Left Behind

There's an interesting correlation between a couple of news stories out today.

The first is the results of three large national database studies showing that between 1971 and 2000 the death rate of men with diabetes has dropped significantly and is in line with the overall rate of decline in death rate among all Americans. The same is not true, however, of women with diabetes, whose death rate did not decline at all.

One of the researchers concluded: "The improvements seen in men suggest that the improvements in diabetes care are working on longevity as well. But the finding in women is concerning and means we may need to explore whether different approaches are needed to improve health outcomes for women with diabetes."

One answer -- one very big, systemic answer -- might be found by reading between the lines of health guidelines being given to women. Take, for example, the recent eating guidelines from the American Heart Association, which one of my favorite blogs, Junkfood Science, rips apart at the seams. Go and read author Sandy Szwarc's breakdown of the AHA recommendations.

In short, though, she points out that:

1) The AHA Guidelines state that to prevent heart disease and premature death, women should maintain or lose weight and maintain a BMI between 18.5 and 24.9 with a waist circumference of 35 inches. However, when the studies to support this recommendation are examined, there are ZERO clinical studies cited to support that women who lose weight live longer or decrease their chances of cardiac disease.

2) The AHA recommends that women consume no more than one alcoholic drink daily. However, an examination of their 54 pieces of "evidence" shows that few were actually clinical trials, and most were conducted only on men. And the AHA expert committee even noted that the results "are not applicable to women."

3) The AHA says to prevent heart disease and increase longevity, women should consume ample fruits and vegetables; eat whole-grain, high-fiber foods; consume fish at least twice a week; limit saturated fat to less than 10% of calories (7% is preferred), and limit sodium to approximately 1 teaspoon of salt a day. Trans fats should make up less than 1% of calories.

To support these recommendations, the AHA cites a whopping 94 studies. However, as Sandy of Junkfood Science discovered, 36 of the studies included no women and the AHA committee noted they were not applicable to women. Another 8 studies were not applicable because they were studies of previous cardiac patients, not prevention studies related to the guidelines. Forty-eight of the studies were observational and could not point conclusively to causal relationships between diet and disease. Only one study was a clinical intervention trial.

Sandy's conclusion: "Not one observational study was able to credibly support the AHA heart healthy eating recommendations for women to prevent heart disease or premature death. The only observational study specifically looking at Healthy Eating in accordance with our government’s dietary guidelines found no benefit. And finally, the strongest evidence — an actual clinical trial of the heart healthy diet on the primary prevention of heart disease in women, that went on for more than 8 years — found it had no effect on heart disease."

So, let's go back to the first data about how women with diabetes aren't experiencing the decline in mortality enjoyed by their male counterparts and non-diabetic Americans as a whole. Is it apples and oranges? I really don't think so. Until and unless we develop a body of clinical work specifically studying the effects of diet and disease on women, we're going to lag behind on more than just pay rates.

Okay. Off the soapbox now. Jeez. I sound like a feminazi. I'm not. Really.

The Poop on Poopy Pants

Well, that got your attention, didn't it?

Actually, I'm talking about a bit of an advertising war between GlaxoSmithKline's new OTC diet drug, Alli, and the OTC weight-loss drug Leptopril from Generix Labs.

Seems Generix created an ad for Leptopril based on its lacking some of the ugly side effects of Alli, a lower-strength form of the diet drug Orlistat. The side effect in question? Poopy pants.

Alli basically forces you to eat a very low-fat diet while taking it by causing uncontrolled diarrhea and, well, poopy pants if you eat too much fat. Leptopril is the drug with the obnoxious commercials that say "don't buy this product unless you're significantly overweight because it works too well for the casual dieter," or some such nonsense.

But anyway, when CBS, NBC and ABC all rejected the Poopy Pants commercial, saying it was in bad taste, Generix placed their ad on YouTube and other video spots. And you gotta admit, it is pretty funny.

Popout

Yeah, Well, At Least I Don't Have a Square Head

Which is pretty much my response to American Medical Association president William Plested, who spoke recently to a civic group about what he thinks is ailing American healthcare.

Is it obesity? No.
Is it the aging of the giant Baby Boom generation?
Is it a shortage of nurses?

No.

It's the legal system and the fact that people can actually--gasp--sue their physicians if they do a poor job and cause more problems than they help.

Now, I admit this has become an overly litigious society, and everyone's answer to everything is "sue the bas..uh...bad guys."

But to blame every healthcare system ailment and, by association, every health problem society faces, to physicians' fear of lawsuits seems a bit over the top.

And, yes, part of my gripe with Dr. Spongebill Squarehead, pictured above, is that he said the result of all these lawsuits-in-the-making is that "we're going to pay for this with a generation of fatso's with every disease you can imagine."

Gasp. Not FATSO'S!!

Sheesh. Maybe I will sue the bas...bombastic boxhead.

Raising the Cereal Bar?

At first I called it "baby steps," today's news that The Kellogg Co. has adopted new nutritional standards for its products that are marketed to children.

It's a huge step for a company to take, I thought when I first heard the news--a big old company voluntarily making its products healthier. A lot of tinkering will be going on in the old cereal labs, I thought.

So, what are the new "nutritional standards?"

Basically, they set an upper limit of 200 calories per serving maximum, 2 grams or fewer of saturated fat, 0 trans fat, 230 milligrams or fewer of sodium, and 12 grams or fewer of sugar.

How does this compare with some of their currently marketed products?

Well, a pop tart (hot chocolate flavor) has 200 calories, 2.5 grams of saturated fat, 200 mg of sodium and 18 grams of sugar. So basically, the pop tart has to trim only 6 grams of sugar to make the cut. (And this is for one Pop Tart and does anyone really eat just one? Really? You leave the other one in that little foil bag? Not me!)

Froot Loops? 120 calories, .5g saturated fat, 140mg sodium, 13g sugar. Virtually no change.

Rice Krispy Treats? 100 calories, 3.5g saturated fat, 95mg sodium, 10g sugar. Virtually no change.

And on and on it goes. So the crafty folks at Kellogg have made this big media splash about all they are doing for our obese kids while, really, they set the "bar" so low that they barely have to lift a foot to climb over it.

Jonesing for a Soda?

So sue me--I am a soda fanatic. I even love Diet Coke, aspartame and all, even though I recognize that it's probably pickling my interior regions with formaldehyde as we speak.

So I was surprised--and pleased--to find a new offering at Wally World last week...Wally World, I might add, that in New Orleans since Katrina barely has any regular supply of merchandise at all and can take weeks before a sold-out item is restocked. And, yes, remember the post-Katrina footage of hooligans ransacking a Wal-Mart and hauling out electronics and massive amounts of Nikes? Well, that was my neighborhood Wal-Mart. But I digress.

So there on the shelf was a sugar-free Jones Soda. I was surprised, since the uber-hip, cultish Jones Sodas are known for their radical refusal to sweeten with high-fructose corn syrup. Their bottles, in fact, boast that they are "Pure Cane Sugar Sodas." So to see sugar-free was surprising.

I snapped up an overpriced four-pack and took it home. As I sipped a fizzy, refreshing, extremely tasty Sugar-Free Green Apple (sweetened with Splenda), I read the bottle, about how for years people had been begging them for a sugar-free soda but they never could find a taste they liked and that lived up to their standards.

Well, I guess they found it and I have to agree--it's mighty tasty. I notice on their website that they make sell sugar-free cream soda, root beer, and black cherry soda. Finding it is a bigger challenge, as I don't have much hope that Wal-mart will carry it long-term or in any variety of flavors. I think that was a fluke.

Probiotic vs Prebiotic

So yesterday, Regina from the top-notch blog Weight of the Evidence pointed out that I had referred to inulin as a probiotic when, actually, it is a prebiotic. And, as another reader asked: What's the difference?

Good question, actually, because we're seeing these terms thrown around a lot these days as more "functional foods" come online. And when you see TV commercials talking about Dannon yogurt with "L casei Immunitas," I guess it's time to find out just what the terms mean. (More on "L casei Immunitas" later.)

For a definitive answer, I went to the godfather of all references, the Oxford English Dictionary--one bonus of working for a university is online access to this beautiful monstrosity.

And here we have it. A "prebiotic" is a non-digestible food ingredient that selectively promotes the growth of beneficial bacteria in the intestine. The beneficial bacteria themselves are "probiotics." So inulin, which I wrote about yesterday, is a prebiotic because it promotes the healthy bacteria. The term "probiotic" first appeared in 1995 in a Journal of Nutrition article--which is the kind of trivia one obtains from reading the OED. We also find that the two main prebiotics are the non-digestible oligosaccharides inulin and oligofructose, the richest nutritional sources of which are chicory root, Jerusalem artichokes, leeks and onions.

Oligofructose is used in what I personally think is the best low-carb chocolate, made by Maine Cottage Foods, which is sweetened with a blend of erythritol, Splenda and Ace-K.

But I digress, which I tend to do when there's chocolate around :-)

What Dannon touts in its Activia and DanActive yogurts--even the "plain" also contains sugar, by the way, so don't go rushing out to buy any--are "L casei Immunitas" and "Bifidus Regularis," which are really the company's own blends of probiotics (bacteria, or live cultures) that they claim promote a healthy immune system (immunitas) and bowel health (regularis). They don't tell us what the blend is--it's their "trade secret"--and tout that they're the only yogurts to have it. (Well, of course they are--Dannon made the blends up, including their "official" fake Latin names. Duh.)

But I don't eat that sugar-laden junk anyway. What I DO eat is plain Lifeway Kefir, which with a splash of DaVinci syrup makes a great yogurt smoothie. It contains 10 active probiotics: 

• Lactobacillius Lactis
• Lactobacillus Rhamnosus
• Streptococcus Diacetylactis
• Lactobacillus Plantarum
• Lactobacillius Casei
• Saccharomyces Florentinus
• Leuconostoc Cremoris
• Bifidobacterium Longum
• Bifidobacterium Breve
• Lactobacillus Acidophilus

What do all those probiotic bugs do for me? Couldn't tell you. But it tastes really good with some DaVinci Sugar-Free Irish Cream or Kahlua. And, yes, we could talk about spiking healthy yogurt with chemical-laden artificial sweetener. But that's a biology lesson for another day. Class is dismissed!

Out of the Inbox

Just cleaning out the files...

• Have you read about the new "Jelly Belly" diet pill? It's a new Italian creation, but unfortunately doesn't offer the flavor offerings of real Jelly Bellies. Instead, the idea is that you swallow this pill and it inflates to a gelatinous mass the size of a tennis ball in your stomach. Makes you feel full and you don't want to eat as much. It eventually dissolves and goes out in the usual manner as if you had simply eaten 42 cups of Jell-O. I think if the scientists hadn't used the words "gelatinous mass" I could get into it a little more. Still, cheaper than gastric bypass.

• Just in case you didn't think most foods' health claims were a bogus bunch of advertising fluff, here comes Frito Lay, who decided that since they have switched to using more non-saturated fat in their chips, they can now make health claims for Ruffles. It seems to be under serious consideration by the FDA, which I think once this passes can officially change its name to the Food Disaster Administration.

• A recent survey by the NDP market research group found that 70 percent of adult Americans want to cut down or avoid sugar completely, with 40 percent saying they check food labels for sugar content. As a result, food manufacturers are responding to the resultant demand for more reduced-sugar or sugar-free products. Great! Well, except that the survey analysts stated that Americans had gotten on an anti-sugar kick in the 1960s, too, and we apparently got over it.

• The buzz over probiotics continues. This latest, from a food industry newsletter, says the science is "building" behind the use of the probiotic ingredient inulin. Inulin is a root fiber that promotes probiotic bacteria in the gut, has a sweet taste, and is classified as a soluble fiber. The latest study, published in Nutrition Research, shows that probiotics such as inulin, consumed regularly, help protect against colon cancer.

Microwave of Evil

How often do you use the microwave oven? I'm thinking, for myself, at least once a day--sometimes more. I tend to reheat more than actually cook in it. I know some low-carbers cook eggs in it but I've never liked them microwaved.

But I also don't blame my microwave for any weight problems that might be found in my household.

Under the heading of "stupid health stories," file this under "REALLY stupid." A UK professor claims thatmicrowave ovens triggered the rise in obesity.

Say huh?

Because the increase in microwave usage parallels the increase in obesity from the 1980s, this undoubtedly means that the microwave did it. Sounds kinda like the "Devil Made Me Do It" defense, and where's Flip Wilson when you need him? Oh yeah, he's dead.

Probably microwaved himself into a size 10X.

And if you need further proof of the evils of microwave cooking, look on the front of your microwave. Chances are you'll find convenient settings for popcorn and potatoes.

So toss out your microwaves, one and all! Heat up your big ovens. Pop in a cake. Obviously, if it ain't cooked in the microwave, the calories don't count.

Porky for President?

I guess it was inevitable, as more and more folks talk about Al Gore as a desired presidential candidate, that talk would turn to his weight. Now, obviously, Al has put on a few. But does his weight make him a worse candidate for president than others? Aren't there better things to make fun of him for?

Guess not, according to the pundits on this recent clip from Chris Matthews' "Hardball" show.

They could at least have joked about him increasing sales of low-carb products and not SlimFast!

Livin' Large

So, I'm always fascinated by what marketers and retailers think Big People need and want in their lives. It can make quite the sociological study.

Obviously, for example, women's clothing manufacturers and retailers have several preconceived notion about overweight women:

• Our arms hang down beyond our knees so we need extremely long sleeves;
• We are very fond of very large prints;
• We enjoy clingy midriff tops (preferably in very large prints);
• Novelty items with pigs, elephants, or cows on them are big favorites, so that we can invite rude comments from strangers; and
• Two words: fluffy chiffon.

Note to manufacturers: these assumptions are not true.

So it was with extreme interest that I came across the LivingXL website, with products designed for plus-sized men and women.

And what do the folks at LivingXL think we need? Let's see: robes up to 8x; super-sized towels; hand-held showers; and the "Big John" toilet seat that holds up to 1,200 pounds. Egads. High-capacity scales. Hmm..a Leg Lifter. Wonder what that does? A "bottom buddy." That's in the personal hygiene category and I don't want to delve too deeply into its use. Large patient gowns--and if you've ever gone to the doctor and had to don a gown that doesn't quite meet you'd see the beauty of having your own. Large-sized life jackets. Don't laugh--I have one of these, for those Hurricane Katrina-like events. I also own an inflatable boat for the same reason, but that's a topic for my other blog. Benches. Picnic tables. Are picnic benches a problem for overweight people? Ah, an airplane seatbelt extender, which you can choose by airline. Travel iron. Uh...fat people need special travel irons? How have I lived this long without realizing that? Oversized clothes hangers. Now that's a great idea.

Oh well.

I'm making light of all this, and admittedly some of the items are pretty strange. But others sound dead-useful, so why not.

On the other hand, let's see what we can do about those orangutan arms that manufacturers insist on putting on plus-size clothing.