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.

One More Additive to Watch Out For

 

 

Calcium propionate is a food additive present in many foods, especially baked goods. It acts as a preservative to help extend shelf life by interfering with the growth and reproduction of microorganisms. Although it has benefits for food manufacturers a 2019 study raises questions about how safe it is to eat.

The study, lead by Amir Tirosh, MD, at Sheba Medical Center in Tel-Aviv, suggests that propionate can alter metabolism in ways that increase the risk of diabetes, even when present only in small amounts. The additive triggered complex hormonal changes that raised blood sugar and insulin levels in both mice and humans. In the mice, consumption of propionate led to high blood sugar levels in the short term and weight gain and insulin resistance in the long term (after 20 weeks). In a small trial involving humans, people who consumed propionate experienced temporary increases in insulin resistance over the space of a few hours compared with those who didn't consume the additive.

While this early research does not prove that propionate causes diabetes, the findings are concerning given how widely propionate is used. In addition to bread and baked goods, propionate is commonly used in dairy products, especially cheese, and in meats, beer, sport drinks, commercially prepared salads such as potato salad, condiments such as vinegar and mustard, soups, sauces and dried or otherwise processed mushrooms, beans and nut butters.

Because it is so widely used and still considered safe by the FDA and DOA, it is very hard to avoid in any processed food.

 

One in Five US Children Not Drinking Water

 

A 2019 study published in JAMA Pediatrics has found that one in five American children had not drank any water in the 24 hours before the survey. The aim of the study was to determine whether water intake had any effect on children’s consumption of sugary drinks. The study found that the children who did not drink water on a given day consumed nearly twice the calories from sugar-sweetened beverages as those with any water intake, far exceeding the recommended 10% of total calories from added sugar. The American Heart Association recommends that children shouldn’t drink more than one 8-ounce sugary drink per week.

The non-water drinkers consumed about 100 more calories each day from liquids than those who drank water. That 100 extra calories per day is enough to contribute to obesity and other health problems like diabetes and dental cavities if continued over time. Just 100 extra calories per day is enough to cause a weight gain of about 1 pound per month.

The earlier children were exposed to drinking water the more likely they were to do so throughout their childhood years.

 

 

Should we Tax People for Their Own Good?

Five years ago, the World Health Organization suggested that taxing soda and sugary drinks would lower consumption and reduce obesity, type 2 diabetes and tooth decay. Now there is evidence that they may have been correct.

A recent study published in JAMA Pediatrics showed that one year after Philadelphia passed its beverage tax, sales of sugary and artificially sweetened beverages dropped by 38 percent in chain food retailers, according to Penn Medicine researchers who conducted one of the largest studies examining the impacts of a beverage tax.

On January 1, 2017, Philadelphia became the second city in the United States to implement a tax on the distribution of sugary and artificially sweetened beverages (Berkeley, California was the first). The goal of the 1.5 cent per ounce tax (18 cents on a typical 12 ounce can of soda) was to generate revenue to support universal pre-K, community schools, and improvements to parks and recreation centers, with the potential side benefit of curbing consumption of unhealthy drinks.

“Taxing sugar-sweetened beverages is one of the most effective policy strategies to reduce the purchase of these unhealthy drinks. It is a public health no-brainer and a policy win-win,” said study author Christina Roberto, an assistant professor of Medical Ethics & Health Policy in the Perelman School of Medicine at the University of Pennsylvania. “It’s likely to improve the long-term health of Philadelphians, while generating revenue for education programs in the city of Philadelphia.”

I am generally not a fan of taxing individuals to alter their behavior, but we have a long history of doing so - cigarettes, alcohol, etc. An argument can certainly be made that those who drink a lot of sugary beverages are being asked to shoulder a tax burden to support schools and public spaces that others are not. But one might also argue that their consumption exacts a pubic cost, since our insurance premiums end up paying for the negative health consequences these people bring on themselves. And I suppose from a freedom of choice point of view it is better than banning such products.

How do you feel about using taxes to "motivate" people to make choices that are better for their own health?

Plastic - Its Not Just the Bottles Anymore

Microplastics, plastic particles less than five millimeters in length (or about the size of a sesame seed), were found in sea salt several years ago. But how extensively plastic bits are spread throughout the supply of the world's most commonly used seasoning remained unclear. Now, new research shows microplastics in 90 percent of the table salt brands sampled worldwide.

Of 39 brands sampled, 36 contained detectable levels of microplastic particles. The recently released study, co-designed by Professor Seung-Kyu Kim at Incheon National University in South Korea and Greenpeace East Asia and published in Environmental Science & Technology, analyzed salt samples from 21 countries throughout Africa, Asia, Europe, North America, and South America. The three brands that did not contain were from Taiwan, which uses refined sea salt; China, which uses refined rock salt; and France, which uses unrefined sea salt produced by solar evaporation. The report noted that the highest concentration of microplastics were found in commercial salt sold in Indonesia. The study also indicated that concentrations of microplastics were highest in sea salt, followed by lake salt, and then rock salt.

Estimating that an average adult consumes 10 grams of salt per day (The average American consumes 3 to 4 grams daily), the report concluded that people could be ingesting approximately 2,000 microplastics each year through commercial salt alone without knowing how harmful the effects could be. “The findings suggest that human ingestion of microplastics via marine products is strongly related to plastic emissions in a given region,” said Professor  Kim. “In order to limit our exposure to microplastics, preventative measures are required, such as controlling the environmental discharge of mismanaged plastics and more importantly, reducing plastic waste.”

"I want to say one word to you. Just one word. Plastics." - Walter Brooke to Dustin Hoffman in The Graduate

 

Waste Less Food and Save Big

 

Let's say you do your grocery shopping and leave the store with 5 bags of food. When you get to your car, one of the bags slips and falls to the ground. Unconcerned, you get into the car and drive off, leaving the fallen food behind. 

Never, you say? Yet that is exactly what the average American family does every week.

Roughly 20% of the food we buy never gets eaten, according to the USDA. For a family of four, that comes to about $1,800 a year. In addition to the money you are throwing away, consider the resources wasted on producing that food, and the plastic packaging that ends up in landfills or, worse, dumped in the oceans. For example, producing a single pound of beef requires about the same amount of water as running your shower for 6 hours.

According to the National Resources Defense Council the reasons most commonly given for throwing away food include:

- Buying more than you need to "save money".
- Buying more than you need because smaller size packages were not available.
- An unplanned interruption left you without time to cook.
- You made too much when you did cook it.
- The food spoiled when you stored it.

Here are some tips for wasting less (and saving more).

1. Wasting less food begins before you even get to the grocery store. Live by the motto “Buy what you need, and eat what you buy.” Always have a meal plan and a list before going grocery shopping. Check your pantry and fridge before you head to the store to make sure you’re buying what you really need.

2. Shop more frequently and buy less each time. Yes, it can be a little less convenient than a weekly trip to the grocery, but your produce will be fresher and go farther than if stored in your refrigerator all week.

3. Cook more with frozen fruits and vegetables if you aren’t sure you’ll be able to use up fresh foods before they go bad. They are often more affordable than fresh and can be even more nutritious.

4. Keep you pantry well stocked with staples like rice, whole grains and pasta, beans, flour, and herbs and seasonings. A well-stocked pantry can be the secret to whipping up a tasty meal from food that would otherwise go to waste.

5. Be creative with leftovers. They can often be transformed into an entirely new meal. The internet is your friend here if you need ideas based on the ingredients you have. For example, check out all these recipes for leftover turkey. 

6. Store food properly. Don't just shove it into the refrigerator wherever you see some space. Use your crisper drawers to regulate humidity and temperature. Here is a guide to proper food storage.

7. Don't obsess over expiration dates. For the most part these are not mandated by regulation or law and are only the manufacturer's suggestion for when the food is at peak quality. Food is generally safe and tastes fine well after its expiration date. If it isn't moldy and smells fine, it probably is.

8. Its easy to forget what you have in your freezer and then discover it there months or even years later. Make sure to see what is already there each time you add more. Food that is "freezer burned" is normally perfectly safe to eat but it may taste "off" so use it in stews and soups that you can season well.

9. Lunch on leftovers. This could literally be eating leftovers straight out of the fridge, or making a new meal that uses leftovers as ingredients. Cook a little extra with this in mind.

10. If produce is going bad faster than you can eat it, preserve it by freezing, blanching and/or dehydrating. Your preservation method will be different for the different foods you’re working with, and you might even have to do a combination of them to maintain quality.

The United States discards more food than any other country in the world: nearly  80 billion pounds every year. That’s estimated to be 20-40 percent of the entire US food supply, and equates to about 219 pounds of food waste per person. Reducing food waste by just one-third would be enough to feed all of the 42 million Americans who face food insecurity. We waste $144 billion of food every year just in our homes alone.

Time for all of us to be aware and do our part.

Glucosamine and Heart Health

 

People have taken glucosamine supplements for years to lesson join pain. It is known to be safe and is moderately effective for arthritis pain. It also a general anti-inflammatory effect. And, thanks to a 2019 study published in the British Medical Journal, we can add an important new benefit to it's resume. The study's findings suggest suggest that glucosamine may have benefits in preventing cardiovascular disease (CVD) events, such as coronary heart disease and stroke.

Researchers led by Professor Lu Qi at Tulane University in New Orleans drew on data from the UK Biobank - a large population based study of more than half a million British men and women. They found that glucosamine use was associated with a 15% lower risk of total CVD events, and a 9% to 22% lower risk of CHD, stroke and CVD death compared with no use.

Several mechanisms may explain these results, say the study's authors. For example, regular use of glucosamine has been linked to a reduction in levels of C-reactive protein (CRP), a chemical associated with inflammation. This may also help to explain the stronger association among smokers, who have higher levels of inflammation and higher risk of CVD than non-smokers.

Despite the large sample size, this is an observational study and, as such, can’t establish cause and effect. It is probably not worthwhile to start taking glucosamine if you are not already doing so but the use of glucosamine supplements to relieve osteoarthritis pain might also be related to lower risks of CVD events.

 

Buyer BeAware

 

The global nutritional supplements market size was valued at over $310 billion in 2020 and is expected to expand by 6.2% annually from 2021 to 2028. Over 70% of Americans are regular users of dietary supplements. Some of these are useful, many of them are not. And many are not even what you think they are. If you use or plan to use supplements, here are some things you should keep in mind in order to be a savvy consumer.

If you buy or are shopping for supplements, know first that the US FDA does not verify in any way that a supplement actually contains what its label claims it does. Numerous store brand supplements aren't what their labels claim to be. An investigation led by New York Attorney General Eric Schneiderman determined that only 21 percent of the products on the shelves of retailers such as GNC, Target, Walmart and Walgreen actually contained what was advertised on the labels. Tests by Consumer Reports found that supplements are not uncommonly contaminated with lead and bacteria.

The best defense is to look for products that have been tested by a reputable third party - ConsumerLab, NSF International, Underwriters Laboratory (UL) and US Pharmacopeia are all reliable independent testers. Such a seal does not necessarily mean that a product is safe to use or that is does what it claims to do. But you at least have some assurance that what you are buying is what you are getting.

Remember that quality is not free. Shopping by price alone is generally not a good idea. That is not to say that the most expensive products are always the best but the cheapest products almost certainly are not. A little bit of on online research into the company producing a product is also a good idea.

Supplements can indeed be helpful in ensuring that you are getting the complete nutrition that you need. But they rarely "cure" anything and are "buyer beware" products. A good guideline is that if a product claim sounds too good to be true, it probably is.

In Praise of Peppers

 

All types of peppers are a part of the Capsicum family, which includes both the sweet peppers as well as the hot and spicy ones, often referred to as chili peppers. Peppers have a lot going for them. They're very low in calories and are excellent sources of vitamins A and C, potassium, folic acid and fiber. Peppers come in all sizes and colors. Some pack heat. Others are sweet. You can get them fresh, frozen, dried, or canned. Truly international in their appeal, peppers have become integral to cuisines across the world, from Mexico to Thailand, the Congo to India, and from Hungary to Tunisia.

Each kind of pepper has its own unique flavor and heat. Bell peppers sit at the sweet end of the pepper spectrum. Orange, yellow and red bell peppers are the sweetest because they have ripened longer on the vine before harvesting. They are staples in salads and and can be prepared as or included in meals of all sorts.

Fall is when peppers of all kinds are at their peak, so pick some up at your grocer or local farmer's market and add some nutritious zing to your snacks and meals. Here are a few ideas to get you started. Useless fact: While bell peppers are usually thought of as vegetables, botanically they are a fruit.

If bell peppers are used as a vegetable, hot peppers provide a unique taste and seasoning to dishes of all kinds. If you prefer a spicy but not too hot pepper, shishito, Anaheim or poblano peppers are good choices. Jalapenos and serrano peppers are a little higher on the heat scale. Thai or habanero peppers are for those who like things hot.

Besides being nutritious, low in calories and high in fiber, peppers may also reduce your risk of cardiovascular disease. This is due mainly to capsaicin, a potent anti-inflammatory compound that is what gives peppers their "heat". According to one 2019 study, people who ate hot peppers more than four times a week were a third less likely to die from cardiovascular disease as those who rarely or never ate them.

And finally, most people need not worry that hot peppers will do any damage to the stomach or digestive system. In fact, research shows that capsaicin actually reduces stomach acids and lowers the risk of developing peptic ulcers. For a few people however, hot peppers can irritate the gastrointestinal lining and cause temporary heartburn or even diarrhea. If that is you, just dial down the heat a little.

 

Living with CKD

 

For people over age 75, the odds of developing Chronic Kidney Disease (CKD) are better than 50%. It can develop at any age though and about 1 in 10 people under age 70 already have some degree of CKD. Kidney function normally begins to degrade by about 1% per year after age 40 and conditions such as high blood pressure, diabetes and heart disease can cause more rapid decline.

CKD has varying levels of seriousness. It usually gets worse over time though treatment has been shown to slow progression. About 37 million US adults are estimated to have CKD, and most are undiagnosed. If left untreated, CKD can progress to kidney failure and early cardiovascular disease. When the kidneys stop working, dialysis or kidney transplant is needed for survival. Kidney failure treated with dialysis or kidney transplant is called end-stage renal disease (ESRD).

We have already discussed four steps that you can take to lower the odds of developing CKD. But what if it is too late? What if you are diagnosed with CKD? Don't panic!

If you have chronic kidney disease (CKD), you can take steps to protect your kidneys from additional damage. The sooner you know you have kidney disease, the better. Making these changes when you have no symptoms may be hard, but it’s worthwhile and you may very well be able to stay healthy and keep CKD from progressing.

The most important steps are controlling your blood sugar and blood pressure. If you are diabetic, manage your condition carefully. Do whatever you need to do to keep your daily intake of sodium at or below 2,300mg. That is not easy but it can be done. Your kidneys have to work very hard to process excess sodium.

Many people with CKD also develop high blood levels of potassium and phosphate. Make sure you are tested and, if necessary, limit potassium in your diet. Phosphates can be controlled with medication.

If you are using blood pressure medication do not stop. But do speak with your doctor about which medication is most appropriate for you. If you need occasional pain relief, stick with Tylenol or generic acetaminophen.

Finally, get on your feet and exercise regularly, if not every day. In a 2019 study, people who did aerobic and strength training 3 times a week reported improvement in kidney function and lessening of CKD symptoms.

You will have to take charge of things and act, but following a lifestyle treatment plan can pay big benefits. "Patients can remain stable for decades and most will never need dialysis," says Dr Richard Glassock of the David Geffen School of Medicine at UCLA.

Be Kind to Your Kidneys

 

Your kidneys filter waste from your blood and also help dispose of excess water. For most people they do this quietly and effectively over a lifetime. But our high sugar, high protein diet of processed food can cause them to become less able to get the job done as we enter our senior years. In fact, about half of people over age 75 have chronic kidney disease.

"A lot of people become quite alarmed when they are told that they have CKD," says Dr Richard Glassock, professor of medicine at the David Geffen School of Medicine at UCLA. "But it is quite common in older adults and is just another natural part of aging." 

Most cases are mild and do not require treatment, but some can progress to the point where the kidneys cannot process waste efficiently enough to prevent it from accumulating in the body to dangerous levels. Untreated, it can become life threatening.

Here are 4 things you can start doing right now to lower your risk of developing serious CKD later.

Don't over medicate.

Over the counter NSAID drugs such as Advil and Aleve are commonly used for pain relief. But taking them frequently can raise your risk of CKD. And people who routinely take PPI drugs for heartburn (such as Nexium or Prilosec) are nearly 30 times more likely to develop serious CKD than those who rarely or never take them. Have a conversation with your primary health care provider about alternatives if you are a heavy user.

Skip the sugary drinks.

Consumption of soda and sweetened fruit drinks is strongly linked to a higher risk of CKD. So is alcohol.

Cut back on red meat.

You don't need to avoid it entirely, but research suggests that people who eat as little as 2 ounces of red meat daily have an elevated risk of severe CKD compared with those who eat half an ounce or less. Plant sources of protein may actually reduce your risk. 

Don't smoke.

Seriously, do you need to be told this again? A tobacco smoking habit reduces blood flow the the kidneys which over time will damage them. As if cancer was not reason enough.

Sugar. Again.

 

I know everyone is sick of hearing me go on about sugar, but as the evidence of its terrible effects on our health continue to mount what else is there to to but warn you?

Currently, an estimated 1 of 6 deaths in the United States is attributed to coronary heart disease. A study published in JAMA Network Open concluded that adults who got 10% or more of their daily calories from sugar sweetened drinks like soda and fruit juices increased their risk of heart-related death by 44% and the risk of death from any cause by 14%.

Researchers looked at over 13,000 people who were participants in the REGARDS Study (an ongoing, long term study of geographic and racial differences in the incidence of stroke).

As a secondary observational study, the results do not prove that sugary drink consumption caused the increased risk. Only that those consuming the drinks suffered that fate. Other studies associate sugar consumption with increased risk for obesity, diabetes and hypertension.

The American Heart Association recommends that women consume no more than 25g (6 teaspoons) of sugar a day and, for men, 36g (9 teaspoons). A single can of sugar-sweetened cola contains about 39g. 

But, hey, y'all do what you think best.

Enjoy Hot Dogs for a Shorter Life

 

Mystery cylinders. Ground up scraps of beef and pork with salt and food coloring and "binders". Hot dogs! Who doesn't love 'em? Perhaps the researchers at the University of Michigan who have concluded that eating a single hot dog could take 36 minutes off your life. But first, some context.

Hot dogs were only one of the more than 5,800 common foods in the US diet included in the study. For each one, the researchers measured their effects in minutes of healthy life gained or lost. The study, published in the journal Nature Food, ranked the foods by their nutritional disease burden to humans and their impact on the environment. It found that substituting just 10% of daily caloric intake from beef and processed meats for a mix of fruits, vegetables, nuts, legumes and select seafood could reduce your dietary carbon footprint by one-third and allow people to gain 48 minutes of healthy life per day. 

This was an observational study, which means it does not prove that each hot dog that a person eats costs them 36 minutes off their life. It only showed that those who do eat them did.

"We wanted to make a health-based evaluation of the beneficial and detrimental impacts of the food in the entire diet," said Olivier Jolliet, professor of environmental health sciences at the university and senior author of the paper.

One of the foods researchers measured was a standard beef hot dog on a bun. Its 61 grams of processed meat resulted in the loss of 27 minutes of healthy life, Jolliet said, but when ingredients like sodium and trans fatty acids were factored in, the final value was 36 minutes lost

Does this mean its time to panic and give up hot dogs? Well giving up highly processed meat would not be a bad idea at all but no, that is not what the study recommends. "Changing a diet to include or exclude any one food is unlikely to make much difference -- it's dietary patterns that count," said Marion Nestle, a professor of nutrition and public health at New York University. "I suppose you could argue that the minutes add up, but that gets into further untested and untestable assumptions."

So what does the study suggest?

"I wouldn't get too worried about eating a hot dog from this," Jolliet said. "Basically, we were trying to show how you can improve your lifestyle and the environment without necessarily trying to be vegan." Making small changes and adjustments can add up to big results.