainly has the "creative" and "destruction" chops.  Absent anyone else with this particular skill set, Newts biggest problem may be that were just not ready for him to combine them... yet.

Newts problem is that hes still far ahead of the curve.

Let the games continue.

The Medicare Modernization Act - signed into law by President Bush on December 8, 2003 - added an outpatient prescription drug benefit for all people with Medicare. Coverage under this benefit goes into effect on January 1, 2006. (Clicking on the new "Medicare-Approved" seal shown will take you to the Medicare site.)

You must enroll to be covered by the prescription drug plans. Enrollment begins on November 15 of this year. You have until December 31 to enroll if you want your coverage to start on January 1.

There will be a number of plans to choose from with differing monthly premiums ("generally about $37 in 2006") and copayments. Your health or income cannot prevent you from benefiting from one of these plans - even if you have prescription drug coverage from an employer, union, or other policy (e.g. Medigap). Those with limited income will get help paying for their coverage.

Medicare lists the following important dates regarding the new prescription drug plans:

• October 2005 - Medicare recipients will receive the Medicare & You 2006 handbook with information on how to sign up.
  
• November 15, 2005 - Sign-up begins.
  
• December 31, 2005 - Last day to sign up to receive coverage beginning January 1, 2006.
  
• January 1, 2006 - Coverage begins.
  
• May 15, 2006 - Last day to sign up for coverage in 2006. (Late fees are charged after that date. Enrollment begins again on November 15, 2006 for coverage in 2007.)

More information about the new prescription drug plans is available at www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week.

________
Below are a few links that answer basic questions. They are all pdf files requiring an Adobe reader to view. (You can download an Adobe reader for free here.) More links about the new prescription drug plans can be found here.

• Basic Information (Very informative, detailed, and recent text file. August 2005)
  
  
• Quick Facts about Medicare’s New Coverage for Prescription Drugs (May 2005)
  
  
• Who Can Help Me Apply and Enroll? (July 2005)
  
  
• Protecting Your Personal Information (July 2005)
  
  
• A Message for People who Care for Someone with Medicare (July 2005)

Dont get me wrong – a good chunk of my love for the greenmarket is love of, and belief in the goodness of, local eating. I like meeting my farmers, I like minimizing my foods road trips, I like the dirt on my kale that comes from nearby. (Okay, I did not love the cocooned caterpillar that came along with that local kale and its local dirt this weekend, but thats my own problems with squeamishness. In theory, I loved that caterpillar.)

But I also fell in love with the farmers market because, during our early courtship, everything was so new. Kale, collard greens, kohlrabi, lambsquarter, Brussels sprouts still on the stalk – my first couple of greenmarket years, I took home something new and strange almost every weekend. I hit the internet and hit the books, and almost every time I added a new and delicious veggie to my repertoire.

I still love the greenmarket, lo these many years later, but things have become a little... predictable. A few extra bucks in my wallet this summer are opening a few new doors – berries, grapes (that actually taste like something!), and endless varieties of stone fruits – but the veggies are all familiar territory. As each veggie comes back into season, sure, theres a weekend or two of excitement, but true vegetal strangers are few and far between.

So I hope youll allow me a digression from the agricultural bounty of the greater New York area (love you, Pennsylvania peppers!), as I allowed myself when I met an international temptation too strange and exciting to ignore.

Fresh garbanzo beans.

The bin of fuzzy green pods was nestled between portabellos and quail eggs in the Whole Foods produce aisle, and I could not resist. At $4/lb I thought my few experimental handfuls would cost me a buck or so. These beans are so light, though, that my bag rang up at a mere twenty-nine cents. Score one for the beans.

I hit the internet, and hit the kitchen, and here is what I learned:

1. Fresh garbanzo beans can be eaten raw. Popped out of the pods they look just like their canned and dried cousins, just green. They have a fresh, not particularly strong taste, like starchier edamame.
2. The internet will tell you that they should be steamed in salt water in their pods. This works, but the pods are so roomy that they become little saline capsules, which then burst in your mouth or in your hands. The beans are still tasty, but they get lost in the saltwater, and it doesnt really work. So, fresh garbanzos edamame-style: technically works, but not so awesome.
3. If you use the same method, though, but shell the beans first, well bingo, there you go. A quick boil in salted water gives you bright, salty, tasty little beans.

The internet is full of more elaborate preparations, but I like to get to know a new veggie simply, at first. (Okay, I often end up sticking with those most basic preparations – salt, and sometimes oil, usually make veggies taste like their best versions of themselves.)

Next time – if I even see them again, because their appearance was sudden and they may vanish as quickly and with as little fanfare - I may try some sort of pan-frying, with cumin and other chickpea-friendly spices. I bet the green flavors of the fresh beans would play nicely with that. But for now, for my new friend the fresh garbanzo, simple and quick is the way to go.

~~~

If you enjoy this, you might also enjoy:

• Pasta with Zucchini and Chickpeas
• Steamed Asparagus
• Sweet Potato and Chickpea Puree

~~~

Fresh Garbanzo Beans
Serves 2


1/2 lb fresh garbanzo beans (about 1 cup shelled)
1 T (or so) salt

1) Shell the garbanzo beans. They usually pop out easily, but scissors can be helpful.

2) In a sauce pan or small soup pan, bring a couple of inches of salted water to a boil.

3) Add the garbanzos. Boil, covered, for about a minute.

4) Drain, and eat warm or cooled.

Approximate Calories, Fat, Fiber, Protein, and Cost Per Serving
134.5 calories, 2.1g fat, 6.3g fiber, 7.3g protein, $0.26

Calculations
1 cup fresh garbanzo beans: 269 calories, 4.2g fat, 12.5g fiber, 14.5g protein, $0.50
1 T salt: 0 calories, 0g fat, 0g fiber, 0g protein, $0.02
TOTAL: 269 calories, 4.2g fat, 12.5g fiber, 14.5g protein, $0.52
PER SERVING (TOTAL/4): 134.5 calories, 2.1g fat, 6.3g fiber, 7.3g protein, $0.26

I hate to say I told you so.  But I did.  Like a million times.  Yet, the fear of cholesterol continues.  What is it?  Is it the Lipitor ads?  Is it your cholesterol-phobic doctor, determined to get your cholesterol under 200 mg/dl at all cost?  Whatever it is, its about time we stopped worrying so damn much about high cholesterol.  This new study, entitled "Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid?  Ten years prospective data from the Norwegian HUNT 2 study.", shows us why.  Did anybody hear anything about this one in the media??  I didnt think so, not with a catchy title like that.  At least now the 3 people that read my blog will be aware of it.  The researchers followed 52,087 Norwegians aged 20-74 who were free of cardiovascular disease (CVD) for 10 years, then assessed the relationship of total cholesterol with total mortality, CVD mortality, and ischemic heart disease mortality (IHD).  (Just to be clear, CVD mortality signifies deaths from any disease of the cardiovascular system, while ischemic heart disease ers only to diseases involving restricted blood flow to the heart.)  Lets jump straight into the data then, shall we?  And another note:  since this study comes from Europe, the units for blood cholesterol are shown in mmol/L, rather than the mg/dL that we are used to.  The researchers classified the participants into four groups, based on their blood cholesterol.  Here are the converted unit values in mg/dL for the four groups...  <193, 193-229, 230-269, and >270


First, the least shocking data.  This graph compares the association between cholesterol levels and death from ischemic heart disease.  For the men, it looks like theres not much variation.  Deaths from heart disease rose slightly along with cholesterol levels, but nothing dramatic.  Women, on the other hand, yielded a much more interesting result.  Clearly, by a LARGE margin, cholesterol below 193 mg/dL was most predictive of death from heart disease.  All other groups, including the group with cholesterol over 270 mg/dL, showed significantly lower risk.  Yes, seriously.  On to the next graph!




This one here shows the association between cholesterol and cardiovascular disease, or CVD, which includes heart disease with stroke and any other disease of the cardiovascular system.  Again, lets begin with the men.  The lowest risk appears to lie in those with total cholesterol between 193 and 229 mg/dL, but a close second is the next range up, from 230 to 269.  If you know your erence ranges, you know that anything over 200 is considered dangerous.  Does anybody ever bother to check why this is considered dangerous, or do we just accept it without question??  Clearly, the data from this study suggests that a cholesterol level in men between 193 and 269 is optimal for CVD prevention.  As for women... oops, looks like they screwed up the data there!  They must have it backwards!  Except they dont... yes, the data shows that if youre a woman, the higher your cholesterol is, the lower your risk of death from CVD.  Id repeat it, but Ill be doing that again shortly.  Read on to all-cause mortality!


Here we are, all-cause mortality... the only statistics that really matter.  Deaths from IHD or CVD are cool, but not nearly as cool as all-cause mortality.  This one cuts through the bullshit.  Its not your risk of dying from one disease that really matters, its your risk of dying overall.  So, for men... the group with the HIGHEST risk of dying overall had the LOWEST cholesterol (below 193 mg/dL).  Even those with a cholesterol level over 270 fared better.  The sweet-spot, protective level here was shown to be 193-229, a level that, based on the current erence ranges, will likely get you prescribed a statin drug for being too high!  Its just not right I tell ya.  And for the women, we see another complete inverse relationship between blood cholesterol and all-cause mortality.  High cholesterol appears to be protective for the ladies!  Maybe I could incorporate that into a pickup line somehow... but I digress.

So, does this prove anything?  No.  Not really.  Although it happens to be in accordance with what I believe, its all just observation.  But this isnt the only study to show this kind of trend, just the most recent; there are at least 20 others like it if you just follow that link.  And it certainly makes a strong case for women... having low cholesterol, in the healthy erence range, mind you, just appears to be straight up deadly!  Despite the studys inability to conclusively prove anything, that didnt stop the researchers from letting loose a little on the drug industry.  And I quote from the conclusion of the paper... "Many individuals who could otherwise call themselves healthy struggle conscientiously to push their cholesterol under the presumed danger limit, coached by health personnel, personal trainers, and caring family members.  Massive commercial interests are linked to drugs and other remedies marketed for this purpose."  That may not seem so harsh, but for a group of researchers to say this and imply that massive commercial interests are wrongly influencing the clinical guidelines... thats a pretty strong statement.  And I agree wholeheartedly.  The guidelines need to be reassessed.

What does this mean, though, if having high cholesterol isnt a bad thing?  What are the implications?  Well, for one, maybe it will get people off these ridiculous statin drugs.  But even more significant, to me, are the implications for saturated fat consumption.  These days, everyone just "knows" saturated fat is bad.  But if I asked you, could you tell me why?  The standard answer is, because saturated fat raises your blood cholesterol.  Well... um... so what?  If you step outside of this cholesterol=bad paradigm for a while, things start to look a bit different.  What else is known about saturated fat?  Well, if you eat more of it, it makes up more of your cell membranes, and its highly resistant to oxidative damage.  So thats good, it protects your cells.  And... short-chain saturated fats like butyric acid, found in butter, are burned perentially as fuel and promote proper immune function.  And... saturated fats enhance calcium absorption, along with all the fat-soluble vitamins (A, D, E, K).  And dont forget, if youre a woman, having high cholesterol appears to be beneficial.  Wait a minute... could saturated fat be... healthy!?  So much for a French paradox...

Three new studies involving tree nuts (almonds, Brazil nuts, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts) were presented this week at the Experimental Biology Meeting in Boston, MA. Tree nut consumption was associated with a better nutrient profile and diet quality; lower body weight and lower prevalence of metabolic syndrome; and a decrease in several cardiovascular risk factors compared to those seen among non-consumers.

First, the Adventist Health Study looked at the effect of nut intake on the risk of metabolic syndrome (MetS) in a population with a wide range of nut intake ranging from never to daily. Researchers at Loma Linda University studied 803 adults using a validated food frequency questionnaire and assessed both tree nut and peanut intake together and separately. "Our results showed that one serving (28g or 1 ounce) of tree nuts per week was significantly associated with 7% less MetS," stated lead researcher Karen Jaceldo-Siegl, DrPH. "Interestingly, while overall nut consumption was associated with lower prevalence of MetS, tree nuts specifically appear to provide beneficial effects on MetS, independent of demographic, lifestyle and other dietary factors."

The second study looked at 14,386 adults participating in the 2005-2010 National Health and Nutrition Examination Surveys (NHANES). Intake was from 24-hour recall data and tree nut consumers were defined as those who consumed more than ¼ ounce of tree nuts (average consumption was about an ounce/day). As seen in previous research, tree nut consumers had higher daily intakes of calories (2468 v 2127 calories) and nutrients of concern: fiber (21v 16 grams [g]); potassium (3028 v 2691 milligrams [mg]); magnesium (408 v 292 mg); monounsaturated fats (36 v 29 g), and polyunsaturated fatty acids (21 v 17 g), but lower intakes of added sugars (15 v 18 teaspoons), saturated fats (25 v 27g), and sodium (3197 v 3570 mg) than non-consumers. Tree nut consumers also had lower weight (80 v 82 kg; p=0.0049), BMI (28v 29; p<0.0001), and waist circumference (96 v 98 cm; p=0.0006) than non-consumers. In addition, those who consumed tree nuts had lower systolic blood pressure (120 v 122 mmHg; p=0.0120) and higher HDL-cholesterol (the good kind) (55 v 53 mg/dL; p=0.0020). On a population basis, these reduced risk factors could lead to better health. "Consumption of tree nuts should be encouraged to improve diet quality, nutrient intake, weight status, and some cardiovascular risk factors," according to Carol ONeil, PhD, MPH, RD, lead author on the paper and Professor at Louisiana State University Agricultural Center.

Finally, a third study looked at several markers for cardiovascular disease risk. In 2011, researchers from the University of Toronto and St. Michaels Hospital in Toronto, Canada, published the largest study to date on nuts and diabetes (Jenkins, D.J.A., et al., 2011. Nuts as a replacement for carbohydrates in the diabetic diet. Diabetes Care. 34(8):1706-11.), showing that approximately two ounces of nuts a day, as a replacement for carbohydrate foods, can improve glycemic control and blood lipids in those with type 2 diabetes. The researchers looked at the effects of nuts on various cardiovascular markers. "We found that nut consumption was associated with an increase in monounsaturated fatty acids (the good fats) in the blood, which was correlated with a decrease in total cholesterol, LDL cholesterol (the bad kind), blood pressure, 10-year coronary heart disease risk, HbA1c (a marker of blood sugar control over the previous three months) and fasting blood glucose," explained Cyril Kendall, Ph.D., of the University of Toronto. "Nut consumption was also found to increase LDL particle size, which is less damaging when it comes to heart disease risk." According to Dr. Kendall, this study found additional ways in which nut consumption may improve overall cardiovascular health.

"These three new studies, independent of one another, support the growing body of evidence showing that consuming nuts can improve your health," states Maureen Ternus, M.S., R.D., Executive Director of the International Tree Nut Council Nutrition Research & Education Foundation (INC NREF). "In 2003, FDA (in its qualified health claim for nuts and heart disease) recommended that people eat 1.5 ounces of nuts per day—well above current consumption levels—so we need to encourage people to grab a handful of nuts every day."

At the end of last year, 36-year-old Erik Chopin walked away the winner of NBCs reality television show, The Biggest Loser. He lost 214 pounds in 8 months, dropping from 407 pounds to 193 pounds at his final weigh-in.

One of Eriks motivations to lose weight was his discovery at the start of the competition (on-air no less) that he had type 2 diabetes:

"The doctor told Erik, right there on television, that he had very high blood pressure, high cholesterol, dangerously high triglycerides - and type 2 diabetes. “I also had sleep apnea,” [Erik] says, “and my knees and back always hurt, but diabetes? I mean, diabetes? It was a shocker. So, I went from wanting to look good to where the whole thing was about surviving. ... The good news is that after I lost 50 or 60 pounds, I no longer had those high blood sugars. I’ll always be a diabetic. But with the exercise, diet and weight loss, the blood sugars corrected themselves.”
- Diabetes Focus, Second Quarter, 2007, Win By Losing

Erik has chosen to capitalize on his win by helping others to cope with their diabetes. Hes promoting the American Association of Clinical Endocrinologists (AACE) new
"Diabetes and You: Step It Up to Get It Down" campaign. The program was developed by a team of diabetes experts along with Bob Harper, the life and fitness coach from The Biggest Loser. It promotes 6.5 Steps Towards Better Blood Sugar Control.

Last week, Erik weighed in on his post-show activities. You can read about whether hes gained back any weight (a little), how his exercise routine has changed (its no longer the grueling 5 hours a day), and whether he still runs his deli, on RealityWanted.nets blog post, Where Are They Now - Erik Chopin.

Erik also has a page on myspace.com. You can visit him there at www.myspace.com/erikbl3.
________

If you’ve been to the supermarket in the last few months, the rising cost of food isn’t exactly an Elliot Spitzer-level surprise. Grain prices are up, dairy products have become a luxury, and meat … well, cheap beef is rarer than a J.D. Salinger sighting these days. CNN, MSNBC, and the newspapers are finally picking up on it, too, with more stories about global grocery shortages and ludicrous shipping expenses. It appears we’re headed for a recession, and it may not get better anytime soon.

Never fear, though – it’s the interweb to the rescue. Lots of wonderfully informed bloggers have been totally on the ball, including Cathy at Chief Family Officer and Blogher’s Alanna Kellogg. They’ve written stellar pieces on combating food inflation, replete with shopping strategies, cooking ideas, and inventive ideas for stretching a budget.

There’s not much more to say after those posts, but I figured I’d jump on the Food/Recession bandwagon anyway. (It’s a nice bandwagon – sage green with mammoth cupholders.) Hopefully, the following suggestions will build on what Cathy and Alanna have to say, and offer a few new strategies along with it.

Don’t panic. It’s not the end of the world. Grocery prices will rise and certain items may become nigh-unattainable, but you will still be able to eat. So will your family. And with a little planning, you might not notice much of a difference.

Stay informed. Information is power. I don’t know who said that (Sophocles? Joan Didion? Cher?), but he/she was right on. As dire as the news may seem sometimes, keeping abreast of the fiscal situation is vital to preparing for sudden changes. So gird your loins and peruse the news, scan some blogs, and watch the occasional Brian Williams broadcast. Be on special lookout for food stories. You’ll be smarter for it.

Take baby steps. Revamping your diet and budget the same day won’t work, and might put you off both forever. Lasting change comes through small actions executed consistently. so take it easy. Start small, with a few simple practices, and work your way up from there.

Set aside one hour per week to plan. During this hour, you can devise a weekly menu, find circular deals online, clip coupons, and map out your shopping trips, all of which could save hundreds of dollars a month. If you were paid $100 for 60 minutes of work, wouldn’t you do it? Would you think twice? (Lawyers and doctors, don’t answer that.) What’s more, it’s much easier to stay on a healthy track when you have a concrete shopping and meal plans. It keeps you from scrounging for last-minute eats.

Write stuff down. Keeping a budget, planning that menu, and creating a grocery list are three time-tested, mother-approved money-saving maneuvers. The last two strategies usually help with weight maintenance, as well. Turns out, there is no greater splurging/gorging deterrent than knowing exactly what you’re splurging/gorging on.

Sign up for savings and perred customer cards. If you haven’t already done this, stop reading and run to your grocer. See, just about every major supermarket has a club program that offers special discounts to regular shoppers. You give them your name and e-mail address in exchange for a dinky little keychain doohickey that magically saves 10%, 20%, or 40% per purchase. As far as I know, there are no reported downsides, except for a very heavy keychain.

Start a price book post haste. Get Rich Slowly has the end-all-be-all post on these, but there’s more at Frugal Upstate, as well as a downloadable template at No Credit Needed. (Incidentally, if you’re in the New York City area and shop at Associated or Key Food, shoot me an e-mail. I keep somewhat anarchic pricebooks for these two stores, and can forward them to you.)

Go to Money Saving Mom immediately. I can’t possibly cover this topic any better than Crystal does on a daily basis. (Brown nosing? Yes. And how!) Essentially, she and a roving gang of coupon-clippin’ ladybloggers have figured out how to score deeply discounted personal effects and non-perishable food from CVS, Walgreens, Rite Aid, and more. We’re talking $133 worth of shampoo, diapers, and toothpaste for $9. And if that’s not enough, there are shopping strategies GALORE, from post to shining post.

When it comes to cookbooks and kitchen equipment, buy only what you absolutely need. If cooking is a hobby, it’s distressingly easy to blow a wad on adorable egg holders. Or a fourth Baoot Contessa volume. Or a hard-anodized 10-piece pot set, because some dude on QVC said you SIMPLY MUST HAVE a sauté pan in every size. Truth is, there are precious few items anyone needs to make a decent meal, and most recipes can be found online nowadays. This Mark Bittman article has more, and these two CHG posts can help you find inexpensive equipment and cookbooks.

Clip coupons and bulk shop, but do it wisely. While both of these tactics might take big bucks off bills, they can also lull folks into buying stuff they don’t need. If you’re going to use coupons, make sure it’s for something you would purchase anyway. And if you’re loading that 128-oz. jar of capers into your elephant-sized CostCo cart, double check to see if it’s really cheaper per unit than a 4-oz. bottle. (While you’re at it, double check to see who on Earth needs eight pounds of capers.)

Cut back on booze, meat, and processed foods. “But Kris,” you might say,“they are the stuff OF LIFE.” And you’d totally be correct. Watching a ballgame without a dirty water dog and bucket-sized Bud Light … it’s unfathomable for some. (Note: me.) However, there’s something to be said for moderation. Eliminating these things from your diet entirely may be a pipe dream (or pipe nightmare), but reducing your consumption will save mad cash AND improve your health. To fill that hole in your stomach …

Eat real food. Pizza rolls, mozzarella sticks, and fries might be convenient, but produce, dairy, meat, legumes, and grain will help you live longer. AND, chosen caully, they’ll cost less in the long run. Always remember to shop in season, from the circular, and around the perimeter of the supermarket, where they keep the whole foods.

Stock up. When frequently-used staple items like flour, beans, and canned tomatoes go on mega-sale, snatch up as much as you possibly can (provided there’s sufficient storage). Not only will they come in handy down the line, but pantry meals can be healthy, filling, and surprisingly delicious. For more information, Motherload’s Amy Clark has an ongoing series on stockpiling.

Go generic. Dont be scared. Its often just as good as the brand name.

D.I.Y. Cook more at home. Cook in bulk. Freeze things. Try gardening. Make your own mixes, dressings, sauces, and marinades. (They taste better, take zero culinary skill, and cost a fraction of the store-bought brands.) With a little time and effort, anything you see in the supermarket or at a restaurant can be accomplished in your own kitchen.

Drink water, but not the bottled kind. No one’s begrudging the occasional Dr. Pepper, but tap water is the superior choice for two reasons: it’s a billion times healthier and 100%, totally, absolutely free-er than free. Bottled water, while not a terrible choice, is a legendary rip-off, like bad chicken or accidentally downloading a Beatles cover band on iTunes.

Brown bag it. Any and every personal finance blog worth its salt has written about this subject 600 times (uh … except this one.), and for good reason. Not only does brown-bagging save me about $1300 per year, but it makes it much, MUCH (much) easier to monitor what I eat. Whether you’re into bento boxes or PB&J, it’s a sure-fire recession beater.

Ahhh it was a good day today when I read this article... "Study raises questions about dietary fats and heart disease guidance".  Heres the scoop... researchers from the United States and Australia have recovered missing data from an old study from the 1970s.  The study, known as the Sydney Diet Heart Study, was a randomized controlled trial in which the participants were told to replace the saturated fats in their diets with polyunsaturated fats from vegetable oil.  The 458 subjects were all men between ages 30-59 who had recently had a coronary event, defined as either a heart attack or angina (1). 

Why was this data missing?  Who knows.  I cant find a good answer.  But had these results been available in the mid 1970s as they should have been, it may have changed the course of the dietary guidelines on fat intake.

Okay so we had two groups, both groups are coming off of either a heart attack or angina.  Let me break it down right quick...

Group 1:  Control group

• Given no dietary advice at all

Group 2:  Intervention group, given the following instructions...

• Reduce dietary saturated fat (animal fats) to under 10% of calories
• Reduce dietary cholesterol to less than 300 mg/day
• Increase polyunsaturated fats (from safflower oil) to 15% of calories

The participants diets were reported through a daily food diary, and they reported to the lab for testing 2-3x per year for several years.  Here are the results for all-cause death, cardiovascular disease, and coronary heart disease...


Here you can see the cumulative death rate over the course of 5 years of follow-up.  The data is essentially the same for all-cause, cardiovascular, and heart disease deaths.  Its also statistically significant and very, very clear.  Those in the intervention group, who reduced their saturated fat and cholesterol intake while increasing their polyunsaturated fat intake, fared worse.  In other words, the people eating more saturated fat and cholesterol lived longer, and they had a lower rate of heart disease.

This shouldnt come as a huge surprise if youre a reader of this here blog.  You know saturated fat is wrongly accused... and that vegetable oils are the devil.  Just further evidence here.  But theres something else thats interesting about this study:  the cholesterol levels.  The data is only available for 1 year of follow up, and I had to make this graph myself for your viewing pleasure.  Check it out...


Sorry about the colors... theyre actually the opposite of the graphs above and I hadnt realized it til now!  But the point is that the intervention group in red, the group eating more vegetable oils, lowered their total cholesterol nearly 40 points!!  They ended up at 243.9 mg/dl by the end of the first year.  The control group?  Well they lowered theirs a measly 15 points to 266.5 mg/dl.  Both began at the same level.  (There were no significant differences between groups in triglycerides, body mass index, or systolic or diastolic blood pressure at baseline or during follow-up.)

So based on this, you would assume that the intervention group would be better off, right?  But they werent.  They died far more often of heart disease than the control group did, and with lower cholesterol!  Lesson #1:  Arbitrarily lowering your cholesterol by any means necessary does not and will not lower your risk of heart disease!!!  Cholesterol is just a semi-accurate risk factor...  it is not the cause.  Theore I dont necessarily give two shits if your diet lowers your total cholesterol. 

But the worst part of all this?  Replacing saturated animal fats with unsaturated vegetable fats has been a cornerstone of mainstream dietary advice for the past 40 years.  I could cite any number of different sources here, like...

• The 2010 Dietary Guidelines:  "Americans should replace solid fats with oils." pg. 40 (2)
• The American Heart Association:  "Replacement of saturated fat and trans fat with monounsaturated fat and polyunsaturated fat might even help lower LDL cholesterol when eaten as part of a healthy diet." (3)
• The My Plate fats and oils info sheet I was forced to teach to teenagers last semester in my community rotation:  "Replacing saturated fats with unsaturated fats lowers your cholesterol and reduces your risk for heart disease."

I, for one, have had enough of this shit.  Its time this changes, and maybe this is the study to put it over the edge.  Saturated fat isnt killing us.  Vegetable oil is.  Eat real food.  Peace Im out.

OK... its not THAT new.  But there is a great compendium of recent posts that has been assembled by the Center for Objective Health Policy.  There are some great links to topics on health orm, insurance and policy.

Enjoy!

On the heels of Avandias new safety warning addressing a potential increased risk for heart attack (see previous post), Takeda, maker of Actos (pioglitazone), plans to launch a big advertising campaign using the headline:

"If you have type 2 diabetes, Actos has been shown to lower blood sugar without increasing your risk of having a heart attack or stroke."

The FDA reviewed cardiovascular data from Takedas PROactive study and approved this claim.

Avandia and Actos are the only drugs in the class of diabetes medications known as thiazolidinediones. They work by increasing insulin sensitivity.

Both drugs, however, may worsen heart failure, a condition in which the heart does not adequately pump blood, and are labeled as such. Below is Actos boxed warning regarding heart failure:

Thiazolidinediones (TZDs), including ACTOS, cause or exacerbate congestive heart failure (CHF) in some patients. After initiation of ACTOS and after dose increases, observe patients caully for signs and symptoms of heart failure (including excessive rapid weight gain, dyspnea, and/or edema). If these signs and symptoms develop, the heart failure should be managed according to current standards of care. Furthermore, discontinuation or dose reduction of ACTOS must be considered.

ACTOS is not recommended in patients with symptomatic heart failure. Initiation of ACTOS in patients with established NYHA Class III or IV heart failure is contraindicated.

________
Takedas press release responding to Avandias new safety warning:
Re. U.S. Food and Drug Administration Decision Summary

Older adults are often encouraged to stay active and engaged to keep their minds sharp, that they have to "use it or lose it." But new research indicates that only certain activities — learning a mentally demanding skill like photography, for instance — are likely to improve cognitive functioning.

These findings, forthcoming in Psychological Science, a journal of the Association for Psychological Science, reveal that less demanding activities, such as listening to classical music or completing word puzzles, probably wont bring noticeable benefits to an aging mind.

"It seems it is not enough just to get out and do something—it is important to get out and do something that is unfamiliar and mentally challenging, and that provides broad stimulation mentally and socially," says psychological scientist and lead researcher Denise Park of the University of Texas at Dallas. "When you are inside your comfort zone you may be outside of the enhancement zone."

The new findings provide much-needed insight into the components of everyday activities that contribute to cognitive vitality as we age.

"We need, as a society, to learn how to maintain a healthy mind, just like we know how to maintain vascular health with diet and exercise," says Park. "We know so little right now."

For their study, Park and colleagues randomly assigned 221 adults, ages 60 to 90, to engage in a particular type of activity for 15 hours a week over the course of three months.

Some participants were assigned to learn a new skill — digital photography, quilting, or both — which required active engagement and tapped working memory, long-term memory and other high-level cognitive processes.

Other participants were instructed to engage in more familiar activities at home, such as listening to classical music and completing word puzzles. And, to account for the possible influence of social contact, some participants were assigned to a social group that included social interactions, field trips, and entertainment.

At the end of three months, Park and colleagues found that the adults who were productively engaged in learning new skills showed improvements in memory compared to those who engaged in social activities or non-demanding mental activities at home.

"The findings suggest that engagement alone is not enough," says Park. "The three learning groups were pushed very hard to keep learning more and mastering more tasks and skills. Only the groups that were confronted with continuous and prolonged mental challenge improved."

The study is particularly noteworthy given that the researchers were able to systematically intervene in peoples lives, putting them in new environments and providing them with skills and relationships:

"Our participants essentially agreed to be assigned randomly to different lifestyles for three months so that we could compare how different social and learning environments affected the mind," says Park. "People built relationships and learned new skills — we hope these are gifts that keep on giving, and continue to be a source of engagement and stimulation even after they finished the study."

Park and colleagues are planning on following up with the participants one year and five years down the road to see if the effects remain over the long term. They believe that the research has the potential to be profoundly important and relevant, especially as the number of seniors continues to rise:

"This is speculation, but what if challenging mental activity slows the rate at which the brain ages?" asks Park. "Every year that you save could be an added year of high quality life and independence."

How They Work

After we eat, cells in our intestines release a variety of hormones. One is called GLP-1 (glucagon-like peptide-1). GLP-1, among others, increases insulin secretion which makes it part of a group of insulin-secreting, or incretin, hormones. The increased insulin works to lower blood glucose levels after a meal.

Our bodies also secrete another compound, an enzyme called DPP-IV (dipeptidyl peptidase-IV) which inactivates GLP-1, and possibly other incretin hormones.

The drugs under study are designed to inhibit DPP-IV, protecting GLP-1 from degradation.

Another plus - Since the amount of GLP-1 released from our cells is dependent on the amount of glucose made available from a meal, its presence doesnt lead to low blood glucose or weight gain - problems that dog a present class of diabetes drugs, the sulfonylureas.

Drugs Of This Type In Clinical Trials (Or Marketed)

• Merck: Sitagliptin
  
• Novartis: Vildagliptin
  
• OSI Prosidion: PSN9301
  
• Amylin and Eli Lilly: BYETTA™ (Exenatide)
  BYETTA™ went on the market in June of this year. You may remember this as the drug developed from the venom of the gila monster lizard. Its different from the three drugs above in that it mimics the action of GLP-1 instead of inhibiting its breakdown. Also, it must be injected where the drugs above can be taken orally.

A Few Good Overviews

Dipeptidyl peptidase inhibitors as new drugs for the treatment of type 2 diabetes.

New Insights Into the Role of Incretins in the Treatment of Diabetes.

Since 1977, there has been a 70% increase in caffeine consumption among children and adolescents. Whether it is coffee, tea, soda, or energy drinks, our children are consuming more of it. One well documented effect of caffeine is improved cognitive performance on certain tasks. However, scientists also hypothesize that habitual caffeine use may lead to greater neural rewards if the caffeine drinker were to consume illicit drugs.

To add more to the research base regarding caffeines effect on cognition in children and teens, Jennifer Temple, PhD, University at Buffalo, recently investigated with graduate student Adam Graczyk whether male and female children perform differently on 5 separate tasks in response to caffeine. Using a sample size of 96 children and adolescents, they measured developmental and gender differences in subjects who were given caffeine or placebo and then put through memory tests, reaction time tests, and color-word tasks. The results showed that caffeine increased the number correct in the memory tests, and that females had more correct responses than males in simple reaction time and color-word tasks. There were also differences across the menstrual cycle in the females.

According to Temple, "This is the first study in children and adolescents to report sex differences in responses to caffeine on cognitive tasks as well as different responses according to the girls menstrual cycles. It suggests that if we look at caffeine as a model for illicit drugs, men and women respond differently because of circulating steroid hormones. Moving forward, this could be helpful in developing treatments for drug addictions based on gender." This poster will be presented at the American Society for Nutritions scientific sessions at Experimental Biology.

This study was funded by NIDA grant RO1 DA030386 and by the Gender Institute at the University at Buffalo.

Caffeine Pairing: A Potential New Way to Eat Your Veggies?

In a separate study addressing caffeine, Temple along with her PhD student Leah Panek wanted to find out whether pairing a flavored food (in this case yogurt) with caffeine consumption would increase ones perceived likeability of that food.

They tested whether a caffeinated beverage paired with a novel flavored yogurt would increase perence for that yogurt compared with placebo. A total of 68 men and women ages 18-50 were randomized to receive a beverage containing placebo or caffeine and then consumed a low energy density yogurt or high energy density yogurt. The flavors were not typical of yogurt in order to avoid any taste perences in place prior to the study; they included almond, maple, peppermint, pumpkin pie, raspberry-lemon, strawberry coconut, and savory (cumin).

Results showed that after rating and ranking the seven yogurts over 4 days, yogurt liking increased over time, with the yogurt paired with caffeine liked more than yogurt paired with placebo.

"Next wed like to do the same experiment with fruits and vegetables, in order to capitalize on the fact that people already consume caffeine," Temple said.

Imagine if you could learn to love the one vegetable you hate by administering caffeine!

Recognizing that...

"Sleep disorders are common in the general population and even more so in clinical practice, yet are relatively poorly understood by doctors and other health care practitioners,"

... the British Association for Psychopharmacology (BAP) on Tuesday released guidelines for the diagnosis and treatment of insomnia and other sleep disorders. The recommendations do not address sleep problems from apnea/hypopnea, restless legs, narcolepsy, and other conditions:

British Association For Psychopharmacology Consensus Statement On Evidence-Based Treatment Of Insomnia, Parasomnias And Circadian Rhythm Disorders, Journal of Psychopharmacology, Sept, 2010

The guidelines emphasize that insomnia should be diagnosed and treated because it is associated with increased risk for depression, anxiety, and cardiovascular disorders.

Treatments included:¹

• Cognitive behavioral therapy (CBT). This is talk therapy which "consists of sessions with a therapist that focus on helping you change your habits and thoughts in a way that helps you sleep."² It is considered so effective and long lasting (compared to drugs) that BAP says it should be offered as first-line treatment.
  
• Hypnotic drugs (sleeping pills). BAP recommends that efficacy, safety, duration of action, and history of substance abuse or dependence be considered. They also say patients should take breaks from these meds every 3 or 6 months to reduce risk of dependency.
  
• Antidepressants.
  
• Antipsychotic drugs. Because of adverse effects and possible abuse these arent indicated as first-line treatment for sleep disorders.
  
• Antihistamines (Sominex, Nytol). These have a limited role and can cause drowsiness.

Other treatments noted for special populations included:

• Hormone therapy for women after menopause
  
• Melatonin
  
• Scheduled light exposure
  
• Behavioral strategies

Do you suffer from insomnia? What have you found helpful?
________
¹New Guidelines Issued For Insomnia And Other Sleep Disorders, Medscape, Sept 2 2010
² Talking Therapy ‘Best Option For Insomnia’, WebMD, Sept 2 2010