Tuesday, February 13, 2007

Older adults have more fat and less muscle

A "double whammy" for adults, announces an article in "Medical News" reporting on a study at Wake University which included over 1800 older adults, 70-79. The "double whammy" according to Medical News is that older adults start in their Autumn years fatter and tend to gain more weight because of the "obesity epidemic".

How much is "more weight"? Turns out that an 80 year old born in 1927, is 10 lbs heavier than his/her counterpoint born in 1918 with 3.75 lbs less muscle.

Sorry but 10 lbs heavier doesn't sound like a whole lot to me.

The result is an increased risk of diabetes, heart disease, high blood pressure, arthritis and disability, according to Jingzhong Ding, M.D., Ph.D., lead author and a researcher on aging at Wake Forest Baptist.
The same old tired phrases which ignore the fact that slim elderly suffer from identical maladies. I guess they hope we won't figure that out.

More bodyfat in the elderly has been shown to be an advantage in several areas, another fact which you will NOT see in the media.

For example, fat people in general tend to survive hospital stays better after a heart attack - they also tend to survive chemo therapy better than slimmer people.

One study of nuns suggested that those who GAINED weight after the age of 65 were the only group which had a zero chance of senility. (Those who lost weight had the highest risk of senility about 25 percent and those who stayed the same had a 10 percent risk of senility).

As far as muscle wasting in the elderly this IS a problem however, not at all related to obesity, but rather lack of exercise which is a problem in our society in general.

I notice the good scientists at Wake forgot to mention that osteoporosis is a serious problem which many elderly face - a problem which occurs 40 percent less in overweight elderly. (see Gaesser, Glenn, PhD: BIG FAT LIES, CA 2004)

This article is typical of the "obesity epidemic" articles. If you read it carefully, it's not really saying anything new nor is it saying anything scary. Unfortunately, many people will read the title and the first sentence only and come away thinking that Wake University has discovered yet more problems in the "obesity epidemic"!

Sunday, February 11, 2007

Is all Food really FOOD?

We read every day that certain foods are bad, other foods are "good". The opinions (I suppose similar to many other topics) seem to run in two extremes:

1. Eat only "whole foods" - no sugar, no white flour items and nothing with anything you cannot pronounce in it.
2. Food is food and it's all good. (This is the "don't worry- be happy sentiment" that seems so right just because it sounds so good)

Both of these are popular - because either one is easy to follow... you either eat everything with no discrimination or you eat practically nothing.
As usual the truth lies somewhere between.

One article in a medical journal, attempting to solve the mystery of what is proper to eat, brought up the apparent contradictions in what we consider "good food" and "bad food"

>>>SAMA Health and Medical Publishing:
South African Medical Journal (1990) 78:441 (Editorial).<<<

It stated for example:

"French-fries are junk-food, but roast potatoes are not"

Unfortunately, perhaps because the article was written in 1990 when we did not know as much about trans fat as we do now, this is NOT a contradiction at all. If you take a good food and add unhealthy chemicals to it, then it's kind of a no brainer that the food will no longer good. Which is exactly what happens with French Fries. Even if they are NOT fried in transfat, we know now that in deep frying anything, chemicals are formed which are suspected somewhat toxic and these are added to the food, and thus it can be, without a contradiction that the same food which is healthy when cooked in the oven BECOMES unhealthy when deep fried.

The same article states:

>>>"bread is a basic food-stuff, but biscuits [cookies] are junk; wine comprises "empty calories," but fruit juices are health foods"<<<

Anyone who has made cookies, knows that they are composed of pretty equal parts of fat, sugar and flour. Where is the food in that? How does the author even compare that to bread?

The statement about wine is outdated - wine is now known to have antioxidants in it and fruit juices are no longer considered very healthy if they have "high fructose corn syrup" in them.

Let's look at "high fructose syrup" - this is highly concentrated sugar, probably added because today's "diet sweetener" generation is used to things which are 100 times sweeter than sugar. It is a manufactured product which is highly concentrated modified sugar and according to some nutritionists, not as easily assimilated by the body as natural sugar. Some rat studies have suggested that fructose can cause liver problems if consumed in high amounts (and a person who drinks a lot of pop could possibly reach those amounts). According to "The Murky World of High Fructose" by Linda Joyce Forristal, CCP

>>> "The medical profession thinks fructose is better for diabetics than sugar," says Dr. Field, "but every cell in the body can metabolize glucose. However, all fructose must be metabolized in the liver. The livers of the rats on the high fructose diet looked like the livers of alcoholics, plugged with fat and cirrhotic."<<<<

Back to the SAMA article, it goes on to state that:

>>the sugar in cake is detrimental to health, but the sugar in honey and grapes is not<<

Here, the concentration of sugar is the difference. Pretty much anything in high concentration can become toxic. Two aspirins cure a headache. Ten aspirins might land a person in the hospital for a stomach pumping.

Although this article is 17 years old and very outdated, the sentiment still exists in many circles today... "it's all food and it's all good".

Today's advocates of "all food is food and good to eat" sometimes use the excuse that "well, we have a longer lifespan today than we did when we did not consume any "junk food" or "fast food". This reason may be a straw man. The longer life span may have a lot to do with many factors from better work conditions and antibiotics, to the flush toilet which eliminated a lot of bacteria and viruses. It also should be noted that today we have an extremely high incidence of cancer in our society and some of the chemicals in junk food have been suggested in some research to be a factor in this cancer epidemic.

Today we have whole classes of substances that I would call "non foods". They are basically mostly fat (often transfat) and/or chemicals with virtually no nutritional value whatsoever but they often have lots of calories. Potato chips, donuts (now there's a real unhealthy combination of deep frying chemicals, transfat and sugar) and much of what you find in the super market isn't REALLY good to eat.

And we have other classes of foods which are perhaps no calories but pure chemicals, stuff which under different circumstances we would never consume as food. This class of "food" includes things like diet soda, coke etc.

Coke is a solvent and has phosphoric acid in it so it's in no way, any type of a food. Sure it tastes good, so does anti freeze but that doesn't mean we go and drink it.

What to do is a matter of opinion but I don't think it's healthy to restrict one's food drastically to exclude whole food groups such as the "whole food" advocates suggest but neither is it healthy to assume that everything in the supermarket is "food" in the real sense of the word and eat indiscriminately.

The best which seems to be a lot of work, is to learn to read labels and decide carefully.

If it's got chemicals in it like nutrasweet or splenda, avoid it... these just give you more sugar cravings and may actually cause weight gain because they unbalance the insulin levels - some research suggests that when you consume artificial sweetener, your body tasting the sweet taste, produces more insulin to deal with the sugar which of course, never comes. Wouldn't it be a hoot if the high rate of diabetes we are seeing today, has more to do with the consumption of artificial sweeteners than it does with "obesity"?

The sweetener, aspartame or nutrasweet has also been suggested in some 90 worldwide studies to be a factor in the incidence of brain cancer and leukemia. Aspartame contains a neurotoxin - an excitotoxin which can kill neurons in the brain. Excitotoxins are newly identified - for the last decade only those in neurology were familiar with them. MSG is an excitotoxin also.

If it's got mostly chemicals that you cannot pronounce in it, then there might not be much food in it.

If it's got "high fructose corn syrup" in it, it probably is best avoided.

But some processed foods can be, I feel, ok. For example, if they have a lot of vitamins in them like health bars.

Drink water instead of soda but get bottled water. Tap water has a lot of chemicals in it which are NOT removed by reverse osmosis filters.

Forget things like donuts and most "sweets" - regardless of what one weighs, these are definitely "non foods" and not healthy to eat.

Sorry but today, sadly speaking, it's NOT "all food" and it's NOT all good.

Friday, February 09, 2007

WLS - Weight Loss Surgery - the real question is quality of life

One blog that I read, the medpundit, has an excellent article about bariatric (weight loss surgery i.e. WLS). In it the physician gives a very unique point of view from her clinical experience with her patients who have had weight loss surgery.

The interesting thing is that she has observed in her patients the following:

1. none of them regret having the surgery, regardless of the medical conditions they may suffer after WLS, even some nasty stuff like kidney stones every 2 weeks, frequent vomiting and re-operation procedures.

2. The patients' view of their condition of health is quite different from the doctor's clinical view. The patients all view themselves as "healthier" after WLS than before WLS but the physician commented that from her prospective, this was not true from a clinical standpoint. She commented:

>>>If asked, every single one of them would call themselves healthier, but from my perspective their health is worse. They all require more monitoring and more interventions than they did before having the surgery.<<<<
I feel this is significant and should be pointed out to those seeking surgery (and also to physicians advocating this for their patients) based on patient testimony that WLS has improved their health. There is good evidence to suggest robust health after WLS would NOT be the case with the nature of the nutritional deficiencies and other health issues introduced by this surgery and this physician's observations of her post op patients, confirm what one may suspect. I've actually heard this from not only physicians and gastroenterologists but from family members as well. One of the patients of a friend of mine, a patient who was very obese herself, remarked to him that her daughter had had a gastric bypass 5 years ago and had stayed slim but "has been sickly and frail ever since".

I feel that WLS is more of a quality of life decision than a health decision. Health-wise, it would appear that the body, pretty much regardless of size, is totally happy and healthy if the person exercises regularly and makes reasonably healthy food choices and avoids obviously unhealthy things like tobacco and alcohol usage etc. But quality of life-wise, some people find "living fat" so intolerable that they are willing to take at least a few health hits in order to be able to live thin. And that is their decision but I try to point out to them that the bottom line may be that health hits can reduce the quality of life even MORE than being fat. i.e. being slim and having a new set of clothing "off the racks" is not fun if the patient is stuck sick in bed or so fatigued or weak that they don't feel like changing from their night clothing. Likewise the daily inconvenience of having a digestive tract which has been basically surgically disabled, may be more of a dealbreaker than people realize i.e. the concept of taking extremely small bites and chewing to liquify or having things "get stuck" and having to take "food breaks" to wait and make sure the last bite has "gone down" before taking another bite, and having to restrict to certain foods, eschewing many - what we consider - treat foods and every patient, at least occasionally, getting bites of food stuck in the stoma which apparently delivers at least 2 hours of rather intense pain until it either has to be surgically removed or "goes down".

The quality of life index of a GERD patient has been said to be 2 out of a possible 10.... and lately an article suggested that although WLS was effective in many people to keep SOME weight off, their quality of life took a serious hit according to what patients themselves, described about their daily lives. Another study which suggested that WLS patients tended to live longer than fat people who did not have WLS, also observed that WLS patients had a far higher rate of death from suicide and accidents, thus again suggesting a serious quality of life hit.

Some people may be surprised that prospective patients can read about the "hard cases", the so called "gastric bypass gone bad" stuff and then, still have the procedure themselves. I've actually seen patients who have had a "gone bad" case in their own family who still go ahead with the surgery. This may be because it seems that most patients or prospective patients and/or medical professionals will dismiss the hard cases as "exceptions to prove the rule" which may or may not be true.... we simply don't know what the case of the "AVERAGE" patient is on the long term as it is evident that some patients have incorporated themselves into society as slim people, and may not identify themselves as weight loss surgery patients. But yet other patients, quietly die or become ill, and although WLS is pretty likely a factor in their illness or death, it is not documented by medical providers as such.

It may be a far better idea as far as helping the individual make the choice which works best for them, to present information about what the daily quality of life hits may be and also with what the REAL clinical health status may be after WLS, a condition including some concerning health issues, which may greatly different from the rosey patient descriptions.

Wednesday, February 07, 2007

Artificial Sweetener - really a diet aid?

Artificial sweetener is considered a good thing in our society because it doesn't have any calories and thus, people feel they can have their sweets for free.
Well, seems nothing is for nothing.

Here is something the diet industry did not publish but it's in the Congressional record:

the Congressional Record, Senate, Page S5511 (protest of the National Soft Drink Assn against the use of aspartame):

"Aspartame has been demonstrated to inhibit the carbohydrate induced synthesis of the neurotransmitter serotonin (Wurtman affidavit). Serotonin blunts the sensation of craving carbohydrates and thus is part of the body's feedback system that helps limit consumption of carbohydrate to appropriate levels. Its inhibition by aspartame could lead to the anomalous result of a diet product causing increased consumption of carbohydrates."

A couple of epidemiological studies have shown that people actually gain weight when they consume diet soda.... perhaps this is one reason.

Another thing I have read about artificial sweeteners is when your body senses the sweetness in your mouth, it starts producing insulin to handle the increased (what it thinks was) sugar. But when no sugar is forthcoming, the higher insulin levels can cause carb craving and actual weight gain.

This is true of ALL artificial sweeteners - it's the nature of the beast.

Finally, here is another side effect I've noticed. If you eat small amounts of sugar, you lose your taste for super sweet stuff. But I have noticed that folks who regularly consume diet soft drinks, have - if anything - a heightened taste for sugar and can consume super sweet stuff with nary a blink of the eye.

Probably why manufacturers have felt it necessary to put stuff like "high frutose syrup" into non diet foods - because consumers of artificial sweetener (which is SUPER sweet) would not find NATURALLY sweetened products, sweet enough.

There is no winning a battle with mother nature.... she always wins....

Monday, February 05, 2007

The Childhood Obesity Hysteria only makes our kids unhealthier

On a show in October, Tyra Banks, host of "America's top models" featured two children with eating disorders. One of them, started in when she was five, eating paper to avoid eating food.

"I would eat a little bit of breakfast, a bite or two at lunch and a bite of each thing that my mom gave me at dinner and then the rest was paper," Justine Galleger, now 14-years-old, told Tyra. "I had a little baby fat on me and I saw other kids being teased, and figured if I didn't put on weight then I wouldn't be made fun of."

During her period of fullblown anorexia, Justine only weighed 32 lbs.

Another child Tyra had on the show chews food, then spits it out to avoid gaining weight.
Tyra who has gotten in the news lately, by allowing herself to gain up to 161 lbs which puts her in the low part of the "normal BMI range", has been trying to bring a message to the public which they need to hear ... our obsession with size and "childhood obesity" is very badly affecting our kids... for anyone who thinks these kids described above are exceptions, keep in mind that many of the kids I know personally, even those as young as 9 years old, are totally calorie conscious, can detail how many calories and how much fat is in most foods (they read labels of most of what they eat), consider being fat as horrible, ugly and negative, consume large amounts of green tea and/or water and chew gum to avoid eating and try to exercise off any food "indescretions". Since most of them do not eat healthy, I suspect that they, regardless of what they weigh, may be poorly nourished. They drink little to no milk, they take no multi vitamins and they don't eat much in the way of veggies but they all eat a lot of fast food and junk food.

In school, most teachers who taught in the 1980's and are still teaching now, have commented that the attention span of the kids, is markedly less now than it was 20 years ago when they were better nourished and not so fat phobic.

We can hope that Tyra gets through to the public where others have not.

Saturday, February 03, 2007

Living with a defective digestive tract

I have GERD, (gastro-esophagal reflux disorder) as a result of a hiatal hernia which I was born with. From the lifetime of reflux, and adhesions from a medical procedure, I have developed a stricture of the esophagus which means there is a narrowing which doesn't stretch very well and can easily get plugged if I take too large a bite or eat too fast.

Most of the time I remember that and try to eat slowly, chew well and take small bites as well as staying away from foods like steak which don't easily liquify, but occasionally, I'm upset or anxious and I forget and take a couple of large bites and then, the trouble starts.

This morning as I was writing my other blog post, I committed the sin of biting 1/2 of a boiled egg, and not chewing well enough, something a normal person would toss down with no problem.

Said egg got stuck so I did my usual thing of gulping water to try and force it down. It stayed obstinately put and didn't move and I could feel that the water I drank was going to come up so I flew toward the bathroom and started to do with the adjustable lap band patients call, "PBing" i.e. "productive belching". In other words, I coughed to try and dislodge the stuck stuff. I finally, got enough up to make the rest of the stuck egg go down but it was a bad moment.

Because if I could not have gotten it down, I would have had to have an scope to push it down and would not have even been able to drink water until it was dislodged. That did happen to me once and it was so not fun.

I see people rushing to get weight loss surgery "done" - gastric bypass which is a permanent change to the digestive tract or even lap band which at least, can be reversed and adjusted. People whose digestive tracts work fine. Who can eat things I only dream about eating like steak, and toss it down with nary a thought. And I think about how they will feel after surgery when they have to wait for every little bite to go down, every time they eat.

When a gastric bypass patient gets something stuck in the opening between the pouch and the small bowel, they can suffer two hours of rather intense pain until it hopefully goes down.

And yet, this inconvenience which they will endure for the rest of their lives after their bypass is never even discussed at seminars or in weight loss surgery groups.

Having GERD as I do, my eating choices are limited (as are those for gastric bypass patients although few will admit this). And I go through this fight to swallow with every meal. Even with this stumbling block to eating, my "weight advantage" (how much less I weigh than if I didn't have this problem) is about 20 lbs. For 20 lbs, I'd druther be able to eat normally.

The quality of life index for a GERD patient has been said to be 2 out of a possible 10. And lately an article in a medical journal which will never hit the light of day in the mass media, observed that gastric bypass patients also experience a quality of life hit. A unpublished study, heralded in the mass media under the headline that gastric bypass patients live longer, also included a forgotten line... that deaths by accidents, and suicides were "significantly" higher among gastric bypass patients than among fat people.

When you decide on surgery that NO ONE guarantees, not even the AMA, remember that being slim if you are among the 7 percent who GET slim and can stay there, wears off but what you live with is fighting with a digestive tract which no longer works as it should, several times a day. (Surgeons state in the medical papers that they expect most patients will only keep off 50 percent of their excess weight and that about 30 percent will gain it all back).

Compliments are nice and so is wearing a smaller size but it's the moments day to day that you live with the most. Make sure there are no dealbreakers in those daily moments or MOST of your life (outside of the compliments occasionally) will have a poor quality.

sick n tired of being sick n tired

I received an email from a weight loss surgery (WLS) patient who complained that since his gastric bypass 5 years ago, he'd had a major surgery every year and now, in 2007, he was facing another. He wrote that this is getting very old and that he's sick and tired of being, sick and tired.

This same patient has also complained about the lack of energy, the daily fight he has with his body to not eat and more.

The story struck me because many people use that reason FOR GETTING weight loss surgery in the first place i.e. that they are sick n tired of being sick n tired and yet, so many older post ops complain that after a gastric bypass they are MORE sick and tired than when they were fat.

And of course, those people have bought into THE myth that losing weight is so going to solve all their problems, that they ignore the fact that the surgery they requested will destroy their ability to digest most vitamins and most nutrients that they eat. Of course when someone is vitamin depleted, they will be "sick n tired" because we NEED 100's of vitamins and nutrients on a daily basis and our bodies can only exist well without these for a limited amount of time.

We all are upset about the starvation in Africa but how often do we realize that many folks trying to keep up, not only with fashion but with their medical provider's advice, would, if they removed their clothing, look similar to the gaunt, boney figures we see of the starving Africans?

We pass the buck to the fashion industry and I'm sure it doesn't help when teens see magazines filled with size 0 models but I suspect the motivating factor for most teens is their parents being "worried" about "the obesity epidemic" and this scare they did NOT get from magazines but from their local medical providers who are so sold on the "dangers of obesity" that they are even more and more, are advocating surgery to partially destroy the digestive system for teens!

And if you think of it, how crazy is this? Destroying one of the most important systems in our bodies for a look, and a size which has never really been proven to be healthy at all?

Isn't it a no brainer that starvation wouldn't be healthy for our bodies on the long term, however you achieve it? The only difference between starvation by weight loss surgery and starvation by dieting is that, as a friend who had weight loss surgery for 22 years, states, "you can walk away from a diet but you cannot walk away from a weight loss surgery".