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Posts Tagged ‘exercise’

Exercise affects Satiety

Posted by tinako on March 15, 2013

This connection took me completely by surprise.  I have been asking friends and family how they experience satiety, the sense that you’ve had enough to eat, and found there was a wide variation.  One friend says she has never felt satiety, that she always wants more.  A family member tells me that to him satiety is on or off, and that it doesn’t kick in for a while after eating.  My son and I, on the other hand, feel it slowly coming on as we eat – we feel a stretching sensation in our stomachs and know from experience at what point we need to stop or we will feel ill later.  Is the knowing satiety, or is it the ability to stop eating?  There was a time (before I ran) when I would eat myself sick and continue to eat – did I experience satiety or just a stomachache?

I also figured satiety was something people were ignoring, or the call for food was overpowering will. My friends and family are often surprised that food just doesn’t have much of a hold on me.  For this reason I’m rather humble about my ability to maintain my weight – somehow my wiring has made it easy.

A recent article in the New York Times has astonished me.  In The Appetite Workout, two studies are cited opening a window onto a new view of satiety, and it’s all about exercise-induced hormones.  The article is short and well-written, so I won’t summarize it.

But they weren’t measuring people’s sense of how full they were.  They were measuring how much they ate.  In this case, at least, satiety is not the awareness but the action.

By the way, I run, but my son doesn’t, and we’re both normal weight, but at 13 he still has less control over what he eats than I do, since I shop and he is penniless.

Posted in Exercise, Nutrition | Tagged: , , , , , | 1 Comment »

Boiling my Garbage

Posted by tinako on March 14, 2012

My husband once told me that he and his friends used to make fun of one of their moms who would freeze her garbage.  This sounded ridiculous until he explained that she was freezing food scraps in a bag so they wouldn’t stink up the trash can, and then would throw them away on trash day.

But I can’t help thinking of this story since I have begun boiling my garbage.  The short story is that I’m making never-ending soup stock.  I’ve just started keeping my smallest pot in the fridge, lid on, and any vegetable trimmings that aren’t spoiled go into it right off the cutting board.  It gets peelings, ends, and even the pulpy centers of peppers, and don’t forget the onion skins.  I typically fill this little pot every day.  When it’s filled, I cover the trimmings with water, simmer an hour, and then let it cool.  I drain it into a plastic container with whatever stock I already had.  The soggy trimmings then complete their detour into the compost bin.  If you’re going to keep adding stock to an existing container, of course you’ll want to make sure to use it all up frequently so you don’t have a mix that’s getting older and older.

The long story: I’m not only doing this to reduce waste and save on purchasing stock, since after all the cooking gas isn’t free.  I’m also doing it to try to cut down on salt.  The bouillon paste I use, Better Than Bouillon, is awfully salty.  Despite my pretty healthy lifestyle, my blood pressure has been climbing for a few years, and I’m consistently in prehypertension now, in the 120’s over whatever.  The word prehypertension sounds like something you don’t need to worry about yet, but a Dummies book I read said it would be better called “lower risk hypertension.”  It’s still hypertension, it still does damage, it still increases risk of heart attack and stroke, just not as much.

After reading the book, I bought an automatic blood pressure monitor and have started tracking some things I think might affect my bp: sleep (snoring husband), exercise, meditation, alcohol/caffeine, and salt.  Too little data to comment yet.  I read that vitamin D deficiency may affect bp, so after several years of failing to bring my D up with vegan D2, I did a 45-day trial with some vegetarian D3.  It certainly brought up my D3 levels, but it didn’t make any difference in my bp, so I’ve returned to the D2.  There are other things that affect bp, such as obesity or lack of fruits/vegetables, but they don’t apply to my situation.

I eliminated most prepared foods, a huge source of sodium, from my diet years ago.  This past few weeks I’ve been able to cut way back on the salt I use in cooking, and while my family often adds salt at the table, I don’t miss it.  I made Lentil Soup last night without salt; I used my stock instead of water and some diced tomatoes instead of tomato sauce; I thought it was great.  I’m not planning on being an anti-salt fanatic, especially if it doesn’t turn out to affect my bp readings; but why not adjust my taste buds to a healthier habit?

Posted in Cardiovascular, Disease, Nutrition | Tagged: , , , , , , , | 4 Comments »

Obesity and Physical Activity

Posted by tinako on November 8, 2010

Steven N. Blair

I just listened to a Yale Rudd Center podcast interview of Steven Blair, PED.  I just the other day listened to Boyd Swinburn talk about how physical activity does not seem to be the main power behind the obesity epidemic, and while Blair does not seem sure about that, he makes the point that while physical inactivity will probably not help an obese person return to normal weight, it makes a big difference in health.

In his research, subjects’ mortality dropped when they added physical activity, such that the increased mortality associated with obesity disappeared.  Diabetes rates lessened, though not to the level of a person of normal weight.  All of this means that a person who is unable to lower their weight can still be healthier as long as they are physically active.  Great news!

Posted in Exercise, Nutrition | Tagged: , | 1 Comment »

Obesity: Diet vs. Physical Activity

Posted by tinako on November 8, 2010

Boyd Swinburn

This is the second podcast from the Yale Rudd Center interviewing Dr. Boyd Swinburn.  I’ll get right to it.

Dr. Kelly Brownell says that often people in their field (Public Health) claim that diet and exercise are equally important.  Even those who might disagree are disinclined to step on any toes, nutrition researchers pitted against physical activity researchers.  Brownell asks, is this an important debate?

Swinburn agrees that the debate has taken a long time to get going.  He states he’s a firm believer in physical activity’s importance both in obesity and other health impacts, but that doesn’t mean it’s contributing to the problem (or solution) equally with diet.  Of course this has very important implications for what’s driving the obesity epidemic and what the solutions might be.

Swinburn in his research has asked the question directly: How much of the rise in obesity over the last 30 years can be attributed to intake vs. physical activity?

Obesity took off in the developed countries all around the world, and even in developing countries, at about the same time, the ’70s and ’80s.  This means something at a global level changed quite quickly.  That argues quite strongly against changes in our genes, parenting styles, even in our physical activity environment, which is of course tightly linked to the built environment.  Most of us live in cities, and while cities do evolve, they don’t evolve that quickly or at the same time.  We also haven’t had a global collapse of willpower in the last 30 years [I criticized the book Fat Land which seemed to suggest this].  All these personal attributes don’t seem as though they could drive a sudden global epidemic.

So it has to be global, it has to be able to change quickly, and the obvious answer is the food supply.  Looking back over the last 30 years and thinking of the four Ps of marketing:

  • Product: They have changed drastically quantitatively and qualitatively: more variety, more energy-dense.
  • Promotion: It’s far more sophisticated, with marketing to children being of particular concern.
  • Placement: It’s everywhere.  Thirty years ago, food was in food shops; now it’s in almost any shop.
  • Price: The relative price of junk food has come down over time relative to other foods and to income.

These four Ps make a big push factor to influence our energy intake [as compared to “pull,” where people are demanding something, and which food manufacturers insist is the driving force behind the food environment].  It seems clear that energy intake is driving the obesity epidemic.

Brownell repeats Swinburn’s point: during the period of rapid increase in obesity, there have been profound changes in the food supply, but less in physical activity patterns.  Swinburn agreed; cars and TV have been around for a while, though use has increased.  Video games are new, walking to school  has declined, but they seem relatively small contributors to the overall energy balance; the food world has changed much more.

Brownell asks how we can know how much people are eating, and Swinburn’s answer is that he is quite skeptical of surveys that ask people what they eat (they clearly underestimate and that effect seems to have increased over time).  Therefore Swinburn puts more credence in USDA statistics which look at the food supply and come up with a per-capita usage across all countries.  This data shows that over the last 30 years, the food energy supply has increased dramatically.  People have come up with different equations for trying to estimate what percentage of the obesity epidemic is attributable to this food energy supply increase.  Using different equations, the answer is very similar – more than 100%.  That is, the food energy supply increase is more than enough to explain the obesity epidemic.  I’ll say it again, all of the increase in weight can be accounted for by the increase in food calories.

Swinburn talks about “push factor” again.  He says we like to think that we have free choice, but we are actually highly responsive to the environment.  For example, the commuter environment in Amsterdam is highly conducive to cycling, and most people do.  The environment in Atlanta is highly conducive to driving, and that’s what people do.  The same is true for the food environment.  If there’s a lot of food that’s tasty, that’s advertised, that’s low price, we’re going to eat it.  So the calories are being pushed, and we’re responding by eating them.

This all has enormous implications for prevention.  Physical activity interventions are likely to have very modest impacts – good for other areas of your health, but unlikely to have a big impact on weight.  Swinburn’s a big advocate of physical activity, but we need to reduce our expectations for what we can achieve.

The policies need to focus on the food side, but this is a highly charged issue.  Politicians don’t like to fight with industry, which is why government policies typically fall on the physical activity side – no powerful industry is opposed to it.  In order to successfully address obesity, we will have to address the food.

Posted in Exercise, Nutrition | Tagged: , , , , , | 1 Comment »

Obesity: a Public Health Problem?

Posted by tinako on November 8, 2010

Boyd Swinburn

I recently listened to a couple of short podcasts from the Yale Rudd Center, interviews of Dr. Boyd Swinburn, a professor and researcher at Deakin University in Australia.   I really liked what he had to say.

The first podcast was about Public Health, and I’ll give a quick sum-up.  The interviewer, Dr. Kelly Brownell, asks why use public policy to combat obesity – what about personal willpower, personal changes?  Swinburn answers that that public-personal tension exists in many other areas such as tobacco, road injuries, etc., and what we’ve learned is that these problems haven’t been reversed until public policy has been implemented.  People still need to take personal responsibility, but it’s society’s role to give them the best chance to make the healthy choice.  So society makes the healthy choice the easy choice, and then promotes the healthy choice, which is the individual’s responsibility to select.

Swinburn describes the upstream/downstream metaphor.  If you tackle a problem downstream, you’re dealing with diabetes, etc., after they’ve happened, which is very expensive.  We currently invest heavily in downstream approaches.  This will not turn the problem around.  You’re just managing complications of a long-standing problem.  Midstream approaches target the individual.  Examples are seatbelt regulation, or for obesity, examples are motivation and education, “soft policies.”  Upstream interventions deal with the environment, the conditions people face when they’re making their decisions.  Swinburn feels most of the effort needs to be upstream.  This can be changing the physical environment so that it’s easier to be physically active, or changing the food environment.

Upstream interventions might be regulations to ban or restrict junk-food marketing to children, a tax on soft drinks, food labeling.  It doesn’t force people to choose a food, but it makes it easier for you.

Swinburn has done research to find which interventions are most effective, the most bang for the buck.  Brownell asks how Swinburn would evaluate, for example, the effectiveness of a proposed tax on soda.  Swinburn answers that the higher the tax, the higher the price, and the more that would affect behavior.  How directly price affects purchasing is called price elasticity, and it varies depending on the product (as you can imagine, for some products people will pay any price, and for others they cut back when the price rises).  This can be well-estimated based on past data, and now you know how much soda consumption will go down.  With that you can figure how many fewer calories the population will be consuming, and what that will do for body weight.

Swinburn has done this modeling and found that policies are generally pretty cheap and have a broad reach.  Health-promotion programs cost money and have a more limited reach.  Health services costs a lot of money and have a person-by-person reach.  Physical activity programs alone had very limited impact – physical activity is important, but not as important as food.

Public policy at the top of the effectiveness list: restricting junk-food advertising to kids.  It affects all kids, and while the influence on each individual is small, all together it has the biggest impact and the least cost and in fact even saves money.  Programs, particularly promoting active transport, are quite expensive with little impact.

Brownell asks isn’t restricting marketing making a nanny state?  Government intrusion into our lives?  I loved Swinburn’s answer to this.  He says “nanny state” is a flip way to dismiss what should be a serious policy debate.  If you’re talking about children, nannies are a good thing; they care about and try to protect children and support parents.  If government took on those characteristics, our children would be in much better shape.

In addition, we accept more intrusive restrictions in our lives all the time: seatbelt laws, speed limits, DWI, tobacco sales to minors, etc.  In many, many areas we accept restrictions on our “freedom” to do whatever we want, for our own benefit and for the greater population benefit.  In the obesity epidemic, nanny state keeps coming up, but he can’t think of a single proposed regulation that would tell him what he can and can’t eat or whether he has to exercise.  Most of the regulations are targeting the environment, making it easier to make a healthy decision.  It’s much less “nanny state” than many things we already accept.

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Killer at Large

Posted by tinako on September 22, 2010

I just watched the movie Killer at Large – Why Obesity is America’s Greatest Threat.  This documentary is a collection of interviews and clips from journalists, researchers, doctors, and public health figures regarding the obesity epidemic.  I must warn you that it inexplicably opens with graphic footage of an obese 12-year-old girl getting lipsuction.  I made the mistake of sitting down with my lunch to watch, and I don’t recommend that.  I think this scene would have been better later on in the movie, or perhaps not at all – I’m not sure what function it served.

However, once past that the movie was very good.  It returned frequently to the point first made in the film by Surgeon General Richard Carmona: people are frantic about terrorism, but obesity is much more dangerous.

The movie covers schools, and I enjoyed hearing what the vending machine rep said to a gym teacher who was trying to get vending machines out of his school.  The dire consequences of this act would be that 1. kids would get in their cars to drive to a store to buy the item they could no longer get in school.  On the way they would be killed in a car accident, and that would be on the gym teacher’s head.  Dire consequence number 2. was that instead of soda bottles with bottlecaps, the kids would have soda cups with lids, and the soda would spill all over the carpets.  I guess the gym teacher would have to live with that, too.  So, every kid in school would die and they’d have a whopper of a carpet cleaning bill.  Ultimately, money won out and the school would not give up the $1,000 that the kids were feeding into the machines.

Absolutely astonishing was footage of parents outraged that junk food was being removed from schools.  They staged demonstrations where they passed junk food in through the schoolyard fence to kids who were being deprived.

Other parents demonstrated against Sesame Street when Cookie Monster told kids that cookies were a sometimes treat and they should eat their veggies.  Parents and children marched with placards showing “C is for cookie, not carrots!”  More signs said “No carrots!” or showed carrots with the circle and line X-ing them out.  Of course, parents were handing out cookies to the kids as they all marched around.  ????

I loved the segment regarding the Shrek “Get out and play an hour a day” public service ad.  The documentary shows representatives from 8-10 processed food companies together with George Bush and the head of Human Services meeting to try to take some action on this obesity thing.  Did the representatives have any suggestions regarding improving the nutrition of their products?  Not that I could discern.  The outcome of the meeting was apparently the Shrek public service announcement, the industry’s typical shunting of blame to the exercise side of the obesity equation, to avoid any embarrassing scrutiny of the diet side.  Steven Colbert takes over from there, and I’ll leave you with him: Clip

Posted in Diabetes, Nutrition, Schools | Tagged: , , , , , , | Leave a Comment »

Living Large

Posted by tinako on September 22, 2010

I just finished the book Living Large, by Michael S. Berman.  I’ve been learning about obesity thanks to a free online Yale university class I just finished, and while Professor Brownell did an excellent job of conveying why people nowadays, especially children and the poor, are particularly vulnerable to obesity, I didn’t feel like I understood why a comfortable, educated adult would have trouble maintaining a healthy weight.  Mr. Berman, a lawyer who has ricocheted between 220 and 330 his entire adult life, has done his best to explain his perspective on that, though he freely admits he doesn’t completely understand it either.

Michael Berman

What he has entirely succeeded at, in my opinion, is to give the reader a glimpse of what it is like to be obese for 60 years.  He explains what cravings feel like, and how pervasive they are – he thinks about food almost every moment of the day.  He simply cannot stop himself from finishing a too-large portion.  He continues to hide food, even when it’s not necessary.

This book is not a pity party.  Mr. Berman, a public figure involved for decades behind-the-scenes in many Democratic party elections, courageously exposes  almost 10 years of psychotherapy, his deepest feelings about being bullied, and many humiliations and personal failures.  And yet the story is positive, of a man finding happiness while battling a chronic disease, and ultimately, cautiously, finding a balancing point where he could feel healthy and maintain his weight more narrowly.

This is an incredibly honest book which can blast our biases wide open.  It would be difficult to read this book without gaining a deeper compassion for people who struggle with serious weight problems.

Posted in Nutrition | Tagged: , , , | 1 Comment »

Fat Land

Posted by tinako on September 17, 2010

I just read Fat Land, by Greg Critser; its tagline is “How Americans became the fattest people in the world.”

What I liked about this book is that it gave an interesting account of how and why portion sizes in movie theaters and restaurants went up.  Briefly, people will not order two packages of popcorn because it makes them feel like gluttons.  This is a problem for movie theaters, because while movie tickets were not all that profitable, the popcorn and drinks were high-markup items, very cheap items for which people would pay a lot.   They tried two-for-one deals, combos, specials, it didn’t matter; one person would not buy two popcorns.  In hindsight the solution seems obvious, but it was a breakthrough in the 1960s: get people to spend just a little more on larger sizes of popcorn and drinks.  The theater adds pennies of popcorn and charges dimes for it.  Sales increases were astounding, and the idea was reluctantly but successfully carried over to fast food.  Voila. [pp.20-1]

Greg Critser

I also liked a brief explanation of why HFCS is not the same as table sugar, despite industry advertising to the contrary [pp.136-7].  There is also a sobering, no, shocking summary of the things that can happen to diabetic bodies [p.141+].

Other than those concise explanations, I had difficulty with the book.  My problems with it were:

1. The writing was frequently unclear.  I’ve read many books on the subject of food in America, and am not sure I’ve come across one that I had so much trouble understanding.   I can’t point to an example now, but I would reread the section a few times and then scratch my head and move on.  It wasn’t that it was a terribly complicated concept; I just felt it was obtusely communicated.

2. I also found the organization within chapters poor and jumpy.  The ending was abrupt, three short paragraphs referring to Dante’s circles of hell that appeared to be tacked on when he realized he needed to finish the book in the next 60 seconds.

3. There was a chapter on physical education that I simply could not force myself to complete.  I got about three quarters through, but it was just too boring.  Granted, my interest is food, so maybe this is my problem and others would be more excited about the history of gym classes.

4. He has a split personality on who is to blame.  Chapters one and two are about how government and industry have sabotaged our food environment, from trade policies promoting palm oil, to that popcorn and french fry supersizing.  But then chapter three, “World Without Boundaries (Who Let the Calories In)”  lambastes permissive American culture, as though once, earlier in the twentieth century, we were all upright citizens who could control ourselves, and then suddenly, mid-century, people fundamentally changed and were now rampant hedonists.  Well, it could be that at one time homo sapiens was able to control its urges and then, coincidentally, just as business started discovering how to get us to buy more, homo sapiens changed and now were a bunch of losers.  Or, it could be that those pious early humans didn’t have pharmacies that sold potato chips, 20-oz. Coke vending machines in schools, and 610-calorie french fries on every block.  People have always wanted “what they want, when they want it.”  But now someone is shoving it in their faces.

One sentence particularly annoyed me: “Parents must take back control of the table” [p.161].  I don’t think he was talking about me, since I provide a healthy diet to my kids and do my best to shield them from unhealthy outside influences.  But that’s just it!  There are so many ways in which our food environment undermines parental efforts in this respect.  Restaurant kids meals are always horrible, commercials on TV encourage kids to eat unhealthy food, teachers have kids visit web sites from candy companies in school, unhealthy snacks are often given to kids in preschool programs, lollypops are handed out on the way out of restaurants, fast food restaurants line the streets near schools, candy and sugary drinks are sold at gas stations and drug stores on the way home from school, schools have vending machines selling sports drinks and candy, weekly birthday or holiday parties include cupcakes with 4″ of icing, classes that behave well earn pizza or doughnut parties; chips, cookies, ice cream, and Little Debbie snack bars are sold daily in the lunchrooms, and on the first day of school my son’s teacher handed out taffy to kids who raised their hands.  Every one of these situations makes parents’ job, to raise healthy kids, harder.

In his last chapter, “What Can Be Done,” Critser seems to make more sense again; he suggests two successful personal approaches such as weight loss intervention programs for schoolchildren and educating and encouraging children to have less screen time, but most of the ideas are not about personal, unilateral change, but about changing the environment: schools, fat or sugar taxes, playgrounds, and other federal programs.  I think Critser has the right idea; he just forgot about it in chapter three.

I agree with Kelly Brownell that obesity is a failure of personal choice, but also a failure of environment.  Our current environment is undermining our attempts to make good choices.  Blaming individuals, either one-by-one or collectively, is not a helpful strategy.

Posted in Exercise, Nutrition, Schools | Tagged: , , , , , | 4 Comments »

Back to my slothful ways

Posted by tinako on June 15, 2010

I am glad to be done with data entry at MyPlate, but I was still a pretty good girl today.  So far.

Breakfast was the same as always and lunch was leftover dinner.  Dinner was a parade of leftovers that I didn’t measure or photograph: Tabouleh, Warm Lentil Salad, Focaccia, whole wheat pasta with Tomato Coulis, and the one thing I “cooked,” Microwaved Swiss Chard.  I had a red pepper for an evening snack, but I’m heading back into the kitchen for something more caloric right now.

But first I want to mention that while I was running today I listened to Colleen Patrick-Goudreau‘s latest podcast “Losing Weight Part 1: Calorie Expenditure,” and it’s on the exercise half of the weight loss equation.  She does a great job of explaining clearly what needs to happen and how much of an impact various exercises can have.  Here is a link to the Mayo Clinic page she used as a source.  I’m not trying to lose weight – I exercise for overall health and because it makes me feel good – but I found the episode very interesting and helpful.

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