Category: Recommendations

Crash or DASH- choosing the right diet

February is heart month.  We’re often told that in order to keep our hearts healthy we should maintain a healthy weight.  Many people try to do this by dieting, but do diets really make us healthier?

New research has emerged that meal replacement crash diets (typically consuming only 600 to 800 calories each day) can temporarily worsen heart function [1].  This means that if you have heart problems, these diets could actually make your health worse instead of better.  If you’re looking for a healthy way to lose weight, you may want to check out the National Heart, Lung, and Blood institute’s DASH diet.  In January, U.S. News and World Report ranked the DASH diet as the best overall diet plan for the eighth year in a row [2].  The DASH diet also claimed first place in the healthy eating and heart disease prevention categories.

If you feel like dieting, stop and ask yourself why you’re doing it.  If you’re trying to get your heart in shape, you may want to rethink that overly restrictive diet.

 

References

[1]   European Society of Cardiology (ESC). “Crash diets can cause transient deterioration in heart function.” ScienceDaily. ScienceDaily, 2 February 2018. www.sciencedaily.com/releases/2018/02/180202123836.htm

[2]  National Heart, Lung, and Blood Institute. (2018, January 3). DASH ranked Best Diet Overall for eighth year in a row by U.S. News and World Report. Retrieved from National Heart, Lung, and Blood Institute: https://www.nhlbi.nih.gov/news/2018/dash-ranked-best-diet-overall-eighth-year-row-us-news-and-world-report

 

Bare cupboards and full bellies: Food Purchasing patterns change over time

Food purchasing patterns are a pretty good indicator of what people eat on a regular basis.  If you purchase healthy food, it’s presumed that you eat healthy food.  Recently, research from the United States Department of Agriculture revealed that food purchasing habits are changing over time. The grocery carts of younger food shoppers’ look vastly different than previous generations’. According to one report, they may even be empty.

Millennials, anyone born between 1981 and 1996, tend to purchase more premade meals and eat away from home more than older generations [1].  Restaurants have become more popular among youth and time spent preparing meals at home is decreasing.  Overall, older generations consume food in restaurants and bars about 70 percent less than millennials. Millennials spend a large portion of their income on pasta, sugar/sweets, and prepared foods, and as they acquire more disposable income they purchase more vegetables to prepare at home.  These findings could indicate that although millennials are more likely to eat out as they move farther into their careers and acquire more household income, they could gravitate toward purchasing more fruits and vegetables.

While millennials gravitate toward healthier foods, we should pay attention to nutritious food options and the food available to lower-income millennials.  Foods prepared by restaurants and bars and premade foods are often high in sodium and sugar.  Fast food restaurants are notorious for these types of foods (think cheeseburgers, deep-fried French fries, milkshakes, and slushies) and found more often in lower-income communities.  These foods put people at risk for hypertension, heart disease, and diabetes.

Nutritionists could encourage eating and cooking at home more often because hello it’s cheaper, made just the way you like, and you know what’s going into your meals that’s not always feasible with busy schedules.  We can, however, consider the following tips for healthier meals away from home:

  1. Choose less processed foods. Foods that are less processed often have less sodium and sugar added. If you can choose between apple slices and an apple turnover, the apple is always a better option. Less sugar. More fiber.
  2. The more fruits and vegetables the better. Fruits and vegetables add a variety of nutrients, vitamins, and minerals to a diet. They also provide fiber, fill you up without so many calories and help you hydrate.
  3. Ask for nutrition facts. Nutrition labels which include sodium, calories, sugar, vitamins, etc let you know exactly what’s in your food.  If you need to cut back on sugar intake, you’ll know exactly how much you are getting.

References:

[1] https://www.ers.usda.gov/webdocs/publications/86401/eib-186.pdf?v=43097

The air up there: air quality for long-term health

As development and industrialization occurred, international and domestic societies became increasingly dependent on mass-produced products and, unknowingly, the chemicals used in their development. Chemicals are used in the production of everything from household products to organic foods, and many of these man-made compounds have detrimental effects on human, environmental and ecological health. One chemical exposure of greatest significance to human health is ambient and indoor particulate matter. These elements are often overlooked; however, a human health risk assessment can be used to determine the severity of their harm.

Particulate matter (PM) is defined as all hazardous particles (including solids and liquids) that are suspended in the air [1]. These pollutants are generally less than ten µg in diameter and include course, fine and ultrafine elements. PM has many detrimental affects on human health because it is so easily encountered and can be deeply inhaled. PM is known to elicit cardiopulmonary responses and is also a risk factor for cardiovascular disease morbidity and mortality. Atherosclerosis, myocardial infarction, and cardiac arrhythmias are just a few cardiovascular disease states with which PM is associated [2]. PM inhalation is also associated with cancer – the second leading cause of death globally.

All people are exposed to particulate matter because it is dispensed into the air we breathe. There are various sources, including aerosols, mist, and all forms of combustion, that emit particulate matter into the atmosphere many of which individuals encounter frequently throughout the day. To protect oneself from these harmful chemicals, it is important that people engage in protective behaviors. Below are a few that could help you improve your long-term health:

1. Use an air purifier in your home.
2. Avoid using aerosols.
3. Check for proper ventilation and air filtration when using a fireplace.
4. Avoid burning incense.
5. Avoid second-hand smoke and stop smoking.

References:

[1] “Ambient Air Pollution.” World Health Organization. World Health Organization, n.d. Web. 23 Feb. 2017.

[2] Du, Yixing, Xiaohan Xu, Ming Chu, Yan Guo, and Junhong Wang. “Air Particulate Matter and Cardiovascular Disease: The Epidemiological, Biomedical and Clinical Evidence.” Journal of Thoracic Disease. AME Publishing Company, Jan. 2016. Web. 23 Feb. 2017.

Using Behavioral Economics to Combat Antibiotic Resistance

By Elsbeth Sites

Antibiotic-resistant infections affect 2 million people and are associated with 23,000 deaths each year in the United States.1 Physicians link medicines and patients, so prescriptions are a target for reducing unnecessary use of antibiotics in humans. But physicians tend to prioritize the patient in front of them, rather than consider the long-term, societal implications of each prescription. How can we make appropriate prescription of antibiotics the new norm?

Behavioral economics embeds insights from psychology into neoclassical theories of behaviors. It’s hard to see the consequences of antimicrobial resistance in the day to day – discounting and present-bias de-emphasize long-term prevention in favor of immediate gratification. For doctors, discounting might take form in the satisfaction a patient leaving the office with treatment in hand, while discounting the long-term impacts of inappropriate antibiotic usage.

Recently, researchers have begun designing behavior-change programs for healthcare providers. One such “nudge” that has shown promise involves hanging letters of commitment in examination rooms that document the physician’s commitment to the appropriate prescription of antibiotics and explain why they are not useful in many cases 4. This strategy may be doubly effective because it helps make the physician feel accountable for their commitment, and facilitates discussions with patients.

Behavioral interventions at the provider level can be powerful tools to facilitate consideration of the long-term effects of a decision made today. Simple, inexpensive programs like this have enormous potential to stall the progression of antibiotic resistance by decreasing the flow of unnecessary antibiotics from doctors’ offices to patients.

References:

[1] Antibiotic/antimicrobial resistance. https://www.cdc.gov/drugresistance/index.html. Updated 2017. Accessed 11/19/, 2017.

[2] Meeker D, Knight TK, Friedberg MW, et al. Nudging guideline-concordant antibiotic prescribing: A randomized clinical trial. JAMA Internal Medicine. 2014;174(3):425-431. doi: 10.1001/jamainternmed.2013.14191.

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/

 

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.

Do you hear those coughs, sniffles, and sneezes?

It sounds like flu and cold season.

Fastidiously washing your hands won’t prevent Mark from coughing in your general direction (thanks Mark), or save you from an ill-timed sneeze. Breathing isn’t optional. But before you break out the Bubble Boy suit, here are a few more tips that will strengthen your chances of staying healthy even when those around you aren’t.

  1. Mark has coughed. This aerosol (i.e. spray) potentially contains infectious droplets. With flu droplets, the trajectory is likely less than six feet. You are unfortunately standing right next to him. Hold your breath for 10 to 15 seconds.
  2. If this keeps occurring and you feel comfortable, politely ask Mark to cough into the inside of his elbow. Make a light, yet pointed, joke about doing the “dab.”
  3. Mark has sneezed onto his desk. Your hand at some point comes in contact with that desk. Don’t touch your face.

Stay healthy my friends.

Source: https://www.prevention.com/health/health-concerns/how-doctors-avoid-sickness

Should you sleep naked?

As someone who traditionally loves wearing pajamas to bed at night I have always wondered about the question: is it better to sleep naked than in pajamas? A lack of sleep over time has been shown to increase the risk for stroke, diabetes, cognitive decline, depression, and obesity, so it’s important to determine what’s best for yourself to get a good night’s rest.

Rather than sit around and continue to wonder, I decided to do some research on the topic and solve this dilemma once and for all. In the US, around 10% of the population admit to sleeping naked; which is actually kind of low considering about 30% of our friends in the UK do so. Now that I know some people in the world actually do sleep naked, what are the benefits of doing so?

The most scientifically sound reason I could find for sleeping naked was to better regulate your body temperature overnight. If you sleep in pajamas and have heavy covers it can be easy to overheat and disrupt sleep accordingly. The Sleep Council has determined that 68°F is the ideal sleeping temperature for a high-quality night’s rest.

Personally, this just tells me to make sure my thermostat is set to 68°F at night before going to bed. I normally don’t have trouble sleeping at night, but I know that is not always the case. It seems there is more research needed to truly determine its effect, but do you think sleeping naked actually helps sleep quality?

 

AB

THAT SHIP HAS SAILED: Why the US should stop shipping American-grown food abroad

The development of the Food for Peace program was the US’s first program for fighting international hunger. This program focuses heavily on donating commodities to vulnerable populations abroad. Most donated goods are grown domestically and shipped to developing countries where over three billion people have received assistance since its inception. It is estimated that another eight to twelve million people could receive help by reforming US food aid policies. A major barrier to expanding reach is the shipment of US agricultural goods abroad. This is a practice that should be eliminated because it is harmful in the following ways:

1. It is time-consuming.

Shipping US grown goods abroad takes on average 126 days. In emergency situations, people are only able to survive for 12 days without foods. In many instances, waiting for US commodities to ship is deadly.

2. It wastes money on transportation fees.

Between 2003 and 2012, the US spent close to $18 billion on food aid. Over half of this money was used on international transportation fees. Money that could be used to feed millions was used to support US-based shipping companies and the transport of good.

3. It cripples international agricultural sectors.

US grown food is sold at a much lower cost than food sold by local farmers. This can put local farmers out of business if they are unable to compete with the sale of US products. Resultantly, communities become completely dependent on aid.

We should discontinue the practice of shipping US commodities abroad and instead support international agricultural ventures. Learn more about FY 2016 reform proposals here.

Do you have an Advance Directive?

Everyone deserves the right to make their own decisions about their health. But sometimes we may found ourselves in certain circumstances in which we are unable to do so, such as during a coma, terminal illness, or serious injury. An important way that we can communicate our decisions during these times, however, is by having an “advance directive” in place.

Advance directives are written, legal documents that outline your decisions regarding medical care when you are unable to make them. They assist doctors and caregivers in making medical decisions on your behalf, and they can be written at any age.

There are several types of advance directives:

Health care power of attorney (also called “durable power of attorney for health care” or “health care proxy”). This is a type of advance directive in which you appoint a person you trust to make medical decisions on your behalf when you are unable to do so. This may be a family member, partner, or friend.

Living will. This is a written, legal document that outlines your wishes for certain medical or end-of-life care treatments. These may range from mechanical ventilation to tube feeding, to even organ and tissue donations.

Do-Not-Resuscitate Orders (DNR). This order informs health care providers not to perform CPR if your breathing or heart were to stop.

While advance directives are not required, it may be a good idea to have one in place so that you can have peace of mind knowing that you’re in control of your health care in the event that you are unable to make decisions for yourself.

It should be noted that state requirements regarding advance directives, such as living wills, may vary, so be sure to check your local state laws if you decide to create one for yourself. Also, be sure to keep a copy of your living will for yourself, as well as provide copies to family members, health care providers, and your health care power of attorney. Advance directives can be changed at any time, but just be sure to redistribute copies as necessary.

For more information about advance directives, check out the following resource links:

Advance Care Planning | UNC Health Care: UNC Medical Center

Living Wills and Health Care Powers of Attorney | North Carolina Bar Association

Living Wills and Advance Directives for Medical Decisions | Mayo Clinic

References:

Advance care directives. (2017, September 5). Retrieved from https://medlineplus.gov/ency/patientinstructions/000472.htm

Advance directives. (2017, July 24). Retrieved from https://medlineplus.gov/advancedirectives.html#summary

Creating advance directives. (2014, November 11). Retrieved from http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303?pg=2

Living wills and advance directives for medical decisions. (2014, November 11). Retrieved from http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303