Showing posts with label Health and medicine. Show all posts
Showing posts with label Health and medicine. Show all posts

10.09.2013

Why popcorn and pretzels are the worst movie snacks... and the best

Tasteless. Unhealthy. The classic “movie” snacks baffled me since day 1. I would rather milk a cow with my bare lips than fill my gut with exploding corn nuggets and knotty dough.

The reason they're popular is simple. When you're watching a movie, you're not thinking. Your brain responds to the salt payload of each bite, and the answer is simple. More. Ever eat an unsalted, unflavored potato chip? Try it. Take a single chip to the sink, rinse, and let it dry. If you're more daring, take a whole bag, and see if you still want to finish 500 grams over a single episode of Parks and Recreation. Not so funny now, Amy Poehler.

Fats and sugar affect brain chemistry, says David Kessler, former head of the FDA and Dean of Yale School of Medicine. Food companies are just as guilty as the tobacco industry. Obesity continues to be the leading cause of preventable death worldwide (counting hypertension, or high blood pressure, whose other main causes are aging, low exercise and poor diet). Smoking is second. Interesting that first and second places for murder, globally, are the products we buy every week at the local supermarket.

Sugar is essential for your survival. It is naturally absorbed through the consumption of carbohydrates. For most of human history, pure sugar was unheard of. In evolutionary terms, humans like the taste of sugar because it encouraged our hunter-gatherer ancestors to eat foods like fruits, vegetables, honey and berries. (Bitter tastes, incidentally, were to scare them away from poisons, diseases, and indigestible flora.) Sugar traders were rare and wealthy until the 18th century, when suddenly sugar became a food ingredient “necessity”. Colonization of tropical islands, and the slave trade, was driven in large measure by the sugar market, and it was only after sugar production became automated that European cultures “rediscovered” their Christian heritage (which started as the truth of universal social equality) and began to outlaw slavery.

Today, sugar is harvested primarily from sugarcane and sugar beets, plus maize from the United States, subsidized to produce high fructose corn syrup. Fructose and glucose, the resultant compounds of all three, are absorbed directly into the bloodstream during digestion, and are fuel for the brain and other body functions. Fructose is almost twice as sweet as glucose (and by the way, some corn syrups are engineered to have almost exclusively fructose). Sugar is even added to apparently non-sweet food products, like potato chips, peanut butter and soup. As a result of sugar inflation, desensitization and marketing tactics, most people in developed countries consume ten times the sugar the body needs.

Likewise, sodium, highly concentrated in salt, is found in naturally high concentrations in nuts and meats, but is present in nearly all foods. Like sugar, salt was an expensive commodity for most human history and was at times used as trading currency. Essential for storing meat, salt transformed seasonal and geographical limits to food, thus playing a major part in the transition from hunter-gatherer to farmer-settler (civilization). 

Biologically, salt (less than a teaspoon daily) is needed to regulate body fluids and pH, and by the nervous system to send electrical signals. When salt is broken down into its constituent elements, sodium and chloride, sodium regulates blood volume and pressure, while chloride is used to break down food into energy.

Food companies take this physiological predisposition toward salt, concentrate it in an almost pure form, and add it to their products so that people find them irresistible. 75% of the world population now consumes more than double the recommended intake, and many surpass the amount agreed by the United States, Canada and Britain to be decidedly unhealthy (6 grams/day).

While we all know that consuming too little salt is lethal, too much (1 gram per kilogram of body weight) is equally deadly short-term and arguably damaging long-term. There are associations between high salt consumption and increased likelihood of stroke, cardiovascular disease, high blood pressure and edema (fluid accumulation and swelling). Since healthy kidneys work to process excess sodium, the data across an entire population is inconsistent, but as a whole an excess salt diet has a markedly negative impact, particularly on margin demographics such as the infirmed, disabled, youth and elderly.

The Salt Institute, Salt Works and other such organizations claim that there is no negative connection between health and overconsumption of salt. Reminiscent, perhaps, of the outcries of the tobacco companies not too many years ago? In any case, the salt controversy continues to rage, and meanwhile, salt, like sugar, is used to sell. For decades food companies been researching how to keep us hooked to their product. 

Coincidentally, Kessler also ousted the tobbaco companies. He's a regular whistle-blower. He was even fired as Dean of UCSF Medical School for calling attention to his own school's questionable financial practices. Kessler's legitimacy is unquestioned. His investigations in tobacco led to a 368 billion-dollar settlement and immunized the companies to future lawsuits. Notice how cigarette prices went up eight-kagillion percent in the past ten years? Notice how cigarette packs have uglier and uglier warning labels on the boxes? That was him. 

Unfortunately, selling eggrolls is a lot harder to tax or prohibit than Camels. Alcoholism was declared an illness as early as 1956 and is currently recognized as both a psychological and a medical afflication. What about food dependency and obesity? 

Dietary fat is an essential part of a healthy diet, despite the attack during the 20th century on the stuff, to the point where being called “fat” (once merely a scientific term) became one of the bigger social insults, and being fat one of the bigger social crimes. However, vitamins essential to our survival can only be digested and absorbed when fat is present. Fat buffers the body's delicate innards from physical trauma, regulates body temperature, protects us from diseases, and increases the health of every living cell. More well known, but less important in the abundance of the western world, fat allows energy to be stored for future use.

The great irony is that “fat” has been for decades the supposed culprit of obesity. The reality is that fat is more a symptom than a cause. Yes, fat tastes good, as studies in 2001 demonstrated, which is why the smooth creamyness of milk chocolate is so easy to recall.

In 1914 the call against fat went out. To support the rationing war effort, gaining wait was called “unpatriotic” by popular American and British magazines. Before that, we can trace the change of heart toward fat as early as the French revolution, when obesity was associated with the aristocracy and thus damnable. Before this time, some state officials and rulers would pad their bodies to look bigger and therefore more imposing, powerful, dangerous. Oh, how the times have changed. Obesity is seen, at least in North America, as a moral issue. If you are fat you are lazy and cannot control your impulses.

Fat, however, is not the great enemy of the 21st century. Lobbyists in Washington continue to block the restriction of high-salt and high-sugar foods in universal policies that could transform the diet of the nation. Symbolic initiatives like the soft drink controversy in 2012 in New York are met with ridicule. And all the while these products continue to make headway in Europe, Africa and Asia. The only way that other producers can compete is to artificially enhance their foods and drinks, too. If you can't beat 'em, join 'em. Check out this webpage for a more complete list.

Speaking of joining them, if you've never tried mixing salted and sweetened popcorn, or eating salted chocolate, it's about the cheapest mouth orgasm out there.

Labeling laws have allowed public opinion to crack down on fat content. Packaging with words like “non-fat”, “low fat”, “less fat”, and “lean” are guaranteed to increase sales. “Unsweetened” and “low sodium”, on the other hand, don't yet sound as sexy. Consequently, the solution is to exchange one tasty substance for another. Take out the fat, label it "non-fat", add salt or sugar, and like magic, sales go up without making food any healthier or less addictive. Everyone wins... except the consumer.

Since fat is a highly stigmatized substance, most foods don't have much. Regardless, remember that fat equals 4 calories per gram, whereas protein (generally viewed as a positive food substance) has 2, so either way you look at it, it's portion size that's going to make a major difference, not whether your yoghurt is 5% fat or 10% fat. As long as the food products are designed to make you crave for more, unable to stop until it's all gone, then wanting to go back to the store to get more, fat content might drop, but portion size will not.

2.29.2012

The pill or the cross? A trumped-up debate

This is a carefully balanced proposal. I think it's high-minded, but I think it's fair-minded. In other words, it's got something to offend everyone. -The Firm (1993)
     Today in the teacher workroom one of my colleagues declared that President Obama is attacking the Catholic Church with a vengeance. And this teacher is not alone. Obama is currently envisioned by many as the contemporary incarnation of the Roman emperor Nero, burning Christians in the backyard of the White House, feeding them to starving circus beasts at the local amphitheater, and cackling gaily all the while. Recent polls show more than half of Catholics taking issue with the President's recent decision regarding enforced health care coverage of contraception.
     Nevertheless, there is no great conspiracy by the current administration to aggravate one of the largest voting bodies in the country. There is no secret plan to undermine the Amendments to the Constitution in order to install an oppressive bureaucracy to control hard-working American men and women. Obama is not a Jew-hating, anti-papal Muslim brother. For the record, he's an intellectual Christian drawing from many traditions. He's not Jacobean.
     What is going on is a centuries-old war between the current liberal landscape, whose crown jewel is the utterly dispassionate and fair medical establishment, and the awkwardly-defunct-but-in-denial religious establishment, codified supremely as the Catholic (=universal! at least claiming such) Church. Sadly, this much more interesting issue will not be addressed in this article. Another time, perhaps. (In the meantime I will refer you to a related issue I wrote about last month.) The scope of this post is simply to outline the facts of the debate and argue its present status as being no longer front-page news material.
     The Patient Protection and Affordable Care Act of 2010, which constitutes the chief legislative reform to the American health care system, is known pejoratively as "Obamacare." It requires health care providers to offer coverage for pre-existing conditions and preventative services. It also increases nationwide coverage by thirty million. The majority of states have appealed PPACA as unconstitutional, hearings in the Supreme Court will take place in late March, and a decision is supposed to be reached by June.
     The health care controversy is obviously complicated enough to reach the highest Court in the land, and I only wish to address the issue of requiring religious organizations to provide contraceptive coverage. This issue has been raising hell for a month or so, now, and like the proverbial bad penny, won't take a hint and go away.
     Let's look at the facts first.
     Before PPACA, women were protected from paying higher premiums for medical coverage just for being women if they received that coverage through their employer. However, if they were shopping for individual coverage, no such protection existed. Women paid higher premiums on average (legal in 37 states), even though they did not receive a corresponding increase in service. Since women are more likely to be unemployed or only employed part-time and in 2010 made up 55% of the individual health care market, this is a substantial problem.
     Let's be clear why. Women who got pregnant could suddenly lose their health insurance coverage without remuneration. Other cost sharing such as additional deductibles because they were treated as a rape victim or got a C-Section (regularly required by a medical doctor as the safest procedure for both mother and infant). Because of this legal discrimination, many women chose not to get any health coverage at all.
     I believe that one of the fundamental marks of authentic civilization, alongside universal education and transparent political system, is a universal health care system. When a society lets its poorer and more vulnerable members suffer physiologically, it is violating their right as human beings to physical dignity. I don't care if you're a crack addict, a pedophile or a jobless ninny. As long as you're a citizen of my country, if you have a disease - even one you suffer from because of your vice - you have the right to receive quality medical treatment for your ailments.
     PPACA stopped this gender-discrimination and requires all employers to provide women with preventative services such as gestational diabetes screening, regular gynecological checkups, contraceptives and related counseling, breastfeeding supplies and relevant support. An exemption to this rule (for contraceptive coverage only) exists for for employers defined as religious institutions.
     The first amendment states, "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."
     This exemption is rife with potential for abuse. Let's say I'm a health care provider and I want my individual rates (not through an employer) to be competitive. Covering women raises the average cost of my plans because women require more medical service than men. I need to find a way to offset that additional cost. PPACA prevents me from raising premiums for women simply for being women. However, if I can legally choose to withhold certain medical coverages that women typically want, they will be less likely to purchase health care coverage from me. In this way I can still encourage them to find coverage elsewhere. To benefit from the exemption clause, all I have to do is claim that I morally oppose contraception on religious grounds. According to the First Amendment, the government cannot legally force me to freely exercise my religious beliefs. I get to exert my religious beliefs over my employees' and beat my competitors' rates.
     Thankfully the writers of the PPACA were smart enough to limit the exemption to religious employers. To qualify as a religious employer, according to the Department of Health and Human Services, the institution must "(1) Have the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets; and (4) is a non-profit organization[,in other words,] churches, their integrated auxiliaries, and conventions or associations of churches, as well as to the exclusively religious activities of any religious order."
     In the case of a religious employer and a woman who needs contraceptive care we have a conflict of interest. Both parties have rights. Women as human beings have a right to quality health care (as stated above) and that includes contraceptive treatment. If you are an employer and you deny that coverage, you are discriminating against an employee. That's illegal. According to the Equal Employment Opportunity Commission, "Religious discrimination involves treating a person (an applicant or employee) unfavorably because of his or her religious beliefs. The law protects not only people who belong to traditional, organized religions, such as Buddhism, Christianity, Hinduism, Islam, and Judaism, but also others who have sincerely held religious, ethical or moral beliefs." Many women sincerely believe that it's morally right to have an active sexual life without overpopulating the planet with additional mouths to feed, that it's morally right to enjoy sex for the purpose of interpersonal intimacy rather than procreation. An employer must respect that belief. That's the law. Otherwise, why shouldn't an employer choose not to hire you because of your religion? your lifestyle? your ethnicity? your sexual orientation?
     The EEOC has been around for more than fifty years, and it's the reason employers are no longer allowed to discriminate in covering their employees. In 2010 PPACA took that same principle and extended it to health care providers, because even though they aren't employers, they shouldn't have the right to discriminate either.
     So how do we uphold both the woman's individual rights and the institution's rights? The solution is simple. Provide coverage to the woman without going through her religious employer at all. The health care provider must offer it without charging the church. Now the church is not spending its monies for what it perceives to be a sinful action. No cost sharing on the part of the employer or the employee.
     And that's exactly what the rules are.
     So why are people still accusing Obama of attacking the church?
1. People think the definition of "religious employer" is too narrow. Catholic universities and hospitals should be included, it is said.
Response. Maybe the definition could be widened. But we still need to provide contraceptive coverage to the woman. She has her rights too, as explained earlier. And in no way does the nuance of the definition of "religious employer" constitute "an attack" on Catholics. It's something to be considered by people of intelligence and experience.
2. People generally want to blame the President for everything. This is especially bad during a recession, and especially especially bad during the last year of his first term in office.
Response. People love to complain and find someone to blame. Frankly I can't think of a perfect solution to this problem, but I certainly can't think of a better solution than the one currently in place. Every alternative I've seen crushes the rights of either the employer or the employee.
3. The President doesn't have a positive religious identity. As a Democrat, Obama is already on the back foot, and worse, was labeled a closet Muslim, despite clearly being a liberal Christian. Contrast Obama with Bush Jr., who during his first term claimed to read Oswald Chamber's classic My Utmost For His Highest (a daily reading of wishy-washy Christian moralisms) on a regular basis.
Response. Personally I don't think Obama's religious beliefs are a problem. I'm betting he's fairly non-committal, which means as a politician he's looking to create and maintain a system in which the beliefs of all are respected, as long as they don't impinge on the beliefs of others. And that's exactly what the government of a religiously free country is supposed to do.
     Since representatives of the Catholic Health Association and Mount St. Mary's University not only accepted the accommodation (while reserving the right to negotiate certain minor details), but praised the President's willingness to listen and respond to legitimate concerns, we can confidently declare that the rest of this nonsense is no different than the long-winded spectacles of Obama's birth certificate, Solyndra, and the Ground Zero Mosque.
     Ongoing questions: The battle between the medical establishment and the old, defunct religious establishment.

2.05.2012

Probably; after all, they're poor

     Humanity is increasingly becoming a civilization that tries to control complex social patterns so the race progresses. We try to find ways to intentionally encourage desirable traits and discourage undesirable traits. In essence, now that we've adopted the Darwinian vision of natural evolution, we seek to control our own evolution to ensure our future existence.
     The primary way to understand large-scale traits and patterns is through statistical analysis. While often useful, this technique is fundamentally at odds with the rights of the individual as enshrined, for example, in the Bill of Rights.
     That is why, for at least the past couple of years, American legislators and judges have been fumbling with the vague language employed in our Fourth Amendment (the prohibition of "unreasonable" searches and seizures).
     Let's look at an example in the news right now.
     In 2010, Governor of Florida Rick Scott introduced state legislation that would require those seeking welfare (under the federal program TANF, Temporary Assistance For Needy Families) to submit to a drug test. Applicants must pay for the $30 screening but are reimbursed afterward, provided they don't fail. This bill was signed into law in June 2011.
     Scott said that it was unfair for taxpayers to support the addictions of drug users; conversely, welfare can now act as an incentive to not use drugs.
     Shortly after Scott signed the bill, a delegation of Democratic representatives attacked the new legislation, calling it "downright unconstitutional." Rep. Alcee Hastings argued that the bill could set a precedent to require drug testings for all federal assistance programs, from Medicaid to education to emergency relief.
     Similar legislation in Michigan was overturned in a federal court in 2003. Moreover, in 1998 a pilot project in Jacksonville, Fl., tested almost 9000 applicants and found that less than 4% failed the test. Given that each test costs around $50 and applicants are awarded, on average, $250 per month, the program would be lucky to pay for itself.
     Besides the financial cost of the program, what about human rights? The Fourth Amendment states:
     The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.
     "Probable cause" is a term that has been debated, but most agree that a warrant must be obtained as a result of information submitted by a law enforcement officer who has sworn an Affidavit. (A minority view suggests that "probable cause" means the same thing as "reasonable cause" and no evidence need be submitted or sworn in.)
     On Thursday The Daily Show ran a special segment that highlighted the sheer prejudice and hypocrisy of Scott's program. The stereotype is that, as Daily Show correspondent Aasif Mandvi put it so well, "The poor love drugs," which is actually false. (I wonder if this suggests that there is, in fact, "class warfare" raging in America.) The inconsistent behavior is that state dollars spent on welfare deserve the attention of drug screening - but what about state and federal employees, and social service programs whose benefits are not reaped primarily be the poor? A dollar is a dollar, and if Rep. Scott wishes to make sure no taxpayer money is rerouted to fund destructive and addictive habits, everyone who receives state monies should be required to submit to similar screening.
     Of course, that's not the case, and that's why the bill was rightly overturned. Preliminary results show that 2.5% of applicants tested positive for drug use and 2% declined to take the test, whereas around 6% of Americans use drugs. (Earlier research revealed that government-assisted families were 50% more likely to report drug use than families receiving no assistance.) Scott is appealing the decision and I'm guessing that the case will end up in the Supreme Court, which means it will finally get the attention it deserves.
     In the meantime, Pennsylvania is advancing similar legislation - but in this case, drug testing is only required of felons with a drug-related conviction in the past five years. Does this constitute "probable cause"? In terms of statistical likelihood, absolutely. People with a history of drug abuse are more likely to return to drugs - that correlation is practically uncontested.
     But how likely? Is over 50% enough? What constitutes "probable"? Am I as an individual ready to be defined legally by the normative behavior of my supposed social class? I don't think I am. Regardless of what people like me have done, I want to be judged according to my own behavior. And if there's not much to go on, give me the benefit of the doubt.
     Ironically, I'm siding with the Democrats (who normally champion social engineering) against the Republicans (who normally champion the rights of the individual). The reason for this reversal, I suggest, may be because Republicans treat poor people as an isolated group and not as individuals. But what do I know?
     So, there are three questions to ponder:
     1. Does statistical probability count as probable cause? Read these two articles (1) (2) if interested. (This is the same problem in Arizona with respect to identifying "likely suspects" of illegal immigration).
     2. Are poor people really more likely to use drugs? My very brief online research, linked earlier in this article, turned up conflicting results.
     3. Is class warfare a myth or a reality? This is a pretty polarized issue right now so it's probably best just to mull it over and not post on it.
     You're welcome to share your thoughts and opinions - I'd like to hear them!