Author Archives: Judy

Are Corporate Shut-In’s as Vulnerable to Vitamin D Deficiency as Nursing Home Residents?

I live near a nursing home and regularly see the staff coming in and out during their shift change when I walk past. What I have not seen, despite the warm, sunny weather, are residents sitting outside in the garden, or being pushed in a wheelchair.

This is not surprising. Few nursing homes have the sufficient staff to permit taking residents outside, and so rely on visitors to do so. The residents themselves often prefer to stay inside. An elderly aunt of mine always had an excuse as to why she did not want me to take her out when I visited. I wanted to take her for a stroll in her wheelchair, but she preferred staying in.

One consequence of being a “shut-in” in a nursing home has been noted for years: a significant decrease in vitamin D levels because of the absence of exposure to sunlight.  The predictable osteoporosis, bone breakage from falls, and decreased mobility affects quality of life, making many unable to move independently, and so is linked to increased mortality. Vitamin D supplementation is strongly recommended, and shown in many studies to be effective in reducing this vitamin deficiency effects on bone strength.

But what about the staff? The nursing staff who leave the residence early in the morning, sometimes just as the sun rises, are going home to sleep. They will be back the next evening, but even though their time off is during the day? The need to rest for at least 7 hours of sleep and the necessity of managing their daily obligations leaves little time for outside exposure to sunlight. This, of course, is especially true during the short hours of daylight during the late fall and winter. Depression has a high incidence among shift workers, and their failure to be exposed to sufficient sunlight has been suggested as one possible cause.

Those who work a traditional daytime shift should not be vulnerable to vitamin D deficiency due to the absence of sunlight, but is this really true? The reality is that many are stuck in their offices from sunrise to moonrise and later. Exposure to the sun is limited to weekends and, in some employment situations, such as law associates (recent graduates from law school) priority to work supersedes any weekend plans (including going outside.) These employees could be described as ‘corporate shut-ins.’ They may be tethered to the “clock” that is tracking their billable hours, and like a galley slave chained to his oars, will not be released until their supervisor (task master) permits time off. Whatever leisure time they have is spent carrying out the essential tasks necessary for their daily life such as buying food, doing laundry, paying bills, and maybe cleaning their apartments.

As we have seen, clinicians are worried (and rightly so) about the low vitamin D levels of nursing home residents, at home elderly shut-ins, and anyone else who is unable to obtain regular exposure to sunlight.  But look in vain for concern about corporate shut-ins who don’t see the sun from Sunday to Saturday during the months of year when daylight is scarce.  According to Dr. Barbara Gilchrest, who discussed vitamin D status at a recent American Academy of Dermatology meeting in Orlando, sun and diet should be enough to supply adequate levels of this essential nutrient for most patients. But can her advice be applied to those whose exposure to sun is severely limited, and whose diet lacks vitamin D fortified foods?

In an ideal work setting, shift workers would be advised on how to eat to minimize the health problems associated with their work schedule such as obesity, high blood pressure, diabetes and depression. Taking vitamin D supplements or finding time during the day to go outside and get some sunshine might be suggested. Much of this advice, however, comes not from the workplace or health care providers, but from anecdotal reports posted on Internet sites by those who also do this type of work.

But even less advice is given to daytime employees whose work hours are long and who may go days without any time off. They will not find bottles of vitamin D on their desk, nor will their supervisors encourage them to go outside during lunch to get some sun. Indeed, they are encouraged not to leave the building. And the meals provided in these organizations so they can work late are probably not planned to ensure that they consume vitamin D fortified foods.

We know already the long-term health consequences of nursing home residents who are shut-ins and get no sun exposure. So too, we know the long-term health consequences of shift workers who rarely see the sun.

We do not yet know the long-term health consequences of the corporate shut-in, the Silicon Valley twenty-four hour programmer, the investment banker who works during Asian, European and American time zones, or the surgical resident who arrives at the hospital at 5:30 AM and leaves at midnight. They, like the nursing home resident, have too little exposure to the sun. Do we have to wait until this generation of workers ages into the nursing home before we start to worry about their vitamin D status?

Research Cites Supportive Available Upon Request.

Can Being on a Committee Make You Overeat?

The neighborhood association meeting started out benignly enough, with a non-contentious minutes read and acceptance, followed by people chitchatting as the chairperson droned on about some street maintenance issue. Someone had placed bowls of snack food on the table, along with diet and non-diet sodas, but all were ignored. About 20 minutes into the meeting an agenda item launched agitated discussions with people talking over each other and, when they couldn’t be heard, muttering to themselves. Just as suddenly hands dipped into the bowls of pretzels, chips, nuts, and crackers and cups of soda poured and gulped. Some people were talking through mouthfuls of chips as they attempted to enter the conversation and others, who were shut out, stuffed more food in their mouths.

The committee meeting was a living poster for stress-induced eating.

What was a little surprising was that the gobbling of snacks occurred in public. We tend to assume that those among us who resort often or even infrequently, to emotional overeating, do so in private. The ice cream, cookies, chicken fingers, pork rinds, or doughnuts are usually eaten alone or in the company of people who are sympathetic and supportive of the problem driving the eating.  But the behavior of this group shows that if the provocation is sufficiently strong, the eating response may be immediate, even if embarrassingly visible to others.

This is not to say that people in groups don’t overeat. Watch people at a meal listening to a speaker as they eat. Their interest in their food increases in proportion to their boredom. If a speaker notices that the members of the lunch or dinner audience are attempting to eat the crumbs of the roll from the tablecloth, it’s very clear signal that he or she ought to wrap up the talk immediately.

But people at the committee meeting were not eating out of boredom; they were eating because of stress. Each member of the committee felt that he or she had to influence the outcome of the discussion, and many were afraid that the outcome would not be to their advantage.

Were they aware of how much they were eating? If they had been asked to fill out a food diary a few hours later, would they have reported eating three handfuls of pretzels or nuts, or drinking 10 ounces of soda? Probably not.

Did the eating influence the intensity of the discussion?  The act of putting food in one’s mouth may have been somewhat calming, just as giving a whining child pieces of breakfast cereal to eat has a distracting and calming effect. And obviously chewing somewhat dry food made it hard to shout out comments without spraying a fellow committee person with bits of pretzels or chips.

The mainly carbohydrate snacks would have had a calming effect—if the meeting had gone on long enough for the food to be digested and serotonin to be made. But that would have taken at least another half an hour, and the meeting broke up before then.

Stress associated with group interaction is usually overlooked among the many triggers inducing overeating. And there are unspoken rules about eating behavior in the corporate culture that probably deem any unrestrained eating at a meeting as unprofessional even when food is available? If someone at a lunch meeting begins to munch on several chocolate chip cookies brought in with the sandwiches, others will notice and wonder at his or her lack of control. There is stress most certainly, but if it generates overeating, it is usually done afterward, in private. I once had a client whose presentation to her team was so criticized that she went to a gourmet chocolate shop in the lobby of her office building, bought five pounds of chocolate and ate it all in her office (with the door closed).

The advice I gave her might, however, be useful to those attending future meetings of committees where emotional discomfort is inevitable: Eat proactively to reduce future stress. She was to eat a small, non-fat carbohydrate, such as half a plain bagel, 30-45 minutes before going into her meetings, so that the serotonin made after she consumed the carbohydrate would be a little calming.

If my fellow neighborhood association members had followed the same advice would there have been a quieter, more restrained discussion? If they had “armed” their brain with more serotonin before the meeting, would they have ignored the snacks on the table?

But of course there is another solution to the problem of committee meeting-induced overeating: stay home.

 

How Much Vigorous Exercise Will Prevent You From Dying?

Two very busy professionals I know took some time off last Sunday to go cross-country skiing. The snow was mushy from a recent thaw, and the legs of the skiers a bit wobbly but, according to my friends, it was a vigorous workout and welcome relief from their 80-hours week of work. They had fun, but they also were doing good things for their health. Like most too busy people, fitting physical activity into the workweek is like squeezing a suitcase into an overfilled overhead bin on an airplane. Often it is impossible to do it. A forty-something year old paralegal whose commute to work on a good day takes over an hour, told me that she is lucky because her workday runs only from 8:30 to 6. After she picks her children up at their nearby after school program, drives home, gets dinner ready, does the laundry and other household chores, helps the kids with their homework, and takes a few minutes to talk to her husband…. she is ready for bed, not for a treadmill. The lawyers in the office are lucky if they leave by 9 p.m.

The weekend may be the only time when a few hours can be used for exercise. But until recently, experts have said that exercising over only two days was insufficient to have much impact on cardiovascular health and eventually longevity.  Rather, we have been told to be physically active almost everyday so that our total exercise time adds up to at least 150 minutes. And we should not assume walking to the car or commuter train station, strolling around the block with the dog, or taking out the trash meets the exercise requirement. We have to exercise with vigor: by running, climbing steps rapidly or taking a challenging aerobics class.

But now this assumption is being challenged. A recent article in JAMA Internal Medicine reported the results of an enormous study that collected information about the health and causes of death among 63,591 adults in England and Scotland from l994 to 2012.  The subjects were asked about the amount of time they exercised weekly, when during the week they did exercise, and to rate how vigorous their exercise was. All this information was self-reported rather than observed by a researcher.

The study found that people who managed to squeeze 150 minutes of vigorous weekly exercise into two weekend days, rather than over 5-7 days, seemed to have the same cardiovascular benefits as the daily workout folk. Both these groups (and a third that did less than the guidelines) all showed about a 45 decrease in mortality due to cardiovascular events compared to the group that did not exercise.

The good news from these findings is that it removes the urgency in finding time to exercise during an already overextended weekday schedule. The bad news is that it is necessary to find time to exercise in an already overextended weekend schedule. The data showing such a significant decrease in the risk of dying from a heart attack, stroke or other cardiovascular cause are too compelling to ignore. On the other hand, filling up the refrigerator, doing the laundry, spending time with the kids, parents, friends, and catching up with bills, phone calls and sleep are too compelling to ignore as well.

It is possible to extract two-and-a-half hours of time to exercise out of 48 hours of “time-off.” That is less time than it takes to watch the Oscars, Super Bowl, or an average movie including previews. And doing so does not necessarily mean playing 150 minutes of tennis or a 2½-hour bike ride or run. Any physical activity, from shoveling snow to removing rocks from a potential garden, would qualify as exercise. And the exercise does not have to be done continually. A seven-minute workout following the instructions on an App or 2 minutes of jumping rope counts toward the 150 minutes.

However, there is a problem with the exercise recommendations. What is vigorous exercise?

If you are still breathing but unable to talk or sing, if your heart rate is high and you are sweating, then you are engaging in vigorous exercise.  Straining to ride your bike up a steep hill and gasping for breath or running as fast as you can after a puppy that has just seen a squirrel and is heading for the street is vigorous exercise.  Jogging with a friend and having enough breath to talk about a television show you saw last night isn’t.

Lists of what comprises vigorous exercise are meaningless to someone who is relatively unfit. A physically well-trained individual may have to do an hour of boot camp, sprinting around a track, or bike at high speed to break a sweat. However, most of us would find any physical activity that pushes us out of our comfort zone vigorous: climbing several flights of stairs, carrying heavy bags of groceries from the car to the kitchen, walking against a strong wind, or pushing a heavily laden shopping cart across a large parking lot. And for someone who rarely moves, climbing the stairs from the cellar to the second floor a few times each day may cause rapid breathing and heart rate.

Were those 63,000 subjects in the UK all doing vigorous exercise according to the definition of exercise physiologists?  Or were some possibly a little vague about the vigor of what they were doing? Were they like some of us who, when asked about our weight and height, remove a few pounds from the former and add a few inches to the latter?  Because if they were really engaging in moderate or even light exercise, “I can still breathe and talk” exertions, then it means that cardiovascular benefits are possible for those of us who may not break a sweat in the gym.

How Can You Get Enough Nutrients If You Don’t Eat Very Much?

Some of the more popular reality shows on television display various mental health pathologies such as super rich housewives always fighting with each other (when they are not having their hair done and drinking wine), or a show about hoarding to the point of suffocation, or even a view into living inside a 600-pound body that is so heavy, any movement is difficult and painful. The latter program is particularly sad, in that it shows how obsessive eating is almost always the result of early trauma, and how difficult it is for the overeater to deal with the pain of such trauma when the emotionally deadening effect of food is removed.

 

What has not been depicted so far is a reality program on the struggles of people at the other end of the eating spectrum. These are the people who believe that, like the Duchess of Windsor, one can never be too rich or too thin. These are the people whose body weight is so low that they run the risk of death. These are the people whose obsession with being extremely thin is as unshakable as the 600-pound individual who seems to be addicted to food.  

 

Perhaps the stories of the too thin are not told because the viewer may not be interested in watching an anorectic chase an almost invisible morsel of food around the plate, before grudgingly eating it and then exercising for three hours to work off the 3 calories the food may have contained. Or perhaps it is because the fashion industry has convinced us that thinness is something to be coveted, even if the price of a too thin body may be malnutrition or, if it becomes anorexia, even death.

 

A few weeks ago I walked past a facility holding a fundraising event. What caught my attention was a group of extremely tall women wearing gowns that would have looked appropriate on someone’s red carpet. They must have been models; they had perfect features, either from genes or a plastic surgeon. I confess I stared at them, not just because they looked so exotic in my neighborhood but also because they were so THIN. They were not skeletal but just on the other side of being all bones and no flesh. Another woman stopped and looked with me. She said, “They don’t look quite real, do they? But it must be nice to be so thin.”

 

Somehow we don’t think of being model thin as associated with health issues. The warnings about the risks of eating too much or the wrong kinds of food are well known, they are hard to escape: Don’t eat too much, don’t eat too much sugar, exercise frequently, and get rid of belly fat.  But how many of us know what medical woes are awaiting the very thin? One has to go searching for them. And some can be as deadly as those associated with morbid obesity.

 

When very little food is eaten, as must be the case if someone is to maintain a weight 20 or so pounds less than normal, an inadequate consumption of nutrients can result. Calcium and vitamin D deficiencies are common, and can result in osteoporosis. This disease, which is mainly silent until the first of many bone fractures occurs, is characterized by the loss of bone mass. This disease usually shows itself around menopause, but the bone loss due to nutrient deficiencies may start decades earlier. Other symptoms of nutrient inadequacy such as thinning hair, fatigue, dry skin and bruising of the skin also may not show up for several years, but can be traced back to a very low nutrient sparse diet. A study of the nutritional adequacy of the Mediterranean Diet in Spain among thin women indicated that they were deficient in vitamins A, D, E, B2, B6 and folic acid, as well as several minerals such as iron. (Ortega, R, Lopez Sobaler, A, et al  Arch Latinoam Nutr. 2004 Jun54; 87-91.)

 

Even athletes, whom one assumes eat healthfully, may be nutrient deficient if they are dieting. Female volleyball players who play the game in the scantiest of uniforms were found to be deficient in a variety of vitamins and minerals, due to their dieting in order to reach a figure perfect weight. (Beals, K,  J Am Diet Assoc. 2002;102:1293–1296). And dancers who must maintain low weight and low body fat are particularly vulnerable to nutrient deficiencies ( Sousa, M, Carvalho, P et al ,Med Probl Perform Art 2013 28: 119-123).

 

Models, dancers and some athletes accept the necessity of maintaining an abnormally low weight as one of the demands of their profession. They may be able to compensate for their restricted calorie, and thus nutrient, intake with the use of supplements. However, supplements rarely provide all the nutrients they would get from food, if only they were allowed to eat more. 

 

Thinness is also prized among women whose weight is irrelevant to their profession but not to their social standing. And its potential nutritional toll and subsequent health problems may be ignored as thoroughly as by an obese individual who cannot stop overeating. A quasi-sociological analyses of the lifestyle of women who live in the rarified neighborhood of New York’s Upper East Side points this out. In her book, The Primates of the Upper East Side, Dr. Wednesday Martin describes the non-eating that takes place at social events. Women diet continually and subject their bodies to workouts that would make a Marine recruit weep in order to have a perfect body. So many foods are eliminated from their diet in order to achieve the desired thin state? It is a wonder that the residents of this neighborhood don’t suffer from scurvy, anemia and other nutrient deficiencies. They are not addicted to food, but rather they are addicted to their almost pathologically thin bodies.

 

And yet this bizarre eating behavior is not the subject of reality television, or urgent messages from health organizations warning about its long-term consequences of nutrient deficiency. We see the consequences of the massive overeating of the 600-pound individual and tsk tsk at what that person has done to his or her body. Maybe it is time to tsk tsk over the damage the too thin are also doing to their health.   

Can You Give a Man a Box of Chocolate for Valentine’s Day?

In former times, when women were courted (at least in books) with gifts, flowers, poems, and perfume, giving a box of ornately wrapped chocolate for Valentine’s Day was not only appropriate, but expected. Presenting a red velvet box tied with a glossy ribbon that contained fancy chocolates was a socially acceptable way of showing interest in the other, female, sex. Moreover, the price of chocolate varied sufficiently, so that brands and sizes were within most people’s budgets.

But this gifting of chocolate was, and seems still to be, unilateral.  Is it because women are not supposed to give Valentine gifts to men to express their interest in a relationship?  Is it because it is unmanly (whatever that means) to like chocolate, and thus giving a gift of chocolate raises the possibility of a diminished manhood?  Is it because cultural norms dictate that giving a six-pack of beer, tickets to a sporting event, or a chain saw are more acceptable gifts? Obviously, the traditional red ribbon wrapped box of chocolates might look out of place on a workbench, in the garage, or on the seat of a pickup truck. And the dainty flower-shaped, decorated chocolates that come in a sampler box are too small, and too  “precious” to appeal to someone who wants a brick-size chunk of chocolate to bit into. Before a woman can even consider giving chocolate to a man for Valentine’s Day, its size and packing have to look suitable for a man cave (maybe a chocolate chain saw?).

Giving Valentine chocolate to women (other than those in an older generation such as mothers, grandmothers and aunts) poses its own set of problems. Indeed, it can be quite tricky. If the recipient is thin, then the gift might be interpreted as a hint that the giver would like some soft curves over the bones and buff muscles. If the recipient is not thin, a can of metaphorical chocolate worms is opened: “Does he like me fat? “ “Does he assume that I will never lose weight?” “Do I look like someone who sits on a couch and eats bonbons?” “Doesn’t he know I am thinking of going on a diet?” “If he knew me better, he would know that I am addicted to chocolate and avoid it entirely.”

The problems do not end with the presentation of the gift. Is the box opened when it is received and chocolate offered to the giver? Does the recipient have to eat a piece of chocolate upon opening the box? Does the giver check to see how long the chocolate stays in the box? Too long a time and obviously the chocolate was not liked. Too short a time? The recipient must be a glutton.  If the box contains a sampling of chocolate pieces with different fillings, what does the recipient do with the chocolates whose insides are not appealing? Finally, Valentine chocolate is hard to re-gift. That red cloth covered box won’t do for Easter, and saving it for Christmas to give to a fellow worker is tricky. You have to take the chocolates out, and put them in a box with reindeer on the cover and hope they haven’t turned, by next December, a grayish color.

Centuries ago, chocolate was seen as an aphrodisiac… although double blind, placebo-controlled studies to see its effect on love relationships are still waiting confirmation. Chocolate comes from the cocoa bean, which is surrounded by a fibrous husk. The husk is broken and removed from the bean. Then the beans, called cocoa nibs, are ground up into cocoa liquor. (No, it is not the same as chocolate liqueur that forms the basis of several delicious and fattening drinks.) The liquor contains a caffeine-like substance, threobromine, which has similar stimulant effects as caffeine. Dark chocolate has more cocoa liquor than typical chocolate, and thus more of this stimulant-like substance. However, it is hard to see how caffeine or this first cousin has any effect on a relationship except to prevent sleepiness if the other person is boring.

The cocoa nibs also contain about 54% cocoa butter which may be similar in texture to peanut butter when ground. Trace amounts of mineral zinc or copper are found in the cocoa bean, along with phenethylamine or PEA. This substance can be made from an amino acid with the similar sounding name of phenylalanine, and results from microbial fermentation in the bean. Phenylalanine and PEA may have amphetamine-like functions, thus possibly stimulating the chocolate eater to say yes to another date. But the amount that actually reaches the brain is as vanishingly small as the amount of chocolate left in the box by a chocoholic.

The magic in chocolate comes in processing these ingredients with sugar, lecithin, an emulsifier made from soy, and vanilla or other flavorings into the final product.  Chocolate is considered a unique food, and to many there is no other food that can meet its immensely pleasing taste and texture. Indeed, so satisfying is chocolate that some might be tempted to exchange a mate for an eternity’s supply of this heavenly food. Years ago in a visit to Zurich’s finest chocolate store, my husband and I each consumed a just made chocolate truffle of such exquisite texture and taste that I thought I saw the pearly gates.

So perhaps the answer to whether men should get chocolate for Valentine’s day is this: Yes!
(as long as women get some too…)

Asking Why You Can’t Lose Weight After Your Medication?

The media is glutted with advertisements for weight loss: after all, this is January. And it is assumed that by denying calories and increasing physical activity, some weight will be lost by March at the very least. This assumption is based on the belief that the weight was gained because excess calories were consumed, and physical activity minimized.

But what if you were thin, fit, ate healthful foods, loved to exercise, and never been on a diet? Then sometime in 2016 you started on antidepressants for a variety of reasons: depression, anxiety, grief, fibromyalgia, or menopausal hot flushes. The medication helped, but there was a problem. Six weeks or so after starting treatment your clothes started to become tight. You no longer were satisfied with normal portions, but started eating larger amounts at meals. And, horrors of horrors, you could not stop snacking. Your physical activity decreased because the medication made you tired.  You ended up 23 pounds heavier at the end of 2016 than you were the beginning of last year.

So now you are off your medications, and you try one of the various weight-loss programs advertised. But weeks go by and you have lost practically nothing, even though you follow the plan exactly and exercise. Your distress is like someone who became bald during chemotherapy, and months later is still hairless.  You assume that like everyone else who is trying to lose weight in January, you should be successful. In fact more so, because unlike other dieters, you never had an overeating problem until you started taking antidepressants!

Help will not come from the people who develop the diet plans because the regimens are for the ordinary obese individual who gained weight the traditional way. Help won’t come from weight-loss support groups for the same reason. And so far no department of psychiatry has a weight-loss program for its patients who have gained weight on their medications, even though such programs are sorely needed.

So you alone are going to have to figure out how to lose the weight the medications caused you to gain.

Here’s what you need to know: Some medications stay stored in the body for some time after they have been discontinued. You can determine whether the medications are still affecting your appetite and physical activity even though you have stopped taking them; simply ask yourself if you are eating larger portions than you did before you started on the medication.

If you were craving and eating sugary, high-fat snacks when you were on the meds (cookies, cake, ice cream) do you still have these cravings?

Do you find it hard to feel satisfied even when you are eating enough food to make your stomach feel full?

Is your body still fatigued from the meds, or even from a residual depression? Does this make it hard to exercise with the same intensity and duration you had before you went on the medication?

Do you think you have lost muscle mass?

If you detect a lingering effect of your medication on your appetite and physical activity, then consider this one possible reason why it is so hard to lose weight.

Forget what the advertisements for weight-loss programs promise. They are not directed toward people whose appetite control and ability to exercise have been hijacked by their medications.

Instead, give yourself more time to lose your weight. If carbohydrate cravings persist, satisfy them with fat-free, healthy carbohydrates like steamed rice, oatmeal, whole grain pasta, polenta (an Italian version of grits, but without the cheese and butter), popcorn, pretzels, and whole grain bread. You need to eat only 30 grams of such carbohydrate on an empty stomach two or three times a day to take away your cravings, and increase your sense of being full.

And you may have to increase gradually your workout time and intensity since your body may not be able to jump into the type of exercise you did so easily before you took the antidepressants.

Be patient. Eventually the residual medication should leave your body, your control of appetite and ability to exercise will return, and you will lose weight.

But, if none of the above applies to you, seek medical advice. Before meeting with your health provider, accumulate data to show that your inability to lose weight is, a) not your imagination, b) not due to overeating and not admitting it, and c) not related to a sedentary lifestyle.

Keep a food log and exercise log. If possible, use apps that will do it for you and allow you to print out the results. The results will look more impressive than some pieces of paper covered with food stains or sweat. Allow at least three or four weeks of record keeping before presenting them to your physician. That is a long enough period of time to lose one or two pounds and if you have lost none, you can make a convincing case for something being wrong. At the very least, the health care provider should investigate possible reasons for the weight refusing to be lost.

Enough people have experienced difficulty in losing weight after they discontinued their antidepressants to make this a not rare occurrence. So far there has been mainly silence from both the psychiatric and obesity communities in response in part because of the belief that it should be possible to lose weight after the drugs are stopped. Presenting evidence that pounds gained during treatment are not lost with dieting after treatment is stopped, may indeed generate research to find a solution to this unwelcome side effect of antidepressants.

Are Reality Cooking Shows Really Fantasy Cooking Shows?

A group of us were chatting about a local restaurant whose chef was eliminated from the Food Network show, “Chopped.” The restaurant was popular; the show was not.

“The problem,” said someone, “is that the contestants are supposed to combine weird ingredients like Marshmallow Fluff and mushrooms into something edible and do it in 30 minutes or less.  How can of you make an entrée with side dishes in thirty minutes?  And using ingredients that are familiar, not Halloween candy and duck breast?”  We laughed but the question resonated and the group’s response was, “No way.”

As one person commented, it would be possible if we employed a full time assistant who would do all the basic prep work like chopping onions, peeling garlic, dicing carrots, and washing greens. And also making sure that water for pasta was always boiling, sauté pans were at the correct temperature and, we all chimed in, “Cleans up as the cooking goes along.”

“Watching the cooking shows, and then expecting to make the same dishes in 30 minutes or less, is like watching an international tennis match and then expecting to serve the same way,” said one of the women. “Even assuming I have all the ingredients on the counter before I start to cook—and that is a big assumption—it takes me twice as long, if not longer, to prepare the same meal.  And the shows are so deceptive. The cook will say something like, “…wilt the onions or beat the egg whites… and 3 seconds later it is done. Tell that to my onions! “

The women were of a certain age; that is, they had raised children, prepared thousands of meals, entertained, and had done this while working most, if not all, of these years. They may or may not have been good cooks, but they were experienced. And the consensus among us  was that cooking shows, whether competitive ones or in demonstrations by individual chefs, were deceptive. It looked too easy, too fast. Indeed, one woman said that she wondered if a younger generation, inexperienced in meal preparation, would end up serving undercooked food if they tried to imitate what they saw on television.

Wouldn’t it be useful to have one cooking program that was closer to reality? Onions would be burnt because the cook forgot to turn down the heat while answering the phone call from a telemarketer. The chicken would still be half frozen and dripping reddish chicken juice, the cat would leap onto the counter and poke around at the fish, the brownies would be overcooked around the edges and too moist in the center, and the food processor, used to puree the squash soup, would thrust its contents all over the floor like an erupting volcano.  But of course who needs to watch this on television when one can see it in one’s own kitchen?

Unrealistic menus or meal preparations are nothing new. During the 19th century and early 20th centuries, women studied and practiced a discipline called Home Economics, whose goals were to teach housewives basic nutritional requirements for their families and healthy cooking techniques on how to prepare food for the household. The goals were worthy, but some of the so-called nutritional meals were anything but. Cream sauces were poured over just about everything.  Salads consisting of Jell-O cubes, canned pineapple chunks and maraschino cherries were considered elegant enough for a luncheon. And, often disdain was shown toward ethnic dishes prepared by new immigrants, despite the fact that they were nourishing and familiar.  Women’s magazines often promoted recipes, not for their nutritional content, but because they used ingredients of their advertisers. The famous string bean dish in which the vegetable is drenched in canned cream of mushroom soup and sprinkled with canned fried onions rings certainly promoted the sales of these products.

But of course, in those far-off times in the last century, people were still cooking. Today one cannot assume that younger generations will or even want to cook at all.  Thus, if a non-cooking younger generation is to be weaned from supermarket or fast food take-out, prepackaged meals, or a diet of smoothies and shakes, they have to be shown, realistically, how to prepare a meal with more than two ingredients (salt and pepper).  Fortunately, the Internet is replacing the food channels in meeting this need. A little bit of searching will produce videos on how to prepare anything from baked potatoes to a soufflé.  And since they can be viewed as often as necessary, a refresher view is possible if it has been several months since the dish, say meatloaf or roast chicken, has been made.

Ingredients in a box that cook into a meal for two or more, delivered to your door, are becoming popular. Certainly the advertisements looks compelling, especially to cooks like this one who always seem to be lacking one or more ingredients essential to the recipe.  These could be considered starter meals. As they are more expensive than meals assembled from one’s own kitchen, they are unlikely to be a permanent substitute for reading a recipe, finding the ingredients, and cooking. Or maybe not.

Programs on the food channels are entertaining, which is their intent. If a recipe looks worth trying, it is always available on the website of the television personality who prepared it. But just don’t try making it in 30 minutes or less.

How To Stay Full In 2017 When You Are On A Diet

January can be depressing. The predictable cold, snow, ice, wind, and bills are accompanied by, for many, the need to go on a diet. It is hard to ignore the pounds you’ve accumulated since Thanksgiving, and even if you do try to disregard them, advertisements for weight-loss programs won’t allow you to.

Diets tend to be dismal, adding to January gloom, and they are often boring. If someone suggests that we have been all wrong in eating X and avoiding Y, then there is at least the possibility of talking about a novel approach to dieting. But, alas, a quick survey of the diet books appearing now indicates that most of them are still promoting low-or carbohydrate-free diets (ho-hum).

Promoting a low-carbohydrate weight-loss regimen while one is enduring the long hours of winter darkness seems somewhat counterproductive. Such diets exacerbate the toll the lack of sunlight takes on serotonin levels and the grumpy moods, excessive sleepiness, uncontrollable food cravings, and lack of motivation to exercise that may consequently follow. And most relevant for the dieter is the absence of a sense of satiety, or fullness, also conveyed by serotonin.

Eating carbohydrate is the only way the brain makes more serotonin, and a diet that denies or limits starchy carbs like potatoes, pasta, bread, cereals, rice, beans, lentils and corn meal will leave the brain serotonin deprived.  It is a better plan to wait until May or June to stop eating carbohydrates in order to lose weight. The days at this time of year are so long that serotonin levels are not affected by carbohydrate depletion.

But, New Year resolutions being what they are (here today, gone tomorrow), many people feel that they’d better grab onto their will power and start dieting immediately.

So if you can’t eat carbohydrates because the diet books tell you not to, then you might consider an extract from a magical fruit called Garcinia Cambogia. (The name sounds a new dance step.) If you missed hearing about this fruit whose extract not only melts away extra pounds but, based on pictures on the Internet, leaves dieters looking as if they have had head-to- foot plastic surgery, then here is the information.

The fruit is tropical, apparently shaped like a pumpkin but grows on a tree, not on the ground, and is also known as the Malabar tamarind. Its popularity as a promoter of weight loss has shifted on and off for the last 20 or more years and had a resurgence this past year. Its virtues were extolled by the television medical personality Dr. Oz a few months ago, and like dandelions after the rain, companies sprang up to sell a particular ingredient in the fruit. Carcinia Cambogia contains hydroxycitric acid, aka HCA. Rodent studies done many years ago suggested that HCA might cause weight loss by blocking chemical reactions in the body that transform glucose into fat.

Fat or triglycerides are composed of two parts: glycerol, which makes up the backbone of the molecule and three fatty acids. So if your body produces fewer fatty acids, then fewer fat molecules are produced. This is what HCA seems to accomplish. It decreases the conversion of glucose  (all carbohydrates are digested to glucose) to acetyl-CoA. Acetyl-CoA is the building block of fatty acids.Rat studies found that when a high carbohydrate diet was eaten, HCA prevented some of the glucose from being changed into fatty acids. Moreover, as a value added sort of feature, people claim that HCA gives them a feeling of fullness or satiety, so they eat less. Serotonin, the neurotransmitter responsible for satiety, is thought to be increased by HCA, but there is as of yet no evidence for this.

A couple of pesky problems are associated with using Garcinia to lose weight: cost and sketchy purity. It is not cheap. One company is selling the extract HCA at a cost of $50.00 for 60 caplets and since it is recommended that a dose be taken before each meal, the cost can add up. The quality of the preparation is inconsistent among brands. ConsumerLab.com analyzed the content of hydroxycitric acid in several supplements and found the actual amount far less than claimed on the package label. Moreover, the HCA seems effective only when a very high carbohydrate diet is eaten.

There is a much cheaper way to prevent the transformation of carbohydrates into fat, while increasing satiety. It’s simple….eat only moderate amounts of carbs so what is eaten is used for energy, not to build up the fat cells. And consume some of those carbs, such as a half a cup of oatmeal or a toasted English muffin, about a half an hour before meals. Serotonin will be made naturally, the appetite will be decreased naturally, and you will lose weight naturally. Stay on this plan and the weight will even stay off long after the snow has melted, and the rest of the New Year’s resolutions have been forgotten.

Should Santa Claus (and his wife) Stop Eating So Many Cookies?

Poor Santa, he certainly has not kept up with modern times. No internet, no computer, no 3-D printer assisted toy maker, and certainly no electric sleigh (or self driving one for that matter). And somehow Santa and his wife have not heard health professionals lament our excessive intake of sugar.

Consider this:

He used to be thin. Orginally, a long time ago, he started out life as a monk (and monks did not eat cookies) and eventually became a Bishop in a town in what is now Turkey. This was around 270, a time way before people thought much about the North Pole and its toy making factory. In his spare time, he gave away money he had inherited by throwing coins and gifts through the windows of homes in which children lived. But no one reciprocated by feeding him sweets.

Eventually, as St. Nicholas (this was long after his death) he became the patron saint of children. Still thin.

Then something happened several centuries later. St. Nicholas was transformed into a chubby (well more than chubby) jovial, cookie eating distributor of gifts because of a poem, meter and rhyme.

In l822, Clemet Clarke Moore, an Episcopal minister wrote the poem, The Night before Christmas, * and Santa lost his buff figure forever.  Others helped enlarge his figure; a cartoonist Thomas Nast drew Santa with a large belly in l890, and Washington Irving described him as a fat Dutch elf. And finally, Coca-Cola gave us the image we associate with him today by picturing St. Nick in a red suit with a white beard, of course.

Given the ubiquity of sugary snacks available to this now robust figure, it is really amazing that he does not grower fatter with every passing century or require a supply of insulin in his sleigh because surely he must have developed diabetes by now! Will he still eat cookies containing gluten, or might this affect his intestinal tract and mood?  Does he know about Grain Brain? We don’t want the presence of gluten to change his “HO HO HO!” into, “Oh, oh, oh….”

Why is he eating carbohydrates at all? That surely must be the reason he is still fat. If he followed the Paleo diet he might be thinner, and also be able to use wooly mammoths to drive his sleigh, rather than reindeer.

And really, what kind of example is he to our children? All year we try to get them to eat healthily, limit their snacks to baby carrots and plain yogurt, and make sure they eat nothing, or almost nothing, with sugar. We try to make sure they get enough exercise, and that they not depend on us to drive them everywhere. And then on Dec 24 along comes this guy who won’t even walk from house to house, no matter how close they are, but insists on riding to each one on a sleigh. He goes down a chimney (how much exercise is there in that? It is all downhill!) and his sleigh is waiting for him at the door. And there are those cookies. Does he even bring them home to his wife? Probably, because she is not exactly svelte herself.

Perhaps his focus on sweet carbohydrates means that like so many who live in northern part of the world, he is suffering from Winter Depression or Seasonal Affective Disorder (“SAD”). SAD suffers have an urgent need to consume sweets, especially in the late afternoon and evening. Maybe if he lived at the South Pole he would be not be so chunky and addicted to chunky chocolate chip cookies; seeing there it is summer in December, and the sun barely sets.

Of course none of us knows whether he and his spouse go on diets on January 2 like most of the world.  They may go the Weight Watchers equivalent at the North Pole, or endure a weeks-long cleanse or eat only meat (reindeer?).  But like most of the world, by next fall they will probably have gained back all the weight they lost, and Santa will be pudgy again. Should someone put out a diet book next to the cookies? Or at least some baby carrots?

But then again, if he loses masses of weight, his clothes will be too loose and worse yet, he will not be the Santa of Moore’s poem whose “little round belly laughed like a bowl full of jelly.”  So keep those cookies by the chimney. With care.

Is Mindless Eating Like a Dog Worrying a Bone?

One of our dinner guests, a thin older man who prided himself on his eating and exercise discipline, sat down next to a bowl of nuts and almost inhaled them. We were having cocktails before dinner, and as hostess I was paying more attention to whether there was a coaster under every glass and napkins next to the finger foods, more than to what our guest was eating. But his rapid almond-to-mouth movements caught my attention.

“Did you see how much Jake (not his real name) was eating?” my husband asked after everyone departed. “He is usually so deliberate and slow in his eating, but this evening he cleaned his plate almost before everyone had picked up his or her fork. “

We mused over his uncharacteristic behavior, and then one of us remembered a story he told later on in the evening about a possibly nasty legal situation he was facing with a neighbor.

“I don’t think he even knew what and how much he was eating,” I commented. “I suspect that if he had been asked what he had eaten for dinner, he would have no idea.“

Not paying attention to what, especially how much, we are eating is one of the unsolved causes of weight gain. Who has not munched on a sandwich or crunched baby carrots while staring at a cell phone? Peering at the screen while eating is so common that eventually restaurants will probably provide cell phone stands so the phone can be propped up while eating, thus relieving the necessity of eating with only one hand. However, the perils of attending to the cell phone screen rather than to your food on the plate is that everything on the plate is consumed (possibly even the toothpick holding the sandwich together) without the eater being aware of doing so. Have you ever eaten a large bag of popcorn in a movie theatre and found that your munching was faster or slower depending on what was on the screen in front of you? Your fingers were able to direct the popcorn to your mouth without much awareness of your part.

Psychologists and nutritionists tell us TO PAY ATTENTION to what we are eating. We are to look first at the food before biting into it and notice its texture, smell, and color, perhaps the same way we might look at a glass of wine. Then we are to chew slowly, savoring the release of flavors and how they change in the mouth. Finally we are allowed to swallow. I was at a workshop watching the facilitator demonstrate this with a strawberry. We all had several on our plates so we could practice along with her. One of the participants was so mesmerized by the slow motion consumption of the strawberry by the leader that she mindlessly munched on all the strawberries on her plate.

Of course, paying attention to what we are eating, and especially noticing when we are full so we don’t continue eating beyond fullness, is helpful in controlling our universal tendency to overeat.  But perhaps more important is noticing why we put our mouths on automatic pilot and eat and eat the way a dog gnaws and gnaws at a bone. The dog is probably not thinking much of anything except where the next bone might be coming from, but the automatic eater is, for sure, thinking of something other than the food.

Mindless eating should really be called “mind elsewhere” eating. Like the dog worrying a bone, or our dinner guest, the “mind elsewhere” eater is gnawing away at an unresolved, troublesome situation.  It is unlikely that the eating and the somewhat obsessive thinking will produce a solution at that moment, but is more likely to result in the consumption of excessive calories. (And, to my mild annoyance, probably no recollection of what the food tasted like.)

A dog owner will take away the bone when it is apparent that the dog should move on to something else.  As owners of our “elsewhere minds” we must take away our own bones. We must put away or move away from the food, set our forks down, determine how much we have already eaten, and halt the repetitive movement of either a utensil or a hand carrying food to the mouth.

Dogs usually sigh and then go to sleep when the bone is gone. We should learn from them. A few minutes of calmness, of allowing ourselves not to be consumed by the problem at hand, will bring our mind and our eating into harmony.  It will also bring the benefit of enjoying the food we are eating.