Some Evidence on Obesity Model

I've been getting harangued for weeks by a severely wounded ego-centric proponent of the I'm-so-desperate-to-be-right approach to intellectual discourse, that I am finally giving in and providing some support for my thoughts on obesity. The blog stalker has insisted that I prove the validity of my thoughts on obesity, and so I will provide some evidence, but let it be known that this is the last response I will make to the ramblings.

In the most recent issue of the International Journal of Obesity [Volume 35, Issue 10 (October 2011)], no less than every article supports my position:

• On the causes of obesity:

Overweight and obesity are the results of an enduring positive energy balance, that is, when energy intake is larger than energy expenditure. Hence, overweight and obesity prevention requires effective intervention programmes targeting behaviours that contribute to both sides of this energy balance. These so-called energy balance-related behaviours include dietary behaviours (for example, consumption of fruit and vegetables, or sugar-sweetened beverages), sedentary behaviours (for example, television (TV) viewing or computer use) and physical activity behaviours (for example, sports or active commuting to school).

Interesting, calories in vs. calories out (boldface emphasis mine), and not one thing about hormones or genetics. That's because it's science, stupid.

• On parents needing to get involved because increased physical activity (PA) at school only is met with greater inactivity outside of school:

The PA of children seems to compensate in such a way that more activity at one time is met with less activity at another. The failure of PA programmes to reduce childhood obesity could be attributable to this compensation.

Duh!  Parents are responsible for their children especially when they see them blowing up.

• That feeding your child crap disrupts their physiology to such a degree as to promote obesity:

Lower insulin sensitivity at childhood may predict subsequent total and central adiposity gain at adolescence. These findings enhance the role of insulin sensitivity as a target of obesity prevention already from the first decades of life.

Or in other words, don't let your children eat junk food.

•  That fat parents breed fat kids:

Children whose both parents were overweight or obese both before pregnancy and after 16-year follow-up had a strikingly high risk of overweight at age 16 years...parents’ long-term overweight (BMI 25 kg m⁻² before pregnancy and after 16-year follow-up) was the strongest single predictor.

I almost can't believe that anyone would need proof of this.

• That drinking sufficient water helps decrease and/or maintain healthy weight:

Consuming the recommended daily amount of water for children could result in an energy expenditure equivalent to an additional weight loss of about 1.2 kg per year...water drinking could assist overweight children in weight loss or maintenance, and may warrant emphasis in dietary guidelines against the obesity epidemic.

• That hormonal changes are the result of fat deposition (obesity) and not the cause:

Too much abdominal (visceral) fat increases an individual's risk of developing insulin resistance and other metabolic disorders. In a Perspective, Hug and Lodish discuss the unexpected finding that blood levels of a hormone produced by visceral fat, called visfatin, correlate with obesity.

Okay, that particular study is from a different journal, but I couldn't resist (and one more from same journal)

But back to the International Journal of Obesity:

Conclusion: Hormone (serum visfatin) levels are influenced by body fat content in obese children

•  On overeating being one significant factor in obesity:

An association between children's body mass index (BMI) and overeating has been established...overeating, impulsivity and reward responsiveness were significantly associated with childhood BMI. Mediation analysis revealed that impulsivity and reward responsiveness equally and significantly predicted BMI indirectly through overeating.

The single most idiotic argument I've heard is that overeating is not a cause of obesity--precisely why this will be my last response to such nonsense. I cannot discuss an idea with someone if we don't speak the same language.  Denying the most basic knowledge we have about physiology puts us on different planets.  Conversation over.

• That eating fast food (FF) regularly leads to obesity:

The teenagers who ate at FF restaurants consumed more unhealthy foods and were more likely to have higher BMISDS than those teenagers who did not eat frequently at FF restaurants. 

• That prosperity leads to obesity:

Ethnic minority groups in Western European countries tend to have higher levels of overweight than the majority populations for reasons that are poorly understood. ..Conclusion: Contrary to the patterns in White groups, the Dutch ethnic minority women were more obese than their English equivalents.

It's only poorly understood because the right questions aren't being asked.  Essentially the study shows that culture alone isn't definitive.  However, I propose that it's the change in culture, particularly entering an environment where conveniences abound.

• That junk foods promote overeating due to chemical and high sugar content:

...higher preferences for sweet and fatty foods compared with the other two groups. Food preferences were also related to all overeating measures, which in turn accounted for a substantial proportion of the variance in BMI...The associations reported in this paper are important from a public-health perspective because of the abuse potential of sweet-fat foods and their strong relationship with obesity.

And that's that. As I've said before, Mr. Stalker, I don't do peoples' research for them. But because you showed such diligence in asserting yourself, I thought I would finally accommodate. I didn't have to go far for supporting articles--one journal, sir, was all I needed. That's because what we know about obesity isn't in need of an overhaul, therefore most of what I put forth is BASIC. What is needed is a halt to the notion that the individual isn't responsible for his or her own weight, and that they are powerless because of their genetics or hormones.

So as I said, I'm done. I will post a few more promised pieces on obesity in the future, and then I move on.

Oral Steroids Linked to Vit D Deficiency

People that take oral steroid medications, particularly children, could be at an increased risk for serious vitamin D deficiency. So says a recent study published in the Journal of Clinical Endocrinology & Metabolism.  Some conditions people take these drugs for are asthma, certain types of arthritis such as rheumatoid arthritis and autoimmune diseases like Crohn's disease, lupus and multiple sclerosis.

Researchers looked at nearly 23,000 Americans in a government health survey, and found that those using oral steroid medications were twice as likely as non-users to have a severe vitamin D deficiency. Eleven percent (2,530 people) of those on steroids had a vitamin D level below 10 ng/mL--far below the minimum requirement to remain healthy. That compared with five percent (1,150 people) of study participants not on steroids.

Blood levels of vitamin D lower than 10 ng/mL:

associated with the most severe deficiency diseases: rickets in infants and children, and osteomalacia in adults. A concentration above 15 ng/ml (37.5 nmol/L) is generally considered adequate for those in good health. Levels above 30 ng/ml (75 nmol/L) are proposed by some as desirable for achieving optimum health, but there is not yet enough evidence to support this. ~ Wikipedia (as of 10/31/11)

The link was especially strong among children. Steroid users younger than 18 were 14 times more likely to have a vitamin D deficiency than kids not taking the medications.

The authors of the study point out the findings do not prove causality, but this should alert doctors and parents to keep an eye on vitamin D levels of the children taking these drugs.  Something else parents can do is make sure their children are out in the sun as much as possible. Some parents may inadvertently keep their asthmatic kids indoors, but I think this is a mistake. Lots of sunshine is necessary for the production of vitamin D. At the very least, the inhaler should be countered each time with a good vitamin D supplement.

As the severity of vitamin D insufficiency in North America is dismissed, data showing its pervasiveness continues to accumulate.  The smart reader will continue to get plenty of sun-screen free sun, and supplement if necessary (not so for those getting sun daily). And making sure that if you or your child are on oral steroids, you get your blood vitamin D levels checked.

Addicted to Evolution

Are you addicted to technology? How about social media? It's a real thing, you know--virtual monkey on the back. Here are the sure signs you are addicted (at least according to one author who has written a book called "The Digital Diet" about when too much is not enough):

• The urge to pull out a cellphone even when someone you're with is in the midst of a conversation with you.
• Texting even while your child is telling you about his or her day at school, and realizing later that you can't remember the details of what your son or daughter has said to you.
• Having the vague feeling that something hasn't really happened until you post it to Facebook or Twitter.
• Feeling isolated and anxious if you are offline for an extended period of time.
• Noticing that even when your family is all together in one room at home, each person is gazing at his or her own screen and tapping at a miniature keyboard.

The author Daniel Sieberg says that some people even create status updates or tweets in their heads when they are experiencing things (Who doesn't?).  He says, "It's as if they have lost the ability to live in the moment, and have become conditioned to feeling that they have to instantly share it electronically while it is still going on."

Ha ha ha...I am only posting this to take enjoyment in what is a natural response to all new and world-changing phenomena. Whether talking about the light bulb, television, rock & roll or the internet, there will be some people that focus on the downside, freak out at where it's leading us, and perhaps even try to prevent the change from happening.

No doubt that every phenomenon has a negative side. In our new technological world, where information is just a mouse-click away, of course, there will be some detriment. And whenever our brain processes something as pleasurable, like multiple responses and comments on social media sites, it will release dopamine, the neurotransmitter "associated with the reward system of the brain, providing feelings of enjoyment and reinforcement to motivate a person proactively to perform certain activities."

Dopamine is released in response to experiences such as food, sex, drugs, and neutral stimuli that become associated with them.  It is believed that this system is responsible for the physical aspects of addiction. So in that regard, there is no doubt some people will struggle with the symptoms of addiction in the early years of the social media explosion.

Saying that, Mr. Sieberg, there is nothing in need of changing.  As I've said before in this blog, the human species will continue to evolve with machine--that is, with our informational systems. This symbiotic growth will not be stopped, so striving for separateness from our cyber-existence is futile. And why would we want to? Sure, neglecting your family for Facebook is lame, but for some it's welcome refrain from family strife and tensions. Some people that are isolated socially from the real world, find acceptance and a forum for their thoughts on social media. You see, it all depends on which perspective you are looking from. 

So don't fear your relationship to social media--I guarantee no matter how absorbed you are now, it will even out over time. And if it doesn't, so what? It just means you're popular...in cyberspace.

Soda Marketing Targets Black & Hispanic Youth

The Yale University Rudd Center for Food Policy & Obesity report I discussed last post discloses the youth market-grab that soda manufacturers are carrying out in an attempt to secure future sales. For a product like soft drinks, it's all about brand loyalty, and people set their preferences early on. The big guns in the current soda marketing campaign are Coca-Cola Co and Dr Pepper Snapple Group Inc, the report found.

Successful companies study their markets and invest in wooing their top consumers, something to think about if you (or your child) fall into one of the following categories:

• Black children and teens saw 80-90% more ads than white children, including twice as many for the 5-Hour Energy drink and Coca-Cola's vitamin water and Sprite.
• Hispanic children saw 49% more ads for sugary drinks and energy drinks on Spanish-language television, and Hispanic teens saw 99% more ads.
• In 2010, teens saw 18% more TV ads and heard 46% more radio ads for energy drinks than adults did.
• 21 sugary drink brands had YouTube channels in 2010, with more than 229 million views by June 2011. Coca-Cola was the most popular brand on Facebook, with more than 30 million fans.
• The most-visited websites operated by soft drink brands were MyCokeRewards.com and Capri Sun, which is owned by Kraft Foods Inc.

According to the CDC, 15% of children are overweight or obese, and no doubt in my mind that sodas are a major player in that phenomenon. Although I agree that sodas are not the stand alone cause of obesity, using that as a reason to dispute the validity of the above report makes about as much sense as excusing cigarette smoking for its role in lung cancer because air pollution is also a factor.

Susan Neely, Chief Executive Officer for the American Beverage Association said that member companies are "delivering on their commitment to advertise only water, juice and milk on programing for children under 12."

But Yale's Kelly Brownell, co-author of the report, says otherwise. He states that there has been a lot of research on the issue of marketing unhealthy food to children. Today's report, he said, is the first that analyzed data from several firms, including Nielsen Holdings NV, to measure the full picture of youth exposure to marketing and advertising. He also said it is important to consider the online interaction children have with brands, especially since they tend to stay on computers longer than they watch TV commercials.

For anybody falling into one of these groups targeted by soda manufacturers--children, teens, and especially black and Hispanic youth--just understand how you are being wooed, and educate yourself on the risks of consuming large amounts of soft drinks. Understand that ingesting that much sugar (ten teaspoons per can) can lead to excessive weight gain, obesity, diabetes and other metabolic disturbances, as well as rotten teeth. And mind you that all of these body changes occur over an extended period, so just because you don't see the physical effects happening right now, don't think they won't in time. Just take a look at some the adults around whom you might wonder exactly how they've morphed into what they have--and realize that could be just what you have to look forward to if you continue your soda habit.

I'm pleased this report has come out, although it's nothing new in soft drink marketing. Makers of liquid sugar have been wooing kids from the start.  But now we are all watching.  We'll see where it goes.

Hate to be the One that Tells You, but...

In my recent obesity debates, I noticed a disturbing trend among many proponents of fantastical new theories on obesity, which included some doctors: They were adopting a "obesity is far too complex to blame a singular (or few) product/action" position. As I remarked in an earlier post, I think this poorly thought out opinion only perpetuates the problem.  No less erroneous than the genetic theory of obesity, denying the obvious simply gives the obese person a reason to pull themselves, and their lifestyle habits, out of the equation. As a result, it ensures that obesity will remain a lucrative disease entity in need of a cure (à la cancer).

Case in point: In response to a recent report coming out of the Yale University Rudd Center for Food Policy & Obesity, that has showed soft drink manufacturers to be stepping-up advertising to children and teens, particularly blacks and Hispanics. The American Beverage Association, whose members include soft drink companies, disputed the study's findings. Said the group's Chief Executive Officer Susan Neely in a statement,

"This report is another attack by known critics in an ongoing attempt to single out one product as the cause of obesity when both common sense and widely accepted science have shown that the reality is far more complicated."

Uh huh...listen up obesity enablers: Aspects of obesity may have some complexity to them, but how it originates physiologically in the individual isn't complex. Any right-minded person not driven by profits or ego (doctors...) simply cannot deny that imbibing ten teaspoons of sugar (contents of one can of soda) will lead to metabolic and hormonal changes that ultimately cause obesity.  If you're this person, forgive me but...you're an idiot.

Soda Fountains and Fecal Bacteria

This may not be news, but soda fountains have been found to be rife with fecal bacteria. Just another reason to bypass drinking that nasty stuff. This story is nearly two years old, but the heebie jeebies remain. I was reminded of this grossness, while researching another piece, and wanted to share my thoughts.

If you hadn't heard the story when it broke January of 2010, here are the details of the study conducted in a region of Virginia:

• 48% of beverages obtained from soda fountains contained fecal coliform bacteria, 11% contained E. coli (which are mostly harmless, but some can cause diarrhea, urinary tract infections, respiratory illness and pneumonia), and 17% had Chryseobacterium meningosepticum (which could sicken newborns or adults with weakened immune systems).
• The U.S. Environmental Protection Agency's drinking-water regulations require that all samples test negative for E.coli.
• Many of the soda beverages from the dispensers fell below U.S. drinking-water standards, according to the findings.
• It is premature, however, to draw broad conclusions about all soda fountains from a localized study.
• The samples were contained in petri dishes and the bacteria multiplied within 48 hours, so much so that they became visible to the naked eye as 300 to 400 tiny dots.
• Researchers were uncertain how the bacteria got inside the beverage machines, but very likely from unclean hands or rags used to wipe down machines.
• National Restaurant Association and American Beverage Association both assured public that eating out and using soda fountains were safe.
• A 1998 outbreak was linked to soda fountains after 99 soldiers in a U.S. Army base were hospitalized with gastroenteritis.

Okay, my thoughts: First, scientist have to practice caution with what they claim, so if they haven't tested something in particular, they can't make unsupported declarations about it. But I can! Fecal matter on soda fountains are probably from poorly washed hands. The only other explanation that it might be from the rags used to clean the machines is no great comfort. Either way, it's unhygienic and disgusting.

Next, if soda fountains are contaminated, then so are the water dispensers. So I could easily say, just don't drink the soda...but now were treading into deeper waters. If the drinking water also at risk, it really doesn't make me feel comfortable. I guess bottled water is going to be in order. Cha-ching for the restaurants. Or maybe bring your own bottles...or, better yet, eat at home.

Finally, it's true that this study was done in one small area in Virginia, but my guess is that if a nationwide study would be conducted, they might find similar results. You see, the problem is that soda machines have to be messed with (I worked in the restaurant biz for many years as a student)--the syrup needs to be changed, as does the carbonated water. Anything that needs to be handled frequently always has an increased risk. Further, soda machines are very often maintained by busboys and wait staff. Whereas kitchen employees may be extra cautious about hygiene, servers and bussers may not. And if it's self-serve...ugh, even worse.

I am sure when the story broke, most restaurants heard the news and went through the extra-diligence to make sure cleanliness became godliness. But that was two years ago. Staffs turn over, and memories are often short; so whether or not the same hygiene is practiced today would be left to be seen. Saying that, I know that at most places where I'd worked hygiene was of paramount consideration.

My major message here is that sodas are nasty across the board. They are bad for your health, and when dispensed in a restaurant, they are at risk for contamination. Yuck! I am pleased that neither me nor my children drink that crap. I would advise you to stay away as well. Thought you'd want to know.

Serratus Anterior Exercises for Shoulder Pain Relief

The serratus anterior is an oft-neglected muscle of the shoulder girdle, simply because the average person doesn't know about it.  As a result, it can get weak disrupting shoulder joint biomechanics.

The serratus anterior attaches to the shoulder blade (scapula) and the thoracic cage (essentially the upper and mid-back).  It's main function is to act as a scapular stabilizer; in other words, when we do shoulder movements, particularly reaching over head, the scapula must get locked into place against the t-cage, allowing unimpeded movement.

When serratus anterior muscle gets weak, stabilization is lost, and it can lead to a number of dysfunctions, including shoulder impingement (very painful), and degeneration (even more painful).  The classic postural sign of a weak serratus anterior is the shoulder blade protruding at its medial border, or the edge closest to the spine.  "Winging," as it's called, is not an uncommon sight among thin women (in fact, I observe it quite regularly here in Hollywood and Beverly Hills), but plenty of men have it too.* 

The answer to a weak serratus anterior is to strengthen it with an exercise called a press-through (aka push-up with a plus).  The actual movement is called protraction of the shoulders, which is the exact opposite of retraction (pulling the shoulders back).  I prefer the weight-bearing version for the use of gravity to help strengthen the muscle, but some people are not strong enough initially to do that.  For those that need to build up to the weight-bearing press-through, there are two alternate versions they can do.

And some people have difficulty just initiating the protraction movement altogether.  For these people, the neurological connection to the muscle and that movement has been disrupted.  The wall version of the press-through is what I recommend to re-establish this neurological connection.

Watch the video below to see a demonstration of the best serratus anterior exercise (weight-bearing press-through), as well as instruction on doing the two alternate versions.  Remember to build up to doing the weight bearing exercise, as this will ultimately give you the strength you need to maintain proper shoulder biomechanics.  As a plus, you'll reduce winging, which will look better as well.

*Severe and one-sided winging should be checked by a doctor as it could signify a neurological lesion of the long thoracic nerve.

Diet Soda Linked to Stroke

Put down that can of Diet Coke, dear reader.  It can be harmful to your health. So says a study conducted earlier this year, that showed diet soda drinkers to be at an increased risk for stroke.

Some believe that by drinking the diet variety of soft drinks, they bypass the harmful effects of sugar, thereby making a healthier choice in their beverage selection. But many of us have suspected that diet sodas have hidden harms, despite the inability of nutrition researchers to find them. Some recent studies, however, have shown that diet soda drinkers not only gain weight, but they do so even more than drinkers of regular soda. Doh! And now stroke.

Researchers followed 2,564 people in the large, multi-ethnic Northern Manhattan Study (NOMAS). They collected soda drinking habits and followed the subjects for 9.3 years on average. They found that people who drank diet soda every day had a 61% higher risk of vascular events than those who reported no soda drinking. Researchers accounted for participants' age, sex, race or ethnicity, smoking status, exercise, alcohol consumption and daily caloric intake. And even after researchers also accounted for patients' metabolic syndrome, peripheral vascular disease and heart disease history, the increased risk persisted at a rate 48% higher.

Researchers believe the reason for the increased stroke risk has to do with sodium intake. A separate study showed that an increased intake of sodium also increased the risk of ischemic stroke (when a blood vessel blockage cuts off blood flow to the brain). Diet sodas contain between 35 and 40 milligrams of sodium per can. Not a massive amount by any means, but when multiplied by the numbers that many individuals imbibe in one day, and the sodium intake starts to approach dangerous levels.

The second study showed that individuals who consumed more than 4,000 milligrams of sodium a day had twice the risk of experiencing a stroke when compared to individuals with an intake of less than the recommended limit of 1,500 milligrams of sodium per day. Only a third of participants met the current U.S. Dietary Guidelines for Americans that recommend daily sodium intake fall below 2,300 mg, or about a teaspoon of salt. Only 12% of subjects met the American Heart Association's recommendations to consume less than 1,500 mg a day. Average intake was 3,031 milligrams.

Well I'm sure you can imagine me shaking my head in contempt. I just don't have tolerance for the liquid sugar habit picked up by the majority of Americans. If you can't see the writing on the wall--sodas (both regular and diet) cause negative health consequences like obesity, diabetes, rotten teeth and now stroke--then so be it. But stop thinking that diet soda is a healthier alternative to regular soda, because it's not.

Montel: Israel Step Ahead in Med Marijuana Practice/Study

Montel Williams is back in the news.  The former Emmy Award winning daytime talk show host is praising Israel, not for its politics or Palestinian relations, but for it's medical marijuana practices.  What?!?!  You heard right, Montel, the patient rights activist, is in Israel on a fact-finding mission to learn about its medicinal cannabis practices. He is meeting with legislators, scientists and physicians.

Montel Williams was diagnosed with multiple sclerosis (MS) in 1999 and has promoted alternative therapies in the past, like chiropractic (booyah!), but today it's medical MJ.  And he believes the U.S. can learn something from Israel.  "We need to get out of the dark ages and into the new ages," he told The Associated Press. "Not every patient can use cannabis, but for those who can--why deny it?"

In Israel, certain doctors can prescribe cannabis and even disperse them from their offices.  It is regulated, and many doctors prefer it as a lesser of evils when compared to narcotics for pain relief.  According to Itay Goor-Aryeh, the head of the pain management unit at the Sheba Medical Center in central Israel, "Those patients, if they do not get cannabis, they will get morphine-like drugs and other harmful drugs. I think that in many ways, cannabis is tolerated and is less addictive that morphine-based drugs."

Well, no duh!  Thank you Montel Williams for bringing this issue to the forefront and adding some credibility to the cause.  As a beneficiary of medical cannabis, Montel is in a perfect position to discuss the advantages of marijuana (and it's active compound, THC) in a serious and meaningful way.

Yes, Montel Williams, 55, says he has been taking cannabis on a daily basis.

"For me, there is nothing else that can do what it does," he said. "It helps me suppress my pain ... When I am not using cannabis I am thinking about my pain every 45 seconds."

And bravo to the Israeli medical profession for it's adoption of a benign yet advantageous drug that has much potential for pain relief, and maybe more.

I agree with Montel, the U.S. government could learn a thing or two from Israel in this regard.  If we don't start investigating cannabis as a pharmacological option, and instead we keep vilifying it, we may never know its full potential.  Fortunately, they are doing the research in Israel, so we may get our answers regardless.

Montel Williams is a hero to me.  He's been a champion for many of the same causes I have taken on in my own life, and for that I commend him.

New Paradigm: Screen Less for Cancer

Interesting happenings in the world of medical diagnostics, a new wave of responsibility and changing paradigms. A small but significant movement is being made away from routine screenings. Bravo! It's about time.  Nothing like a good ol' politicized "health care crisis" and a few creative thinkers to right a decades long wrong of over-using screening diagnostics.

For years, the school of thought in western medicine was to screen for diseases liberally, so that illness could be caught early-on and addressed. But just recently, some medical groups have cautioned against certain routine screens, warning that these tests have just as many harms as benefits. Today, experts recommend less screening for prostate, breast and cervical cancer, with the rationale that these tests do not necessarily change the overall outcome, and in some cases can actually lead to worse outcomes for the patient. Wow!

In the case of prostate cancer, it has been found that the widely used PSA (prostate specific antigen) test does not save lives, but can lead to aggressive treatment which is often unnecessary. The influential United States Preventive Services Task Force (USPSTF), which evaluates evidence and publishes screening guidelines, said that PSA screening often leads to what can be disabling treatments for men whose cancer otherwise would never have harmed them.

The same group two years ago recommended less mammography for women, particularly those under 40, whom the group says gain little if any benefit from the test. For women between the 50-74, the group recommends a mammogram every two years instead of yearly. As for cervical cancer screening, the group recommends Pap tests be done every three years now instead of annually.

According to the New York Times,

A new analysis of mammography concluded that while mammograms find cancer in 138,000 women each year, as many as 120,000 to 134,000 of those women either have cancers that are already lethal or have cancers that grow so slowly they do not need to be treated.

A little known fact is that we develop cancers all over our bodies throughout our lifetime. Thanks to our immune system, which does its own innate screening and surveillance continually, many cancers never progress enough to be a threat. Screening thus leads to premature human intervention, when leaving the body to its own accord is the most prudent approach (sound familiar?).

Evidence accumulated over the last ten years shows how little benefit these screening tests actually provide. Although not a total wash, widespread screening helps in very small numbers, not worth the risk or cost. One study has concluded that $5.2 million must be spent on screening to prevent one prostate cancer death, and the authors pointed out that that numbers is probably even higher than that when including all costs.

Despite the growing evidence, changing the early detection screening paradigm will not be easy. When doctors are groomed in a culture of prevention (at least according to the obsolete medical model still dominating western health care), no matter how convoluted the version, and that culture then seeps into the mainstream consciousness to such a degree that the public expects diagnostic screening, it will be a difficult hill to climb to change things. No matter how erroneous the principle behind wide-spread cancer screening, in terms of practicality for doctors, weaning the public, getting over the fears of legal liability and just breaking habit will take time.

I am personally pleased by this spark of light igniting in medicine. It is part of the new paradigm I have been pushing for the last decade. My message is not that medicine is bad, or that a great conspiracy by the pharmaceutical industry and greedy doctors is in play (although a small movement has formed today pushing just this notion), but that we are following a faulty paradigm in health care. Our emphasis over the last half-century has been to direct the processes of the body, which are normally controlled by Innate. And if I've said it once, I've said it a million times: The body knows how to run itself. Yes, it occasionally needs help, but not to the degree with which we apply medical intervention. The latest findings by the USPSTF, and the push toward decreasing some screening test is a step in the right direction.

Lat Workouts and Stretches for Pain Relief

Lat pull downs and chin-ups are favorite exercises of bodybuilders and other athletes.  Aside from the fine aesthetics of a well developed latissimus dorsi (the V-shape of a man's back), low back stabilization benefits also apply.

But chinning-up without stretching these massive muscles is a mistake, and it can lead to back pain, shoulder pain and even difficulty breathing.  In the video below, I demonstrate the best lat workouts and stretches for pain relief and prevention.  Further, stretching the lats just feels good.  It's one of my personal favorites.

Whether you have low back pain, a chronic shoulder pain or just tightness from working out, the stretch I demonstrate in the video will be sure to open you up and make both your upper and lower torso feel tops.  Enjoy.

Warning: Recall on Pine Nuts.

The FDA has issued a recall on Turkish pine nuts from bulk containers at Wegmans Food Markets, and also food items such as pesto, salads or baked goods that may have been prepared with the pine nuts.  Agency officials report that the pine nuts are imported from Turkey, and have sickened at least 42 people with Salmonella in seven states including California, Maryland, New York, New Jersey, Pennsylvania, Virginia and Washington.  Two people have been hospitalized for salmonellosis.

The CDC has reported 42 people sickened in five states--Maryland, New Jersey, New York, Pennsylvania and Virginia--and implicated pine nuts purchased in Wegmans bulk bins and prepared foods that included Wegmans pine nuts as an ingredient as the source of the outbreak.  The CDC mentioned Caprese salad and asparagus with pine nuts sold at Wegmans stores as possibly being contaminated with Salmonella.

A recall by the Wegmans grocery store chain was limited to 5,000 lbs of pine nuts sold in the bulk foods department of most of its stores in Maryland, New Jersey, New York, Pennsylvania and Virginia between July 1 and Oct. 18, 2011.  The CDC said labs in Virginia and New York have isolated the Salmonella Enteritidis outbreak strain from retail samples of Turkish pine nuts collected from a Wegmans store and from pine nuts and homemade pesto at outbreak victims' homes.  Federal, state and local health authorities are continuing to use the national PulseNet monitoring system to identify other reports of Salmonella infection that may be part of this outbreak. 

As I've reported in this blog, we're seeing increases in the number of food-borne illness every year, and they will continue to rise.  This latest recall of pine nuts on the heels of a cantaloupe listeriosis outbreak that has been the deadliest in modern U.S. history.  As of this writing, the 26-state outbreak is still in effect, and it might be some time before we can assess the final damage.  But, I digress--today, we're talking pine nuts.  Make sure to check your cupboards for the Wegmans brand, and if you unsure...toss 'em.  It ain't worth the puke.

CMA Endorses Marijuana Legalization

Another small victory for marijuana proponents, as the California Medical Association (CMA), is calling for cannabis legalization. The state association, which represents more than 35,000 physicians statewide, has taken an official position that despite its questionable medicinal value, marijuana should be made legal and regulated like alcohol or tobacco.  The CMA is the first major medical association to take that stance.


According to Dr. Donald Lyman, the Sacramento physician who wrote the group's new policy, the change in position stems from frustration over California's medical marijuana laws. As he explains, doctors are in a difficult position as more patients start to ask about marijuana's medical benefits, particularly for pain relief, but which is still an illegal substance under federal law. Dr. Lyman believes that the question of whether marijuana has medicinal value can only be determined by legalization and research.

But this latest statement by the CMA has stirred much controversy.  John Lovell, spokesman for the California Police Chiefs Association said, "Given everything that we know about the physiological impacts of marijuana--how it affects young brains, the number of accidents associated with driving under the influence--it's just an unbelievably irresponsible position."


Other doctors associations have voiced concerns as well. Dr. Robert DuPont, M.D. and professor of psychiatry at Georgetown Medical School, said the association's call for legalization showed "a reckless disregard of the public health. I think it's going to lead to more use, and that, to me, is a public health concern. I'm not sure they've thought through what the implications of legalization would be."

But the rationale from the CMA has merit.  Although they acknowledge some health risks to using marijuana, they believe that the consequences of criminalization outweigh the hazards. Dr. Lyman says current laws have "proven to be a failed public health policy." He cited increased prison costs, the effect on families when marijuana users are imprisoned and racial inequalities in drug-sentencing cases.

I tend to agree with the CMA, though I think they are taking the politically safe, yet smart, route by doubting benefits of marijuana use and playing up the risks, so as not to encourage recreational drug use, but also by pointing out, and rightly so, that the drug is benign...and it may have greater benefit than we know!  But we'll never find out if we don't open that smokey door.

Listen, I've said this repeatedly in this blog: There is no doubt that marijuana carries with it side effects (2 am Taco Bell runs for instance) physiological changes, but when compared to alcohol and tobacco--it's lite-weight. The warnings by police enforcement officials is about as convincing as Reefer Madness. C'mon. Regulate it, tax it, punish driving under the influence, and you've got an open revenue source. No way it'll lead to more chaos than booze...or pharmaceuticals...c'mon.

I am convinced that the ol' MJ will be legalized in California within ten years, maybe sooner.  And as Cali goes, so goes the nation. That's what the Heshers say, anyhow.

Obesity Goes Where the Money Goes

I wanted to address something I touched on last post--obesity as a condition of prosperity.  The obesity epidemic that we are witnessing today in western society is only possible in an environment of abundance.  I am not talking individual wealth here, but prosperity of nations; and American obesity statistics, and pretty much that of the rest of the world, support this claim.  Obesity is rampant in North America and Europe, with Japan and South Korea having the highest rates in the east.

But wait, what about the rising powers of China and India?  They are experiencing rapid economic growth, but have they an obesity epidemic?  According to a recent report, extreme fatness is making its way to India.  As India's economy grows, the middle class increases as well, and western fast food companies are smelling opportunity like they haven't since, well, 1950s America.

And which demographic do you suppose the fast-food industry is targeting?...You got it--youngsters.  Let's go to the Hop... Reports disclose that one in three children in private schools in New Delhi are obese compared with one in ten in government schools.


"Obesity is emerging in India which has serious implications for metabolic health in the future," says researcher Seema Gulati. "Schoolchildren are attracted to the way it (junk food) is advertised," she said. "They feel it is something that is high status. They want to try it out."

Exactly...convenience, good taste, high status, western, bourgeois, you know...you've been there America, but now look atcha: 30% obesity in most states.  That's not overweight...that's obese...and it's crazy.  And I'm certain the trend will continue in the East, as Asian countries get more powerful.

Brazil is there already, and India is on its way...China anyone?  We'll see.  A major 2010 study called "The Rise of Asia's Middle Class" by the Asian Development Bank warned that in the next 20-30 years Asia will be faced with "an increasing number of chronic diseases on a scale previously unseen".

Obesity is a natural consequence of prosperity.  As money flows, so does the drive for convenience, and nothing more convenient than ready-made food for the go.  Wealth comes from work--lots of it--and this means limited time.  We Americans know that lifestyle all too well--the burning candles, chasing sensory stimuli and seeking greater and greater conveniences--and how it can lead to greater excesses.  Ultimately these excesses cause problems, like rising chronic diseases and epidemics of addiction: food, drugs, sex, and so on.

Hey I'm not knocking any of it...just pointing out the truths of the bigger picture.  We can waste time looking for new and novel causes of obesity--heck, lots of money to be made there--but if we really wish to make a dent in the obesity numbers, then understanding how the condition arises and develops over time is a hell of a lot more useful than trying to create new fantasies about genes and hormones, especially as we see it unfolding in other cultures mirroring our own.  Let's put two and two together, find real solutions to help those that truly want them, and then maybe we might even pave the way for others to understand and resolve their own issues.  But it won't happen anytime soon if we continue to foolishly blame outside forces when the problem is completely man-made.