Author: Casey Evans

Teaching Old Recipes New Tricks

As the weather makes some serious changes here in North Carolina, I’m always looking for rich, comfort food that incorporates nutrient-dense vegetables. This week I came across an amazing recipe that not only boasts low-calorie options; it’s packed with flavor! Registered Dietitian Andrea Mathis features a beautiful Kale, Tomato, & Mushroom Egg White Frittata. This new spin on a historically Italian dish is the way to go if you’re looking for a healthy option that makes meal prepping a breeze. Get the directions here.

 

It’s icing on the cake…and calories

Smaller portions equate to fewer calories. But what sized portions are you serving? If you’re like most people, your portions may be determined by images on food packaging, not by nutrition labels. Most individuals who consider calories while serving food do not take into account added ingredients. Packages may display multiple ingredients, like frosting and the enclosed cake, but often frosting and other added ingredients are not mentioned in the nutrition facts. This means that the nutrition facts denoting 200 calories in a slice of cake fail to mention the additional 200 calories of icing covering the slice. When people understand that nutrition labels do not include added ingredients, they eat smaller portions to account for the increase in calories. Next time you’re buying cake mix you might want to consider what frosting adds outside of taste. It could help you cut a smaller piece.

Brand, J., Wansink, B., & Cohen, A. (2016). Frosting on the cake: pictures on food packaging bias serving size. Public health nutrition, 19(12), 2128-2134.

Masters of Disguise: How artificial sweeteners make it past consumers

Viewed by consumers as a healthier alternative to sugary drinks, artificially sweetened beverages are becoming increasingly popular. These drinks include most diet sodas and juices, energy drinks, and flavored water. The shift away from drinks sweetened with sugar came after research showed the relationship between sugar intake and excess weight, obesity, and diabetes. Artificially sweetened beverages have little-to-no calories; however, the medical community has not supported any of their proposed health benefits. In fact, many scientists believe that artificially sweetened drinks lead to overeating and encourage sweet cravings. They could be an alternative route to health problems. Researchers are still looking into these associations, but for now, water is always a safe choice. Check out this article for tasty ways of sprucing up your water.

(1) https://www.ncbi.nlm.nih.gov/pubmed/17712114

Image: https://www.nerdfitness.com/blog/is-diet-coke-bad-for-you-what-about-artificial-sweeteners/

 

#FreeCyntoiaBrown

“If I can keep one child from going down the path that I went down, it will be worth it.” Words spoken by twenty-nine-year-old Cyntoia Brown. The path she embarked on as a child was not one she chose. Brown was forced into prostitution as a child during which time she was abused and raped until the age of 16 when she was arrested for murdering one of her solicitors.

Brown’s story has garnered a lot of media attention recently with a number of high profile celebrities including Rihanna and Kim Kardashian sharing her story on social media outlets and calling for her release from a life prison sentence. Brown has served 13 years thus far and is ineligible for until she has served at least 53 years.

Cyntoia Brown’s story brings to light both the legal and health-related problems associated with sex trafficking. After having their human rights violated, victims who comply with their abusers’ demands are often jailed for prostitution. Those who fight back against their violators often face legal prosecution and serve jail sentences. Is this how we should treat victims of human trafficking?

Not only do victims face legal ramifications they also endure health consequences of their physical and emotional abuse. Women are often subjected to unwanted, unplanned pregnancies because they do not have access to birth control methods including condoms (1). This also places them at risk for gynecological problems including sexually transmitted diseases and infections. According to Stop Violence Against Women, rates of abortion, infertility, and sterilization are higher among female prostitutes. Victims are also subject to long-term mental health issues including depression, suicidal ideation, substance abuse and post-traumatic stress disorder.

Brown’s story is not unique. According to the Human Trafficking Hotline, in 2015 over 5,500 cases of human trafficking were reported (2). This number rose in the following year. Over 7,600 cases were reported in 2016. The challenges that victims of human trafficking face need our attention. Their struggles with physical and emotional abuse do not belong only to themselves. They are public health issues that affect us all.

(1) http://www.stopvaw.org/health_consequences_of_trafficking

(2) https://humantraffickinghotline.org/states

Image: https://www.fbi.gov/news/stories/human-trafficking-prevention-month-raising-awareness-of-a-devastating-crime

 

Using Mass Communication to Curb Obesity

Internationally we continue to see substantial increases in overweight and obesity rates. In 2016, the World Health Organization reported that about 39% of all adults were overweight. Since overnutrition seems to traverse cultures, languages and international waters many people are looking for the most effective and efficient way of promoting positive health behaviors that promote a healthy weight. I believe mass media campaigns could serve as a solution to the problem. Health professionals can use mass media to improve the dietary habits of populations through multimedia-based communication efforts.

Over the past ten years, we have seen considerable changes in mass media communication largely due to increased use of mobile technology, especially social media. As access to mobile technology increases and people use smart-technology at increasing rates, health professionals have increased opportunities to address the importance of nutrition and physical activity. I believe that no other intervention approach has the potential for as wide a reach as mass media. Mass media campaigns that target individual dietary behaviors like increasing vegetable intake or reducing sodium are effective at promoting those behaviors (1). The “5-A-Day” campaign was successful in its efforts to increase fruit and vegetable intake. It was associated with a significant increase in fruit and vegetable consumption and increased awareness of health benefits associated with consuming fruits and vegetables. The success of mass communication in campaigns and interventions is not exclusive to increasing fruit and vegetable intake. This method has also proven effective at promoting folic acid supplementation and the maintenance of weight loss The Community Guide (2). I believe mass media campaigns advance nutrition efforts to reduce overweight and obesity rates because of the extent to which media is incorporated into people’s daily lives. Mobile technology gives health professionals a chance to engage in dialogue with individuals outside of clinical settings. I believe engaging with individuals in spaces they already visit may help people feel more comfortable and make them more receptive to adopting health-promoting behaviors.

Cultural Challenges with the DASH Eating Plan

Heart disease is a leading cause of death in the United States contributing to over 633,000 deaths annually. Like most chronic diseases, individuals can reduce their risk of developing this condition with proper diet and exercise. When someone is at extremely high risk of developing heart disease, nutrition professions suggest a few things: exercise, stop smoking, eat nutrient dense foods and reducing sodium intake with the DASH eating plan. While these modifications are proven to reduce the risk of heart attack and stroke, the DASH eating plan can be problematic for communities of color.

DASH, or Dietary Approaches to Stop Hypertension, is a proven eating plan for lowering blood pressure without the use of medication. The reason blood pressure is so important is that it is one of many factors that contribute to heart disease. DASH recommends the following:

1. Eat fruits, vegetables, and whole grains
2. Including fat-free or low-fat dairy products
3. Consume fish, poultry, beans, nuts and vegetable oils
4. Limiting foods high in saturated fat
5. Limiting sugar-sweetened beverages and sweets

This diet is excellent for promoting a healthy diet; however, for communities of color which suffer in greater numbers from lactose intolerance DASH’s promotion of dairy products can cause discomfort. Lactose intolerance results in symptoms such as indigestion, bloating, stomach cramps, diarrhea, indigestion, flatulence and fatty stool after consuming lactose, a sugar found in dairy. The premise behind increasing dairy consumption is its higher calcium content which is associated with reducing blood pressure. The eating plan fails to acknowledge that there are other excellent sources of calcium like broccoli, calcium-fortified real fruit juices, beans, almonds, and sardines. In doing so, DASH recommends a diet that may lower hypertension, but that also makes people sick. This could diminish its credibility in communities of color. By including non-dairy sources of calcium, our healthcare systems and dietary recommendations could acknowledge and accommodate all people instead of offering a one-size-fits-all approach to health.

Health Literacy: The final healthcare barrier?

How can health professionals support and serve our most vulnerable populations? When discussing access to health care, income and location are generally agreed upon barriers to access. Populations who live just above the poverty line often do not qualify for government assistance; however, without it, they often cannot afford coverage. Similarly, populations that live in rural areas often have less lack access to health services. One barrier that accompanies these and is often overlooked is health literacy.

Literacy is not only an education issue it affects access to healthcare as well. When populations have difficulty reading, they may misunderstand health brochures or worse take medication incorrectly. According to Kelly Warnock, Program Manager at the Durham County Health Department, health professionals have a responsibility to reach populations where they are. After working for over 10 years with lower-income, low literacy populations, Ms. Warnock believes that it is possible to increase all communities’ access to healthcare and health information. For health professionals, that means being creative with communication techniques organizing information clearly, using visuals, and non-technical language. If you’re interested in learning more about health literacy and communication, check out this resource from the Food Research and Action Center.

Photo: https://communicatehealth.com/2014/07/frequently-asked-question-can-i-measure-a-patients-health-literacy/

Updates on Food Labeling in the US

Along with household chores and laundry, grocery shopping is a part of my weekly routine. (Welcome to adulthood!) Meal planning saves me a lot of time and keeps me organized with my busy graduate school schedule. I don’t have to worry about what I’m eating on a daily basis because I planned ahead.  When planning meals and grocery shopping, I’m always sure to look for low-sodium and lower fat options that taste good and keep my body health. (If you haven’t tried Skinny Pop, you’re missing out!) Food labels make finding healthy options a lot easier because I can simply flip a box over to find the sodium, fat and calorie content along with vitamins and minerals. Easy access to information makes it simple to make healthy choices, but this could all change.

In 2016, the US Food and Drug Administration unveiled new food labeling requirements. These requirements are meant to give food shoppers, even more, access to information. The new labels will include details about added sugars and serving sizes that reflect what people generally eat instead of recommended serving sizes. The initial implementation date was set for 2018 but was extended to 2021 after organizations like the Grocery Manufacturers Association and the Food Marketing Institute petitioned for an extension. These organizations represent some of the largest trade organizations within the food industry. They are currently encouraging the use of SmartLabel, an online database that lists ingredient and nutrition information. While at first glance this initiative seems like a one-stop shop for desired food information, it’s not that simple. Check out what the Environmental Working Group has to say about these not so smart labels and let us know what you think in the comments below.

The Health Impact of Natural Disaster

This week I was reminded of the things I take for granted on a daily basis. This week I considered the luxuries I expect access to and consider a right. This week marks the second week that many citizens of the US territory of Puerto Rico lack access to clean drinking water and food.

Hurricane Maria left Puerto Rico in devastation.  Before the category 4 storm hit on September 20th, the governor, Ricardo Rossello, knew that disaster was imminent releasing this video just 5 hours before impact. What no one knew, was the severity of the damage this storm would cause. Generally, after a natural disaster, the public hears about breakdowns in infrastructure and property damage. What is often missing from the conversation is a focus on health. Today, many Puerto Ricans endure the stress of not knowing from where their next meal will come. Although aid has made it to the Puerto Rican shores, many supplies remain undistributed because of damaged roads and a lack of fuel. Fuel is very important in the aftermath of natural disasters because it is needed to distribute food and medical supplies. It also allows medical staff to reach hospitals to deliver much-needed care to those in need.

It is important to consider how natural disasters affect health outcomes. Food, water, and fuel are essential for survival. The citizens of Puerto Rico are devastated but not in despair. Hope remains high and citizens are determined to rebuild.

Could food stamps cause low test scores?

Going without food has serious implications on your health, mood, and if you’re someone who gets hangry, you know that combination of hungry and angry, your social interactions. Research from the University of South Carolina (USC) has recently shown that the effects of hunger might not end there. It could also play a role in the academic performance of students from low-income communities who receive food assistance.

In the state of South Carolina, families receive government food assistance once per month. These benefits are administered in the first ten days of the month. This means that many families can run out of benefits towards the end of the month. When researchers from USC examined math scores of students from families who receive food assistance, they found something interesting. When students take exams on a date far away from when their family received benefits, their test scores are significantly lower than when exams are administered toward the beginning of the month. This can also mean that a child who is tested earlier in the month generally performs better than a child tested toward the end of the month.

It is unclear if this relationship is because of hunger or some third factor; however, we clearly need to give more attention to supporting families with inadequate access to food and resources.

 

Source: http://www.npr.org/2017/09/21/552530614/researchers-examine-links-between-academic-performance-and-food-stamps