  |  Diet and Nutrition | What we eat and how we eat are at the very core of good health. Many societal factors intersect to influence our food choices. What are these factors and how do they contribute to diet and nutrition trends? | |
| | Story of the Week | May 26, 2009 | | By Mike Magee, MD According to experts in nutrition, eating disorders have become the norm rather than the exception for college women in America.1,2 Surveys indicate that nine out of every ten college women attempt to control their weight with dieting. Thirty-five percent of those who begin as “normal dieters” become “pathologic dieters.” Of these, about one-quarter will develop partial or full-blown clinical eating disorders. One study of 682 non-anorexic college women, with a body mass index (BMI) greater than 18.5, found that only one-third demonstrated normal nutritional behavior. Sixty-one percent had intermediary nutritional disorders and three percent had Bulimia Nervosa, a secretive style of binge eating followed by purging or vomiting.1,2,3
Major eating abnormalities have their origins in childhood in America. Forty-two percent of girls age 6 to 9 “want to be thinner.”4 Eighty-one percent of 10-year-old girls are “afraid of being fat.” In the pre-teen years, approximately 50% exercise to lose weight, 50% diet to lose weight, and 5% take diet pills or laxatives to lose weight.5,6,7 Many young women also smoke to suppress their appetite.6,8
The fact is, nearly 15% of young women head into college already burdened by substantially disordered eating attitudes and behaviors.3 College campuses are unique breeding grounds for eating disorders in women. The contributors are multiple. The environment is stressful and filled with change. Loneliness, depression and sleep disorders are common. Substance abuse is deeply embedded in the college culture, and peer pressure for women to be thin is enormous.1 Access to excellent nutrition and personalized nutrition counseling services for students have been relatively uncommon.
A continuum of strategies is needed to create healthier nutritional behaviors for college women. Parents, students, and colleges all have a role to play. Parents should begin early by examining their own prejudices and biases regarding food, nutrition, weight, and body image.9 What behaviors are you modeling for your children?
For college students, particularly females, recognize that you are vulnerable to an eating disorder. Through discussion with family and peers, come up with a realistic nutrition plan. Choose a college that will support your needs. Know your BMI. Do not abuse substances. Do not smoke. Focus on balance, self-worth, and reaching your full potential.10
Colleges: consider formally monitoring BMI each semester through student health services. Offer full nutritional counseling with registered dieticians who will personalize nutrition plans when it is necessary – if BMI is outside the 20-30 corridor. Integrate mental health support where appropriate. Consider making nutritional leadership a center of excellence for your institution.
For Health Commentary, I’m Mike Magee.
References
1.National Eating Disorders Association. Information about NEDAW 2005. 22 Feb. 2005.
2.Perfect Illusions: Eating Disorders and the Family. Accessed February 22, 2005.
3.Shisslak CM, Crago M, Estes LS. The spectrum of eating disturbances. International Journal of Eating Disorders. 1995; 18: 209-219.
4.Mintz LB, Betz, NE. Prevalence and correlates of eating disordered behaviors among undergraduate women. Journal of Counseling Psychology. 1988; 35: 463-471.
5.Collins ME. Body figure perceptions and preferences among pre-adolescent children. International Journal of Eating Disorders. 1991; 10: 199-208.
6.Mellin L, et al. A longitudinal study of the dietary practices of black and white girls 9 and 10 years old at enrollment: The NHLBI growth and health study. Journal of Adolescent Health. 1997; 20: 27-37.
7.Serdula MK, et al.Weight control practices of US adolescents and adults. Annals of Internal Medicine. 1993; 119: 667-671.
8.Picard CL. The level of competition as a factor for the development of eating disorders in female collegiate athletes. Journal of Youth & Adolescence.1999; 28: 583-594.
9.Gustafson-Larson AM, Terry RD. Weight-related behaviors and concerns of fourth-grade children. Journal of American Dietetic Association. 1992; 92: 818-822.
10.Lamberg L. Advances in eating disorders offer food for thought. JAMA. 2003; 290: 1437-1442. | | |
| Story of the Week | May 09, 2009 | | By Mike Magee, MD New York City is 8 million strong, the epicenter of global finance and "type A" personalities. It is also the home of 1 million obese Americans and an additional 2 million who are clinically overweight.1 Eighteen percent of those who are obese and 10% of those who are overweight suffer from diabetes.1,2 The cost of hospitalizations for diabetes in the city approach a half a billion dollars a year, and deaths from heart attack touch nearly 25,000 families per year.1,3
It is not surprising then that New York City's leaders have become downright militant when it comes to the classic American diet. In 2006, they banned trans fats from city food establishments. By October 2007, 96% of restaurants were in compliance. In January 2008, any restaurant that was part of a chain of 15 or more outlets nationally that served standard portions had to post calories on all menu boards, menus, and display tags. In addition, any restaurant that had chosen to make calorie information public had to place this information directly on their menus.4
Now the city is taking aim at sugared beverages. Why? Because many experts believe that sugared beverages "may be the single largest driver of the obesity epidemic."4 Per capita intake of calories from these drinks has increased nearly 30% in the past decade.5 The average American child's diet now includes 10 to 15% of its calories in liquid sugar drinks.6 One of the drivers of consumption has been advertising, primarily directed at children. This advertising has been instrumental in moving soft drinks ahead of milk consumption in kids by the mid-1990's.4,5
New York City's leaders believe reverse advertising may play some role in reaching a solution to this problem. Yet they are after a quicker fix that would use the same approach that worked so well for cigarettes: raise the price of sugared beverages by applying taxes by the ounce. Studies show a penny per ounce excise tax would immediately reduce consumption by 10%.4 In 2008, after Coca-Cola raised its product prices by 12%, sales dropped nearly 15%.7
Would New Yorkers support such a "soda tax"? Fifty-two percent say "yes" regardless of how the tax revenue is used. But 72% say they would support a tax increase only if the funds were used to fight childhood obesity.4
For Health Commentary, I'm Mike Magee.
References:
1. Mello MM. New York City's War On Fat. NEJM. 360:19, 2015-2020. 7 May 2009.
2. NYC Dept. of Mental Health and Hygiene. Epiquery: Community Health Survey. 2006.
3. NYC Dept. of Mental Health and Hygiene. Cardiovascular Disease Prevention Program. 2008.
4. Brownell KD, Frieden TR. Ounces of Prevention: The Public Policy Case For Taxes on Sugared Beverages. NEJM 360; 18, 1805-1808. 30 April 2009.
5. Vartanian LR et al. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. American Journal of Public Health. 2007; 97: 667-675.
6. Ludwig DS et al. Relation between consumption of sugar-sweetened drinks and childhood obesity: a perspective observational analysis. Lancet 2001; 357: 505-508.
7. Elasticity: big price increases cause Coke volume to plummet. Beverage Digest: 3,4. 21 Nov. 2008.
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| Story of the Week | March 15, 2009 | | By Mike Magee, MD Our country is experiencing a financial downturn. People are jittery and scared. You can feel it in the air. What we need is a bit of a boost from people who have weathered adversity in the past.
My nominee is Elfisio Farris, a first generation American from Sardinia, the large island off the western coast of Italy. Elfisio, a chef, arrived in Dallas some 20 years ago and opened his first restaurant, The Pomadora.
Elfisio’s grandfather lived to be 107, and that’s not unusual in Sardinia.1 The island is one of 4 “Blue Zones” on our planet, sites identified under a National Geographic grant that support unusually prolonged life spans. Here people routinely live beyond 100, with full functionality.2
Sardinia is no stranger to adversity. Over the centuries the native people have been invaded by Phoenicians, Carthaginians, Romans, Arabs, Moors, and the Spanish, before officially becoming part of Italy in 1861.3 In fact, Elfisio says that because of the invaders, the sea developed a very bad reputation. His words, “The sea was ugly, nothing but trouble. That was where the invaders came from. They kept coming, so people moved inland where there were better pastures anyway.”1
It was inland where the Sardinians developed their unique way of living. Here they shared four characteristics with the other “Blue Zones”: close family and community ties, heavy socializing especially around the dining table, constant low impact movement, and a predominantly plant-based diet. Their cultural imperative: you are always welcome at the dinner table. And what you will find there is as predictable as the hospitality. As they say, “Sa cuchina minore no timet su fuste” (Simple cuisine makes the home great).4 Studies of the four “Blue Zones” found that they were sustainable, interdependent and remarkably efficient at delivering a high quality life.
So here are five recommendations straight from the “Blues” that will allow you to live better while spending less during these difficult times.2
1. Quit the gym and walk everywhere you can. Sardinians routinely log 5 to 6 miles a day - walk, don’t run.
2. Save on the meat. Meat is expensive and unhealthy in large doses. Make small portions of it an occasional treat, not a three times a day staple. Find a farmer’s market and fill in with fresh vegetables.
3. Commit to family. Spend time with each other. Eat together. Sacrifice for each other. And care, especially for the very young and very old. While you care, listen and absorb what they have to say.
4. Celebrate with a simple inexpensive glass of wine with your meal. It improves digestion, lowers stress, and aids socialization.
5. Laugh at adversity. Maintain a sharp wit. There is great strength in laughter.
The silver lining of this situation we find ourselves in is that a long, high quality life doesn’t cost more, it costs less. Take advantage of the tough times to re-equilibrate and reorder priorities. Keep it simple. Keep it light. Keep it close to home.
For Health Commentary, Im Mike Magee
References:
1. Eber, J. May you live to be 100. Cooking Light. 2009 March.
2. National Geographic. Quest For Longevity: Blue Zones. 2005.
3. Sardegna.Net. History.
4. Farris, E. Sweet Myrtle and Bitter Honey: The Mediterranean Flavors of Sardinia. 2007.
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