understanding of health

Sunday, March 28, 2010

Friday, March 26, 2010

A Pair of Announcements

Sweet readers! The links are coming a little later today, but first: Leigh and I wrote an opinion piece for CNN. It's here: Want Healthy Kids? Learn How to Cook.

In related news, Husband-Elect and I will be appearing tomorrow morning on CBS' The Early Show to discuss the $25 Food Project. We are super excited, and currently in desperate search of things to wear.

See you back here in a few hours.

~~~

In the meantime, hello everyone from CNN! If you’re visiting the blog for the first time, welcome! We’re so happy to have you. Bathroom’s on the left. If you’re a longtime reader, we love you! We’re not kidding. It's a little scary.

To get an idea of what CHG is all about, our FAQ and mission statement are good places to begin. To go a little deeper, these six posts give a pretty solid overview of what we do here:

Our master article directory of over 135 similar pieces can be found here. We also post one or two frugal, healthy, and delicious recipes per week, which are compiled here. There's something like 300 right now, and we’re always adding to the list. Here are ten fairly simple favorites to get you started:

Hope you’re enjoying the blog so far. We’d love to hear from you if you have suggestions, and best of luck with your cooking!

Thursday, March 25, 2010

Interesting Articles in the AJCN

I just received an RSS alert for the American Journal of Clinical Nutrition's latest articles. This upcoming issue is full of very interesting material:

1. Dr. Neil D. Barnard reviews food consumption patterns in the US from 1909 to 2007 (1). This is something I've written about a number of times. The most notable change is that industrial seed oil use has increased by more than 3-fold in the last 40 years, and even more in the last 100 although he doesn't provide those numbers. Butter and lard use declined sharply. Meat consumption is up, but the increase comes exclusively from poultry because we're eating the same amount of red meat we always have. Grain consumption is down, although it peaked around 1900 so it may not be a fair comparison with today:

In the late 1800s, wheat flours became more popular and available due to the introduction of new [high-gluten] wheat varieties, [low extraction] milling techniques, and transport methods, and during this time new breakfast cereals were introduced by John Harvey Kellogg, CW Post, and the Quaker Oats Company. Thereafter, however, per capita availability of flour and cereal products gradually dropped as increased prosperity, improved mechanization, and transport (eg, refrigerated railway cars) increased competition from other food groups. [Then they partially rebounded in the last 40 years]

2. Dr. S.C. Larsson published a paper showing that in Sweden, multivitamin use is associated with a slightly higher risk of breast cancer (2).

3. Soy protein and isoflavones, which have been proposed to do everything from increase bone mineral density to fight cancer, are slowly falling out of favor. Dr. Z.M. Liu and colleagues show that soy protein and/or isoflavone supplementation has no effect on insulin sensitivity or glucose tolerance in a 6 month trial (3). This follows a recent trial showing that isoflavones have no effect on bone mineral density.

4. Dr. Ines Birlouez-Aragon and colleagues showed that high-heat cooked (fried and sauteed) foods increase risk factors for diabetes and cardiovascular disease (insulin resistance, cholesterol, triglycerides), compared to low-heat cooked foods (steamed, stewed) in a one-month trial (4). The high-heat diet also reduced serum levels of long-chain omega-3 fatty acids and vitamins C and E.

5. Dr. Katharina Nimptsch and colleagues showed that higher menaquinone (vitamin K2) intake is associated with a lower cancer incidence and lower cancer mortality in Europeans (5). Most of their K2 came from cheese.

6. And finally, Dr. Zhaoping Li and colleagues showed that cooking meat with an herb and spice blend reduced the levels of oxidized fat during cooking, and reduced serum and urinary markers of lipid oxidation in people eating the meat (6).

The take-home message? Eat stewed beef with herbs, but don't pre-brown it in vegetable oil. Throw out the tofu and have some artisanal cheese instead.

Veggie Might: I Want to Be Tofu Butcher

Written by the fabulous Leigh, Veggie Might is a weekly Thursday column about all things Vegetarian.

Last night there was a vegetarian quorum in my living room: two lacto/ovo vegetarians, one vegan, and one omnivore (who had once been a vegetarian). We voted a moratorium on the question, “So, will you ever eat meat again?”

BA mentioned she was coming up on her 17-year vegan anniversary and that people still asked her that question. We all nodded in sympathy. “They may as well ask if I’d ever eat wood.”

Well, according to the trend piece Flesh Mob in the New York Press, it’s not such a crazy question. Apparently, the bacon craze and conscious carnivorism has vegetarians abandoning their previously held convictions and signing up for butchering classes and joining CSAs for the grass-fed beef—really getting back to the land.

“People were encouraged to avoid meat with scary PETA videos and horror stories about factory farming, but these days, newly carnivorous New Yorkers are able to cushion their consciousnesses with locally grown, free range and all-around-happy meat.”

I found the claim that vegetarians are lining up to become butchers quite disingenuous. Whatever their reasons for becoming vegetarian, none of my current veg-head friends would dream of consuming meat just because it’s de rigueur.

Most former veggies I know, including BH of our living room quorum, made the switch after some soul searching and for myriad reasons, including access and convenience, love (of another human)—and nearly all of them eat meat sparingly.

Plus, I thought people were catching onto the idea that a little meat goes a long way. What happened to being a flexitarian to improve one’s health, bank balance, and environment?

A 2009 Vegetarian Resource Group Poll put the nation’s vegetarian numbers at about 3%, up from 2% in 2006. Even my sister, whose husband hunts and fishes, and a pair of dear friends and avowed omnis are giving part-time vegetarianism a try.

Food is deeply personal, and increasingly, has become moral and political. I am not questioning people’s decision to eat what they choose and live as they believe is right. (I have lots of omni friends!) My beef (har) is with the framing of the story: that vegetarianism is a “phase” we’ll all get over when we grow up—an get a good whiff of frying bacon.

Maybe wood pulp and poly-cotton will be the next big thing. BA and I are on board, since they’re vegan.

Readers, what about you? Are you vegetarian, vegan, part-time vegetarian, or conscious carnivore? Would anything make you change your diet? How do you balance your ethics with your grocery bill? Is food a moral issue in your household? Let ‘er rip in the comments.

(Photo courtesy of Flickr member FantasyFan.)

~~~
If you like this piece, you might also dig:

Wednesday, March 24, 2010

The Junk Food Tax: Reader Ideas, Opinions, and Solutions

Last week, we discussed the prospect of a Junk Food Tax, a hypothetical federal tariff that would be placed on ostensibly unhealthy edibles like soda, pizza, and more. Ideally, it would curb obesity and prompt buyers toward making healthier grocery choices. Probably, it would make a lot of people angry.

I asked readers their opinions of the potential tax. Responses were voluminous, wonderfully thoughtful, and chock full of good points. Perhaps unsurprisingly, many were vehemently opposed to a junk levy. Of around 40 commenters, only eight were firmly in support, though many had reservations. Those favoring the tax did so mainly for two main reasons:

1) It would help regulate national health care expenses.

Rip: High sodium and sugar junk food diets cost the US FAR more than smoking or alcohol, in terms of health costs.
Sister6: Decreasing consumption would also decrease the incidence of health problems, and health care costs.

2) It’s not unlike taxing alcohol and cigarettes.

Lori: I see snacks and desserts as luxuries, and, as such, I'm fine with taxing luxury items.

Incidentally, I really liked one of commenter Mike’s solutions: “Good behaviors like gym attendance should be subsidized.” Some health insurance companies already do this (note: not mine), and it can only be a good thing.

Still, the vast majority of readers seemed uncomfortable with a Junk Food Tax. Many expressed a deep distrust in elected officials, particularly in their abilities to apply the taxes objectively and morally. Here’s a sampling of the responses from those who were not in favor:

1) There’s no way to regulate the regulators.

Amanda: The idea of who would be in charge of drawing the lines, what is "junk" and what is not, and the inevitable lobbies … scares me to death.
Alice: Can anyone tell me what happens to the tobacco and alcohol taxes in the US, and where they're proposing the revenues from the new 'fat tax' will end up?

2) There are no clear guidelines on what would be taxed.

Anonymous: Where do you draw the line? Why soda and not candy bars?
Lisa: If the government-designed USDA Food Pyramid is used … then Wonder Bread and Rice Crispies will be health food, but we'd be taxing salmon and olive oil for the high fat content.
Elizabeth: Our understanding of what constitutes unhealthy food evolves so quickly that it's hard to know where to draw the line in a tax like this, or how often to update it.

3) It’s another symptom/indication of a growing Nanny State.

JuLo: They can educate, they can advise, but they absolutely cannot tell me not to drink soda, and taxing specific foods over others sure feels that way.
Anon: We need to start looking inward and taking responsibility for the things we do, eat, and say in this country.

Though readers disagreed on the concept overall, three alternatives to the Junk Food Tax were mentioned repeatedly, by people of every opinion, across the board. And those solutions were freakin' sweet.

1) Subsidize healthy foods.

The Happy Domestic: Here in Ontario, Canada, all pre-packaged, processed foods are taxable, and all whole-food staples are non-taxable. Now THAT's a tax scheme that makes sense to me.
AmandaLP: [I’d] be for a tax on junk food IF it were used to subsidize healthier whole food options…Making apples or lettuce a cheaper options than candy or chips is the way to do it.

2) Decrease or eliminate subsidies for corn, soy, and unhealthy foods.

KarenL: Cut the subsidies then we'll talk about taxes.
Shesasering: End corn/soy subsidies. The logic is better: we're fat because we eat at Mickey D's and drink soda, right? And we eat that because it's cheap. And it's cheap because corn/soy/wheat are produced at the government's expense. So it makes no sense to subsidize it on one end and tax it on the other.

3) Invest in long-term education.

Kristen: I'd rather see encouragement towards and education about good foods rather than taxation of bad foods.
Jennifer: Teach people how to garden and give them room to do it. Get some brilliant advertising people to develop ad campaigns that show home cooking from scratch as fun, easy and quick and full of those family values we're so fond of.

Finally, a few readers made a very important point: when we’re considering food and health on a national level, we can’t make the overweight into scapegoats. Not only is it discriminatory, but it’s a misdirection of anger that should be pointed elsewhere, like corporations that make bazillions off stuffing our four-year-olds.

Sweet readers, I want to thank you very, very much for responding in such a spectacular way. It's been a pleasure and an education reading your thoughts. If you have anything more to add, the comment section is open.

~~~
If you like this article, you might also dig:

Tuesday, March 23, 2010

Green Kitchen: Chickpea Cutlets and Non-Meat Proteins

Green Kitchen is a bi-weekly column about nutritious, inexpensive, and ethical food and cooking. It's penned by the lovely Jaime Green.

When it comes to humanely raised food, meat is a big question. If you've seen Food, Inc. (which Kris has written about before) or read Fast Food Nation or The Omnivore's Dilemma, you're familiar with the cruelties of the industrial livestock industry. The animals suffer, the workers are mistreated, food safety is a joke, the health value of the meat plummets, and the negative environmental repercussions are epic.

But okay, farmers market meat is usually humanely raised on small-scale farms that are a bajillion times better than factory farms. Sadly, it’s also hella pricey, and this website is not called Worthwhile Expenses Healthy Good. Of course, we should support small operations so they can grow and thrive, but there’s an alternative: non-meat protein.

When you can't buy from a local farmer, non-meat protein is a solid alternative on every level. It will save you money. It almost always will be healthier. It will be better for the planet, having required less energy to produce.

So: non-meat protein! Yay! Nearly all supermarkets have some tofu and mock-meat cold cuts these days, which is spectacular. Still, even the most enthusiastic vegetarian gets tired of tofu, and have you looked at the ingredients on a box of fake ham? There are a lot of them, and I don't know what most of them are. The solution: DIY.

Take these chickpea cutlets, for example. Adapted from inimitable vegan cookbook Veganomicon, they’re healthy, cheap, homemade, and DELICIOUS. (Meat-eating boyfriend-approved!) They’re also packed with protein (thanks, legumes), and a cousin of seitan, the hearty vegan protein Leigh and I have both written of.

A couple of recipe notes: You can bake the cutlets or pan-fry them, and instructions on both methods are below. The pan-fried are a little juicier and tastier than the baked, but that's what fat does for your food. The baked cutlets (I made two of each) were still totally delicious.

Also: one cutlet is a good, albeit slightly small portion. Depending on what else you serve, hungrier or larger folks may want one-and-a-half. The recipe makes four. I ate them with roasted root vegetables (love you, parsnips!) and broccoli, because there is nothing green at the greenmarket right now, and that just doesn't work for me.

From the wonderful/hibernating vegan blog, Yeah, That Vegan S***, I got the idea to dip these cutlets in agave nectar, and oh my goodness was it good! Also great: honey, a squeeze of lemon juice. Maybe a sandwich with an herbed mayo? (Sorry, Kris.) Honey mustard? BBQ sauce? Go mad. Anything you'd dress chicken with would work.

~~~
If you like this recipe, you might also like:

~~~

Chickpea Cutlets
Makes 4 cutlets.
Adapted from Veganomicon by way of Yeah, That Vegan S***

1 cup chickpeas
2 tablespoons olive oil
½ cup vital wheat gluten
½ cup oatmeal, food-processed to breadcrumb consistency (or ½ c plain breadcrumbs)
¼ cup vegetable broth or water (I used Better than Bouillon)
2 tablespoons soy sauce
2 garlic cloves, pressed or grated
½ teaspoon lemon zest
½ teaspoon dried thyme
½ teaspoon paprika (I used hot, and it was great)
¼ teaspoon dried sage
Olive oil or cooking spray for baking or pan-frying

0) If you will be oven-baking these, preheat your oven to 375.

1) In a medium bowl, combine chickpeas and olive oil. With a big spoon and/or fork (plus a little muscle), mash them together until all the chickpeas are broken apart.

2) In a separate small bowl, combine dry ingredients: gluten, oatmeal, thyme, paprika, sage.

3) In another small bowl, combine wet ingredients: broth, garlic, lemon zest.

4) Dump both dry and wet ingredients into the chickpea mixture. Knead about 3 minutes or so, "until strings of gluten have formed."

5) Divide your dough into quarters. Flatten each piece until it's a patty roughly the size of your flat hand.

TO PAN-FRY: Heat a large skillet over medium heat and coat lightly with olive oil. Cook cutlets about 12 to 15 minutes, flipping once halfway through. When finished, they should be browned and patty-esque in texture.

TO BAKE: Grab a baking sheet and lightly oil or coat it with cooking spray. Then, "brush both sides of each cutlet with olive oil" (or spray with cooking spray – you get the idea here). Pop in the oven for 20 minutes. Flip once and bake 8 or 10 more minutes. When finished, they should be browned and patty-esque in texture

Approximate Calories, Fat, Fiber, and Price per Cutlet
246 calories, 8.2g fat, 3.8g fiber, $0.65

Calculations
1 cup chickpeas: 286 calories, 2.7g fat, 10.6g fiber, $.50
2 tablespoons olive oil: 239 calories, 27g fat, 0g fiber, $.24
½ cup vital wheat gluten: 280 calories, 0g fat, 0g fiber, $.82
½ cup oatmeal: 150 calories, 3g fat, 4g fiber, $0.15
¼ cup vegetable broth: 1 calorie, 0g fat, 0g fiber, $.05
2 tablespoons soy sauce: 18 calories, 0g fat, .3g fiber, $.21
2 garlic cloves: 10 calories, 0 g fat, 0.1 g fiber, $0.10
½ teaspoon lemon zest: negligible calories and fat, 0.1g fiber, $.50
½ teaspoon dried thyme: negligible calories, fat, and fiber, $.02
½ teaspoon paprika: negligible calories, fat, and fiber, $.02
¼ teaspoon dried sage: negligible calories, fat, and fiber, $.02
TOTAL: 984 calories, 32.7g fat, 15.1g fiber, $2.63
PER CUTLET (TOTAL/4): 246 calories, 8.2g fat, 3.8g fiber, $0.65

New Review of Controlled Trials Replacing Saturated fat with Industrial Seed Oils

Readers Stanley and JBG just informed me of a new review paper by Dr. Dariush Mozaffarian and colleagues. Dr. Mozaffarian is one of the Harvard epidemiologists responsible for the Nurse's Health study. The authors claim that overall, the controlled trials show that replacing saturated fat with polyunsaturated fat from industrial seed oils, but not carbohydrate or monounsaturated fat (as in olive oil), slightly reduces the risk of having a heart attack:

These findings provide evidence that consuming PUFA in place of SFA reduces CHD events in RCTs [how do you like the acronyms?]. This suggests that rather than trying to lower PUFA consumption, a shift toward greater population PUFA consumption in place of SFA would significantly reduce rates of CHD.

Looking at the studies they included in their analysis (and at those they excluded), it looks like they did a very nice job cherry picking. For example:

They included the Finnish Mental Hospital trial, which is a terrible trial for a number of reasons. It wasn't randomized, appropriately controlled or even semi-blinded*. Thus, it doesn't fit the authors' stated inclusion criteria, but they included it in their analysis anyway**. Besides, the magnitude of the result has never been replicated by better trials, not even close.
They included two trials that changed more than just the proportion of SFA to PUFA. For example, the Oslo Diet-heart trial replaced animal fat with seed oils, but also increased fruit, nut, vegetable and fish intake, while reducing trans fat margarine intake! The STARS trial increased both omega-6 and omega-3, reduced processed food intake, and increased fruit and vegetable intake! These obviously aren't controlled trials isolating the issue of dietary fat substitution. If you subtract the four inappropriate trials from their analysis, which is half the studies they analyzed, the result disappears. Those four just happened to show the largest reduction in heart attack mortality...
They excluded the Rose et al. corn oil trial and the Sydney Diet-heart trial. Both found a large increase in total mortality from replacing animal fat with seed oils, and the Rose trial found a large increase in heart attack deaths (the Sydney trial didn't report CHD deaths, but Dr. Mozaffarian et al. stated in their paper that they contacted authors to obtain unpublished results. Why didn't they contact the authors of this study?).

The authors claim, based on their analysis, that replacing 5% of calories as saturated fat with polyunsaturated fat would reduce the risk of having a heart attack by 10%. Take a minute to think about the implications of that statement. For the average American, that means cutting saturated fat nearly in half to 6% of energy, which is a real challenge if you want to have a semblance of a normal diet. It also means nearly doubling PUFA intake, which will come mostly from seed oils if you follow the authors' advice.

So basically, even if the authors' conclusion were correct, you overhaul your whole diet and replace natural foods with bland unnatural foods, and...? You reduce your 10-year risk of having a heart attack from 10 percent to 9 percent. Without affecting your overall risk of dying! The paper states that the interventions didn't affect overall mortality at all. That's what they're talking about here. Sign me up!

* Autopsies were not conducted in a blinded manner. Physicians knew which hospital the cadavers came from, because autopsies were done on-site. There is some confusion about this point because the second paper states that physicians interpreted the autopsy reports in a blinded manner. But that doesn't make it blinded, since the autopsies weren't blinded. The patients were also not blinded, so the study overall was highly susceptible to bias.

** They refer to it as "cluster randomized". I don't know if that term accurately applies to the Finnish trial or not. The investigators definitely didn't randomize the individual patients: whichever hospital a person was being treated in, that's the food he/she ate. There were only two hospitals, so "cluster randomization" in this case would just refer to deciding which hospital got the intervention first. Can this accurately be called randomized?