Tuesday, December 26, 2006

The effect of wildfires on respiratory health of children

This study caught my eye because the California wildfires of 2003 impacted me and my family. In fact, over the last 10 years, we have had to evacuate from our home three times. In the 2003 fire, we were away from our home for 2 weeks.

If you have ever been near a forest fire, you know how sickening the smoke and ash can become. During the early days of the 2003 fire, white ash was falling everywhere and breathing was laborious for us all.

To measure the impact of the 2003 wildfires on asthmatic and non-asthmatic children, researchers at the University of California, LA, surveyed over 800 high school children and the parents of over 5,000 children between 6 and 7 years old who had lived in one of the 16 communities affected by the fires. Although asthmatic children were two to three times more likely to suffer wheezing, other respiratory symptoms and eye problems, non-asthmatic children also had increased symptoms as well. The results were published in a recent American Journal of Respiratory and Critical Care Medicine.

The 2003 wildfires sent plumes of smoke into the air that hovered for days, raising levels of air-polluting particulate matter by 10 to 20 times. The smoke also contained carbon monoxide and numerous other toxic substances. Such poor air quality is particularly dangerous for people with asthma, whose symptoms can be exacerbated.

So, what can you do if you are in an area that is burning? Health authorities recommend staying inside during the fires and, if necessary, wear a mask. As a dietitian, because the body is being exposed to harmful substances that can be oxidizing to the system, foods that are high in antioxidants would be a good choice. Examples would be increased fruits and vegetables and omega-3 fatty acids, such as fish or fish oil tablets. Researchers are not sure if long-term damage results from exposure to the smoke from fires, but they feel that since even smokers’ lung health improves once they quit, there may not be long-term damage from the wildfire smoke.

Monday, December 18, 2006

Does daily weighing ensure weight loss?

Do you weigh yourself often or obsess over what the scale tells you on a regular basis? Researchers at the University of Minnesota wanted to know if obsession of frequent weighing would impact the diets and weights of teenage girls and boys. They studied over 2,000 junior high and high school kids in 1998 and followed up with these same kids in 2003.

I often work with clients and encourage them to weigh themselves no more than once a week at the very most. Some I will encourage them to only weigh monthly. The scale will tell you a trend, but daily weighing just tells you fluid status. What I have learned is when someone is unable to avoid weighing themselves on a daily basis, or is obsessed with the scale, they have a harder time controlling their weight. I see it time and time again.

The study mentioned above was recently published in the Journal of Adolescent Health and found that the girls who weighed themselves daily practiced unhealthy eating habits and gained, on average 33 pounds, almost twice as much weight as those girls who did not obsess over their weight. Almost 10%of the girls said at the beginning of the study that they agreed with the statement, ‘I weigh myself often’, and in follow-up, these girls said they engaged in some type of unhealthy weight control behavior, compared to 68% of girls who strongly disagreed that they weighed themselves frequently. These girls averaged a weight gain of 18 pounds.

Boys who frequently weighed themselves didn’t gain weight, but they did practice unhealthy eating habits and measures to lose weight.

What does this study tell us? For me, it’s nothing new; you cannot obsess and weigh yourself daily as a way to ‘control’ your eating habits. The habits must improve and often discovering the underlying reason for uncontrolled eating is the only solution. Many women feel that if they just weighed themselves daily they can keep themselves from gaining too much weight. However, for anyone who knows someone like this, you know that their obsession does not result in weight loss or ideal body weight. It results in higher stress levels and a very unhappy individual.

Monday, December 11, 2006

Serving Sizes Have Grown through the Years

How many times have you been to a restaurant and complained that the servings were too small? Unfortunately, today this is a common complaint if the plates are not overflowing. However, did you know that serving sizes have actually grown through the years? And, so have America’s waistlines.

A recent study at Rutgers University just compared the serving sizes of today to that of 20 years ago. This research was done in 2003 and was described in a recent issue of the Journal of American Dietetic Association, and is a replicated 1984 study at Penn State University.

Here are a couple examples of what they found: Diners were offered three sizes of plates, bowls and cups in a buffet-like setting. There were 177 students in the more recent study at Rutgers and 147 students in the 1984 Penn State study. The students in 2003 took 20 percent more cornflakes than students took in 1984, Schwartz said. The glass of orange juice grew by more than 40 percent compared to 20 years ago. That translates into 50 additional calories, or a weight gain of five pounds over the course of a year, if consumed on a daily basis. Dinner and lunch servings grew, too — 50 percent more fruit salad wound up on the plates of the Rutgers students.

Researchers in both studies felt that people are not listening to their bodies, and are eating more with their eyes than their stomachs. Also, the frame of reference for serving sizes is increasing. I find it, myself, that if I ask people how to translate what they ate into amounts, they really don’t know. In fact, many people don’t have any concept of how many calories they are actually eating.

It’s often pointed out that many restaurants serve food in larger plates, which results in more food. People feel that to get the most value for their meal, they need to clean their plates, too. Some of these plates can result in up to 25% more food, which really can increase the amount of calories in a meal! Value pricing in fast food restaurants is an issue, also; people tend to ‘order up’ to get more for their money. However, this translates into more calories, again.

But the most surprising result the Rutgers study pointed out is that the amount of food consumed at home has also increased.

So, what can we learn from this study? My first recommendation to all new clients is to understand what constitutes a ‘serving’. For instance, did you know that ½ cup of rice or pasta is one serving? And, one slice of bread is a serving. For more on serving sizes, the best site available online is http://www.mypyramid.gov. Spend some time on it and read the descriptions of the food groups as well as the suggestions on how to eat healthier. I often provide my clients with a handout that describes servings in common items, such as a computer mouse and a deck of cards. People are able to relate to these items better than a measuring cup.

My second suggestion to all people is to ask for a doggy bag as soon as you receive your food at a restaurant! How many times have you intended to eat half of an entrée, only to find, when you’re all done, that you ate the whole thing? Another good suggestion for eating out is know ahead of time what you would like to eat. Planning can make a big difference when you are trying to watch what you eat in order to lose weight.

Next, can you tell when you’re hungry and when you are no longer hungry? The time to stop eating is BEFORE you are full. Many people don’t listen to what their bodies tell them, today, however. It is just as important to eat when you feel hungry, also. Trying to avoid a meal when you feel hunger actually results in eating more calories, because then you will tend to binge on foods that are not as healthy as if you sat down and ate a planned-out meal.

Finally, be sure to pay attention to what you eat at home. It’s very easy to pull out a box or bag of something to snack on, only to find, again, that you ate the whole thing! Even if it’s a food that is ‘fat free’, this does not mean it’s calorie free!

The bottom line is pay attention to what you’re eating and how much. Learn to listen to your body, eat when you are hungry and stop when you are no longer hungry. If necessary, weigh and measure out food for awhile to get a good sense of what ½ cup and 4 ounces looks like. Regardless of what strategies you use, remember that what you put into your mouth and how many calories you burn through your activity WILL show up on your body! What is your weight goal and what are you doing to achieve it?

Monday, December 04, 2006

Where does YOUR health information come from?

If you are reading this, you already know that the internet has changed the lives of many of us. According to the PEW Internet & American Life Project Online Health Search 2006, eighty percent of American internet users, 113 million adults, have searched for information on at least one of seventeen health topics. Sixty-six percent of health seekers began their last search at a search engine, 27% began at a health-related website, and 72% visited two or more sites during their last health information search.

In 2006, 63% of searchers searched for a particular health disease or medical problem. About 10 million American adults searched for information on at least one health topic on a typical day in August 2006. This places health searches at about the same level of popularity on a typical day as paying bills online, reading blogs, or using the internet to look up a phone number or address.

53% of health seekers report that most recent health information session had some kind of impact on how they take care of themselves or care for someone else: 42% described it as a minor impact and 11% described it as a major impact. Only 15% of health seekers say they “always” check the source and date of the health information they find online, which another 10% said they do “most of the time”.

Three-quarters of health seekers say they check the source and date “only sometimes,” “hardly ever,” or “never,” which translates to about 85 million Americans gathering health advice online without consistently examining the quality indicators of the information they find.

These findings show that actually less people check the source of the health information than they did in 2001. The reason is believed to be because a recent study commissioned by the U.S. Department of Health and Human Services found that just 4% of “frequently visited” health websites disclosed the source of the information on their pages and 2% disclosed how the content is updated.

Although about 85% of the people who look up medical information are not checking their sources when researching health information online, few report bad outcomes and many report positive effects of their online health queries. Only 3%, or about 3 million adults, say they or someone they know has been seriously harmed by following the advice or information they found online and 66% of people who find information online do NOT talk to their doctors about the information they discover. 31%, or about 35 million adults, say they or someone they know has been significantly helped by following medical advice or health information found on the internet.

Although the fact that ‘only’ 3 million people were harmed by misinformation online, this is a large number. And, what if YOU are one of those 3 million people? There are many websites that sell products or supplements that feature articles and information that help promote the products they sell. So, their primary focus is not to provide accurate information as much as sell products. This is one clue to watch for: Does the website sell products? If so, look for another site.

Most people in the survey used common search engines, such as Google and Yahoo, which will bring up any site that fits your search terms. There are new medical search engines coming online that hope to change the way internet users approach health information online, such as Healthline.com, Healia.com, Kosmix.com, Mammahealth.com and Medstory.com, but there is still no guarantee this will ensure you find quality sites.

So, if you are looking for health information online, what should you do? The first site to consider is WebMD, www.webmd.com. This is probably the most widely respected site available. Any website connected with a medical center or hospital is also a credible site. Educational institutions such as Loma Linda University (http://www.llu.edu/) or UCLA Collaborative Centers for Integrative Medicine (http://www.mbcrc.med.ucla.edu/Index.htm) are examples of sites that can provide accurate information on topics such as alternative care and vegetarian diets.

To read the entire PEW

http://www.pewinternet.org/pdfs/PIP_Online_Health_2006.pdf