Sunday, September 28, 2014

The Obesity Dilemma & Good News About Tomatoes

We are the fattest country in the world, in terms of the proportion of our citizens who are overweight or obese – about 70% of adults and 32% of children.  Data from 1988 to 2010 showed that obesity increased in this time period, but average daily calorie intake was more stable.  The proportion of adults who did not engage in physical activity increased markedly  - from 19% to 52% in women and from 11% to 44% in men. 

The impacts of this trend on individual well-being, the incidence of diseases such as diabetes, heart disease and many cancers, and the cost of medical care and medical insurance are huge.  Prevention is needed, and must be aimed at increasing the space and time for people to walk and play, and decreasing the desirability of sugar-laden drinks, salty snack food and junk food with empty calories.  While it is easy to say this, public health officials and thinkers are struggling to come up with ways to reverse the trend. 

University of Illinois researchers have written that easy access to junk food, even when vegetables are available and people exercise, is a major cause of the obesity epidemic.  They think that reducing calorie intake from sweetened beverages and salty snacks would be more effective than convincing people to eat more vegetables.  How can this be done? We live in a society that questions and dislikes regulations , and we are inundated with advertising for easily purchased fattening foods.    Attempts to remove sweetened soda drinks from schools have not been successful nationwide, both because of school resistance (sales are a source of income) and because children buy the drinks elsewhere.  Our local schools are an exception!

In general, taxes on sweetened soda drinks have failed at the ballot box- Richmond, CA tried to pass a soda tax in 2012 but the nay vote was 67%. 

Michelle Obama has been working with the U.S. Department of Agriculture to formulate nutrition standards for schools with predominately low income students.  Starting this summer, these schools will receive financial aid to implement healthy breakfasts and lunches.  These recommendations set limits on calories, salt, sugar and fat in foods and beverages, and also promote snack foods with more whole grains, low-fat dairy and fruits and vegetables.  This is a start, especially if children are given instructions on food, cooking and gardening, and can raise some food at school. 

It is also important to provide school activities beyond competitive sports, such as dancing, theater, martial arts, gym workouts and hiking.  This will allow shy or ‘non-athletic’ students to find a way to be active that they can enjoy and pursue for a lifetime. 

Cities must have sidewalks and parks, including pocket parks, and encourage the placement of markets and farmers’ markets where there are food deserts. 

California is doing better than 45 other states with regard to the epidemic, but it’s hard to be satisfied with our rate of adult obesity of 24%.  We have abundant produce and a beautiful out-of-doors.    Something is drastically wrong.  Food is a survival issue, a huge source of pleasure and of course an emotional  issue – but it can kill us as well as nourish us.  We are swayed by powerful financial interests to buy and eat or drink the wrong things for our bodies.  Solving this problem will take many approaches, including a return to ancient wisdom and age old methods of cooking and eating found in each culture.  

And now for some good news – about tomatoes and watermelon.
Lycopene is one of more than 600 carotenoids found in vegetables and fruits – it is the red pigment in tomatoes and watermelons.  It is an antioxidant that substantially lowers the risk of many diseases.  A study from Harvard showed that women with the highest blood levels of lycopene had a 50% lower risk of  heart disease when followed for 5 years.  Lycopene also lowers the risk of developing  many cancers, including prostate, cervix, skin, bladder, breast, lung and digestive tract.  It’s tomato season, so go for the deep red kind;  include a little fat in your meal to help you absorb the lycopene – such as olive oil on your salad.  Watermelon for dessert or in salad is another good choice for lycopene.  In the winter, tomato paste or tomato sauce will give you abundant lycopene.  Put a little, or a lot, in all your dishes.  Tomatoes will give your dish 3 of the 5 tongue tastes – sweet, sour and umami flavor.  (Salty and bitter are the other tastes in the mouth.) Umami taste is considered to be ‘meaty’ or ‘brothy’.  It’s also found in mushrooms and meat, fish and poultry.    We are so lucky to have great tomatoes this year.

Sadja Greenwood, MD, MPH   back issues on this blog

Sunday, September 14, 2014

Flaxseed can help lower blood pressure

Flax plants, used for food and to make textiles (linen) have been used for thousands of years.  Flax fibers spun into clothing have been found in a cave in the Republic of Georgia and dated as made 30,000 years ago.  Modern science has found that flax seeds contain a plant form of omega-3 fatty acid (alpha linolenic acid) as well as lignans - substances that act as plant estrogens. Lignans are also found in lower amounts in rye, wheat, oats, barley, soybeans, sesame seeds, cruciferous vegetables and in certain fruits such as strawberries and apricots.  Flax seeds, but not flax seed oil by itself, has been found to be associated with a lower risk for breast cancer.  A study from Duke University showed an association of flax seed with slower growth of prostate cancer.  

A recent study from St. Boniface Hospital Research Center in Manitoba showed that people with high blood pressure and resultant leg pain from constricted blood vessels were helped by supplementing their diets with ground flax seeds.  They took 30 grams a day, which is about 4 tablespoons, put into muffins and bars or eaten as plain ground flax.  The flax seed provided abundant fiber, and the subjects did not gain weight during the 6 month trial.  Subjects in the comparison group, also with high blood pressure, were given food enhanced with almonds and other  ground nuts.  Their blood pressures did not change during the 6 month study.  The blood pressure reductions seen in the flaxseed group were impressive - systolic blood pressure was 10 mm Hg lower and diastolic 7 mm Hg lower after 6 months.  In subjects with initial systolic blood pressure readings of  140 mmHg or higher, there was a reduction of 15 mm Hg systolic and 7 mm Hg diastolic.  These figures compare favorably with the reductions seen with many blood pressure medications.  It should be noted that subjects in this study continued their prescribed medications for blood pressure reduction.  The authors cautioned that people trying flaxseed meal should remain under their doctor’s care and not change their meds unless advised to do so.  

A study from the University of Saskatchewan in 2009 showed that men, but not women, had reduced scores of factors in the ‘metabolic syndrome’ when they took flax seed components and engaged in a walking program.  The metabolic syndrome is a cluster of conditions: increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels.  These factors can lead to an increased risk of heart disease, stroke and diabetes.

This article has given the reader several good reasons to try adding flax seeds to your diet.  It’s easy to do so, and the taste is nutty and pleasant.  You can grind your own (with a spice or coffee grinder) from organic flax seed from many stores, or buy it already ground.  Be sure to refrigerate the ground flax.  Put it on oatmeal, salad, stir fries  or in shakes.  Incorporate it into baked goods.  There are lots of recipes for this on line. Ground flax adds fiber to your diet and can relieve constipation. Be sure to drink more fluids if you start using flax.  
Post-menopausal women may enjoy the slight increase in safe plant estrogens from the flaxseed lignans,  However, flax has not been shown to relieve hot flashes.

Sadja Greenwood, MD   back issues on this blog