The Year is Dead. Long Live the Year.

 

 

No sharing, educating or preaching today my friends. I just want to take the time to wish you a safe and happy New Year's Eve and a successful and fulfilling 2022. 

This has been a strange year for me, a hard to understand mixture of successes and failures, happiness and loss, excitement and fear. With all the challenges we have faced this past year, it has been in some ways a wonderful year for me.

My next year will be one of transition, leading to major life changes that I have planned for 2023. That is both encouraging and intimidating.

I hope that you have had your fair share of successes in 2021 along with its challenges, and wish you much joy, wellness and empowerment for 2022.

Want to Stay Mentally Sharp? Forget Reitiring!

A 2021 study published in SSM Population Health concluded that working past the usual retirement age is protective against age-related cognition issues compared with people who do retire.

The study authors concluded that continuing to work in the labor market up until the age of 67 helps slow cognitive decline and protects against the type of cognitive impairment often associated with Alzheimer's disease. Notably, these findings held up across genders, education levels, and job fields. In short, the study suggests that continuing to work past retirement age helps keep the brain sharp.

Don't much care for your job? The study showed that it doesn't matter what job you have and that part-time and volunteer work have similar benefits. So if you like what you do, keep doing it as long as you are able. If not, or if you just feel the need for a change, then find something else and do that. Turns out that Nike was right: Just Do It!

How Much Does Exercise Lower Stroke Risk?

 

I doubt it will come as much of a surprise to anyone reading this that regular exercise helps lower blood pressure and avoid or control hypertension. Old news, right? But you may not be aware of just how great the benefit to your health might really be.

Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. As a result, the force on your arteries decreases, lowering your blood pressure. Becoming more active can lower both your top and bottom blood pressure numbers. How much lower isn't entirely clear, but studies show reductions from 4 to 12 mm Hg diastolic (bottom #) and 3 to 6 mm Hg systolic (top #). That is as much as some commonly used hypertension medications.

High blood pressure can lead to a vast number of serious health consequences over time including: heart disease, stroke, kidney disease, vision loss and dementia.

A 2021 study by researchers in Portugal and published in JAMA Cardiology sheds some light on just how significant the benefit of exercise can be. Sixty participants aged 40 to 75 years with a diagnosis of drug resistant hypertension were enrolled and observed at hospitals' hypertension outpatient clinics. Half of the participants exercised on a stationary bicycle and/or walked daily for 12 weeks. After 12 weeks blood pressure had fallen enough to lower the risk of heart attack or stroke an average of 25% for those who exercised compared with those who did not.

If you are getting some exercise every day, keep it up. If you aren't, what are you waiting for? A stroke?

Poultry Safety

 

 

Who really knows why chickens cross the road? Who really cares? In any case this post is not about poultry making it safely to the other side of the street.

The CDC estimates 48 million people get sick, 128,000 are hospitalized, and 3,000 die from foodborne diseases each year in the United States. Of course that is from all sources, but nearly 2 million people are sickened annually just from poultry contaminated by bacteria (principally salmonella and campylobacter). 28,000 of them end up in the hospital and nearly 500 die, but it is an experience that nobody wants to have. Reducing the incidence of these bacterial illnesses has been a stated national public health goal in the US for over a decade, yet the same number of people get ill from eating contaminated poultry today as in 2010.

Maybe this is at least partly because the US Department of Agriculture, who is responsible for regulating food safety, allows contaminated chicken to go from slaughterhouse to market legally. The USDA, in fact, allows 9.8 percent of the whole chickens it tests to be contaminated with salmonella. The percentages are even higher for chicken parts (15.4 percent) and ground chicken (25 percent). Campylobacter, too, is allowed in poultry—15.7 percent of samples for whole chickens, 7.7 percent for parts, and 1.9 percent for ground.

As if that is not bad enough, the USDA applies the limit to all bacterial strains in total. "What this means," says Brian Ronholm, director of food policy at Consumer Reports,"is that a manufacturer can meet the USDA's target by reducing strains that rarely make people sick without targeting the strains that tend to cause more severe illnesses."

But wait! No one eats raw poultry, right? Doesn't cooking kill salmonella and other bacteria?

“The short answer is yes, cooking will kill salmonella, but it has to be the right type of cooking,” says Trevor Craig, corporate director of technical consulting for Microbac Laboratories. As a general rule of thumb, cook all poultry to an internal temperature 165℉. The only way to ensure that you have hit the right temperature is using a meat thermometer to check. If you don’t cook your food to a certain temperature you’re not actually going to kill off that bacteria.

It is also very easy to spread the contamination from poultry to other foods by using, say, the same utensils or cutting board to prepare them. Always clean your tools and prep area after working with poultry. Better yet, use different ones.

You can read more about the issue of bacteria contamination here and here.

Enjoy those holiday turkeys!

Nutrition Issues with Vegan Children

 

A study by researchers the the University of Helsinki in Finland and published in EMBO Molecular Medicine concluded that vegan diets do not provide very young children (the median age of study participants was 3 1/2 years) with enough of certain key vitamins and nutrients. 

Vegan diets often include supplementation with vitamins D and B-12 as well as certain minerals like iodine that can be challenging to get enough of from solely plant-based foods. Supplementing usually resolves the issue. But the study found that even with supplementation children on strict vegan diets had significantly lower vitamin D levels than did children eating a more traditional omnivore diet.
the vegan children also had lower levels of vitamin A.

On the positive side, vegan children had higher levels of folate (folate - aka vitamin B-9 - is important in red blood cell formation and for healthy cell growth and function) and lower levels of LDL cholesterol.

The study calls for larger studies before early-life vegan diet can be recommended as a healthy and fully nourishing diet for young children, despite its many health-promoting effects in adults and suggests that the metabolic effects of vegan diet in adults cannot be generally extrapolated to children.

This is a preliminary result and not a call to avoid a vegan diet for young children. But caution should be exercised to ensure that they receive a supplement regimen that compensates for the observed deficiencies. Also, the study results apply only to young children and not to older children or adults.

Is 10,000 Daily Steps Fact or Fiction?

 

Does walking 10,000 steps per day elude you no matter how much you try to do it? Well, relax. 

There is no scientific evidence supporting 10,000 daily steps as a standard. In fact, this often-cited guideline originated as an ad campaign for a Japanese-made podometer. In 1965, Japanese company Yamasa Toki introduced their new step-counter, which they called Manpo-Kei. This translated into “10,000 steps meter” and they marketed their device with the slogan, “Let’s walk 10,000 steps a day.” Japanese walking clubs were fairly popular at that time and the idea of a 10,000-step target seems to have caught on because the slogan was catchy and people tend to like nice round numbers. The rest, as they say, is history.

Of course this is not to suggest that being sedentary is ok. It's just not. But what does the science suggest as a target for how much walking you should do to enjoy significant health benefits from it?

A recent study by University of Massachuestts Amherst physical activity epidemiologist Amanda Paluch and published in JAMA Network Open has the answer. She recently determined that walking at least 7,000 steps a day reduced middle-aged people’s risk of premature death from all causes by 50% to 70% — compared to that of other middle-aged people who took fewer daily steps. “You see this gradual risk reduction in mortality as you get more steps,” Paluch said. “There were substantial health benefits between 7,000 and 10,000 steps, but we didn’t see an additional benefit from going beyond 10,000 steps.”

If even 7,000 steps seems more than you can achieve, do what you can. Any walking will benefit your health. No kidding.

 

How Long Have You Got Left?

 

 

 

As 2021 moves toward its conclusion, most of us are not thinking about how we all are doing the same thing. We know when 2021 will end. Our own conclusion is unknown to us. But if you are curious about how much more time you have, there are a number of life expectancy calculators online that would be happy to ballpark it for you. 

Some, like the free calculator available on the Social Security Administration web site, are overly simplistic but quick to use. Others will analyze the personal information that you provide on your family, health and lifestyle and provide an eerily specific result.... sometimes right down to the day you can expect to...err, conclude.

If you want a quick (less than 5 minutes) and reasonably good estimation, try the unfortunately named Death Clock. With just a few quick questions it will let you know when to call the undertaker. (March 22, 2043 for me.)

If you want a much more accurate forecast, and don't mind spending a bit more time answering questions (about 15 minutes), the Living to 100 Life Expectancy Calculator is for you. Unlike many of the other calculators, this one will give you personalized feedback on your answers, customized lifestyle change suggestions and specific things you could review with your healthcare provider.

For the ultimate in life expectancy forecasting, try the Actuaries Longevity Illustrator. Developed jointly by the US American Academy of Actuaries and the UK Society of Actuaries, it will evaluate your answers against the databases used by insurers to set life insurance premiums. Since there is money involved, you can expect it to be as accurate as something this inherently inaccurate can be.

Besides morbid curiosity, what would be the point of doing this?

For me, I find knowing my "use before date" to be personally motivating. It is much harder for me to justify wasting even one day when I know that I have only 7,747 of them left. Yeah it sounds like a lot of days, but once one is gone, its gone for good.

It may also motivate you to make changes that can add more days to your clock. As Ebeneezer Scrooge said to the Spirit of Christmas Yet to Come when faced with his own gravestone, "Men's courses will foreshadow certain ends, to which, if persevered in, they must lead. But if the courses be departed from, the ends will change."

Happy New Year.

Exerci$e Pay$ Off

 

How would you like to have an extra $1,350 every year to spend on anything you liked? 

An analysis from the National institutes of Health published in BMJ Open Sport & Exercise Medicine concluded that older adults who were active and exercised through adolescence and adulthood spent that much less on healthcare every year than those who had not maintained an exercise habit. 

The study examined various levels of participation in physical activity throughout adulthood and how activity affected Medicare claims. Among the findings: Exercisers with a moderate level of activity had health care costs $1,200 a year lower after age 65 compared with adults who were consistently inactive from adolescence into middle age (moderate exercise involved walking or otherwise being in motion for a few hours most weeks). The health costs of those with a high level of activity were $1,350 lower per year.

Already a senior and did not devote much attention to exercise in your past? Even late starters benefited, the analysis showed. Waiting until middle age to increase activity still led to cost reductions of $824 per year.

So get off the couch, stop making excuses and get moving. How do you plan to spend the money you save?

 

New Hope for an Alzheimer's Cure?

 

Alzheimer's Disease is the 6th leading cause of death in the United States. One in 3 seniors dies with Alzheimer's or some other form of dementia, more than breast cancer and prostate cancer combined. More than 6 million Americans suffer with Alzheimer's and that number is expected to double over the next decade. Treating and caring for dementia patients costs $355B annually in the US, and by 2050 is expected to cost more than $1T per year.

This does not even consider the emotional cost. Alzheimer’s is a disease that affects everybody it touches—husbands, wives, children and grandchildren—they all bear witness to their loved one’s slow demise. 

After the ongoing Aduhelm fiasco  we are all understandably skeptical of any news of treatments or cures. But the financial, emotional and social costs of the disease are so enormous that we can not help but remain hopeful. Perhaps our hope has been rewarded, or soon will be.

Scientists at the University of California at Riverside (not a drug company) tried to study Alzheimer’s disease from a different perspective and the results may have led them to the cause of the disease. The researchers  recently published results from a study that looked at a protein called tau. By studying the different forms tau proteins take, researchers discovered the difference between people who developed dementia and those who didn’t.

The tau protein was critical for researchers because they wanted to understand what the protein could reveal about the mechanism behind plaques and tangles, two critical indicators doctors look for when diagnosing people with Alzheimer’s. By analyzing donated brain samples, researchers found that those with brain buildup, like plaques and tangles, but had no dementia had a normal form of tau. However, those who had a “different-handed” form of tau and developed plaques or tangles did have dementia.

You can read more about the study here.

Most proteins only survive for less than 48 hours in the body, and if they hang around too long, certain amino acids can convert into the other-handed isomer. So that means a left-handed isomer could inadvertently convert into a right-handed isomer, which can lead to serious problems.

However, the human body has a solution through a process called autophagy, which clears spent or defective proteins from cells. Unfortunately, as people age autophagy slows down, especially in people over the age of 65. It’s not clear exactly why.

There are drugs currently being tested to improve the process of autophagy, and some existing ones that are approved for cardiovascular disease and other conditions could speed up the approval process. Ryan Julian, a chemistry professor at UC-Riverside involved in the research, says that “if a slowdown in autophagy is the underlying cause, things that increase it should have the beneficial, opposite effect.”

Could this be the key to unlocking a cure? It is too soon to know but this latest advance seems especially promising.

 

An Alternative to Single Use Plastic?

 

 

Humans buy about 1,000,000 plastic bottles per minute in total. Americans purchase about 50 billion water bottles per year, averaging about 13 bottles per month for every person in the U.S. It is estimated that 4 trillion plastic bags are used worldwide annually. Only 1% of plastic bags are returned for recycling. Single-use plastics frequently do not make it to a landfill or recycling. A full 32% of the 78 million tons of plastic packaging produced annually is left to flow into our oceans; the equivalent of pouring one garbage truck of plastic into the ocean every minute. Even when single-use plastics make it to landfills they aren’t harmless. Landfill liners can leak harmful pollutants into the watershed and plastics on the tops of landfills can be carried away by the wind.

What if there was a practical alternative to plastic packaging that was from a sustainable source and was fully compostable? 

Researchers at the University of Cambridge in the UK have created a plant-based, sustainable, scalable material that could replace single-use plastics in many consumer products. The researchers created a polymer film by mimicking the properties of spider silk, one of the strongest materials in nature. The new material is as strong as many common plastics in use today and could replace plastic in many common household products. Even better, the new material is home compostable and can safely degrade in most natural environments.

The results were published in 2020 in the journal Nature Communications. While not ready for large scale commercial use just yet it will be commercialized by Xampla, a University of Cambridge spin-out company developing replacements for single-use plastic and microplastics. The company will introduce a range of single-use sachets and capsules later this year, which can replace the plastic used in everyday products like dishwasher tablets and laundry detergent capsules. You can read more of the details here.

With any luck, we may have a practical alternative to single use plastics for the first time.

How Much Walking is Enough?

 

Pretty much everyone agrees that walking is good exercise. Its free. It doesn't require any specialized equipment or training. And you can keep doing it no matter how old you are. If you haven't been exercising then walking is a great way to start back into it. And, lets be honest, your dog will totally support you.

But how much walking do you need to do and at what pace to really benefit from it?

Well unlike many other things, more is definitely better. But here is some good news if you don't have the time (or ambition) to devote an hour or two to walking every day. 

According to Michael Weinrauch, MD, a New Jersey-based cardiologist, the bottom line is that even the smallest neighborhood loop can have an immense impact on your health and well-being. "The take home point here is that even 15 minutes a day of walking, without stopping, provides benefit with regards to cardiovascular morbidity and mortality," he says.

Read the entire article here. Then lace up your shoes and go for a walk. Your heart will thank you. 

Beyond vs Impossible

 

Like it or hate it, plant-based "meat" is making inroads into the American diet. Even fast food burger places are climbing on board. So who makes a burger that is better - or maybe least bad - for you: Beyond Meat or Impossible?

Taste. Advantage: Tie. Believe it or not, by the time you cook one, slap it on a bun and add onion, tomato, lettuce and catsup, you will have a hard time telling that it is not real meat. They don't taste bad at all. Unfortunately, the very ingredients that deliver on taste also make these meat substitutes, at best, no better for you than real meat.

Saturated fat.  Advantage: Beyond Burger. Both products have too much saturated fat, mostly from coconut oil. A four ounce Beyond Burger has 5 grams of it, vs 8g for Impossible. For comparison, a Quarter Pounder from McDonald's delivers 7 grams.

Protein. Advantage: Beyond Burger. Since meat provides a lot of protein, replacing it with a plant-based food should provide a lot as well. Beyond edges out Impossible with 20g in a 4 oz burger from peas and rice vs Impossible's 19g from soy and potatoes. Four ounces of 95% lean ground beef contains 33g.

Heme. Advantage: Beyond Burger. Heme is an organic, ring-shaped molecule that easily binds to iron and so plays a key role several essential reactions involved in energy metabolism. Meat's contain an abundance of it. When exposed to high heat, such as in grilling, heme can help form carcinogenic substances in the gut which may explain why red meat eaters have a higher risk of colorectal cancers. Impossible contains heme; Beyond does not.

Sodium. Advantage: Impossible. But really there is not much difference. Impossible has 370mg of sodium while Beyond Burger has 390.

Cholesterol. Advantage: Tie. Both products are cholesterol-free.

Additives. Advantage: Tie. Both products contain preservatives and coloring to make them look and clump more like meat.

Cost. Advantage: Tie. Impossible was recently selling six 4oz patties for about $14.00. Beyond Burgers were just over $15.00. For comparison, a pound of ground beef sells for about $5.

I'd call it in favor of the Beyond Burger, but not by enough to worry about. Environmental impact aside, neither one is much better for your health than ground beef. But don't count plant-based meat substitutes out just yet. They are certain to improve with time and the sustainability of their production methods may give them the edge in the long run.

 

Marketing Pro-Buyotics

 

There is little doubt that our microbiome - the collection of bacteria, fungi, viruses, and their genes that naturally live on and in our bodies - influences our overall health in significant ways, many of which are as yet poorly understood. That hasn't slowed the food industry from trying to convince you that products containing "beneficial" bacteria are healthier than ones that do not. Are they correct? Spoiler alert: No.

"Scientists have not defined what a healthy microbiome looks like," says Geoffrey Preidis, a gastroenterologist at Texas Children's Hospital. "Everybody's microbiome is different and it is impacted by many factors like age, genetics, diet, exercise, lifestyle habits and so on." That a healthy microbiome should look a certain way is a misconception. And even if you wanted to "adjust" your microbiome, no one knows how to do that. Certainly not the marketing department of your favorite probiotic maker.

So far, most researchers agree, the most likely route to a healthy microbiome is to eat a diet rich in fiber from fruits, vegetables, whole grains and beans. But that's no help if you are selling cereals, snack bars. muffins, juices, trail mixes, teas, or just about anything else "enhanced" with probiotics. "Whenever companies see an opportunity to boost profits they will use science, no matter how good is is," says Marion Nestle, professor emerita of nutrition, food science and public health at NYU.

"The public's enthusiasm for probiotics is just not matched by the evidence" that they are effective, concludes Pieter Cohen, associate professor of medicine at Harvard Medical School.

There is plenty of evidence that bacteria rich foods like yogurts and fermented foods have health benefits. But don't allow yourself to be swayed by the word "probiotic" on a food label.

Are You FRAXed?

 

About 20% of women and 5% of men over the age of 50 have osteoporosis, or brittle bones. Another 50% of women and 30% of men in that age group have osteopenia, or low bone mass. Either condition increases the rick of a fractured bone after even a minor slip or fall. And in older people, the consequences of any fracture can be serious.

An overview of various studies found the one-year mortality rate for elderly patients with a hip fracture to 21%, and that the 12-year mortality rate doubles once elderly individuals fracture their hips. A compression fracture of the vertebrae is especially common in older adults. Such fractures can cause significant pain, leading to inability to perform many activities of daily living, and life-threatening decline in the elderly patient who already has decreased reserves.

Even when a fracture is not life threatening, older adults heal more slowly, may not fully heal at all and may suffer decreased independence as a result of any fracture. 

The National Osteoporosis Foundation recommends that women have a bone density test at age 65 and men do so at age 70. If you are that old, have a conversation with your healthcare provider the next time you see him/her.

In the meantime, anyone can use this fracture risk self-assessment tool to estimate your risk. Even if you are not at an increased risk, it is not a bad idea to make the following lifestyle tweaks to help strengthen and protect your bones.

Make sure your Vitamin D levels are normal. The Endocrine Society recommends that everyone maintain a Vitamin D blood level of 30 - 60ng/mL. This is higher than the 20ng/mL formerly recommended. Also, with Vitamin D, more is not better. Levels above 60ng/mL are correlated with a number of health issues. Get tested at your next physical.

Watch your calcium, but don't overdo it. Many doctors used to recommend taking as much as 1,000mg of calcium per day from a supplement. More recent advice is to get about 900mg per day. In fact nearly everyone gets that much from their diet and doesn't need supplements. Too much calcium can cause other issues such as kidney stones.

Reduce the acidity of your diet. The typical American diet is loaded with acidic foods. Even a small increase in the acidity of the body can trigger a process of bone breakdown called resorption. The best way to reduce the acidity of your diet? More fruits and vegetables and fewer grains.

Do resistance exercises. Resistance exercise like weight lifting does more than build muscle, it strengthens your bones. Two or three times a week is enough to see a benefit.

Don't wait till you break something, start taking care of your bones today.

Just a Bit of Tomato Paste Right When You Need It

 

Did you ever open a whole can of tomato sauce because you needed just a little bit for a recipe? Or, more likely, tomato paste. What do you do with the rest? Here's an idea.

Find an old ice cube try, the sort people used before every refrigerator came with its own ice maker. Spoon the leftover sauce or paste into the cells and freeze it. Then pop it into a plastic bad for storage. Next time you need just a little, grab a cube, let it thaw and you are good to go.

The Dairy Debate

 

 

More and more people believe that plant milks are healthier than dairy milk, question whether dairy products are necessary at all or that perhaps they are even harmful. It is certainly true that dairy products are rich in nutrients such as protein, calcium and potassium. But they also contains a lot of saturated fat, and hormones such as estrogen-like growth factor and prostaglandins. They may also contain trace amounts of antibiotics. So should diary be a part of a healthy diet or not?

The scientific evidence in favor or against dairy is mixed.

Increasingly, studies have found that consuming full fat dairy products does not seem to raise your risk of heart disease or stroke. A 2018 study published in Lancet found that those regularly consuming more than two daily servings of full fat dairy had a lower risk of cardiovascular disease than those eating only half a serving. "You can't judge a food by its fat content," explained Dariush Mozaffarian, MD and dean of the Friedman School of Nutrition Science at Tufts University. "There are many different saturated fats and each has potentially different health effects."

While dairy is rich in bone-building calcium, large studies have not found that dairy is protective against either osteoporosis or fractures in adults. 

Studies suggest that yogurt may somewhat reduce the risk of developing type-2 diabetes. This may be due to a beneficial effect on the microbiome. Cheese also seems to help, possibly because it is a good source of vitamin K.

Generally there is no strong evidence of a link between consumption of dairy and breast, ovarian or bladder cancer. However there is some backing for a connection between high dairy intake and endometrial and prostate cancers.

A 2020 meta-analysis published in Advances in Nutrition found that the risk of obesity was no higher among those who ate full fat dairy than those who did not.

Most researchers now agree that dairy is not essential for good health. "Drinking cows milk," says Mozaffarian, "doesn't seem to have any major benefits or harms." So here is one case where you can let taste and personal preference be your guide.

Five Reasons to Give Jicama a Try

 

Jicama is a root vegetable with papery, golden-brown skin and a starchy white interior. Originally grown in Mexico, jicama eventually spread to the Philippines and Asia. It requires a long growing season with no frost, so it thrives in locales that are warm year-round. Its flesh is juicy and crunchy, with a slightly sweet and nutty flavor. Some think it tastes like a cross between a potato and a pear. Others (including me) compare it to a water chestnut.

Other names for jicama include yam bean, Mexican potato, Mexican water chestnut and Chinese turnip. It is often available in the produce section of your grocery store. Here are five reasons why you should give it a try.

1. Jicama is a nutritional powerhouse. Most of its calories come from carbs. The rest are from very small amounts of protein and fat. Jicama contains many important vitamins and minerals, as well as a significant amount of fiber. This root vegetable is low in calories and high in water, making it a weight loss-friendly food. Jicama is also an excellent source of vitamin C, magnesium, potassium and folate. It contains small amounts of vitamin E, thiamine, riboflavin, vitamin B6, pantothenic acid, calcium, phosphorus, zinc and copper.

2. Jicima is heart healthy. It contains dietary fiber, potassium, iron, copper and nitrate, which may benefit heart health by lowering cholesterol levels, reducing blood pressure and improving circulation.

3. Jicama supports gut health. Jicama contains a type of prebiotic fiber that feeds beneficial gut bacteria. Healthy gut bacteria reduce the risk of developing obesity, heart disease and diabetes.

4. Jicama is easy on the waistline. It is a nutrient-dense food that is low in calories and high in fiber and water. Studies show that eating jicama can decrease blood sugar levels, improve insulin sensitivity and help you feel full longer.

5. Jicama is tasty, versatile and different. There are many different ways to eat jicama. It can be eaten plain, with a dip, or incorporated into dishes like salads and stir-fries. Grate it and toss with cabbage and carrots for a slaw or use it in a stir fry. Slice it into thin rounds or matchsticks, season with chili, lime and a dash of salt for an easy snack.

Jicama is just a healthy food to include in your diet. Plus, it's tasty and crunchy and can be eaten by itself or paired with many other foods. Given all of the benefits that jicama has to offer and its wide availability and low cost, you should consider incorporating it into your diet.

 

Your Holiday Battle Plan

 

Thanksgiving is behind us and The Holidays are here. The average American gains about 2 pounds between Thanksgiving and Christmas. But then they put on another 3 pounds in the 10 days following Christmas. Five pounds may not sound like a lot, and really it isn't. The problem is that most people never lose those added pounds and they add up year after year.

When it comes to maintaining your wellness routine the holidays can be a real challenge. You don't need to throw in the towel though, you just need to have a plan that will work for you. Here are some ideas to get you on your way.

1. Don't ruin your holidays over a few pounds. The holiday season comes only once a year and after the year we have had you deserve to celebrate with friends, family, food and fun. Just do so mindfully. You can allow yourself to enjoy without overdoing it.

2. Watch the booze. Alcohol is all calories and little else. Go ahead and have a drink. Just limit yourself to one or two. Drink water between alcoholic drinks to stay hydrated.

3. Portions, portions, portions. Don't skip your favorite foods. Just watch your portion sizes. Go for the more nutritious choices, and minimize the surgery treats.

4. Move more, sit less. If you have the option of standing versus sitting, stand. If you have the option of walking versus driving, walk. If you have the option of moving about versus standing, move about. Every calorie you burn now is one less you will need to deal with later.

5. Resume your routine. Try to maintain your diet and fitness routines through the holidays. Ha ha ha. Just kidding. But do plan to resume them on January 2nd. Gaining a few pounds will do you no harm as long as you lose them again. This is the key item.

Temptations will be everywhere, and parties and travel will disrupt your daily routines. Be mindful of this to minimize the impact and be ready to resume your routines as the new year begins.

Your Facebook Friends Are Wrong

 

Scientific studies can be difficult for a lay person to interpret, so it is not surprising that we rely on intermediaries - news outlets, social media, well meaning friends - to help us understand them. Every field has its own specialized technical jargon and the design and execution of the studies themselves can be complex. Unfortunately this leaves a lot of room for misinterpretation, both accidental and intentional. News media cherry pick studies and misrepresent their meaning, typically through ignorance. Organizations will search for studies and data that support their agenda and ignore any that don't. Critical context is often lost in the rush to post a great story. And the technicalities of statistical significance and study design are often just ignored.

Would you like to get better at interpreting the news of medical studies and new developments? Would you prefer to be a more critical and informed consumer of social media without having to get a medical degree?

Here is an option. A free course that explains how study design works and what questions to ask to intelligently interpret the results. "Understanding Medical Research: Your Facebook Friend is Wrong" will give you the basics you need to sort through all the noise and separate fact from wishful thinking, or worse. The instructor is from Yale University and knows his stuff.

Four Lifestyle Tips to Lower Cholesterol

 

 

Healthy cholesterol levels are pretty much the same for all adults. These are a Total Cholesterol under 200mg/dL, LDL (Bad) Cholesterol under 100mg/dL and HDL (Good) Choesterol at or above 40mg/dL (50mg/dL for women). The LDL and HDL numbers are the more significant ones for assessing your hearth health, along with keeping Tiglyceride levels under 150mg/dL. Do you know your numbers?

Whatever your levels, the following four lifestyle factors, taken together, will improve your cholesterol levels and lower your overall risk for heart disease.

Eat Smarter. Limit your consumption of red and processed meats, fried foods, sodium and added sugar. Focus on whole grains, poultry, fish and healthy fats.

Get Off Your Butt. Move more. Exercise like brisk walking is ideal but at least get on your feet and move. Aerobic exercise can help raise your HDL levels and resistance/strength training helps lower LDL.

Lose the Extra Weight. If you are overweight even a little - and 70% of us are - lose the excess. What is a healthy weight for you? It's less than you think it is. While it is complex and different for everyone, here is a calculator that will get you in the ballpark.

Stop Smoking. Seriously. Do you still need to be told this? And don't delude yourself that vaping isn't smoking.

There are effective medications for optimizing your cholesterol levels but they all come with unpleasant and potentially serious side effects. So why not try these things first?

Happy Thanksgiving

 

For me Thanksgiving is a day to take a deep breath and remind myself of all the things I have, the ways in which I am fortunate and everything that there is in my life to be grateful for. 

I do an exercise each Thanksgiving Day of sitting down in a quiet place and making a list - with pen and paper - of 100 things that I am thankful for. It is a great thing to have at hand throughout the year for whenever I am feeling sorry for myself or get caught up in thinking about all the things I don't have.

It is also the perfect day to pause to give some thought to those people who are no longer with me to celebrate it - more and more of them every year. 

Whatever your family traditions may be, however you celebrate Thanksgiving Day, I want to wish you a happy, healthy and special holiday. Be well, do good works.

 

Rolling the Dice on Social Media

 

Long gone are the days of people getting most of their news from a local TV station, their local newspaper or the national newscast from one of the networks. Increasingly, people turn to social media for news and information. Facebook leads with 36% of social media consumers using the social media giant for consuming news. Instagram news consumers were 11% of the social media population. Twitter was statistically tied at 12%. YouTube had 21% of social media users looking at news on the popular video site. WhatsApp had 16%. This is so even though, according to reports from Gallup and the Knight Foundation,  Americans believe that 65 percent of news on social media is made up or can’t be verified as accurate.

So increasing numbers of people are relying for their news and information on sources that they view as increasingly unreliable. Besides being just goofy, this has serious implications for our health and wellness too.

A recent study published in the Journal of the National Cancer Institute looked at the quality of cancer treatment information available on social media and the results were not encouraging. The researchers found that 32% of articles on Facebook, Pinterest, Reddit and Twitter giving advice on cancer treatment contained "misinformation and potential for harm". Generally the errors prompted readers to postpone therapy or try ineffective or inappropriate remedies. 

This is not simply being misinformed. It is potentially life threatening.

There is nothing on the horizon to suggest that the information you glean from social media is becoming any more reliable. Perhaps it is time to restrict your social media time to cat photos and catching up with family and friends and find your news and information elsewhere.

 

The Food Labeling Wars Continue

 

 

One has to wonder why every time food labels are enhanced to include more accurate and complete information about what is in it, the food industry shrieks as though bitten in a tender place by a very angry dog. You might almost think they oppose pretty much any change in labeling regulations because they are hiding something.

The Food Labeling Modernization Act (HR4917) was recently introduced by Congressman Frank Pallone, Jr. of New Jersey and is presently in the House Energy and Commerce Committee. The proposed bill would mandate several changes to required food labels including nutrition summary labels on the front of food packages and warnings of excessive amounts of substances such as added sugar and sodium. If a food package highlights a specific ingredient, say, "whole grains", "fiber" or "real" fruits or vegetables, it would be required to list how much of it the product actually contains. Finally, food manufacturers would be required to list complete nutrition and ingredient information for their products on their web sites.

Food manufacturers are not amused and are fighting hard to spare us the "confusion" that the new labeling requirements would cause.

Meanwhile, Brian Ronholm, Director of Food Policy for Consumer Reports, points out that under present rules "claims about healthy ingredients are sometimes used even if the product has only a very small amount." For example, in a recent Consumer Reports review of 56 breads touting "whole grain" and "multi grain" content nearly all contained little else than refined wheat flour. "The bill would make labels simpler, clearer and more informative," Ronholm says, "and reduce the chance that consumers will perceive food as being more nutritious than it really is." Sounds confusing to me!

This would be an excellent time to let your Representative know that you want his or her support on this bill.

Foods Better Frozen Than Fresh

 

It may seem counterintuitive to use frozen ingredients instead of fresh. In fact, in some situations frozen can be better than the fresh alternative. This can be true for a number of reasons. 

There is essentially no nutritional difference between frozen and fresh fruits and vegetables, and frozen fruits/vegetables retain their nutritional value while fresh ones have decreased levels of nutrients after being stored for a few days.

Frozen foods will not spoil for months and with vegetables and fruits that are prewashed and cut, you can reduce your meal prep time and add more healthy foods to your meals.

Frozen foods are often less expensive than fresh ones, especially if you’re thinking about fresh organic foods. Frozen vegetables give you the option to pull some out only when you want them and then put them back until later. With fresh fruits and vegetables, you typically need to consume them all soon after purchase. So frozen reduces waste.

One study looking at the impact of fruit and vegetable storage options discovered that frozen fruits and vegetables can have more antioxidants than their refrigerator-stored counterparts. It turns out that freezing them preserves the antioxidants, and letting the fruit sit in a refrigerator causes some of that free radical fighting power to be leached away.

Finally, frozen can actually be "fresher than fresh". Modern ‘harvest-to-freeze’ technology has evolved so much that fresh fruits and vegetables are picked when they’re ripe, full of flavor and nutritional value, and then quickly frozen. Whereas the fruits and vegetables you buy in the grocery store that are purported to be fresh have actually been picked prematurely and spent days or even weeks in transit.

Here are five foods that you should consider buying frozen rather than fresh.

Shelled Peas.

Peas taste amazing in the spring, when they’re fresh and filled with nutrients, and not so great anytime after that. You can capture that healthy flavor all year long by cooking with frozen peas. As a bonus, they’re already shelled so they’re easier to cook with, too!

Berries.

When berries are in season, you should definitely seek them out at the farmers market. The rest of the year, choose frozen berries. They’re picked and packed at the peak of freshness, and they won’t lose their antioxidant-rich properties in the freezer either.

Spinach.

If you are making a salad by all means stick to the fresh stuff, but use frozen spinach for any cooked dish. Frozen spinach lasts longer and is typically less expensive than the fresh stuff. Plus, freezing spinach actually makes it more nutritious, increasing its concentration of thiamine and beta-carotene.

Corn.

(Yes, I know corn is a grain. Humor me.) Corn is not only expensive when it’s out-of-season, but it also doesn’t taste that great. Frozen corn, on the other hand, is packed at the peak of the season, so it’ll taste sweet and delicious any time of year.

Bell Peppers.

Bell peppers lose their nutrients super fast. In fact, the vitamin C found in peppers starts to oxidize as soon as the peppers are chopped! Freezing the peppers stops the process, preserving the nutrients more efficiently. Plus, you won’t have to worry about de-seeding the peppers if you buy them frozen.

If, like me, you get tired of throwing away produce that has gone bad while waiting for you to use it, frozen provides a healthy, convenient and less expensive alternative for you to try.

It's Not Dead Yet!

 

I don't really talk much about Covid-19 because conversations usually become arguments where little information is exchanged and no minds are changed. But I recently read an article in the Bottom Line Health newsletter about what is likely ahead for us regarding Covid. Bottom Line publications are not always rigorous but they do provide timely information free of political bias and backed up by verifiable references, so I thought I would share the key points. Take them or leave them, I'm not looking for an argument.

The article was written by Dr. Joseph Feuerstein, a professor of clinical medicine at Columbia University and the director of integrative medicine at Stamford Hospital. Here is his take on what we can expect over the coming weeks and months.

Expect more variants. There are now more than a dozen variants of the original virus and we should expect more, possibly many more. Viruses always mutate and new strains continually develop when they are not held on check. Most variants are harmless but some will be more contagious or cause more severe symptoms.

Vaccines are safe. There is no question that vaccines were approved conditionally and rushed into production. Concerns about their safety were overblown but not unreasonable. But now there is a peer reviewed study of nearly 2 million people published in the New England Journal of Medicine that has concluded that the mRNA vaccines are both effective and extremely safe. 

Herd immunity is out of reach. At least any time soon. It was hoped that when enough people had been vaccinated that Covid would effectively run out of opportunities to spread. For better or worse, not enough people are getting vaccinated and it does not look like enough ever will. So the virus will continue to mutate and spread.

Get used to booster shots. The effectiveness of the existing vaccines appears to lessen after 9 to 12 months. So expect to be taking regular booster shots that will maintain your immunity as well as address the threats posed by new variants.

Keep your vaccination card safe and handy. The time is coming when you will need it to gain entry to many public places and events. This will vary State by State unless the Federal government establishes a national standard. You will certainly need it for any foreign travel so keep it with your passport.

Schools will continue to struggle with infections. The politicization of mask mandates and vaccinations mean that we will continue to see increasing infection rates among school-age children. There is no appetite for a return to virtual learning so the arguing will continue until mounting transmissions and outbreaks force localities to change, probably after the worst damage has already been done.

Effective treatments for the virus are on the way. Two new drugs for treating Covid are in clinical trials and may start to be available as soon as the end of 2021. More are sure to follow.

Is Obesity a Disease?

 

In June 2013, the American Medical Association (AMA) House of Delegates voted to recognize obesity as a disease requiring treatment and prevention efforts. A number of other medical societies had sponsored a resolution to support this idea, including the American Association of Clinical Endocrinologists, the Endocrine Society, the American College of Cardiology, the American College of Surgeons, and the American Heart Association. The National Institutes of Health had declared obesity a disease in 1998.

The AMA's decision remains controversial, since the AMA’s own Council on Science and Public Health in 2012 said that there was not sufficient data to support calling obesity a disease. So then is obesity a clinical condition or a behavioral problem?

Right now, 42% of the population of the USA are obese (a BMI of 30 or higher). Another 30% are overweight. And despite spending $3.7B on weight loss products and programs in 2020 more than 70% of us are overweight and the number keeps growing year after year. Being overweight is a risk factor for over 200 chronic diseases including cancers, hypertension, diabetes, arthritis and heart disease.

In designating obesity as a disease, the AMA recognized that it is not simply a matter of choice and willpower but of a complex set of factors that include genetics, socioeconomic status, education, medications that a person may be taking, sleep quality and more. This does not negate the timeless advice to "eat less and move more". But it suggests that it is a condition serious enough to merit the attention of doctors and other healthcare practitioners. 

The stigma associated with obesity is also an important factor. No one who is obese does not realize it. But, unlike a person hobbled by arthritis or insulin dependence, they are often shamed and told to "just stop eating so much". There is no shame in needing therapy to treat a cancer but many obese people are too ashamed of their condition to seek help.

Another mitigating factor is the lack of insurance coverage for weight loss support programs. Considering the the serious and widespread negative public health impact of obesity this may seem strange. But as long as it is seen as purely a matter of personal choice and willpower, insurance companies are reluctant to provide coverage.

No one is saying that a healthy lifestyle that includes whole, nutrient-dense foods, exercise, stress management and restful sleep is not the foundation of weight loss. But many people are not able to succeed at it. Failing to recognize it as a serious health condition, if not a disease, worthy of support and attention from insurers, doctors, the healthcare community and society at large seems likely to allow the alarming prevalence of obesity to continue to grow.

If I Can Do It So Can You

I talk a lot on here about weight. Where it comes from, why too much is bad and how to lose it. I base what I say on what I read (I'm a pretty critical reader) but more importantly I base it on my own real life experience. At the start of 2020 I was heavier than I had ever been in my life. So much so that I felt crappy, my joints hurt, I had no energy, was sleeping poorly and could not fit into my pants.

I'd been there before. I knew I could drop some weight just by eating less for a while because I had done it many times before. But this time I wanted to do it sustainably. I didn't want to gain it all back again. The graph above shows my progress from February 2020 to today.

No special diets. No weight loss programs. No gym membership. Just eating a better diet, exercising and burning more calories than I consumed. No tricks, no magic and if I could do it, anyone can.

If you would like more detail on exactly what I did, drop a comment and I am happy to send it your way.

The Aduhelm Fiasco

 

In June of last year, to great media fanfare, the FDA approved the new drug Aduhelm (aducanumab) to treat Alzheimer's disease. Six million Americans suffer from Alzheimer's, which is a horrific and ultimately fatal form of dementia, and available drugs typically delay cognitive decline by only a few months at best. So any new medication is eagerly welcome. If it works, that is. And if anyone can afford it.

Two clinical trials of Aduhelm had concluded that the drug was so unlikely to slow the progression of the disease that both trials should be stopped early. They were.

Six months later, Biogen, the manufacturer of the drug, announced that they had analyzed the data more carefully and that the study group receiving the highest dose had actually improved. Based on this new information the FDA convened an external advisory committee to examine the evidence. 

"The totality of the data does not seem to provide sufficient evidence to support the efficacy of the high does," the FDA's internal analysis concluded, noting that even the "favorable" results presented by Biogen produced only a 0.4 point improvement on an 18 point scale. The advisory committee voted 10 to 0 against approving Aduhelm.

Instead, the FDA approved the drug, justifying its decision by citing that it appears to reduce the amyloid plaques often seen in Alzheimer's patients - despite the fact that there is no proof that the plaques cause the disease, rather than just being a symptom of it. Three  committee members resigned in protest. Further, the drug was approved for all Alzheimer's patients, not just the early stage patients on whom it was tested. (Did I mention that the list price of Aduhelm is $56,000 a year?)

Fortunately, new leadership at the FDA is taking a new look. In July, 2021, the FDA changed its recommendation and said that only people with early stage Alzheimer's should use the drug. That same month, the FDA's Acting Director ordered in independent investigation of the agency's approval process, citing an "off the books" meeting between the head of the FDA's neuroscience division and Biogen executives.

So there you have it. An enormously expensive drug that is mostly ineffective and has side effects such as brain bleeds and swelling approved against the advice of the FDA's own annalists and independent advisors. Doesn't sound like anything is amiss here to me. How about you?

Shrinkflation

 

 

No one is going to be surprised to hear that prices have been going up lately. Post-Covid inflation is bringing price increases across a wide range of goods and services from gas for your car to food for your family. What you may not know is that food prices have been going up for years, long before the current bout of inflation. The cause? Shrinkflation.

Shrinkflation, also known as grocery shrink ray or contents downsizing, is the process of items shrinking in size or quantity, or even sometimes reformulating or reducing quality, while their prices remain the same or even go up a bit. You aren't paying more, but you are getting less. And unsurprisingly, manufacturers carefully disguise this from you. For example, packaging is usually identical, it just contains less. "New and Improved" often means nothing more than less product in a redesigned package.

Instead of increasing the price of a product, something that would be immediately evident to consumers, producers reduce the size of the product while maintaining the same price. The absolute price of the product doesn’t go up, but the price per unit of weight or volume has increased. The small reduction in quantity is usually unnoticed by consumers (at least that’s what the manufacturer hopes). Producers always indicate the weight, volume, or quantity of their products on packaging labels. So it’s not illegal – it’s just sneaky.

Some examples....

Coca-Cola: in 2014, Coca-cola reduced the size of its large bottle from 2 liters to 1.75 liters. The price did not change.

Toblerone: in 2010, Kraft slashed the weight of Toblerone bars from 200 grams to 170 grams. The price did not change.

Tetley: in 2010, Tetley reduced the number of teabags sold in one box from 100 to 88. The price did not change.

Toothpaste: a tube of toothpaste used to contain 7.2 pounces of product. Now nearly all brands contain only 5 ounces... but the size of the tube, like the price, is unchanged.

Other common victims of shrinkflation include breakfast cereals, toilet paper, canned tuna, ice cream, coffee, peanut butter and canned anything.

There is not a lot that you can do about these ubiquitous hidden price increases. But you can at least be aware of them by checking the "unit cost" information that is posted by grocers along the edgers of their shelves.

Patently Ridiculous

 

Developing an effective new drug and then bringing it to market is an expensive process. A very expensive process. In an analysis of the drug development costs for 98 companies over a decade, the average cost per drug developed and approved by a single-drug company was $350 million. But for companies that approved between eight and 13 drugs over 10 years, the cost per drug went as high as $5.5 billion, due mainly to geographic expansion for marketing and ongoing costs for Phase IV trials and continuous monitoring for safety. Any way you look at it, that is a lot of money.

Drug companies often cite these high costs as justification for the often astronomical prices of drugs on the market. Most people would agree that investing in the development of important new drugs is a social good and should be well rewarded. But according to Andrew Witty, the former CEO of GlaxoSmithKline, one of the largest pharmaceutical companies in the world, the R&D costs cited by drug manufacturers are "one of the great myths of the industry". Why? Because of the patent system.

Patent protection allows a company to sell the product that it developed for over a decade without any competition. Its no secret that brand name drugs are more expensive than essentially identical generic versions of the same drug, and the difference is growing rapidly. In 2013, brand name drugs were about 6 times more expensive than generics; by 2017 - just 4 years later - they are 18 times as expensive. The patent system prevents generic drugs from even being sold so long as the patent is valid (about 10 years in most cases). Ten years of charging 18 times what a competitor would charge for a product people urgently need.

But wait! There's more!

Drug companies are constantly gaming the system by making insignificant changes to a drug as it comes out of patent protection - making it a pill instead of a capsule or changing the dosage or targeting it at a different condition - and then patenting the same drug all over again. And when a drug does come off patent protection, it is not uncommon for a drug company to simply pay generic manufacturers to not produce a generic version of a profitable drug.

There is much more behind the high cost of drugs than just the patent protection system. But do we really want to tolerate a system that lets us pay $200 for a drug that we could buy for $10 in Toronto?

What can you do to protect yourself? Often nothing. But here are a few things you can do.

1. Drugs do not cost the same everywhere. Shop around. If you have a chronic condition be sure to investigate online sources.

2. Do not assume that your health insurance will get you the best price. If can often be cheaper to use a pharmacy discount card or, if you have hefty copays, to just pay for it yourself. (Truth.)

3. ALWAYS ask you doctor if there is a generic or cheaper brand name version of what you need. Doctors tend to prescribe what they are familiar with without regard to the cost.

4. ALWAYS ask your doctor or pharmacist if a combination drug would be cheaper to buy as individual components. In some unusual cases this can reduce the cost as much as 96%.

5. Review your medications at every doctor visit and make sure you still need to be taking them. Doctors will rarely suggest stopping a medication.

Better yet, make the diet and lifestyle changes that will minimize or eliminate the need to tale medication at all.

Are You Confused?

 

The Department of Health and Human Services (HHS) recently proposed a new rule that drug manufacturers don't like. They don't like it a lot. In fact they are pulling out all the stops to prevent the rule from ever taking effect.

What is this controversial new rule? HHS wants drug companies to be required to reveal the "list price" of all medications they advertise on TV. The rule would apply to any drug costing more than $35 for a monthly dose. 

The $35 limit is laughable, but drug companies aren't laughing. Not when a monthly supply of Humira rheumatoid arthritis pens costs $5,684. Even that seems like a bargain compared to the common multiple sclerosis drug mavenclad, which will set you back over $60,000 a month. And many cancer drugs, while not usually advertised on TV and so not subject to the proposed rule, can cost over $100,000.

Why are the manufacturers so unwilling to share prices in their ads? Really, its all about protecting you! Because if they were to make their prices public, you, the consumer, might be "confused".

Or is it that with price information the consumer might decide to shop around for a better deal? Nah. That would be even more confusing.

Are you confused?

Pros and Cons of BMI

 

Body Mass Index (BMI) is a popular measure of a healthy body weight. It is simple to calculate using any online BMI Calculator and is a useful tool for monitoring your body weight. It isn't perfect, however, and you should understand its strengths and weaknesses.

BMI delineates where normal weight crosses the line to overweight or obesity. An ideal BMI is between 18.5 and 25 (mine is 24). Over 25 is considered to be  overweight and a BMI over 30 is classified as obese. People with a high BMI have been shown to be greater risk of a list of health issues, including metabolic syndrome and diabetes, arthritis, fatty liver disease, high cholesterol and some cancers. But as a single indicator its accuracy and validity can vary a lot.

At BMIs over 30 the risk measure is reasonably accurate but it becomes less reliable below that. That is because BMI only considers height and weight and it can not distinguish between fat and lean muscle weight. So for example, a weightlifter with an unusually high lean muscle mass might show a high BMI.

BMI does not consider the location of fat deposits either. Belly fat tends to be more closely associated with health risks than fat in other parts of the body.

Even ethnicity can affect the interpretation of BMI. Asians tend to have higher health risks at significantly lower BMIs and Caucasians have higher levels of body fat at a given BMI than African Americans.

So is BMI a useful indicator? Yes. Its is easy to calculate and gives you a quick assessment of your weight. Just don't rely on it to the exclusion of other measures and factors.

When Are You Too Old to Start Exercising?

 

The short answer is: Never.

A longer answer would be: When your excuses overpower your motivation.

According to a recent study by the National Institutes of Health, formerly sedentary individuals who first began exercising between 40 and 61 years of age reduced their risk of death from all causes by 35%. The odds of cancer and heart disease also declined among those who began exercising vs those who did not.

The results of the 315,000 person study add to ample existing evidence that becoming active later in life can provide substantial health benefits. On the other hand people who were active during adolescence but not later in life gained little benefit compared to people who were never active. People who stopped exercising in their 20s and 30s but picked the habit up again later seemed to benefit just as much as people who maintained activity across their lifespan.

So there is the answer. It is never too late unless you are too lazy.

 

Tips for avoiding "Seafood Fraud"

 

Although seafood is one of the most popular foods in the United States, consumers are routinely given little or no information about where their seafood is from. Worse, the information provided on seafood labels is often misleading or outright fraudulent. In fact, a study of seafood sourcing by Oceana.org found that as much as one third of all the seafood sold in the US is "mislabeled". The problem was so pervasive that the study authors called it "seafood fraud".

A separate study of sushi sold at 26 different Los Angeles area restaurants conducted by UCLA researchers found that nearly half the sushi being served was made with an entirely different variety of fish than what the menu said.

So a significant percentage of the seafood you buy may not only not have been raised or harvested as advertised but may not even be the type of fish you think you are buying. One example from the Oceana Study: Tilefish, a fish with very high levels of mercury, was being labeled and sold as Alaskan halibut.

Some suggestions for protecting yourself against ending up with something fishy?

Shop at large chains. Seafood is mislabeled much less often at large grocery chains than at small markets. Large stores must follow USDA regulations while smaller stores and restaurants are exempt.

Buy salmon. The Oceana study revealed far lower levels of mislabeling of salmon than of any other fish variety.

Beware of bargains. If the price is too good to be true, it probably is. If a price seems unreasonably low, it may be a sign it’s a mislabeled fish.

The problem varies from fish to fish. The three fish you need to be extra careful about buying due to frequent mislabeling are some of the most popular species: tuna, snapper, and grouper. Consumers should make sure to ask extra questions when buying these fish.

Buy the whole fish whenever possible. You can ask for it to be cut into fillets at the store. The more processed your fish and the more hands it passes through, the more opportunities for a bait and switch.

Don't let any of this put you off eating seafood. Just become a smarter, and more skeptical, shopper.