Better health, one drop at a time!

 
Through my previous blogs, I have tried to bring together diverse issues/topics that I think effect the overall health of an individual. For those of you reading through my blogs, my intention was to drift away from the 'expert' image of a nutritionist and lean more towards looking at issues from a community perspective. In other words, my view is that if we closely examine our surrounding environment we are likely to find the underlying problems (to adverse health) and hopefully solutions so as to prevent these factors from adding up. Be it learning to accept our body image and becoming comfortable with it to recognizing laughter as a way of preventative medicine. There are so many ways of improving our quality of life just by means of improving our built environment, taking small steps towards social change and so on. I hope I was successful in conveying that point.

In this blog I want to shift my focus towards the importance of clean water as a major determinant of health. Having talked about the methods of purifying water in microbiology class got me thinking about the importance of clean and safe water in health so when I came across an article on CNN regarding a UN report on foul water, I simply had to blog about it!

For most of us blessed enough to be living in Canada this is not a major problem (except for few unfortunate incidents in the past, Walkerton anyone?). However, a recent United Nations report called polluted and contaminated water as a greater killer than all forms of violence. Water is essential in growing crops, feeding animals, cleaning and ofcourse drinking as well.

But with the recent globalization and industrialization, our waters have become polluted with all kinds of waste coming from factories, farms, sewage, agriculture and other wastes. 90% of wastewater discharged in developing countries is untreated leading to as many as 2.2 million deaths which surpasses war victims. However, these deaths can be drastically reduced with proper management which is an example of an opportunity where a great challenge can be turned into an opportunity. No doubt, this would require millions of dollars worth of investment but if we look at it in the long run, the benefits outweigh the costs.

Too Much information: Good or Bad?

I came across a blog posted by a fellow classmate talking about her surprise at seeing the nutritional information printed on a subway tissue paper. It reminded me of my experience in the States just last year, where I was quite shocked myself to see the nutritional information printed on the tissue. Although, my friends were quite pleased to find that information conveniently placed on the tissue, I found it quite bizarre. Sure it is an initiative at trying to help individuals make healthier choices, but is it really user friendly and easy to understand? How many people who eat at subway actually know how to correctly interpret the nutritional information? Whether the information is successfully accomplishing its' objectives also needs to be considered. Is the information meaningful to the people eating at Subway and what impact does it have on their food choices (if any). More importantly, it is important to consider what level of understanding a person is required to have when they come across caloric values in grams, or daily value percentages of macro nutrients and vitamins.

This reminds me of the nutrition labeling dilemma, where the labels are not having the desired impact because people are not able to correctly interpret the information. The nutrition labeling is designed to be used in conjunction with Canada's Food Guide to Healthy Eating (CFGHE), but not many people are using it accordingly. Something that people tend to overlook is the lack of consistency among the suggested serving sizes between products. For instance, a 75g bread is likely to have more calories or nutrients than a bread weighted at 65g.  While it is good to provide nutritional information, we need to be careful so as not to overwhelm people and more importantly, to provide them with the knowledge and skills necessary to interpret the information provided. I think that by just providing the calories found in the Subway sandwiches we run the risk of encouraging calorie counting if we do not provide the basic skill set required to know how to use the information correctly.

That being said, nutrition labeling is a useful tool for comparison and has been known to influence consumer decisions. Even though there are aspects of nutrition labelling that need improvement, it is a valuable tool in assisting people make healthier choices. 


One weakness that I found in the subway nutritional information was that they are based on 9-Grain Wheat bread, lettuce, tomatoes, onions, and green peppers in the sandwiches. Thus, any sandwich with pickles, mushrooms, a different type of bread will have different nutritional amounts. Subway proudly claims to have sandwiches that contain 6g or less fat, however, these values do not include condiments and sauces that usually account for a large chunk of the fat content. So when a person proudly orders a vegetarian sub claimed to be less than 6g of fat, they are getting more fat than they expect once they add condiments and sauces to it.


In conclusion, I think that these initiatives are a great step towards promoting healthy eating, however, we need to make sure there is adequate information out there for people to successfully interpret this information. With all the nutritional information being handed out, we need to be careful in the message we deliver to people because even the most healthiest of most fast food products are not that healthy when comparing it to meals prepared at home.

Unhealthy foods promote unhealthy eating..Hmmm

As my inbox flooded with different articles talking about essentially the same thing -the addictive nature of "fatty" foods- I decided to look into it and figure out what the hype is all about. Weight loss always tends to be a hot topic in nutrition field so why not blog about it and see what others have to say. Especially nowadays with the the stress on finding an instant fix for obesity or weight loss, the stress is on  researchers to find a magic pill that cures all. An article I found on canada.com called Bacon and cheesecake 'alter brain like heroin' referred to recent research findings that high-fat foods tend to drive the development of compulsive eating. In the research conducted by Paul M Johnson and Paul J Kenny, 3 groups of lab rats on different diets were monitored. The first group was on regular chowder diet with no access to the high-caloric fiood, second group received chocolate bars, cakes, bacon, sausage and other human fatty foods  for one hour, while the third group had full access (18-23 hours) to all the high-calorie human foods that are often considered palatable. Lab rats on regular chow diet lost control over their eating habits once given free access to human fatty food. The rats with most access to the high-calorie food continued the compulsive eating patterns till they gained 25% more body weight within 40 days and not surprisingly gained the most weight among the three groups. The author even goes as far to say that the rats when put back on their regular chowder diet, "voluntarily starved themselves". This is a very interesting finding in rats but we need to be careful before making the same assumption in humans. It is important to be critical of these research findings as I am sure some of us might remember examples of earlier lab experiments that had been successful in vitro but did not show the same results inside the human body. Perhaps more studies can be done to follow up and see if there really is a connection in humans as well or just to validate the results by conducting more robust studies.

Looking more specifically into the study, researchers observed differences between the rats that were fed human fatty food versus the rats that remained on their regular diet. The overeating rats had higher levels of dopamine D2 receptor. Dopamine is a neurotransmitter in our brain and is mostly associated with the pleasure system or the "reward system" (for more information on dopamine click on the hyperlink). Dopamine is a key chemical involved in motivation. It is especially linked with theories of chemical addiction as observed in this research, where the obese rats were found to have decreased levels of dopamine receptor. As the rats ate more junk food, the dopamine levels elevated but since the receptors became less responsive, the rats continued eating essentially becoming compulsive over eaters. One would think that once the dopamine levels were artificially lowered in the rats when feeding regular chow, their feeding habits would increase as well to compensate for the low levels. However, upon lowering the dopamine levels no such thing happened- the rats continued with regular eating patterns. This is interesting in that the nature of the food consumed had an effect on the consumption patterns. This article talks about how eating certain fatty foods is bad for us as they have a tendency to become habitual if we overindulge in them enough times. Associate professor at Scripps Research Institute in Florida and study co-author, Paul Kenny draws a parallel between overeating and drug addiction stating that drug addicts are aware that their actions are wrong but they cannot stop as it seems to be beyond their control, suggesting that treatments for drug addiction may work for overeating. Although, the research has rather interesting findings, I feel like it is quick to form that conclusion. The research does not take into consideration the fact that switching from rat chowder to high-caloric human foods high in preservatives could have the effect on the rat hormone levels. Moreover, I am curious how they decided upon the list of human foods that were fed to the rats as it ranges from high-sugar foods to bacon and sausage which contain protein and are quite different than cakes and pastries. The variation in the human foods could have some impact on the rats' consumption as well.

On a slightly different note, these findings remind me of why I am always skeptical  when it comes to consuming highly processed foods as we have very little information available on its impact on humans.  Perhaps this is a manifestation of all the hormones and antibiotics that we have injected in our cattles and chicken to help them grow faster and to prevent them from getting sick (aren't antibiotics suppose to be used after and not before getting sick. Consider: what are the implications?). With the swift improvement in technology and genetically engineered products that are faster and cheaper to consumer with longer shelf life, perhaps our health is the price we paid in exchange.

Awareness is not enough- we need to take Action to bring about Change!

Watching a short clip in class about Malcolm Gladwell, journalist and author of The Tipping Point, talk about social change inspired me to dedicate this blog to social change and how it can be achieved. In the short fifteen minute presentation, Gladwell argues that we tend to focus a lot on the "knowing" and not enough on the "doing". He discusses how we have become a nation fixated on raising awareness and that we are forgetting an important aspect- ACTION.

As we look back at our history, it becomes evident that raising awareness is just as important since it has helped us tremendously in assisting several social transformations such as the womens rights movement which started with raising awareness. After all, understanding more about an issue allows us to realize the reality behind it and it often sparks our interest or raises concerns. For instance, informing people regarding unsafe working conditions led to drastic improvements in workplace safety and reduced the incident of work-related accidents among other transformations. This was largely possible because people became aware of the hazardous working conditions and the dangers associated with them, that led to increased public support. The support from the public put pressure on the industries to invest into creating safer working conditions. Getting support from the public, however, is not easy and can sometimes result in polarized responses when dealing with more controversial matters such as in the case of the pro-choice and pro-life groups when talking about abortion. It is important to realize that as humans we tend to personalize things, which is good in some ways as it allows us to empathize with others, while bad in others as we become limited by our narrow frame of reference and worldview. Becoming aware of different stand points on the same issue can lead to greater understanding and hopefully readjusting of our preconceived perceptions.

This relevant to us as future nutrition professionals as we strive to achieve positive change involving so many issues in public health and nutrition be it improving fruit and vegetable consumption, being more physically active, to reducing smoking and alcohol consumption. All these choices that we make as individuals are hard to change as there are many factors that affect our decision. Whether it is about access to the right type of foods (financially or physically), our level of understanding and knowledge, our immediate surroundings, culture, people that are part of our community. All these factors or otherwise known as the social determinants of health really play into an individuals' overall health choices and it is hard to cause changes if without working with the underlying causes. If a person is unable to make healthier choices because of their built environment, we cannot expect change without looking at their physical surroundings and working towards improving that. For change to be sustainable, and thereby meaningful, it needs to deal with whatever the underlying problem is and not be a band-aid solution. This ties into our discussion of built environment and its role into creating healthier communities. It's encouraging to see the government recognizing the importance of these social factors and working towards improving them. I am thinking in particular about the regent park revitalization project where the government has intervened for a complete redevelopment of the area in efforts to promote community development, cohesion and acceptability.

Going back to Gladwell's comment about "fetishizing awareness" raises a valid point since raising awareness without having the right knowledge or tools to know how to translate that knowledge into action can be meaningless. Consider this: if people know that they need to eat healthy but are unaware of which foods comprise of a healthy meal then they will not be well equipped to make that decision. Or maybe, a single mother does know that fruits and vegetables are healthier for her children but she simply cannot afford them. Having the knowledge but not having the means to provide a healthy meal to her family is likely to make the mother feel guilty, ultimately doing more harm than benefit. I think it is important to stress that people do not purposely make an unhealthy decision and that we are not here as health care professionals to put blame on them. But in fact, we are here to promote healthier living and to provide the appropriate tools in making the best possible decision that suits their situation. Even if accessibility is not an issue, knowledge about the healthier choice does not translate into behaviour. Many of us know the harmful effects of junk food or foods that are very high in fats with little or no nutrients yet we still continue eating them. Even with proper income to be able to afford fruits and vegetables and appropriate education, obesity is still on the rise, the fast food sector is still a booming industry. Clearly, we are in need of a paradigm shift as Gladwell suggested being the success behind the seatbelt campaign (as also mentioned in two of my classmates' blogs that I had a chance to read). I could keep talking where this topic is concerned but to keep it concise, I will provide links to the video of the presentation by Gladwell below where he talks about how getting people to buckle up was very difficult. The campaign was not being successful despite the hefty funding and vigorous campaign and this was because North American's tend to be resistant when complying with authority. Meanwhile all it took was a simple shift from asking adults to wear seat belts to gearing the campaign towards making kids wear seat belts. The seat belt usage went up from 15% to 75% after this change. Perhaps we need to re-orient ourselves and popularize healthy eating. There needs to be an action plan to bring this change of healthy eating into action and I would like to part with a famous quote to keep us motivated,

"Knowing is not enough, we must apply. Willing is not enough, we must do."



Gladwell lecture : http://www.tvo.org/TVO/WebObjects/TVO.woa?videoid?24640858001

Laughing your way to Health!

Waking up late on a lazy Sunday morning, sipping a cup of warm and frothy hot chocolate I could not help but think of Mark Twain as I skimmed through a Toronto Star article that caught my eye.

Mark Twains' saying in my head :
“The human race has only one really effective weapon and that is laughter".

Hmmm...being a pacifist myself, I agree with Twain as he points out the power of humor. Humor is not only a great form of amusement but also serves as an ice-breaker in social settings or a great stress reliever for people under pressure. Provided that my knowledge of humor therapy is based mostly on what I have learned from the movie, "Patch Adams", I decided to do a little research on the topic myself. Turns out that laughter therapy is widespread around the world, often used as a form of coping mechanism for people with critical illnesses. According to professor of psychology and neuroscience Dr. Robert Provine, humor is one way of inducing laughter, however both laughter and humor do not necessarily go together.


Based on various laughter therapy websites, laughter releases endorphins that are neurotransmitters in the body that are often referred to as natural stress fighters because they decrease the amount of pain felt by the body helping it manage stress and anxiety. However, I wonder where this assumption has been made from. Several websites (created by laughter therapy groups, non profit organizations and newspaper articles) suggest laughter as being "healthy for the heart" by means of increasing blood flow and improve "immune function" by decreasing hormones associated with stress and increasing immune cells. It seems to be coming from a good place but it is important to be critical of accepting big claim statements that are not always supported by sound evidence/experiment.



That being said, laughter is a great way of de-stressing and pain reduction (Robert, 2000). By virtue of reducing stress, I think laughter manages to reduce risk for so many other ailments that are associated with stress. It works as a great coping mechanism as well as a great way of bonding and socializing with others (think Social Determinants of Health :D ). Sounds to me like laughing might not only be good for social life but also for overall well-being! Dr. Robert explores the Science of Laughter  and comments briefly on the gender disparity that he noticed in laughter patterns- in cross gender conversations females laughed more than males (though both genders laugh a lot). I cannot help but notice that even in my circle of friends, the guys tend to make the jokes while the girls tend to laugh at them. Though, I know a few girls that are known for making jokes (I do not know that many :(  ). Does this suggest that laughter is inherent in certain genders more than others, or that socially we are taught to laugh more or less based on our sex? Interesting, I will keep an eye out for that- but for now, going back to laughter therapy!

Laughter therapy has been gaining popularity in some parts of the world more than others with more than 400 laughter clubs in India and has been gaining popularity in Canada as well. I often see humor being used to communicate ideas that are political in nature in a subtle (and more socially acceptable) manner. Whether it is used in stand-up comedy to get people thinking about stereotyping or late night television hosts poking fun at political leaders and questioning their ulterior motives, humor is successful in getting the point across!



Toronto Star Article Headline:
"Clown conference explores health benefits of humour"

The article that got me thinking about laughter is about a symposium taking place in Toronto for clown therapy.  Clown doctor and professor, Bernie Warren, at University of Windsor is one among the many individuals' sharing their expertise at the symposium. His area of research is in the use of art and humor in caring for seniors with dementia. Often dressing up a bright red plastic nose and brightly coloured clothes, Warren visits hospitals as "Dr. Haven't-A-Clue". Through his visits, he has noticed notable improvements in patients involving lucidity and memory. Even Warren believes in the community-building power of laughter as he describes in his own words, " Laughter has the amazing power to help people communicate and build bridges...It's just extraordinary, the changes that can occur". Indeed, it is interesting the power of something as simple as humor and good atmosphere that can help patients feel much better and at ease.

At the conference, there will be Dr. Peter Spitzer setting a workshop to help health practitioners incorporate humor into their everyday practice. I think this is a great example of sharing resources and leading an interdisciplinary approach, where we can take something completely different like therapeutic clowning and apply it to health practice to help improve the patient experience. It is all relates back to the idea of working in partnership with different professionals because there is not one correct way of patient care. Growing slowly but surely, there is even consideration of creating a medical clowning degree at Haifa University in Israel that will be discussed at the conference. As more research is being done, it is important to note that if we can improve patient care by simple acts of "humor", then I say why not? In Canada, where we are constantly faced with health care burden problems where funding is often an underlying issue, if something as simple as a laugh can help ease the stress or the overall health and atmosphere of the hospital or health care setting, then I think this is one venue worth exploring. Ofcourse, it is easier said than done. There is a long way to go but as long as we're in the right direction, all we have to do is keep walking!

Be Healthy or Avoid being Unhealthy?

Ever since I decided to switch my career goal from Business to Nutrition, one of my close friend started sending all sorts of articles relating to health, fitness and nutrition my way. It boggles my mind that when I was in high school no one did a double take when I told them I wanted to work in the business industry. And now in university, if I express my passion towards nutrition, it needs to be followed up by a small explanation of what led me to this. Nevertheless, I find it interesting to see people's reactions as I tell them I want to be a nutritionist because I like to help people. I feel that nutrition is one field that aims to help individuals lead healthier lives by working with them and not for them. Every client is unique and has different needs. There is no set procedure to follow when it comes to leading a healthier lifestyle and that's whats so beautiful about nutrition, to me anyway! (see the immediate desire to defend my career aspiration : )  )

This time around, the article that was sent to me was called "Health and Fitness tip" from the healthzone section in the Toronto Star website aimed at providing health tips to parents with young children. I tend to be somewhat skeptical of health tip articles because they need to be simple and easy to follow, however, health is anything but simple! But at the same time, some information is better than none (provided the information is correct and relevant). The need for such a list is understandable because we need to get the message out there to the public in a way that is easy, accessible to large groups of people and interesting enough for them to read. .


While I was doing some research relating to this article, I did a quick google search and by the looks of it, it seemed like every other person (expert and non-expert) is handing out parenting advice which made me feel bad for new parents. Not only is there so much pressure to be a good and responsible parent on one hand, but on the other, there is so much information out there that it becomes  tough for a lay person to know what to follow and what to ignore (especially if one is unfamiliar with the topic, which is likely to be the case for most parents). It also seems like young parents are always under the watchful eye of the public- we tend to be rather quick to judge a parent if we see them scolding their child in public without even knowing what the situation is (perhaps the child was doing something dangerous). I am not claiming to be an expert in parenting by any means, and neither am I advocating a certain way of parenting. All I am trying to say is that we tend to be quick to judge parents at first glance (influenced by our experiences and/or bias) without really looking at the scenario from all viewpoints before forming an opinion.

In a nutshell, the article talks about 

•  understanding that "safe" does not translate into "without risk"
• what not to avoid: Bread crusts and

• what to have plenty of: vitamin D-3, folate, tomato products, cruciferous vegetables (think cabbage family), and yogurt.
• exercise!

I am just curious how the authors came up with this list. Moreover, all the recommendations have a prevent-cancer message following them, which is hard for me to swallow since this article is aimed at parents. Since when is cancer prevention one of the top priorities for new parents? In my opinion, our purpose as health professionals is not to scare individuals but to provide them with the tools necessary to lead healthier lives. Agreed, nothing is definitive in the world of nutrients as every individual is different and we speak in terms of risk reduction, but we have long surpassed the concept of health as being merely the absence of disease. Health is enjoyment of life and beyond. Perhaps, I was not expecting this article to have a risk reduction tone to it, but a more health promotion perspective to it (victim of my own bias?).With that thought, I will part and hope that with the nutrition month right around the corner everyone stays healthy, happy and safe!

Vanity Insanity

"This has got to be madness!"

said I, after I read the news article on a very much controversial procedure for losing weight. It involves stitching a small piece of plastic mesh onto a human  tongue so as to feel pain while ingesting solid foods. (Causes pain, did I mention that?) This is done to force a low-calorie liquid diet for weight-loss purposes.

Perhaps, I should not be quick to judge since I always tell myself to understand something before forming an opinion. So let's see what this is all about.

The patch sewn directly in the centre of the tongue is meant to cause discomfort so that people are able to change their eating habits. The person with the patch is on a 750 calories a day diet, which is less than half the recommended calories for a sedentary adult female as recommended on the health canada website (1900 Calories/day) and 1/3 of the recommended calories for a sedentary male adult (2500 Calories/day). Four or five stitches stiches are made in the direct centre of the tongue and it is removed later on. The idea is to teach people to eat differently so that when the sutures are removed, the individual is able to make healthier choices. It is for this reason, that the 10-minute surgery is accompanied with weekly psychological consultations and a diet and exercise plan for a hefty price of $3000.

Having thought about the procedure in my most rational mind possible, I still think it is unreasonable for a person to have to stitch their tongue to be able to learn healthy eating habits. Putting a person on a restricted diet of liquids only with 750 Calories/ day is unhealthy and would definitely have implications on the persons' entire body if they are not receiving any of the essential nutrients for a prolonged period of time. The liquid meals prescribed to the adult, in such a case, become absolutely essential as it is their sole source of food after the surgery. Whats worse is if someone forgets to take a prescribed liquid drink or decides to "speed" their weight loss procedure by reducing their intake- this would seriously jeopardize their health and put them at risk for malnutrition depending on their nutrient history and requirements (this does not sound healthy to me). Furthermore, the idea of having to hurt someone to "encourage" healthy eating habits is contradictory in its nature.We all know that eating disorders associated with malnutrition have come into the forefront along with distorted media images of "beauty" that is in reality unhealthy and unattainable. With the rise in obesity trends, it is important to promote healthy eating and living, however, "losing weight" does not equal being healthy.

news article: "Some find controversial new weight-loss technique hard to swallow"