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SOLVING CHILDHOOD OVERWEIGHT

mtdufour@gmail.com — 2009-09-08T09:48:23-04:00

By Marie Dufour, RD - The last hospital patient I saw as a clinical dietitian was a 20-year old African-American girl. She weighted over 400 pounds and was dying from lack of oxygen, her chest so heavy that she could no longer lift it to breathe. That broke my heart just as much as did the teenagers asking me about bariatric surgery to save their lives. With my little food guide and nutrition pamphlet, I felt quite alone and ineffective, having only one shot at nutrition education.

Reversing childhood overweight requires a complex, multi-faceted approach, not necessarily focusing on weight loss, but on behavioral change.

Let's set aside the topic of physical activity, and look strictly at nutrition. Children and their parents have lost touch with what constitutes appropriate nutrition for two major reasons: lack of education and a toxic environment. This can be reversed with structures already in place, repeated exposure to health-conscious messages, and an effort from food distributors to identify non-toxic products on their shelves.

- Child education: nutrition needs to be taught as a mandatory school subject.
- Parent education: through television nutrition and healthy cooking shows, newspapers and magazine articles, written or produced by Registered Dietitians.
- Grocery stores health-promoting stance:
- "Light" circuit shopping, away from "Heavy" aisles;
- Decentralized produce carts located in parking lots and at curbside;
- In-store light cooking shows;
- In-store free dietitian consultation;
- Hospitals and medical groups proactive policies:
- Nutrition education pamphlets to all members;
- Free nutrition screening and dietitian initial consultation;
- Healthy Living Health Fairs (Nutrition and physical activity);
- Business participation:
- Healthy cafeteria menus, including nutrition labels on menu items;
- Employee education via web-based "Nutrition Spots;"
- Insurance discount for participation in nutrition education workshops.
- City programs:
- Healthy Camps: nutrition, physical activity, healthy cooking;
- Healthy Cooking for Moms, Dads, & Families community classes;
- Health-promoting infrastructures: sidewalks, parks, and security;
- Pro-health policies: produce cart licenses, no-Fast-Food zones near schools.

Each of us has a role to play. Whether a business owner, a city worker, a teacher or a health worker, each of us can create a climate and an environment where we can rear healthy and lean children.

Don't wait for "THEM;" What will YOU do?

DEWAP* DRINK WATER, O WORLD!

mtdufour@gmail.com — 2009-08-03T14:21:18-04:00

By Marie Dufour, RD - Some of the main contributors to the obesity boom in general, and to childhood overweight in particular, are the various sweetened drinks on the market today. Sadly, the taste for sodas and the marketing blitz from the big distributors are not limited to the USA. Wherever I travel, I see a drastic change in traditional and healthy drinking patterns.

In Paraguay, for example, the YERBA MATE is the traditional drink. Either in the hot morning MATE, the COCIDO QUEMADO, or the ice-cold TERERE, the YERBA is the basis for some of the healthiest and calorie-free drinks in the world. Sadly, I notice that the social habit of drinking TERERE is replaced by sharing a 32-oz bottle of soda, especially in the young. Overweight and obesity rates in Paraguay are reaching in excess of 50%.

In the most remote places of the world, I come across the biggest names in the soda business. On the UROS islands of Lake Titicaca (Peru), women in traditional garb present the guides with the red-label 2-liter bottle as a tip for bringing tourists. In the ancient villages of the Colca Canyon, a place we reached after a day of dirt roads and an hour on horseback, the toothless old women were proudly offering me a swig of their 2-liter soda bottle.

No doubt that being able to afford a soda is a social status. But this alters the nutrition equation in devastating ways as children expect to drink soda as soon as they leave the breast or the baby bottle. The situation, as I see it, is even worse in third-world countries, where the social conscience of big business is null and public education is unheard of.

True, soft drinks are not the only culprit in the global weight gain bubble, but they are the easiest to control, withdraw, ban, tax, or regulate. Also, reducing their consumption by just one drink a day can have drastically positive results on obesity and type 2 diabetes. The three major "Liquid Candy" products to take out of our diet are:

- Sodas: sodas and other sweetened drinks are full of sugar (9 to 12 teaspoons per can, depending on the brand). Some also contain caffeine, a diuretic that can cause dehydration. Even at 150 calories per glass, sodas leave us hungry because our hormonal response to "fullness" works only with food, not with drinks.

- Fruit juices: a 12-ounce glass of orange juice, which is the juice of two to three oranges, has about 180 calories (= 3 chocolate chip cookies.) Some "Juices" contain only 10% of real fruit juice or less, and are filled with sugar and chemicals.

- Sports drinks: also 100% sugar and salt. Some companies (i.e. Gatorade) have re-formulated their drinks, with 14g of sugar per 8oz can, 50 calories. But sports drinks don't hydrate better than water, and some have such a high electrolyte load that they actually dehydrate us.

Bottom line, the human digestive system is not designed for drinking calories.

Alternatives - What can you do?

- Drink water. Zero calories, total hydration and detox power. On occasion, a diet soda of low-cal beverage is a treat. ONLY as a treat. Drink tea, coffee, TERERE, or any other water-based infusion.

- Whole fruit: Limit fruit juice to one daily 4-oz cup of real juice with pulp (60 calories). Better, eat one whole orange (80 calories) whose fiber makes your feel fuller.

How much weight can be lost this way?
- Eliminate 1 soda per day: save 15 lbs a year.
- Reduce the 12 oz of orange juice to 4 oz or a small orange: save 13 lbs a year.

DO both? That's more than 25 pounds saved in one year.

Is it that simple? Yes, and no. There are other factors that make us want to cling to that extra weight once we have gained it, BUT eliminating calories from drinks should be the first offensive in our war against overweight.

Some responsive sugar drink companies are improving their politics and products by taking sodas out of schools, doing away with high fructose corn syrup, and coming out with attractive zero-calories products. Parents have a duty to take the soda bottle away from their children. They also must lead by example by drinking water themselves, campaigning to keep soda out of schools and sports clubs.

Together, we can bring about a change.

STRESSED INTO WEIGHT GAIN

mtdufour@gmail.com — 2009-07-09T07:54:19-04:00

By Marie Dufour, RD - Stress from job-related demands, difficulty paying bills, or depression and anxiety can lead to weight gain. While women are more stressed by family relationships and perceived life constraints, men are more affected by stress in the workplace (i.e. lack of decision authority).
This relationship between stress and weight gains seem to have no effect on people who are already thin, but affect more individuals with higher BMI.

WHY? Science has no definite answer. Perhaps the stress hormone cortisol slows down the metabolism and stores excess energy as abdominal fat. Perhaps there is a tug of war between our appetite-stimulant and appetite-suppressant hormones. Perhaps it is behavioral. "Stress-eaters" have a tendency to reach for the cupboard or the refrigerator in search of something that will make them feel better. On the contrary, "stress-fasters" are unable to eat anything when they feel under a load of stress. What, if anything, drive these behaviors is yet unknown.

So, what do we do? Let's address the problem at the root and reduce stress. Do what we can to solve our problems on the job, at home, and in our relationships: working toward a solution is a positive step and a partial stress relief. For immediate stress relief, however, here are a few tips:

- engage in physical activity: it releases endorphins and burns calories;

- practice yoga, tai-chi, or any activity that helps you feel in control of your body and mind;

- take a bath, listen to your favorite music, do something pleasurable… that does not involve eating or drinking.

These are small steps that, if taken daily, help us in feeling in control, decrease our stress, and ultimately lead to weight control.

reference: Block JP, et al "Psychosocial stress and change in weight among US adults" Am J Epidemiol 2009; DOI: 10.1093/aje/kwp104.

DEWAP* - Avoid the "Liver Crisis"

mtdufour@gmail.com — 2009-07-06T18:08:58-04:00

By Marie Dufour, RD - Maybe the French know something we don't. They routinely suffer from "Liver Crisis" after cholesterol-loaded meals (i.e. Daube, Cassoulet), a condition they treat with "La Diète," a couple days of vegetable broth, steamed vegetables, whole grains and plain rice. We, hamburger and BBQ fans, remain perplex about this strange Gallic illness. But what if there really were a relationship between diet and liver disease?

So says a recent research by Ioannou & al, based on NHANES data. Researchers associated a diet high in cholesterol and protein with increased liver disease risk. However, a diet high in carbohydrates was associated with a decreased risk.

Individuals following a high protein diet were 1/3 more at risk for hospitalization or death due to cirrhosis or liver cancer. Those who consumed the most cholesterol (top quartile) were more than twice as likely to develop cirrhosis or liver cancer than those who consumed the least (bottom quartile.) However, serum cholesterol levels were not associated with disease risk, which means that the liver damage comes from what we eat, not from the cholesterol our body naturally produces.
Interestingly, individuals following a diet high in carbohydrates had a 58% lower risk (HR 0.42).
How do we, then, eat for liver health?
- Drink the least alcohol possible.
- Keep a diet low in cholesterol intake: avoid processed meats (bacon, sausages, patés, salami), eat egg yolks occasionally (egg whites are OK), drink non-fat milk (even children after the age of 2), select lean cuts of red meat, chicken, fish;
- Keep protein intake at a moderate level (20-30% of daily calories), selecting plant-based and fish proteins;
- Select grains, fruit and vegetables for at least 50% of daily caloric intake;
- Chose polyunsaturated vegetable oils;
and avoid the "Liver Crisis."

* Drink And Eat With A Purpose (DEWAP) is the nutrition lifestyle program I have developed for the DOMINO HEALTH FOUNDATION.

Reference: Ioannou GN, et al "Association between dietary nutrient composition and the incidence of cirrhosis or liver cancer in the United States population" Hepatology 2009; 50: 175-84.

DIET? MEDITERRANEAN!

mtdufour@gmail.com — 2009-06-26T16:33:15-04:00

By Marie Dufour, RD - Analyzing the data of over 23,000 men and women followed for 8.5 years by European Prospective Investigation into Cancer and Nutrition (EPIC) study, researchers found that mortality dropped with tighter adherence to the Mediterranean diet (13.5% per two-unit increase on a 10-point adherence scale).

They monitored the relative intakes of alcohol intake, meat and meat products, vegetable, high fruit and nut, monounsaturated-to-saturated fat ratio, legumes, cereal and dairy consumption. In my book, that's 8 components, and a statistical 12.5% chance for individual contribution of each element.

Here is how the micro-analysis of individual contribution to the total effect stacked up:
- Moderate alcohol intake: 23.5%
- Low intake of meat and meat products: 16.6%
- High vegetable intake: 16.2%
- High fruit and nut consumption: 11.2%
- High monounsaturated-to-saturated fat intake: 10.6%
- High intake of legumes: 9.7%
- High cereal intake: 6.1%
- Low dairy consumption: 4.5%

Really, these results can be cooked up at any sauce. So, to your saucepans!
- If you eat less meat, you're going to eat more vegetables: add these ingredients to each other, and they now contribute to 32.8% of the benefits.
- Don't like veggies? Fine, eat less meat and replace it with legumes, and you still get a combined effect of 26.3%
- Don't like legumes nor veggies, but would rather eat fruit? That's a combined effect of 27%.

The problem I see with the way researchers presented the results is that they did not account for total food combinations. What is sure, is that the red wine that accompanies the food stands alone from the rest. What is also sure is that a diet low in meat and high in vegetable, fruit, nuts and legumes promotes total health and longevity.
As for the word "alcohol" in the result, I understand that it is mostly red wine taken with meals, which denotes a very different lifestyle than a couple scotch downed in a bar.

Based on this study, I wouldn’t advise non-drinkers to go and start drinking but I would advise heavy drinkers to moderate their drinking. But mostly, I would remind all consumers to take such publicized headlines with… a grain of salt!

Reference: Trichopoulou A, et al "Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study" BMJ 2009; 338: b2337.

HEALTHY LIFESTYLES ON THE DECLINE

mtdufour@gmail.com — 2009-06-23T19:07:05-04:00

By Marie Dufour, RD - Since the 1980s, we've seen an explosion of gyms, nutrition stores, miraculous diets, and a plethora of health magazines, yet only half as many American adults engage in healthy lifestyles as they did two decades ago.

Taking results from NHANES (National Health and Nutrition Examination Survey) 2001-2006, researchers considered five healthy behaviors in their patients ages 40 to 74 and compared them to the 1988-1994 data. The five healthy behaviors were: maintaining a healthy weight, eating fruits and vegetables, drinking alcohol in moderation, exercising, and not smoking . Twenty years ago, 15% of patients engaged in all five healthy behaviors. Today, only 8% of them do. That's just a little more than half.

Here is how it breaks down, compared to 1988:
- 36% of the patients are now obese (BMI 30 or greater): 8% more
- 43% are regular exercisers (at least 12 times a month): 10% fewer
- 26% eat five servings or more of fruits and vegetables daily: 16% fewer
- 51% drink alcohol in moderation (1 drink/day for women, 2/day for men): 11% more
- 26.5% are smokers: unchanged

And, surprisingly, patients with hypertension, diabetes, or cardiovascular disease are no more likely to adopt healthy lifestyle than those without these conditions.

What's going on? We drink more, exercise less, eat less fruit and vegetables, get thicker around the waist, and WE DON'T CARE if it makes us sick.

Are we not caring about our health any more? Are we just dreaming that technology and pills are going to get us magically well? Are we thinking that watching Dancing With the Stars on Blue Ray will count as our cardiovascular workout? Is Emeril or The Iron Chef migrating in our kitchens and making us forget about basic healthy nutrition? And are we simply hoping that the latest fat-burning pill or restrictive diet will keep us away from obesity? At the grocery store, did we substitute the stop at the produce department for a run through the nutritional supplement aisle?

Being healthy doesn't come in a pill, nor can it be infused from the TV screen. A healthy lifestyle takes dedication and planning. How do you start? A walk around the block is a good debut. If that's not feasible, an old Jane Fonda video will do!

Reference: King DE, et al "Adherence to healthy lifestyle habits in U.S. adults, 1988-2006" Am J Med 2009; 122: 528-34.

Atkins' Green twist

mtdufour@gmail.com — 2009-06-20T11:15:18-04:00

By marie Dufour, RD - Dr. Atkins is long gone, but his marketing machine lives. Propelled by the soy and almond industries, a new study heralds the weight-loss benefit of a plant protein-based diet. But should we go all out on textured soy protein yet and keep loading up on almonds? Hold your shopping carts!

- During a four-week period, researchers fed 47 overweight men and women only 60% of their caloric needs. One group was fed the "Eco-Atkins" diet, with 26% of calories from carbohydrates, 31% from protein, and 43% from fat (26/31/43). All from plant foods.
The other group was fed a high-carbohydrate vegetarian diet with low-fat dairy and whole-grain products, which included 58% of the calories from carbohydrates, 16% from protein, and 25% from fat (58/16/25).
Both groups lost a similar amount of weight and both groups improved their lipid profiles, although the "Eco-Atkins" showed a slightly greater reduction in LDL (20.4% vs. 12.3%).
The "Greentwist" on the Atkins diet advocates proteins from gluten, soy, nuts, fruits, vegetables, cereals, and vegetable oils, and is all looks oh-so-good for you! But there are really 3 issues here:
- Anyone who eats 60% of their caloric needs is going to lose weight. PERIOD! By the same token, the lipid profile will improve. And anyone can follow any kind of restrictive diet for four weeks.
- As demonstrated over and over, the long-term sustainability of an Atkins-type restrictive diet is dubious, and after one year there has been no shown difference in weight loss between Atkins and other dieters. The lack of palatability and the restricted choices are an issue with Atkins-type diets.
- The Eco-Atkins nutritional balance is still out of whack: too high in fat (and unbalanced fatty acid distribution) and way too low in carbohydrates (75g for a 1200 Kcal diet.)
While the soy and almond industries are drumming up yet another consumer hype, let's remember that, when it comes to weight loss, it's all about calories. When it comes to sustained weight loss, it's about calories and palatability. And when it comes to healthy life-long weight control, it's about calories, palatability, and balance.

Reference: Jenkins D, et al "The effect of a plant-based low-carbohydrate ("Eco-Atkins") diet on body weight and blood lipid concentrations in hyperlipidemic subjects" Arch Intern Med 2009;169: 1046-54

Curbside Produce to Curb Obesity

mtdufour@gmail.com — 2009-06-19T08:33:27-04:00

This morning's story comes to us from Canada where investigators found that people were 25% less likely to be obese if they lived in an area with fewer fast-food outlets than supermarkets, "The proximity of the obesogenic environment to individuals appears to be an important factor in their risk for obesity."

Would you agree that, as a specie, we'll get our nutritional needs where the least effort is required? Why would we expand energy to then have to refuel? It's counter-nature (unless, of course, we want to lose weight.)

In the Canadian study, researchers drew the line at 800 meters. What is that? Half a block or so? I draw the line at curbside.

I was driving my clunky car through the chaotic stone-paved streets of Asuncion (Paraguay) this morning when I came across a stand at roadside. I rolled down my window and the stand attendant started to load my canvas bag with his merchandise: bananas, pears, apples, white lettuce, baby carrots, red onions, yellow peppers, eggs from the farm and fresh cilantro. And I thought how lucky I was to work in a third-world country where you could still buy fresh produce at curbside. Not that the big marketing machines are absent. At the next big light, I was assailed by the soda vendor, the chip peddler, and the candyman but I did not roll down my window.

So I say, bring back the fruit-and-veggie stand at the street corner, at the school gate, at the baseball field. Let's have cities issue inexpensive food cart licenses, provided that the carts only carry pre-approved healthy merchandise. It could help us hunt and gather close to home and help us keep that so-called obesity "epidemic" in check.

reference: Spence JC, et al "Relation between local food environments and obesity among adults" BMC Public Health 2009; DOI: 10.1186/1471-2458-9-192.

CALCIUM DIET BITES THE DUST

mtdufour@gmail.com — 2009-06-18T21:49:50-04:00

by Marie Dufour, RD
Calcium diet bites the dust… but don't throw that yogurt out the window yet!

A recent study reported that calcium supplementation (1,500 mg of calcium carbonate daily) was "unlikely to have clinically significant efficacy as a preventive measure against weight gain in patients who are already overweight or obese." Perhaps the results would have been different if the researchers had used calcium citrate, better absorbed. But I doubt it. But, why the research in the first place?

Back in 2000, Dr. Michael Zemel published a bombshell paper stating that three or four daily servings of low-fat dairy products can help us lose fat and get thinner. Dr. Zemel and his fellow researchers proposed metabolic pathways for fat burning inside our fat cells that were novel and attractive. Calcium acted as a fat-burning machine. The more calcium was stored in a fat cell, the more fat would be burnt. Genial for fat loss. Genial for weigh loss. Genial for Dr. Zemel and the entire dairy industry. We all went on the 2-to-3-non-fat-yogurt-a-day-diet. And yes, we lost weight. Dr. Zemel's theory seemed to work. Thinking of it, it has not been disproved yet.

What was proved, however, is that calcium pills, as supplement, do not have the same effect. Why is that? We really don't know. It seems that MILK SOLIDS have a role to play in calcium metabolism, but that role has not been explained yet.

But don't throw away your calcium pills either. Calcium citrate, taken between meals, is a good supplementation if you don't drink milk or don't eat yogurt. However, calcium pills won't make you skinny.

So, if you want to lose weight, eat less, move more (ouch, I said it again!) and enjoy your 2 to 3 servings of non-fat (sugarless) dairy (milk or yogurt) a day.

reference: Yanovski JA, et al "Effects of calcium supplementation on body weight and adiposity in overweight and obese adults" Ann Intern Med 2009; 150: 821-29.

Is Moderate Drinking Good for You?

mtdufour@gmail.com — 2009-06-16T14:50:34-04:00

by Marie Dufour, RC - More than 100 studies link moderate drinking to heart health, as alcohol has been found to increase the “good” cholesterol (HDL) and to have anti-clotting effects. Based on these studies, the 2005 Dietary Guidelines state that alcohol may have beneficial effects when consumed in moderation (one to two drinks per day.) In other words, one would be better off drinking moderately than abstaining from drinking. Or, re-stated, not drinking may be a health danger. The media have taken a hold of this message and, pushed by the marketing machine of the alcohol industry, are just short of promoting moderate drinking as heart disease prevention.
It is true that observational studies have shown that abstainers, as a group, have a higher overall mortality risk than moderate drinkers. But can those two groups even be compared? Does moderate drinking make people healthy, or is moderate drinking something healthy people do? The answer, I think, lay with the populations’ socio-economic strata.
Who are the non-drinkers? Are they are people who stopped drinking because they already had heart disease or another chronic illness? People whose self-imposed restrictive diets present nutritional deficiencies and cause illnesses? Older people who have stopped drinking as they aged and whose overall mortality rate is higher? A social stratum that is economically disadvantaged, consequently with restricted access to health care and at higher risk for disease? Could it be that the non-drinkers are simply an adverse-selection population and that their higher mortality has nothing to do with alcohol consumption?
And who are the moderate drinkers? A study from the CDC found that moderate drinkers were wealthier, more educated, had better health care. They were found more likely to eat right and exercise, and even to have all of their teeth, a marker of well-being. Could it be, then, that moderate drinkers represent a socially advantaged stratum and their lower mortality has nothing to do with their alcohol consumption?
The two groups are so different that they shouldn’t be compared, and suggesting that abstaining from drinking increases one’s disease risk is a fallacy. In addition, no study has shown a cause-to effect relationship between moderate drinking and lower risk of death — only that the two often co-exist.
The most recent studies link drinking, even in moderation, to stomach and pancreatic cancers. It is unwise, therefore, to recommend non-drinkers to start drinking in order to protect their health, and moderate drinkers should weight the benefits of possibly higher HDL and anti-clotting effects against the danger of cancer and liver disease.
In that regard, why not study the benefits of eating fish and exercising daily compared to drinking alcohol daily? We might just get the same benefits without the risks.

Of Children, TV, Autism & Weight Control

mtdufour@gmail.com — 2009-06-08T11:20:23-04:00

In today's medical news, researchers found that the more time young children spend in front of the TV, the less exposure they have to adult voices and the less likely they are to speak themselves (1). This echoed a 2006 Cornell University study where researchers found that the more time toddlers spent in front of the television, the more likely they were to exhibit symptoms of autism disorders.(2)
This caught my attention because children on the autistic spectrum have specific nutritional needs. But since this morning's report also mentioned the correlation between the hours of passive screen exposure (TV, computers, videogames) and childhood overweight, let's look at the effect of passive screen time in young children.
Literature on the subject abounds. For example, in a review of 31 possible early-life risk factors, television viewing was associated with increased risk of overweight at age seven. Incidentally, the presences of a television set in the bedroom outweighed the impact of hours of TV alone. High amounts of TV were shown to have a number of other negative outcomes: poor scholastic performance, poorer food choices, less sleep , less play and limited social interaction. (3)
We cannot deny that, over the last 50 years, the advent of "screens" has drastically altered our behaviours. TV, of course, but also computers, video games, up to the latest iPhones and Blackberries, have generated a plugged-in society that passively feeds on images, craves instantaneous data and often suffers from information indigestion and facts intolerance.
That we, insatiable adult consumers, should end up with leaner pocketbooks and fatter waistlines, is our personal choice. But that we should blissfully expose our younger generations to well-known health and developmental risks is irresponsible.
It is utopia, however, to think of eliminating screen time. Therefore, parents and educators have a duty to properly manage exposure to limit risks.
- Turn the TV off and physically play. Hide-and-go-seek is a good start. Plastic bottles make for a great indoor bowling alley. Small paper plates become indoor freesbees.
- Cook with the kids. I you don't know how to cook, learn! If kids are to eat well, parents need to teach them. No one else will.
- Eat at the table, family style. That's right, even a family of two can sit together, eating and talking, with the TV off, the phones off, and no video game at the table.
It's not too late to redress the odds and make sure that the younger generations do not, as reported, have a shorter life expectancy than their parents.
References:
1 - Christakis D, et al "Audible television and decreased adult words, infant vocalizations, and conversational turns" Arch Pediatr Adolesc Med 2009; 163: 554-58.
2 - Waldman & al, "Does television cause autism?" Cornell University 2006
3 - Gibbons K, "Interventions for childhood overweight and obesity: a place for parenting skills" 2007 Jour. Dietitians Assoc. Australia

OF Wii & NUTRITION

mtdufour@gmail.com — 2009-06-05T13:14:41-04:00

Scientific research from Russell R. Pate, Ph.D., of the University of South Carolina in Columbia suggests that active video games may counteract weight problems in children. The new research links active video gaming (i.e. Wii Fit) to increased energy expenditure. WOW! Who would have guessed? Any housewife --pardon me, Domestic Engineer-- knows that she sweats more when she vacuums the house than when she watches her soaps; and any week-end gardener -- or Proud Homeowner -- gets his heart pumping with lawn-mowing and tree-pruning to make-up for his couch-potatoe-ing in front of a 3-hour football game.
OK, stereotypes and sarcasm aside, a new dawn has sprung on video gaming: active gaming. And it's a good thing, really, not only for children but also for their parents. It's not just the children who are struck by the obesity "epidemic" (as if obesity were a communicable disease--and may be it is, in certain ways); their parents' waist line is growing too. Therefore, I have high hopes for the long-term results of active video gaming: children move more, perhaps play more with their parents, everybody expends more energy and keep their weight gain in check. Not being a Wii expert, I can't tell you which game burns more energy, but I'm sure this can be researched.
What disturbs me more is the typical activity associated with television-watching in general, and video-gaming in particular. Anyone who has stood in line at FRY's between the unending rows of chips, cookies and candy can relate. Snacking has become engrained in our TV/video culture. High-fat, high-sugar, simple carb snacks, ice cream and soda are the typical couch-side companions of the juvenile (and adult) video gamer.
Dr. Pate advocates to fight fire with fire. I concur. Since video gaming is entrenched in our society, let's pave the way for active gaming. I'd say, "Bring'em on!"
But, here's a tip for the marketers of active video games. Make your product a full healthy experience. Bring us a "GAME + SNACK" package, with a specific AVF (Active Video Fitness) snack pack. Oh, I can see it on the shelf, the ACME-AVF-Triathlete Pack, with sports cap water bottle, dehydrated apple slices, sugar-free gum, and any other orally gratifying implement. That's right, we might have put away baby bottle and pacifier a long time ago, our generation still seeks oral gratification. But more on that in a later blog.

MILK as SPORTS DRINK?

mtdufour@gmail.com — 2009-06-03T09:02:32-04:00

In athletes' muscle recovery, is a glass of low-fat chocolate milk as effective as a high-carbohydrate energy drink?

Apparently so, reports the American College of Sports Medicine. In a small study of soccer players, low-fat chocolate milk consumption provided better muscle recovery after intense training than a high-carbohydrate drink of the same caloric value. (1)

After one week of normal training, followed by four days of more intense training, the two study groups were compared for measures of creatine kinase -- a marker of muscle damage -- and myoglobin levels, muscle soreness, mental and physical fatigue, peak isometric force of the quadriceps, and leg-extension repetitions.

The chocolate milk group registered significantly lower levels of serum creatinine kinase and greater changes in peak isometric force of the quadriceps than the high-carb group.

It's hardly any surprise, looking at milk composition. Carbohydrates and protein to help with energy replenishing and muscle fiber repair, but also calcium, phosphorus, sodium and potassium.

I won't discuss the benefits of chocolate, at least not in today's blog. But I will give a few pointers about the benefits of cow's milk. First of all, I advocate NON-FAT milk for adults and children over the age of two. There is enough fat in the American diet to do without the fat in milk. But the components of milk and milk solids work wonders for the human body.

Low-fat milk consumption has consistently been linked to reduced risks of hypertension, heart disease, colorectal cancer, obesity and its corollaries: insuline resistance and type 2 diabetes.

But a lesser-known fact is that milk is a source of conjugated linoleic acid (CLA). CLA is a fatty acid shown to inhibit several types of cancer in mice. It has also been shown to kill human cancer cells in vitro, particularly skin, colorectal and breast cancer cells.

So, when you go do the store to buy your muscle recovery drink, think of your entire body and get yourself some non-fat milk. But make it ORGANIC milk, since CLA is only present in milk from grass-fed cows.

Reference:
1 - American College of Sports Medicine - Gilson SF, et al "Effects of chocolate milk consumption on markers of muscle recovery during intensified soccer training" ACSM 2009.

DEWAP - Drink and Eat With a Purpose

mtdufour@gmail.com — 2009-05-19T17:36:20-04:00

By Marie Dufour, R.D.

Are we gaining weight because we eat more or because we exercise less? Researchers reporting at the European Congress on Obesity in Amsterdam found that excess food intake alone explains the obesity epidemic.

Boyd Swinburn, M.D., of Deakin University in Australia, lead author of the study reports that "Weight gain in the American population seems to be virtually all explained by eating more calories... It appears that changes in physical activity played a minimal role."
Robert Lustig, M.D., an obesity researcher at the University of California San Francisco, contains that he majorities of obesity studies fail to show that exercise translates into sustained weight loss.

However, researchers agree that reduced activity in children may predispose them to obesity later in life. Scientists also point out to growing evidence that chemicals in the environment --such as bisphenol A or BPA -- may disrupt the endocrine system and prompt us to eat when we are, actually, full.
EXCESS CALORIES is not a new concept. How many physicians tell their overweight patients to "just eat less?" Unfortunately, eating less is easier said than done. Chronic overeaters often feel threatened at the thought of no longer having unrestricted access to food, and the resulting anxiety causes an immediate reaction: eating more.

With regards to caloric intake, "eating" is not just as a mealtime activity, but also includes mindless snacking, day-round beverage drinking, alcohol ingesting and other candy and ice-cream treating. It is the entire concept of INTAKE that needs to be taken into consideration: what we eat, drink, suck, lick, chew, sip, purposely or mindlessly.

Perhaps there is little we can do to quickly change the environment, but we can control our INTAKE. In fact, it is very effective in the treatment of morbid obesity by bariatric surgery (lapband or gastric bypass). But bariatric surgery is a drastic, invasive step with long-term ramifications that should only be considered when all other avenues have been exhausted.

DRINKING & EATING WITH A PURPOSE (DEWAP) is a way to look at nutrition as a precursor to healthy and happy living. Each age, each stage of life, each mental and physical state elicits a purpose in life. Just as physical activity varies with life stages, so does nutrition. Matching our nutrition to our needs-in-time is the key to the EWAP plan. More on this in the next blog.

Primary source: European Congress on Obesity
Source reference:
Swinburn BA, et al "Increased energy intake alone virtually explains all the increase in body weight in the United States from 1970s to the 2000s" ECO 2009.