Building A Better Sidewalk

Subway grates and sidewalk beds

Recently in Scientific American, Better Sidewalks Could Bring Improved Public Health:
A new report recommends 43 public health changes that can make big improvements in overcoming preventable diseases. “To arrive at their recommendations, researchers reviewed more than a thousand studies of public health. Their findings are in the American Heart Association journal, Circulation. [Dariush Mozaffarian et al., Population Approaches to Improve Diet, Physical Activity and Smoking Habits.]  Some surprisingly simple suggestions could be easiest to institute. (For instance) try improving sidewalks and visual appeal of neighborhoods to make people want to walk, bike, or run more often.”

Around the corner from my Brooklyn apartment, policy makers have put the sidewalk recommendation into action. For quite awhile now, like maybe two years, the NYC Department of Design and Construction have been working on the Eastern Parkway Reconstruction Project from Washington Avenue at the Brooklyn Museum to Grand Army Plaza. They installed water mains and sewer replacements and now they are finishing up the pavement, curbs, sidewalks, bike path, catch basins, pedestrian ramps, green spaces, street lighting, and traffic signals. The job is nearly finished.

And so, this is a public health project in action, a benefit of city living, not so “surprisingly simple,” but easier than beating down each individual to change. I, for one, need no encouragement to use the sidewalks and bike path.

Your thoughts: Does your town have good sidewalks?

Serves 3 Over Ice – NICE!

There are some things we would rather forget and I’ll bet Coke would like to forget this.This picture was taken from a poster at the New World of Coca-Cola Museum in Atlanta. Judging by the outfit and decor, it is nearly 60 years old. It was included in a recent presentation by the New York City Department of Health in support of Mayor Bloomberg’s “Maximum Size for Sugary Drinks: Proposed Amendment of Article 81.”

Mike Bloomberg wants to ban the sale at restaurants, food carts, movie theaters, and concession stands at sports arenas of any cup or bottle of sweetened drink larger than 16 ounces. Bloomberg says the proposed ban is a way to fight obesity in New York City, but opponents say that soda is unfairly singled-out as the cause of a multidimensional problem. In fact, the premise that soda causes obesity is unproven. The most that can be said comes from the CDC: “Sugar drinks have been linked to poor diet quality, weight gain, obesity, and, in adults, type 2 diabetes. U.S. dietary guidelines issued in 2010 recommend limiting the consumption of foods and beverages with added sugars.” Save them for a special occasion.

Many people dislike Mayor Bloomberg’s healthier-than-thou arrogance, but I like his attention-getting style. But whether you are for or against the mayor’s proposal, the poster shows that even Coke agreed a “big” 16-ounce soda is enough for three people. His proposal is simply a handy reminder that today’s food portions are out of control. Presently in NYC, you can’t even buy a soda that is smaller than 16 ounces — not even on the kid’s menu; 16 ounces is usually the “small” size, while 32 to 64 ounces is the “large.” Studies show that when people are given larger portions, they simply eat more without realizing it. It is especially true when it comes to beverages. This quote from Michelle Obama’s address to the National Restaurant Association Meeting in 2012 is a good one. She said, “…no matter what you do, it’s important, truly important, to keep portion sizes in check, because we all know that the size of a meal is just as important as the ingredients it’s made of.” And so, next time you see a 16-ounce soda, remember that it “serves 3 over ice – nice!” Coca-Cola said so in writing. Ouch.

Your thoughts: Where do you stand on the 16-ounce sweetened drink limit?

How I Use Calories on the Menu

Yesterday, at a rest stop in New Jersey, standing in the combined line for Cinnabon, Popeyes and others, waiting to pay for the blueberry-granola-and (un)real yogurt that I always get, I spied a “MiniBon” roll and mentioned that, calorie-wise, it was better than the classic. (The Cinnabon Classic has 880 calories, while the Minibon has 350 calories per roll.)  My daughter and the woman standing ahead of me, both in their 20s and of slim/normal weight, admitted they had no idea of the number of calories they need. Neither one seemed the worse for the lack of information, but I gave them a tiny lesson on calories (and told them never to “diet.”)

Later that night, I read this on the Intuitive Eaters Professionals Group on Linked-In:
“The other day I went to a restaurant for lunch with friends and was surprised to see calorie counts next to each menu item. My friends, both fairly health conscious “normal” eaters, didn’t seem to mind, but did remark on the counts. I was bothered because I found that the counts drew me away from eating intuitively and back to my days, half a lifetime ago, of dieting. I had to force myself not to look at them and then was okay. My question is: Are menu item calorie counts helpful or not? Might they be useful for different populations, i.e., okay for “normal” eaters who want to eat more nutritiously but not so much for anyone who leans toward dis-regulated eating?”

Calories on the Menu

Expect to see calories on the menu in restaurants with 20 or more outlets as part of the Affordable Care Act upheld by the Supreme Court last week. Restaurants and movie theaters must post calorie information on menus, menu boards, and drive through displays, and provide written information about total fat, saturated fat, cholesterol, sodium, carbohydrates, sugars, dietary fiber, and protein upon request.

For people like my daughter and the woman in line, the information will be meaningless, but for others, it may be extremely informative or downright disconcerting. As a longtime registered dietitian, intuitive eating practitioner, and former dieter over thirty years ago, I think a “calorie information free menu” should be available to anyone upon request, no questions asked. (Heaven forbid the Affordable Care Act returns to the Supreme Court for alleged “actual harm” coming from calories on the menu!) Anyway, I live in New York City where calories have been on the menu since 2008. Real-world studies show that, as a public health intervention, it has only a modest reduction or no effect in the calories purchased by customers. In time, the issue could be a moot point.

For what it’s worth, this is what I told my daughter and the woman in line about how I approach calories on the menu:

  • Women need about 2,000 calories a day and men need around 2,400.*
  • When the calorie count is high – say greater than 20% of the daily total or 400 calories – look askance
  • Decide if the extra calories are from too much wholesome food or from “empty calories” full of added sugar and/or animal fats but with negligible nutrients.
  • For wholesome food, I split the serving with my companion or carry away half, and for empty calories, I decide if I love it enough and have to have it right then. (Luckily, I’m not impulsive.) If yes, then I have it; if no, then I skip it. But if I were to feel guilty or otherwise, awful, I’d ask why and think of it as a growth opportunity.

Righteous indignation seems to fuels me. You can’t get me to eat most of the crap sold in American chain restaurants. I don’t value filling my body with junkie food. I am attracted to fresh food well prepared, mostly by me. Usually, I’m sated at don’t care about dessert. If I really want dessert, then I eat it only a little at the meal.

Your thoughts: What do you think about calories on the menu?

*To find your calorie requirements, use this chart from the government or use a calculator fromany one of the online diet websites.

Pedal Power, Think About It

This woman is using a stationary bicycle to power a generator to run electrical devices. The generator might be on the other side of the blue tarp. The picture was taken at Zucotti Park, the Occupy Wall Street camp in New York City last fall. When you think about it, why aren’t we using human power to generate electricity and turn mechanical cranks more often? Pedal power offers so many solutions: fuel, exercise, disaster-preparedness, and “the obesity crisis”. Pedal power could be mandatory to run laptops and TVs. (Calories burned: Stationary Bicycle: 333/hour; Sitting Quietly: 47/hour) There is really no reason NOT to have a pedal power generator. Even in my small apartment, I could keep the apparatus in the basement. To bring pedal power into your life, read this article: Pedal powered farms and factories: the forgotten future of the stationary bicycle

Your thoughts: Do you know anyone who generates energy by pedal power?

Hepatitis C and All of We

Line up baby boomers – all 78 million of you – it’s time to test for hepatitis C. That’s what the Centers for Disease Control and Prevention (CDC) propose. We all need to get a blood test. Hepatitis is an inflammation of the liver that may progress to liver cancer or cirrhosis. Hepatitis C, the most common type in the United States, is spread when blood from a person infected with the virus enters the body of someone who is not infected. Around 15%–25% of infected people clear the virus without any treatment, but the remaining 75%–85% develop a chronic infection that may be silent for years. Most infected people don’t feel sick – while their livers are slowly being damaged.

Historically, the CDC has recommended testing people known to be at high risk.  They include current and past users of injection drugs, recipients of blood transfusions and organ transplants before 1990 when screening blood donations became widespread, and healthcare workers exposed to blood. Much less commonly, the hepatitis C virus is spread by sharing razors, toothbrushes, and other personal care items that may come in contact with blood. Having sex with someone infected with hepatitis C is somewhat risky too, especially when exposed to multiple sex partners who have sexually transmitted diseases. Sex, drugs and rock and roll. Bummer.

I, for one, I wish the CDC would stop scaring me. Doctors test for the hepatitis C antibody (also called HCAb or anti-HCV) to tell if you’ve been infected. The test is very sensitive, which means false positives, more testing, and more being scared. All when only 3 percent of asymptomatic boomers actually test positive. As a responsible health blogger, I probably shouldn’t say this, but I am always skeptical of guidelines that push asymptomatic individuals en masse towards prescriptions. I just wonder who is being best served. The CDC’s draft recommendations are available for public comment until June 8, 2012.

Your thoughts: Are you worried about having hepatitis C?

Addendum:  August 16, 2012
It’s official: The U.S. Centers for Disease Control and Prevention (CDC) is now recommending that all U.S. baby boomers get a one-time test for hepatitis C virus (HCV) infection, according to final screening guidelines released by the public health agency.  Read more.

Hey Sailor! Watch Your Weight

Thousands of sailors wearing their summer dress whites hit the streets of New York City today, the start of Fleet Week. You’d think I’d be over the uniform by now, having worked as a cocktail waitress in the enlisted man’s club back in the day when the Navy was in Newport, Rhode Island. But, no, I’m still captivated by that costume, unchanged since the late 1800s. It is a uniform is build on tradition: bell bottom trousers are easy to roll for deck work, the neckerchief functions as a sweat band, the jumper’s collar keeps tar spots off the shirt, and the indestructible “Dixie Cup” hat is comfortable and easy to make and clean.

The Future of the Fleet

Here’s hoping our shores stay safe because we don’t have the men to defend them. Of all military applicants, 25 percent are declared unfit to serve and rejected because they are overweight or obese. CDC data shows, in 1960, the average American man was 5’8” tall and weighed 166 pounds; by 2004, he was 5’9” tall and weighed-in at 191. The military only accepts candidates who fall into a specific height and weight range. A fighting man’s height is between 5’0” to 6’6” and the Navy’s maximum allowable weight is around BMI 25.5, which translates to 174 pounds at 5’9.” If an applicant exceeds the weight on the chart, then his body fat is measured and the goal is 23 percent or less, a realistic number. I’m not worried because those young guys can get fit fast when they try, and in a Star Wars defense system, unfit sailors can sit at computers. But what about those cute sailor suits? They won’t look nearly so fine.

Your thoughts: Is weight threatening national defense? How ’bout that sailor suit?

Light Treatment for a Heavy Matter

Have you heard about the documentary, Weight of the Nation™, on HBO in four parts starting on May 14th? The show is so important that HBO is airing it for free! It coincides with a conference in Washington this week also called, Weight of the Nation, hosted by the Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity. (What a mouthful!) The conference showcased the Institute of Medicine’s (IOM) new report, Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation.

The IOM evaluated prior obesity prevention strategies and identified recommendations to accelerate progress. They say:

  • Integrate physical activity every day in every way (e.g. make more green space)
  • Make healthy foods and beverages available everywhere (e.g. health vending machines)
  • Market what matters for a healthy life (e.g. industry-wide guidelines on food and drinks marketed to kids)
  • Activate employers and health care professionals (e.g. more worksite wellness programs – yawn)
  • Strengthen schools as the heart of health (e.g. 60 minutes of physical activity in schools every day! That’s after you lay-off the teachers and teach to the test.)

Do you remember last November when the IOM recommended ways to made school lunch healthier? Congress sold out to Big Food in the “pizza as a vegetable” fiasco. I wrote about it for Diets In Review, Congress Denies All Changes to School Lunch Throwing Children’s Health Under the Bus.

Sorry, but I’ve been following this issue going on 40 years, and don’t think this will make a difference. I see the ultimate solution (to all things) as coming from the people. Kids who were practically born fat and sick will find their indignation and provide the critical mass needed to turn the tide toward all things healthy.  Alternately, a good famine could save the day. In the end, only the obese will survive!

Read all of the IOM’s recommendations here.

Your thoughts: What will it take to fix the obesity crisis?

Colbert Reports on ‘Pink Slime’

Truly, let this be the last word on ‘pink slime’ the other name for ‘lean finely textured beef,’ LFTB, or as Colbert says, “Because our beef has so many hormones, it’s a member of the transgender community!” ‘Pink slime’ is simply beef offal and trimmings treated with ammonium hydroxide gas to control pathogens. Like it or not, ammonium hydroxide is added to lots of food: cheese, chocolate, confections, baked goods, breakfast cereals, eggs, fish, sports drinks, beer, pudding – and meat. (Read more about it from The International Food Information Council Foundation.) All I can say is, America, you have no idea. Watch Stephen slime pink slime.

What You Should Know About Labeling Genetically Modified Food

My job at Diets In  Review keeps me, a slacker, on her toes. This week, I had to pay attention to petitions to label genetically modified foods.  For that, I turned to the eloquent public health nutrition scholar, Marion Nestle, who examined the issue in her blog, Food Politics.

The Condensed Version

The Committee for the Right to Know is a grassroots coalition of groups in California that is trying to get the issue of labeling of genetically modified foods on the California ballot. Last year, 14 states introduced bills to require GM foods to be labeled, but none passed because the bills were fought by multinational agribusinesses. Now, the campaign has now gone national. Marion says, and I agree, that consumers have a right to know.

Man has been manipulating the genetic material of plants ever since Mendel first hybridized pea plants in the 1850s. It’s just that today’s methods of bombarding seeds with radiation and chemicals seem so unnatural. Modern day GM techniques began in a big way in 1996, and now, close to 90 percent of corn, soybeans and sugar beets grown in the United States are GM varieties. At time point, GM crops have not produced any noticeable health problems, but there are no long-term epidemiological studies that might find subtle effects. The FDA thinks GM foods are safe, but the fact is that no one knows for sure.

My gripe has more to do with the business argument. I dislike giving Monsanto (the company that dominates the GM market) any more control over the American food supply. Monsanto’s strict intellectual property-regulations are unfair to farmers and they divert energy away from research on organic farming. This clip from the movie, Food, Inc., shows just how powerful Monsanto is in the food industry, which leaves the average person no other choice but to eat their genetically engineered soy beans. Watch Monsanto bully the poor farmers. It’s pathetic.

The Bottom Line

Marion writes, “Intelligent people can argue about whether GM crops are good, bad or indifferent for agriculture, the environment and market economies, or whether the products are safe. But one point is clear. The absence of labeling cannot be good in the long run for business or American democracy.”  Ultimately, it’s more important to eat wholesome foods in the correct amounts, than it is to worry about whether or not they are GM. Still, Monsanto needs a punch In the nose.

Your thoughts: Will you sign the petition to label genetically modified foods?

Susie Orbach Tells It Like It is About Women and Beauty

Woman Is the Nigger of the World~John Lennon & Yoko Ono

Weren’t they the best at getting our attention?  The words are appropriate because today is March 8th, International Women’s Day, a day celebrating the economic, political and social achievements of women past, present and future. In China, Russia, Vietnam and Bulgaria, they get the day off.

In honor of the celebration, Susie Orbach, psychoanalyst, author and feminist (mentioned in my blog, My Intuitive Eating “Aha” Moment) delivered a speech, “Body Image in the Media: Using Education to Challenge Stereotypes,” to the UN Commission on the Status of Women in New York City last week. Susie compared the self-starvation, surgical cosmetic procedures and the use of appetite suppressing pharmacological agents to all forms of violence practiced against girls and women in the rest of the world. You can read the transcript of her speech at, Susie Orbach Speaks at the UN Commission on the Status of Women. She explains that beauty’s tyrannical hold zaps females of their energy, dollars, and sense of self.  In her speech, Susie Orbach says,

“The beauty companies, the fashion houses, the diet companies, the food conglomerates who also of course own the diet companies, the exercise and fitness industry, the pharmaceutical industry and the cosmetic surgery industry combine together, perhaps not purposefully or conspiratorially, to create a climate in which girls and women come to feel that their bodies are not ok. They do this through the promotion of celebrity culture, through advertising on every possible outlet from billboards to magazines to our electronic screens, through the funding of media outlets which can only exist because of their economic support.”

Don’t you love it?  All people, women and men, have a responsibility to rally against using the female body as a profit center. It’s especially important this year as basic rights like birth control are being challenged. We need the energy spent on beauty to protect our rights!

Your thoughts: How much beauty-time is too much? Do you share Susie views?