Bisphenol A (BPA): What you should know

BPA is one of the most commonly manufactured chemicals in the world. It is a component of polycarbonate plastic and is found in a wide range of common materials and food packaging. It has been known for many years that BPA has estrogenic properties; its effects on the reproductive systems of animals -fish, amphibians and mammals - have raised concern for humans. The chemical has been called an endocrine disrupter, which can mimic the body’s own hormones and lead to negative health effects. Animal studies (those unfortunate mice and rats) have suggested effects of BPA on the brain, breast, prostate, thyroid, obesity, sexual behavior et al. Some studies suggest an increased risk for breast and prostate cancer. Newborns and children may be specially affected by environmental BPA levels, due to their reduced capacity to eliminate the substance and their higher daily exposure, adjusted for weight. A study from Rockefeller University on primates in 2008 showed that even at relatively low exposure levels, BPA abolishes the ability of spinal synapses to respond to estrogen, which may play a critical role in cognition and mood. An English study published in the JAMA (University of Exeter - 2008) showed that higher levels of BPA in the urine of US adults correlated with cardiovascular disease, diabetes and abnormal liver enzyme levels. A study carried out by the Division of Research at Kaiser in Oakland showed that male workers in China with high occupational exposure to BPA had a significantly higher risk of lowered sexual desire, erectile dysfunction and difficulty ejaculating. This study is obviously important to men, and a motivator for youth to avoid exposure as much as possible. I have cited only a few examples of research on BPA that suggest negative health effects on humans and animals. While studies abound, our response in the US has been painfully slow.

Canada announced its intent to ban the import and sale of polycarbonate baby bottles containing BPA in 2008. Walmart announced soon thereafter that it would stop selling food containers, water and baby bottles, sippy cups and pacifiers containing BPA at its Canadian stores. In 2010, Canada declared BPA to be a toxic substance and is proceeding to decrease its use overall. European countries have been slower to act. But the European Union executive commission plans to stop the manufacturing of polycarbonate baby bottles containing BPA by June, 2011. Minnesota, Chicago, Connecticut, Massachusetts and Maine have taken steps to ban products containing BPA from baby food containers and other products. However, in 2009, California’s EPA unanimously voted against placing BPA on the state’s list of chemicals that are believed to cause reproductive harm.

What you can do
1) Shop wisely: BPA is found in the internal coating of food and beverage metal cans to protect the food from the metal. Choose fresh or frozen foods over canned whenever possible. Eden Organic has eliminated the use of BPA in their canned and packaged food, and Muir Glen organic tomato products will be BPA free this year. These products are available at natural food markets.
2) In your kitchen: If you feed your baby from a bottle, use glass, and avoid plastic pacifiers and cups. Don’t microwave food in plastic containers, and store leftovers in glass or ceramic containers. Carry extra water in a stainless steel or glass bottle. Nalgene is now selling plastic water bottles made of copolyester , with non-BPA materials. Hikers will want to have a light-weight water bottle, but more research may be needed on the long term safety of these new materials.
3) Go to the website of healthyfoodaction.org and sign their petition asking President Obama to eliminate the use of potentially cancer-causing chemicals in our environment, including BPA
4) Ask our assemblymember, Jared Huffman, to work on banning BPA containing products in California. Mention the 2009 California EPA vote when you call or write. Huffman is an environmentalist – 479-4920. Contact Governor Jerry Brown while you are at it: 916-445-2841. Go citizens!
Sadja Greenwood MD, MPH back issues on this blog

Go to Health: The 2012 Farm Bill: What you can do

Every five years, Congress writes a Farm Bill that establishes our nation’s food and agricultural policies. The 2012 Farm Bill will cost approximately 300 billion. It’s largest slice, the Nutrition Title, governs foods bought by those on food stamp assistance. Currently, farm policy has driven down the price of commodities such as corn and soybeans, resulting in lower prices for high fructose corn syrup and soybean oils. Our consumption of unhealthy foods made with these substances has increased. At the same time we have grown and eaten fewer vegetables and fruits; their production has not been subsidized, and their prices have increased over the years.

Many organizations interested in local food production, water and soil quality, and the health of our population are working on changing the way we support farmers. A prestigious group of nutrition experts, including Walter Willett of the Harvard School of Public Health, Marion Nestle at New York University and Andrew Weil, have written a charter for a healthy farm bill, which concerned citizens are urged to sign. The charter calls for a new food system that is:
*healthy – accounting for health impacts on farmers, workers in food industries, and eaters
*sustainable – protecting natural resources and biodiversity
*resilient – overcoming challenges of climate change, pest resistance, and problems with expensive water and energy
*fair – providing fair access to affordable and healthy food, and fair conditions for farmers, workers, and eaters
*economically balanced – providing economic opportunity across the nation’s states, for a diverse range of farmers and workers , from local to global in scale
*transparent – farmers, workers and eaters should be able to participate in decision making on food production distribution, marketing, and disposal.

You can sign the Charter for a Healthy Farm Bill by going to the website of www.healthyfoodaction.org. There will undoubtedly be more discussion and controversy than ever before as the new farm bill is debated and written. Energized and informed people (you are probably one of these!) confront a system that has given rise to overproduction of foods for animal feed and underproduction of healthy vegetables and fruits, and a national health crisis. This column will continue to discuss the new Farm Bill in coming months.

While you are at the website for healthyfoodaction.org, you can also sign a petition asking President Obama to set the course for a new cancer prevention strategy, by eliminating the use of potentially cancer-causing chemicals in our food and environment, such as Bisphenol-A (BPA) and Dioxin.

BPA is a compound used to make polycarbonate plastics and epoxy resins.. BPA is known as an ‘endocrine disrupter’ because of its estrogenic properties and possible effects on fetuses and young children. It has been found in the internal coating of food and beverage metal cans to protect the food from direct contact with metal. It is also found in polycarbonate bottles. Eden Foods has eliminated the use of BPA in their canned and packaged foods, and Muir Glen organic tomato products will be BPA free this year. You can find foods from Eden and Muir Glen at many natural food stores.

Dioxins are chemicals that enter the atmosphere as by-products of the bleaching of paper pulp, chemical and pesticide manufacture, and burning of trash. The defoliant Agent Orange, used by the US in the Vietnam war, contained dioxin. Stay tuned for a more complete discussion of BPA, Dioxin and other chemicals in my forthcoming columns. You will be pleased to know that Bolinas citizen Sharyle Patton, working at the Biomonitoring Resource Center and the Collaborative on Health and the Environment at Commonweal, is a world expert on the chemicals in our environment and their effects on our bodies. Her research is having an important impact on policy in many countries.
Sadja Greenwood, MD back issues on this blog

Go to Health: Strategies that work for weight loss

Researchers at Brown Medical School and the University of Colorado have established the National Weight Control Registry to follow people who have successfully lost 30 pounds or more and have kept it off for long periods of time. These people’s approaches are diverse and inspiring. Given the obesity epidemic among adults and children in the US, with an associated rise in diabetes and health care costs, the subject is important for all of us. Here are some salient findings from people who joined the registry:
*Weight losses range from 30 to 300 pounds.
*Duration of successful loss: 1-66 yrs.
*Some lost weight rapidly, others very slowly – over as many as 14 years.
*55% lost weight with the help of a program or support group.
*98% modified their food intake
*94% increased physical activity, most frequently by walking.
*78% eat breakfast every day
*75% weigh themselves at least once a week
*62% watch less than 10 hours of TV per week
*90% exercise about 1 hour a day

Mayo Clinic on Weight Loss: Here are some ideas from the Mayo Clinic Diet Book, which is sensible and pays attention to motivation as well as food and exercise. Permanent weight loss takes time and effort, and is a lifelong commitment. Address the other stresses in your life, so that you can focus on changing your habits. Find your inner motivation – looking better, or getting healthier. Pick people to support you in positive ways. Set realistic goals, such as losing 1-2 pounds a week, or walking at least 30 minutes a day. Enjoy healthier food – fruits, vegetables, whole grains, olive oil, nut butters, low-fat dairy products. Cut back on sugars, and limit meat consumption. Stay physically active. Work out a way to gradually change the habits and attitudes that have sabotaged your past efforts.

Childhood Obesity: 20% of children are now overweight or obese, mainly due to lack of physical activity and unhealthy eating patterns. Michelle Obama has put forth an action plan – “Let’s Move” to solve the problem of childhood obesity within a generation. Her plan includes getting parents more informed about nutrition and exercise, improving the quality of food in schools, making healthy foods more accessible in poor neighborhoods, and focusing on physical education. The American Academy of Pediatrics recommends that children under 2 not watch any TV, and those older than 2 watch no more than 1-2 hours a day of quality programming. Children who consistently watch more TV and computer screens – including computer games - are more likely to be overweight. Here are some other tips for parents to keep their children healthy and slim: don’t drink soda, and don’t have it at home. Keep kid-friendly snacks in the house: fruit, nuts, low fat yogurt, nut butters, whole grain bread and pre-cut vegetables. Avoid storing cakes, chips, full-fat cheese, white crackers and most lunch-meats. Make healthier versions of favorite recipes, like cookies and pizza. Be active together – get everyone out for a bike ride or hike. Don’t make it about losing weight; make it about being healthy. Be a good example!

Sleep: getting too little sleep adds to weight gain in children and adults. The relationship in children is strongest, and may be related to disrupted levels of the hormones – gherlin and leptin – that regulate hunger. Sleep deficits also elevate levels of cortisol from the adrenal glands, raising blood sugar levels. Catching up on lost sleep on weekends is not as effective as maintaining a consistent pattern of sleep. If you are working on weight control, regular and adequate sleep will help you.

Some Extra Exercise Ideas: Get a pedometer in order to measure your steps every day, and slowly increase your walking. I recommend a Digi-walker SW - 200, available on-line. Put bricks under your desk, so that the top is at elbow height. You then have a standing desk – used by Benjamin Franklin and Thomas Jefferson among other enlightenment thinkers. Standing will increase your strength as you work on your computer, or pay bills, or write your poems. Put a stationary bike or other exercise equipment in front of your television, and pedal as you watch your favorite programs. You can easily get to that hour a day recommended by the people who successfully lost weight. Get an exercise pal – who could be a dog.
Sadja Greenwood, MD, MPH back issues on this blog

Updates on Brains, Vitamin D and Green Vegetables

Your brain on weights: You’ve probably heard that running, brisk walking and other aerobics increase blood flow to the brain and may be linked to the creation of new brain cells. Recent research shows that weight training may do the same. Rats with weights tied to their tails (!) who climbed ladders, or rats on loaded running wheels, packed on muscle mass and had higher levels of ‘brain derived neurotropic factor’, which is thought to spark the growth of new brain cells. Older women who lifted weights did better on tests of cognitive functioning than women in toning classes. Teresa Liu-Ambrose at the University of British Columbia speculates that resistance training, by strengthening the heart, improves blood flow to the brain, which is associated with better cognition.

Confusion on Vitamin D: A recent report from the Institute of Medicine (IOM) recommended that adults get 600 IUs of Vitamin D daily, and those over 71 get 800. They said that most people get this amount from foods (fatty fish and fortified milk) and sun exposure, and do not need supplements. These recommendations were contrary to the more widespread view in recent years that considered the importance of Vitamin D for bone health and other benefits, including protection against certain cancers and auto-immune diseases. Beth Dawson-Hughes, a vitamin D researcher at Tufts University, criticized the IOM recommendations as insufficient for the following groups:
*people with little sun exposure, including winter residents at higher latitudes, shut-ins, those who use sunscreen, those with dark skin (absorbs less D).
*osteoporosis patients
*obese people – it is thought that vitamin D is deposited in body fat and is less available from skin or dietary sources.
*people with gastrointestinal disorders that affect absorption.

Dawson-Hughes, as well as other vitamin D researchers, said that a laboratory level of 30 ng/mL (rather than the 20 ng suggested by the IOM) is good insurance, and is difficult to achieve by diet alone. Most adults need 1000 to 2000IU daily in supplement form, depending on their blood levels.

More benefits of Green Vegetables
Nitrate (NO-3) is found in vegetables such as red beets and spinach, and has been considered either without nutritional value or potentially toxic. Researchers at the Karolinska Institute in Sweden have found, however, that dietary nitrate is transformed by friendly bacteria in the mouth into nitric oxide (NO) – an important molecule in our bodies. NO helps blood vessels relax, lowering blood pressure and promoting more blood flow. It also makes the mitochondria that power our cells perform more efficiently. A high intake of vegetables and fruits has been found to protect against diabetes and heart disease. Boosting the nitrate to NO pathway may be one mechanism by which vegetables exert their protective effect. Readers may recall that dark chocolate also results in NO production in the body. But – try leafy greens first! And – think twice about using a strong mouthwash – we need oral bacteria for the system to work.
Sadja Greenwood, MD back issues on this blog. Leave a message or question.

Pesticide & herbicide residues in food - what to do

According to the Environmental Working Group, people can greatly reduce their exposure to pesticides by avoiding the most contaminated fruits and vegetables and eating the cleanest ones. Eating organic produce avoids these problems, but is usually more expensive. Even if you generally rely on organic food, you may eat conventionally grown foods in take-out or in restaurants. Here is the 2010 list of foods with highest pesticide residues, based on testing by the US Department of Agriculture and the FDA. The list reflects measurable pesticide residues after a food is washed and peeled.
The Dirty Dozen:
*Celery – with no protective skin it is hard to wash off the 64 pesticides found in residues on this vegetable.
*Peaches – conventional orchards use multiple sprays - 62 pesticides have been found on peaches.
*Strawberries – 59 pesticides found. If you buy out of season, they may come from countries with less regulation of pesticide use.
*Apples – 42 pesticides found. Peeling an apple removes many beneficial nutrients, and still there is residue.
*Blueberries – 52 pesticides found. This fruit is new on the list in 2010, possibly due to it popularity and intensive cultivation.
*Nectarines – 33 pesticides found.
*Bell peppers – 49 pesticides found.
*Spinach – 48 pesticides found.
*Kale – generally considered resistant to pests, but high pesticide residues were found in 2010. (Note – it is easy to grow your own organic kale almost year round in our climate.)
*Cherries – 42 pesticides found. Cherries grown in US had more pesticide residue than imported.
*Potatoes – 37 pesticides found.
*Grapes – only imported grapes made the ‘dirty dozen ‘ list in 2010. Wine can also harbor many pesticides.
Salad greens, carrots, and pears have been on the ‘dirty dozen’ list in recent years; when possible, look for organic varieties.

Organic Foods –If you don’t want to eat foods on the ‘dirty dozen’ list, and are able to pay more for organic varieties, what are the benefits? Organic agriculture is better for the environment, avoiding the problems of monoculture. The ocean, rivers and lakes are not contaminated with chemicals and high nitrogen fertilizers that promote the rapid growth of algae, reduce oxygen levels and create ‘dead zones’ in oceans and lakes. The soil is treated with healthier fertilizers and crops are rotated to enrich nitrogen retention. You will probably benefit from greater amounts of beneficial plant compounds that the plant makes to fight off insects, fungi, viruses and bacteria. Farm workers are not exposed to dangerous chemicals, which have resulted in high pesticide blood levels and serious health problems. You and your family will also have lower levels of pesticides and herbicides in your body. The role of such chemicals in disease promotion is under study, and is controversial. With a rapidly growing population the world needs more food, and its production probably requires a mix of industrial and organic agriculture.
This leads us to the question of choosing safer, ‘cleaner’ conventional foods:

The Clean 15: These foods have fewer pesticide residues. They should be washed, and peeled if applicable:
onions, avocados, sweet corn, pineapple, mango, asparagus (fewer pests/diseases ergo fewer chemicals used), sweet peas, kiwis, cabbage, eggplant, papaya, watermelon, broccoli, tomato (used to be on the ‘dirty dozen ‘ list, but is no more), sweet potato.

Note that the grains and beans used as fill-up foods by most of humanity are not on this list. Unless they are grown organically, they also have chemical residues. Corn and soybeans are increasingly genetically modified to be ‘Roundup ready’ , with a potential problem with ‘super-weeds’ needing more Roundup (glyphosate ) spray. What will happen to super-weeds and the results of increased use of Roundup is yet to be known.

Global food prices have currently reached a record high, because of food shortages. This has recently caused riots in several North African and Middle Eastern countries. At such a time, it may seem elitist to be concerned with chemical residues in food. However, the problems of industrial agriculture, climate change (droughts and floods impeding food production) and population growth are interrelated. These and other crises facing humanity are daunting. Among the many proposed solutions are several that seem extremely important to this writer: limiting population growth with voluntary and accessible family planning, the spread of regional and sustainable food systems, and working to diminish global warming. Think globally, act locally
Sadja Greenwood MD, MPH Back issues on this blog

Walk, Dance and Eat Your Way Through 2011!

Walking one & 1/4 miles daily, or 9 miles a week, can protect the grey matter of your brain. This was the finding of a study at the University of Pittsburg which looked at older adults over a 13 year time span. Those who walked 9 miles a week had half the risk of cognitive impairment of more sedentary subjects. You know the other benefits of walking – weight control, reduced risk of high blood pressure, heart disease and diabetes, reduced risk of falls and fractures, and mood improvement . There are also studies showing a lower risk for cancers of the breast, uterus, colon and prostate with physical activity. Here are some strategies to make regular walking a part of your life.
*get a pedometer – I suggest the Digiwalker SW-200, available from Amazon for $22.50 or from Step into Health. Get it with a strap that secures it to your pants. This simplest pedometer only measures steps – for most people a walk of 3200 steps would be one & 1/4 miles. Some people wear a pedometer all day long, and work up to 10,000 steps a day, which is the amount popularized in Japan by research showing better health at that level of activity. If you get a digiwalker, a booklet on the 10,000 step philosophy will come along with it. It’s a great motivator. You’ll be surprised at the number of steps you take in the house and yard, and you may find you want to take more trips to the compost pile.
*find a walking partner – a person or a dog who will motivate you to keep going. If you like to talk and socialize, choose a compatible person – if you want to tune into your own rhythms, try a dog. It could be your neighbor’s dog.
*dance at home to your favorite upbeat music on rainy days. You can get endless amounts on Pandora radio (on your computer or smart phone). I favor Cajun and Zydeco to keep me moving. Don’t wait for a dance partner – go free form. For ballroom dancing, Cenize Rodriguez and Don Jolley run great classes at the Stinson Beach Community Center, and Carol Friedman teaches at the Dance Palace. You can go to these classes with or without a partner. They are fun! If you don’t live in West Marin, find a class through the yellow pages or a community college.
*For the arms and spirit – try conductorcise. Maestro David Dworkin leads classes of older people , standing or seated, through the exercise of conducting classical music. Watch him at www.conductorcise.com and put on your favorite symphony. Using the upper body this way is invigorating, and moving to the music is thrilling.

Eat for Your Brain A French study showed that older people who took good care of their brains had a lower risk of developing dementia. Taking care of the brain meant avoiding diabetes and depression, and eating lots of fruits and vegetables. Here is a list of fruits and vegetables with the highest antioxidant values. Prunes, which lead the list have the greatest ORAC value (oxygen radical absorbance capacity): prunes, raisins, blueberries, blackberries, kale, strawberries, spinach, raspberries, Brussels sprouts, plums, broccoli, beets, oranges, red bell peppers. Many other vegetables and fruits not on this list are also valuable sources of antioxidants and other nutrients. We are so lucky to have great organic produce at the Bolinas People’s store and our local farm stands.

Update on citrus peel After my column last week on the benefits of hesperidin in citrus fruit and peel, a friend told me that her daughter had become violently nauseated after putting a whole orange in a blender drink, and had to go to the ER with intractable vomiting. This will not happen to you when you make or eat marmalade, but avoid too much peel in blender drinks.
Sadja Greenwood, MD, MPH Back issues on this blog

What’s new in school food, food safety, arsenic, and hesperidin

An important bill on child nutrition was signed by President Obama in December. It gives schools extra money for meeting nutrition standards for breakfast and lunch, requires the USDA to develop new meal/snack patterns based on current science, allocates funds for school gardens and farm to school programs, enables the USDA to establish national nutrition standards for all food sold on school grounds (including vending machines), funds state and local organizations that promote healthy eating and fitness, funds projects to research and end child hunger and child obesity, promotes breastfeeding, and helps foster children get free meals. While food in our local Stinson-Bolinas schools is already healthy, and even organic, this bill bodes well for the rest of the country. Nutrition activists, parents and students will need to be vigilant in insisting that changes take place rapidly. $8 billion will be available over 10 years. Possibly Stinson-Bolinas schools could benefit from the farm to school programs.

The Food Safety Modernization Act was also signed by Obama in late December. This bill gives the FDA power to directly issue a food recall – previously a company could stall because the recall was voluntary. Companies must develop plans to prevent contamination, share them with the FDA, and show the FDA how effectively they carry out their plans. Any whistleblower in a company will be protected when providing information to the FDA. Inspection of foreign food facilities must happen more frequently. There is a long lead time for important provisions to go into effect, and the ability of the FDA to enforce the law will depend on funding. This funding could well be cut by the next congress. However, major industry groups are in favor of the bill because of the harm that recalls can do to sales. Stay tuned.

Arsenic in poultry and pig feed: A compound called roxarsone, containing arsenic, is routinely added to feed for poultry and hogs to control intestinal parasites and thereby promote growth. There have been a few media stories on this practice, including a recent one about two children in Utah who developed arsenic poisoning by eating eggs from their backyard chickens. Some large poultry producers, including Perdue Farms and Foster Farms, have stated that they do not use arsenic (however they may well use other antibiotics in their feed). Arsenic is a poison, and also a carcinogen. Until there is more action on roxarsone, I advise readers to buy organically raised poultry, and to feed backyard chickens organic feed. Also, be careful about the use of chicken manure in your garden, unless you are sure about the source. I find it disgraceful that the media and the FDA have paid so little attention to the widespread use of arsenic in our food supply. Vast amounts of chicken manure from confined animal feeding operations are spread on fields throughout the US, endangering workers and the public. Roxarsone is banned in the European Union.

Some good news – Hesperidin: When I watched a friend eat a whole organic Meyer lemon, peel and all, I felt she might be on to something. A recent study looked at the effects of orange juice on blood pressure, and found that both o.j. and a compound called hesperidin found in citrus fruits and peel lower diastolic pressure. The juice and hesperidin both resulted in dilation of blood vessels, compared to a placebo. Hesperidin, also found in green vegetables, is an anti-oxidant, anti-inflammatory agent with some effect in lowering cholesterol. You can get more hesperidin by making your own marmalade - cut oranges, tangerines or lemons into small pieces with the skin, soften them by boiling in a little water, then add honey or maple syrup and cook until your favorite consistency. Yum.
Sadja Greenwood, MD, MPH back issues on this blog

Go to Health – Our Food System – what YOU can do to improve it!

Food-borne disease – think eggs, ground beef, peanut butter, spinach – is difficult to trace to its sources because of the complex web of national and international shipments of food. Antibiotics are routinely fed to factory-farmed animals (European meat producers & US organic farmers do not use them). These substances end up in manure, leach into ground water, and breed resistant bacteria. The FDA and the CDC (Centers for Disease Control) have both stated that the routine use of medically important antibiotics in animal feed is a significant public health problem. Pesticides, food dyes and hormone-disrupting bisphenol A (recently banned in Canada) are found in the foods and containers commonly used by most of us. Mercury has been found in high-fructose corn syrup. According to Dr. David Wallinga, writing in the November issue of San Francisco Medicine, these crises are an interrelated result of our industrialized food system, which is unhealthy, responsible for the fast (junk) food eaten by many of us, and for the obesity and health care crises. The food system is desperately in need of change. Individual change can only go so far – think about smoking and seat belt use before laws were in place. Here are some action-oriented organizations suggested by Wallinga: For children and schools – www.iatp.org, and www.OneTray.org. For communities –www.HealthyFoodAction.org is an excellent source for understanding the present and future policies around food and the farm bill in a very readable way.

Take Action: Brian Raymond, a Senior Policy Consultant for Kaiser Permanente Institute of Health Policy, wrote an article in San Francisco Medicine entitled Taking Action. Here are some of his ideas. The Farm Bill is revised every 4 years, and will be reauthorized in 2012. This important bill addresses issues such as nutrition, food stamps, and food policy. The 2008 bill did not have health sector involvement, and this must change.

*The new bill should include more support for sustainable and organic agriculture, small and mid-sized farms, and regional food systems.

*Food safety and expanded plant inspections should be included.

*Subsidies for corn, wheat and soybeans, mainly used for animal feed and unhealthy calories should be shifted to support fruits & vegetables.

*CAFOs – huge enclosed animal feeding operations should be regulated to protect the communities surrounding them, their water supplies, and the public health. Our local author and rancher, Nicolette Hahn Niman, has written about CAFOs in her fascinating and persuasive book, Righteous Pork Chop.

*The use of routine antibiotics for healthy animals should be stopped.

*Support for healthy food access in underserved neighborhoods is needed.

*Food stamp programs should be increased and used to support farmers markets and grocery stores.

*Advertising of unhealthy food to children on television should be addressed.

*Food labeling should include information about chemicals, hormones, and additives. Food that has been genetically engineered should be labeled, to give consumers a choice to assess the environmental implications of this food – be it corn, soy, canola oil, salmon et al.

Each one of these proposed changes will meet strong political resistance, so citizen pressure and action will be needed. Your awareness of the issues involved in the politics of food will enable you to make a difference this year and next. After writing this column, I am changing from being a health-foodie to a political-health-foodie. Take a look at www.HealthyFoodAction.org keep up with what’s going on, and to learn how you can influence the outcome.
Sadja Greenwood, MD, MPH back issues on this blog

Go to Health - Six suggestions for your Stash, or Cache

No, this is not about marijuana; it’s my suggestions for some other useful things. Press on regardless, as a friend of mine often says.
1) QR – Quick Relief, for bleeding from cuts. QR is a non-prescription ‘powder bandage’ that is made from a potassium salt and a polymer (a substance made of large molecules with repeated structural units) that absorbs fluid. If a wound or cut is bleeding profusely and will not stop with manual pressure, pour QR onto the wound and then press with a clean (preferably sterile) bandage or cloth. Bleeding generally stops with one or two applications. Wounds should always be cleaned, and QR does not replace stitches if these are needed. There is a separate QR substance for use with nosebleeds, which is also really effective. Anyone taking Coumadin or aspirin, or people with frequent cuts or nosebleeds, might consider having a handy stash of QR. Find this product on line, or ask your pharmacist to order it for you.

2) Alkamax - If you have problems with gastric reflux (GERD), a condition in which backward flow of acid from the stomach causes a burning feeling in the chest, you may be taking drugs such as Zantac, Pepcid, Prilosec or Nexium. These drugs are really important in certain situations, including the prevention of esophageal cancer and stomach ulcers. If your doctor has prescribed them, do not stop without her/his OK. However, many people are taking these meds without knowing why, or for minor problems that can be treated more naturally. If you have occasional discomfort after a big meal you may not need to suppress your stomach acid all the time – that acid helps your digestion. Try eating frequent small meals, and have dinner at least 3 hours before bedtime. If you do experience reflux pain, try drinking a few ounces of water with a scant teaspoon of Alkamax – potassium bicarbonate. This will usually cause you to burp and feel better. If you have a comfortable reclining chair, sip your Alkamax, cover your eyes, and go to sleep. The ‘alkaline tide’ will send you into dreamland. I buy it online.

3) Prescription Drugs – have a one month stash if possible, in case of an earthquake or other emergency.

4) Cabbage – this healthy and tasty brassica vegetable lasts a long time in the refrigerator. If you always have one on hand, you can make slaw or a stir-fry or cabbage borscht even when you have run out of other veggies and the grocery store has closed. Have I mentioned that Johns Hopkins University has a brassica lab and a brassica foundation that studies the chemopreventive effects of brassica vegetables? More in a future column – for now, try a cache of cabbage.

5) Fava Beans - For gardeners, beginners, or anyone who has access to a little piece of mother earth, there is an easy, tasty and virtually foolproof plant – the fava bean. You buy dried favas at a plant store, and poke a few into the ground, two inches deep. Separate them by about 4 inches. You can plant them now, and actually year round in our mild California climate. They don’t need to be staked, and rarely need water. First come the green shoots – when they are leafed out you can enjoy the leaves in salad or as a cooked vegetable. Fava shoots have become a gourmet food, because they are delicious. The beans are very tasty too, but need a little more preparation. Growing favas will enrich your soil, as they fix nitrogen in little nodules on their roots. Some people (mostly men) with origins in Greece and other Mediterranean countries develop anemia and other problems when eating fava beans – if you have a family history of this problem, get a blood test and don’t eat favas until you find out. This problem is rare in the US, so most of us enjoy this really easy plant. Get a stash!

6) Be Happy – A friend who is prone to depression told me about this book by an English author, Robert Holden. I make a beeline for the self-help section in bookstores, so I’ve read a lot of these books, starting with Dale Carnegie when I was 16. I’m quite taken with Be Happy; it is a summary of an 8 week course that Holden gives in London every year. He is a psychologist with the National Health Service. After reading it, I decided to go back and do the written (or spoken) exercises, and my partner, Alan, is doing them with me. We are finding out new things about ourselves and each other; this has been a very positive experience. If you want to have new views on happiness, and to become happier, add this book to your stash. It’s in our local library system, or can be ordered from your book store..
Sadja Greenwood, MD, MPH. Back issues on this blog. Leave me a message!

Go to Health – New Data on Falls & Fractures

Bess Dawson-Hughes, a professor of medicine at Tufts University School of Medicine in Boston, has written extensively on the factors that predispose aging people to falls and fractures. The November issue of the Nutrition Action Health Letter has an interview with her that summarizes her current advice.

Loss of bone and muscle mass: She points out that we lose bone and muscle mass as we age, and also the ability to keep our balance. This predisposes us to falls and fractures. The common dietary factor in bone and muscle loss is the ‘acid load’ in our diet, contributed by protein and grains. When these foods are metabolized, they release sulfuric and other acids into the bloodstream. Because of declining kidney function, older people don’t handle the acid load in these foods as well as they did in their youth, and therefore their blood pH becomes slightly more acidic. Normal human arterial blood pH is between 7.35 and 7.45; as you recall from chemistry, a lower level of your blood pH would mean a more acidic fluid. Since aging kidneys can be less effective in regulating pH, our bodies break down bone and muscle to neutralize the acid. However, protein is needed to build strong bones and muscles. Your target protein in grams is roughly half your weight in pounds. A table to calculate the protein content in foods you eat is found at http://www.herbalvitality.info/list-of-high-protein-foods.htm. We should cut down on excess protein and refined grains to reduce our acid load, according to Dawson-Hughes.

Fruits and vegetables in the diet have an opposite effect, since they are broken down into alkaline products that help to neutralize acids. This includes fruits that may taste acidic, like citrus. Sugars and fats are generally neutral with respect to pH. Dawson-Hughes suggests that people really maximize produce – she suggests 9 to11 servings a day to neutralize excess acids! A serving of cooked vegetables is a half-cup, and of salad greens is a full cup. Such a diet is possible, but would take planning, and would not fit into some people’s budgets or work schedules. I will outline a plan at the end of this column.

Potassium bicarbonate (KHCO3) Because of the difficulty of her recommendations, Dawson-Hughes is working on finding the appropriate amount of KHCO3 that could be taken to neutralize excess acids. KHCO3 is an alkalinizing agent. She found, in one small study, that women taking KHCO3 had reduced markers of bone turnover and muscle wasting, and performed better on a leg press at the gym. However, she cautions people not to take KHCO3 at present, as the right dose has not been found, and too much potassium in supplements can be dangerous to people with compromised heart and kidney function.

Exercise is vitally important in maintaining bone and muscle strength. Dawson-Hughes, and many other experts, advises at least 30 minutes a day of weight-bearing exercise like walking or dancing. Strength training is also necessary; you can read Miriam Nelson’s book Strong Women Strong Bones and find an excellent guide to building muscle and bone.

Vitamin D is another key to building strong bones. Dawson-Hughes, and many other experts, advise that people over 60 take supplemental Vitamin D – about 1000 IU daily, in order to keep their blood levels of D at 30 nanograms per milliliter.

Calcium is essential for bone building, and must be accompanied by adequate Vitamin D. Dawson-Hughes has suggested about 800 mg per day, from food and supplements.

Salt in the diet contributes to bone loss. When the kidney gets rid of excess salt, it also excretes calcium that is leached from bones. Here is another reason for a diet lower in salt.

How to maximize fruits and vegetables without going crazy: Along with your other foods, try the following: 2 fruits for breakfast, say an orange, or orange juice, and a banana. Mid-morning – a glass of low-salt Very Veggie or V8. For lunch include a carrot and a tomato, or have vegetable soup. Mid-afternoon – an apple, or raisins or dried figs (both very alkaline). Dinner – include a salad and a cooked vegetable, and a fruit desert. That makes 9. Another glass of Very Veggie or low salt V8 will take you close to the top!
Sadja Greenwood, MD, MPH back issues on this blog