"Healthy" processed foods: not so much

New York Times: The Package May Say Healthy, but This Grocer Begs to Differ

Hannafords' ratings expose that most processed foods labelled as "healthy" are misleading at best. I'm surprised the grocers haven't been sued or blacklisted.

I don't think we collectively care, unfortunately.

[S]everal customers said they had heard about Guiding Stars in radio advertisements or seen it in the store, but that it had not influenced their purchasing. Several shoppers said they did not see the point.

"I buy whatever it is on my list," said Karen Wilson, 43. "If my kids want Cheerios, I buy them Cheerios and don't look at the stars."

Wow, quality nutrition and quality parenting there.

LiseAnne Deoul, 34, said she liked the idea of Guiding Stars even though the system had not helped her narrow her choices during a quick stop last week to buy pasta.

"All of it was the same," she said. "They all had two stars."

It does not occur to people that this tells you something useful about pasta?

This is why dishonest food labeling works, and why it'll continue to work regardless of what the stores may do.

Fat in Paradise

Several weeks ago now, I saw a special on TLC set at the Freedom Paradise "size-friendly" resort. It seemed to be some sort of "fat acceptance" workshop or retreat, not just vacations. Interesting, because I thought the FA movement was kinda over in the 1990s, but there it was on everybody's favorite cable lifestyle channel.

The insight that I had while watching the show was that there are (potentially) two totally different levels of FA.

One is more like a fat-pride movement. Fat is fabulous. Fat people shouldn't ever change. This leads to some predictable stuff that I think is lame (fat isn't my fault, weight loss is impossible), delusional (lots of fat people eat right and exercise vigorously and are still fat), and/or dangerous (fat is a safe and healthy lifestyle choice). It can get downright weird (everyone should find fat attractive and sexy). Emphasis on discrimination. Everything would be OK if only the MSM would show fat in a positive light. Fat celebrities who lose weight viewed as turncoats. Not much left of this one these days. I think it pretty much lost the war with science.

Someone on the TLC show said something about how nice it was, as a fat person at a fat resort, to be able to go back to the buffet again and again without anyone being judgmental. That's old-school FA for me in a nutshell. Delusions and coverups notwithstanding, it's pretty much Gluttony Acceptance, and that's just sad.

On the other hand, I don't think it's helpful to vilify fat people, to moo at them out of passing cars, or for department stores to cram the fat women's clothing section in a dark corner of the basement and fill it with polyester and muumuus. Fat is so locked up with self-esteem and self-worth that ironically, it's necessary to think well of yourself in order to sustain the motivation and discipline needed to lose the weight!

It's a dilemma and I don't really know whether it's possible to balance meeting fat people's basic needs against trying not to enable fat and make it so comfortable that it really does become yet another alternative lifestyle. I like the idea that fat people can have a normal and relaxed vacation on a beautiful beach with respectful staff and sturdy beds and chairs. On the other hand, being pinched in an airline seat serves as a helpful reminder that my size is not normal and what I'm doing is not OK in the long term. It encourages me to straighten up and fly right, as it were.

I figure regardless of what should or should not be, the marketing niche will win out and fat will be accommodated because fat money is worth just as much as the skinny kind (and there's increasingly more of it). And yet, since the TLC show was filmed, Freedom Paradise has abandoned their size-friendly theme and don't market themselves as such any more. I don't know if that means there isn't support for the niche, or they need to partner with a size-friendly airline to make it work. Maybe it means that all resorts catering to Americans are becoming size-friendly anyway and it isn't a niche any more!

Glad I'm not a thoroughbred

Horses cannot convalesce; their internal organs shut down if they're kept off their feet for any significant length of time. Veterinary surgical techniques may produce state-of-the-art repairs, but the horse is so unlikely to survive the non-weight-bearing period of recovery that euthanasia is still the most humane option.

I, on the other hand, hit golf balls and bowled this weekend on my bionic knee. Life is good.

Gemini vs. Taurus

Like I was saying about what one can and can't count on.

On January 23, before dawn, I was crossing at a reasonably well-lit intersection, in the crosswalk, with the signal, when a royal blue Ford Taurus turning left failed to stop and hit me. The bumper struck my left knee and I rolled up onto the hood before rolling off onto the pavement. Screaming my fool head off the entire way.

If we accept the basic premise of being hit by a car, then after that I'm about as lucky as it gets. As soon as I landed I realized [1] not dead, which is good, and [2] pain in the left leg but nothing else. Everything was basically functioning, even the injured leg, and nothing else hurt. I was conscious for the entire ride and remembered every excruciating detail.

It seemed like a big crowd gathered around pretty quickly, perhaps attributable to my singer's lungs. Folks helped me get comfortable, directed traffic around me, called 911, and talked amongst themselves about the license number of the car because, indeed, the miscreant drove off.

Seattle police, fire and paramedics are really second to none in the quality of their response. I got treated to a ride, with lights and siren, to the Level 1 trauma center at Harborview Medical Center, where I also can't say enough good things about the entire staff of the ER, radiology, CT, and whatever other departments I passed through. Especially the one with the morphine.

The thoroughness of a Level 1 trauma center is also impressive. They weren't going to take my word for any of my injuries, so I had at least 100 radiographs taken of my entire spine, both legs, and my left wrist, as well as multiple CT scans of my abdomen (including one with the funky dye in the IV that makes your blood vessels glow on the scan) and also CTs of my injured leg to get a closer look at what turned out to be a grade V tibial plateau fracture. Funny how things hurt more when you know they're broken than they did when you were thinking soft-tissue injury....

I had surgery the next day to repair the fracture with a whole mess of titanium plates and screws and composite bone graft material and whatever it is they fix a torn meniscus with. Fortunately, because I have plenty of "tissue" (read: fat) around my knees, they were able to take care of everything with a single immediate surgery, rather than the medieval external fixator which involves rods and screws through the skin and into the bone while waiting for the swelling to diminish.

I spent the next two days relaxing in the orthopedic trauma ward while decidedly foul dark goopy stuff drained out of a tube inserted into my knee. Apparently it's better to have the goop sucked out than to leave it where it is. Once the drain came out (imagine a 6-inch tube being pulled out of your insides, eeew), the atmosphere changed from spa-like and heavily medicated to plenty more work, and physical therapy began. I slacked at first, but it's amazing how the threat of a roommate (public hospital, you know) can motivate one to haul oneself to a real bathroom with a door that closes.

Now I'm home, and the parts of the house that I can get to look like a medical supply store. I've got a continuous passive motion (CPM) machine on the sofa, which I can lie in all day having my knee bent and stretched for me (strangely, this is not torture at all and is in fact quite comfy). I've got a thigh-to-ankle brace that I wear most of the time, except in the CPM. I've got a walker, crutches, a shower chair, and of course an orthopedic potty seat. Mom picked up barstools for the kitchen and the bathroom, which make it possible for me to brush my teeth at the sink instead of into a bowl in bed.

One regains one's dignity slowly, one hygienic function at a time.

There's a diminishing but stubborn list of things I can't do for myself at home, which so far has meant babysitters every day, evening, and overnight. It kinda comes down to not being able to carry anything while walking with crutches or a walker: cooking, feeding the cat, and general fetching just don't work. We think with some advance planning I'll be able to manage this well enough to fly solo during the day starting next week.

Work has been great and accommodating so far.

The cops located the miscreant registered owner of the Taurus, but he denies being the driver. It's pretty obvious he's lying and has enlisted some friends to lie for him, but without a solid witness placing him behind the wheel, there won't be enough proof to prosecute. Liability? Uninsured, of course. Lawsuit? Sufficiently lower standard of proof, but probably more expensive to pursue than any award I'd ever hope to see. Looks like there will be co-pays and deductibles in my future, but still investigating options there.

I think my at-home PT exercises are going well, and I like my range of motion already, but I suspect there'll be a rude awakening when I start the formal PT sessions next week.

Three weeks down, nine to go until I'm weight-bearing and stick-shift-driving again.

If there was something else I was planning on doing in late winter and early spring 2006, I sure can't remember now what it was.

Diet revolution, part IV

Amber Waves, June 2005: Obesity Policy and the Law of Unintended Consequences

Amber Waves is a publication of the U.S. Department of Agriculture's Economic Research Service, whose job is not to look out for your health. The USDA supports agriculture; they're dedicated to making sure that US food producers can sell things.

And thus, I'm not sure whether this journal article is just an appalling piece of agricorporate propaganda*†‡, or an accurate reflection of the futility of trying to change gluttonous habits, or both.

Either way, it's some serious obfuscation of the role aggressive marketing plays in the fattening of America.

---

* Suspicious:

Numerous studies, though ongoing, largely conclude that aggregate cigarette advertising has a small or negligible impact on overall cigarette smoking.

† Highly suspect:

The American Dietetic Association says that each additional 3,500 calories a person consumes results in an additional pound of body weight. That implies that a person who gave up 100 calories (equivalent to a piece of toast) each day for a year would end up approximately 10 pounds lighter at year's end.

‡ Coincidence? The biggest processed food companies are owned by tobacco companies....

Diet revolution, part III

It's a simple plan. It, like anything else in life, is not guaranteed. Here it is anyway.

• Count calories.

This is unglamorous, but it's physics. Fewer calories in and more calories out is all there is. Gather data, determine basic calorie needs to maintain current weight, then set a reasonable daily caloric target to achieve a reasonable pace of weight loss.

Never, ever, ever substitute marketing claims ("low fat!" "low carb!" "healthy whole grains!" "wholesome!" "vitamin-enriched!") for calorie count.

• Measure.

We got into this mess in part because our idea of portion sizes is so far out of line. We need to take our brains back from the restaurants and marketers and learn how to perceive the food correctly.

• Trust the math.

Realize, accept, and make peace with mathematically-determined portion sizes. That is the amount of food we need, even if our bad habits tell us otherwise.

Rely on the numbers and use them to learn new and better habits.

• Make conscious choices.

There are no "forbidden foods", only trade-offs we make to achieve our daily caloric target. Instead of feeling deprived and resentful, we are empowered to make these choices. We need to pay attention to the real consequences of each choice, and be aware of which decisions support our weight-loss goals and which ones sabotage us.

• Question "convenience".

Things marketed to us as convenience often aren't. The time it takes to stop at a restaurant or a drive-thru or to assemble a processed food from a kit often are not meaningful savings over the time it would take to put together our own real food at home.

• Be wary of processed and restaurant foods, even in small doses.

Make sure that the additives and artificial flavors aren't stimulating cravings or reinforcing bad habits.

• Learn to love whole, natural foods.

One of the scariest things about artificial marketed foods is that they teach us the wrong things about what food is "supposed" to taste like. We then reject reality because it doesn't taste fake enough.

Reclaim the flavors of grape, orange, cherry, cheese and meat! Say no to the Kool-Aid- and Cheeto-ization of our everyday diet!

• Learn, get angry, stay angry.

Practically everything about the American diet has been engineered by corporations. The urge to eat harmful foods, the gimmicky diets that don't work (and the deliberate undermining of confidence in simple calorie-counting), the reluctance to exercise, the frantic drive toward elusive convenience, the fallback onto artificial supplements for ourselves and our children, and much, much, much more, are all dreamed up in marketing departments and inflicted on us for nothing more, nothing less than profit... with our enthusiastic participation. Recognize it and reject it.

ICU psychosis 101

ICU psychosis is a disorder in which patients in an intensive care unit (ICU) or a similar setting experience anxiety, hear voices, see things that are not there, and become paranoid, severely disoriented in time and place, very agitated, or even violent, etc. In short, patients become temporarily psychotic. — Medicinenet.com et al.

Causes of ICU psychosis (partial list):

• Sleep deprivation, exhaustion
  
• Disruption of day/night schedule
• Constant interruptions
  
• Unfamiliar surroundings
• Disruption of regular routine & activities
  
• Sensory deprivation
• Windowless rooms
• Little human contact
  
• Sensory overload
• Hallway and neighbor noise
• TV
• Flashing monitors
• Beeping alarms
• Loss of control over surroundings
• Lights on/off
• Windows open/closed
• Door open/closed
• Access to food, drink, belongings, lip balm, etc.
  
• Pain
• From medical condition
• Post-surgical
• Needle sticks, injection with stinging medications
  
• Discomfort
• Furniture
• Sleeping positions
• Room temperature
• Tubes & wires
• Hunger, thirst
• Lack of hygiene
• Poor caregiver communication
• Slow response to call button
• Failure to explain procedures
  
• Refusal or inability of caregivers to honor requests
• Nurses' need for doctors' approval, and slow response thereof
  
• Inability to communicate
• Due to medical condition or breathing apparatus
• Due to declining mental state
  
• Medication problems
• Disruption of regular medications
• Especially psych medications
• Reactions and side effects of new medications
• Interactions of old and/or new medications
  
• Powerlessness
• Immobility
• Due to medical condition
• Due to monitors, IVs, other tubes
• Due to fatigue or atrophy
  
• Lack of personal privacy
  
• Indignities
• Exposure
• Detailed monitoring and measuring of bodily functions
• Requiring assistance with bodily functions
• Loss of control of bodily functions
• Catheters, etc.
• Fear, anxiety, depression
  
• About medical condition
• About ongoing or upcoming procedures/treatments
  
• About anything/everything on this list
• Exacerbated by disruption of psych medications
  
• Compounding confusion, agitation
  
• Caregiver frustration
• Self-injury or interference with needed treatments
  
• Possible physical restraints
• Family and friends "siding" with caregivers "against" patient
  

Compound all this by the patient being disabled: say, blind.

Disclaimer: health professionals are generally great and try their best, but most do not have adequate staff time to handle ICU psychosis, nor will they necessarily have an arsenal of valuable techniques for dealing with it.

Diet revolution, part II

It's a little creepy to me how much the media looove gastric bypass surgery.

I got curious; I looked it up. Gastric bypass is normally described as something like "stomach stapling" (which has been around for years), where the stomach's capacity is reduced. I didn't realize that it also includes partial removal or bypass of the intestines, which causes "malabsorption". If the patient overeats beyond the stomach's capacity, the intestines' ability to digest is also reduced and excess food passes undigested. In other words, diarrhea. (I assume this is the "dumping syndrome" that is sometimes cryptically mentioned by the media; they don't describe it or explain its cause.)

What I'm wondering is how this is any different from a bulimic who uses laxatives to purge after a binge.

On the other hand, desperate times call for desperate measures.

I'm thinking there's some math that goes into a weight loss surgery decision. Diet and exercise takes time. If a person has serious weight-related health problems, it's possible that the time it would take to lose the weight the "right" way may be greater than the time they may have. Those people probably need surgery. But even in our obese society, those folks are still outliers.

Nobody targets a major advertising and media blitz at just a few outliers.

Pretty recently, I had hopes that weight loss surgery might rescue me from this problem of not having my head in the right place to lose it the right way. Just fix it once and for all. I was annoyed, but also relieved, to learn two things: one, surgery doesn't work unless you also get your head in the right place (hence the 50% failure rate), and two, I don't qualify. Yet.

Diet revolution

I don't think figuring out a proper diet for weight loss is hard. If you expend more calories than you consume, you'll lose weight. A lot of people try to make it seem more complicated than that, but I don't think it is. It's just physics. Newtonian physics, even.

I think the same physics dictates that, for us fat folks, adopting a general-purpose "healthy lifestyle" is necessary but not sufficient to bring us to a healthy weight. A proper healthy caloric intake is, by definition, whatever we need to maintain whatever weight we're at (and not gain more). So if we want to lose rather than maintain, then we need to cut the calories even further until we reach our target. Yes, that means "diet", and yes, that means potentially feeling deprived in the short term.

The more I've thought about it, the more I firmly believe in the physics. If I set a dieting caloric intake at 1,200 calories/day, in terms of weight loss it shouldn't matter whether I consume those calories in leafy green vegetables or potato chips. Calories are calories. (That doesn't mean I wouldn't have lots of other health problems if I chose the chips, but I assert that I'd lose weight.)

So why do we agonize over which diet we should choose for weight loss (Atkins, Zone, South Beach, low-fat, etc., etc.)? I don't think one's choice of diet has any effect on the physics of calories. I think it's about compliance. Barry Sears is somewhat honest about this in his Zone books, and it's the foundation of the low-carb craze, and I think it's legitimate.

Slashing caloric intake is hard when we're accustomed to eating way more than we should. And I tend to believe the key balanced-carb and ultra-low-carb claim: carbs give you a burst of energy and spike your blood sugar, but then they burn off quickly, leaving you feeling down and craving more. Cutting carbs doesn't change your caloric requirements, but may make it easier to stick to those requirements. I also agree with the related claims that proteins and (good) fats are more filling and more satisfying in smaller amounts, and that bulky (good, high-fiber) carbs allow you to eat high-volume but low-calorie, which can also be filling and satisfying. Again, the calories don't change, but how we feel about the calories makes a big difference.

This doesn't address the issues of emotional or stress eating, or sedentary lifestyle, or the natural evolutionary urge we humans and animals all have to acquire the richest possible foods with the least amount of effort and consume them in the largest possible quantities. I don't know how all those skinny people's ancestors' genes survived this long, but now that we're here, the tables have turned and those genes are well-suited to our post-scarcity era. The rest of us have work to do.