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Lifestyle and habits

The Reason for Obesity Is not Rocket Science

The reason for obesity is not rocket science.

As this recent article in The New York Times points out, weight gain takes place when one consumes too many calories, and Americans are consuming more calories today than in the past. This increase in calories, not offset by an increase in activities and use of the calories, causes weight gain through storage.

We obsess and ruminate about what we eat, in the nonsensical belief that it matters when it comes to weight. Anyone who has taken a physics course understands the First Law of Thermodynamics: “Energy can be changed from one form to another, but it cannot be created or destroyed. The total amount of energy and matter in the Universe remains constant, merely changing from one form to another.”

In the case of calories, the energy is either used through metabolism or it is stored in the body and one gains weight. If one wants to lose weight, the solution is simple – consume fewer calories or use more energy. Whether the calories are consumed in carbohydrate, protein, or fat – it is calories being consumed. Whether one eats vegan, shops at Whole Foods, eats from their own garden, or buys fast food at McDonalds, one’s weight is a function of how many calories are consumed vs. used. “Healthy” foods don’t lead to health, and processed foods don’t cause damage if consumed in moderation.

The reasons that we consume more than we need are indeed complex and one can point to culture, government policy, marketing and more. These externalities can and do influence individual choice but in the end it is individuals who make the choice to consume. Obfuscating the reasons for obesity with delusions about diet is attractive to many. Education on the root cause is key to changing individual and social behaviors, and it starts with basic science.

How to Deal with Illness & Death

In a recent Wall Street Journal article, “A Better Journey to the Final Exit,” reviews three books that address interesting issues regarding illness and death.

While these two subjects are often painfully uncomfortable topics of discussion, three authors confront specific issues that may help prepare us for the “final exit”.

The first book, “Happier Endings,” by Erica Brown proposes that even joy and inspiration can come from death. She shares stories of how other cultures deal with death through rituals or spiritual traditions in order to prepare and accept death’s inevitability.

Another book, “In the Kingdom of the Sick,” sheds light on the social history of chronic illness in America. Laurie Edwards, a science writer who suffers from chronic illnesses herself, seeks to bridge a communication gap—between society and the chronically ill.

After extensive research, the book questions whether stress, depression and anxiety (fueled by purported medical information on the Internet) create psychosomatic patients who merely believe they have certain illnesses or whether their ” stress and depression might result from the isolation and anxiety of having legitimate symptoms dismissed. If patients felt more supported and doctors “less besieged” in their first encounters in the doctor’s office, Ms. Edward says, physician-patient collaboration could narrow the gulf between patient and healer.” Read More…

The last book, Letty Cottin Pogrebin’s “How to Be a Friend to a Friend Who’s Sick,” is a guide to bedside manner for friends and family. She explains that while most family and friends mean no harm when trying to console or talk to loved one who is ill, many commit major bedside manner faux pas out of discomfort.

In her recent essay, “What to Say to a Friend Who’s Ill,” she provides a detailed account of  inappropriate things people say to their ill friends out of nervousness and discomfort. She also provides a list of the “10 Commandments for Conversing with a Sick Friend” :

1. Rejoice at their good news. Don’t minimize their bad news.

2. Treat your sick friends as you always did—but never forget their changed circumstance.

3. Avoid self-referential comments.

4. Don’t assume, verify.

5. Get the facts straight before you open your mouth

6. Help your sick friend feel useful.

7. Don’t infantilize the patient.

8. Think twice before giving advice. .

9. Let patients who are terminally ill set the conversational agenda.

10. Don’t pressure them to practice ‘positive thinking.’

Read More…

A Compassionate Surgeon & Friend

David Hanscom, MD, is a long-time friend, colleague, and neighbor in Seattle. He is also a noted orthopaedic spine surgeon.

David has a personal story about his own experience with chronic pain and recovering from it. He has dedicated his professional life to understanding chronic pain in a holistic fashion.

He is a surgeon who is judicious and very conservative, especially when it comes to addressing pain.

His personal website outlines his own methodology and is highly recommended.

We invite our readers to visit his website and read his book:

www.drdavidhanscom.com

Back in Control: A Spin Surgeon’s Roadmap Out of Chronic Pain

Junk Food is Not an Accident

By Brian L. Grant, MD

Every so often a book is published that impacts how we live or at least how we see our world.

The new book “SALT SUGAR FAT, How the Food Giants Hooked Us”, by Michael Moss may be one of them.

Like “The Jungle” by Upton Sinclair, that exposed the abuses of the meatpacking industry on immigrants in 1906 or “Fast Food Nation” by Eric Schlosser, that helped expose the abuses of factory farming of animals that help make today’s fast food – this new book by Moss describes how the fast food industry has succeeded in creating products that compel consumption, contributing to our current obesity epidemic.

Moss is a reporter for the New York Times. Excerpts of his book appeared in the New York Times Magazine on February 24. In addition, we have included the recent review of his book from the New York Times, and a link to the Amazon description, author interview and reader reviews.

Marketing and research work. We are persuaded to consume, to embrace styles and brands, and otherwise spend our money based upon real or perceived values and needs, informed by marketing efforts. In most cases the only damage is to our wallet if we consume goods or services that we don’t need. And many times what we get is quite useful and valuable.

The food industry faces a challenge. The success of food marketing requires food consumption. The more successful the marketing is, the more food is consumed. This consumption, especially of the sorts of processed foods that the global giants create, is a driver for obesity.

To quote the review:

“…that is the nub of Mr. Moss’s case: By concentrating fat, salt and sugar in products formulated for maximum “bliss,” Big Food has spent almost a century distorting the American diet in favor of calorie-dense products whose consumption pattern has been mirrored by the calamitous rise in obesity rates. Entire food categories were invented to support this strategy (Mr. Moss is particularly fascinated by Kraft’s near-billion-dollar line of Lunchables snack trays), as processors bent the American appetite to Wall Street’s will.” Read More…

Read the article, the reviews, and the book. After doing so, you may never enjoy Cheetos or Dr. Pepper quite as much.

Is Dr. Oz Abusing His Pulpit By Promoting Nonsense?

Dr-Mehmet-Oz-300x241The detailed and lengthy New Yorker article, “Is the Most Trusted Doctor in America Doing More Harm than Good?” profiles Dr. Mehmet Oz, a cardiothoracic surgeon and television personality.

Dr. Oz is a clearly talented, smart, and charismatic man who, with the help of Oprah, is considered by many to be “America’s Doctor.”

In medicine there is a continuum between hard science, that which can be objectively observed and tested, so-called ‘art’, and unsubstantiated beliefs masquerading as science.

A warm touch, good listening, and a smile by a physician feels good and can instill confidence, but does it heal in the same way that an effective antibiotic or surgery does?

There is certainly no harm in being a good person and given the nature of many illnesses, conveying warmth while the body heals itself may be more than enough.

But promoting amulets, strange foods, and other hocus pocus presented by charlatans does a disservice to society. Oz appears to personally promote unproven products and their promoters in his show – conveying an irresponsible and unearned aura of legitimacy. It appears he has embraced celebrity at the expense of credibility and his millions of fans are none the wiser.

The Difference: Looking Healthy vs. Being Healthy

Every January, millions of people resolve to change their habits of years past in hope of making better choices for the new year.

And while vowing to become debt-free, to quit smoking, or to be more organized rank among top resolutions, statistics show that the No. 1 goal for millions of Americans is to lose weight.

After reading the New York Times article “Our Absurd Fear of Fat,” the author addresses our nation’s obesity epidemic and poses an argument about a key issue: What truly makes someone healthy?

The author proposes that our nation’s definition of “normal” or “healthy” weight may not be supported by medical literature. He states that a study by Katherine M. Flegal and her associates at the C.D.C and the National Institutes of Health, found that:

“All adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals…The study found a 6 percent decrease in mortality risk among people classified as overweight and a 5 percent decrease in people classified as Grade 1 obese, the lowest level (most of the obese fall in this category).

This means that average-height women — 5 feet 4 inches — who weigh between 108 and 145 pounds have a higher mortality risk than average-height women who weigh between 146 and 203 pounds. For average-height men — 5 feet 10 inches — those who weigh between 129 and 174 pounds have a higher mortality risk than those who weigh between 175 and 243 pounds.”

With so many mixed messages about what “healthy” looks like or entails, it is often difficult to create a realistic goal about our weight. On one hand, we are trying to reverse our nations obesity epidemic, while on the other, we are also trying to combat our nation’s unhealthy obsession to be overly thin.

We invite our readers to comment on what they think about this article and share resolutions that have helped kick-start the new year in good health.

Social Media: Can It Really Change Our Number of Meaningful Connections?

by Brian L. Grant MD

This fascinating article describes the size of social networks that societies generally adapt.

I was struck by how accurate it was in my life, comparing my own holiday card tradition with the experiment cited by the author. In his case, the average number of cards sent out by individuals was about 150.

In recent years, I have engaged in an annual ritual of sending a holiday card to a number of people, hand addressing the envelopes and using a real stamp – a very analog task in my otherwise digital world. How many did I send this past year?

About 150 plus or minus 10%. These comprise of family, close friends and acquaintances, a few colleagues and some closer co-workers. It is a small subset of the many people that I know. But as the article states, they likely comprise a good portion of the people I would feel comfortable having an impromptu drink with.

It appears that 150 is a size that many groups limit themselves to for a variety of purposes. Facebook, which I rarely use at any meaningful level, lists that I have 274 “friends,” and I have 572 “connections” on Linked In, many of whom I accepted an invitation from, but I would not know if they walked up to me.

Cognitively, regardless of how far technology may extend us, our ability to relate closely may be limited by our biology.

Risks and “Dangers” of Marijuana Legalization?

Overall evidence for dangers of marijuana do not support continued criminalization.

Steadily it appears that its use will be permitted, though there remains a disconnect between state laws liberalizing possession and growing, vs. federal standards that at least as written, continue to criminalize use and distribution.

As the matter evolves, we should not be naïve to the potential risk of users abusing and developing an addiction to marijuana and its potential impact on cognition, and youth, especially when not used in “moderation.”

A New York Times article, “Legalizing of Marijuana Raises Health Concerns,” states:

“While marijuana can be addictive, scientists generally agree that fewer than 10 percent of marijuana smokers become dependent on the drug, compared with 15 percent for alcohol, 23 percent for heroin and 32 percent for tobacco.

Marijuana does contain carcinogens, including tar and other toxins similar to those found in tobacco, but people generally do not smoke marijuana in the same amounts as cigarettes. Still, legalization takes health consumers into murky territory. Even though marijuana is the most commonly used illegal drug in the United States, questions about its health effects remain.”

Sounds like the same risks, more or less, of many other legal substances, consumed in excess or misused, including alcohol, prescription drugs, and/or firearms. Whether society should outlaw substances and products that can be used with little risk or high damage is a question that is increasingly being answered at the ballot box.

Should Sperm Donors Have to Pay Child Support?

When should the biological father be held financially accountable for a child born from his sperm?

A recent Kansas case demonstrates the collision of the imposition of a medical standard on a decidedly non-medical act.

A number of issues arise in reproduction — individual rights to control their own bodies and reproduce as they see fit, society’s right to ensure financial accountability for children when the custodial parent can’t or won’t provide adequately, the child’s right to adequate care, and the mother’s right to seek child support from the “father” of her child.

There is nothing high tech about sperm donation, but we do face many complex scenarios in cases of assisted reproduction via In Vitro Fertilization using donor eggs and other variations on the old fashioned way of getting pregnant.

Sometimes the situation flows from a simple belief on the part of man and woman who procreate with no intention of having an ongoing relationship who make a verbal agreement that the father will not be responsible for the resulting child, believing the agreement will hold.

I am not aware of a situation where the mother gives up the child to the father with a similar understanding of lack of subsequent responsibility, but could see it happening. People can and do change their minds, especially when the economic burden of raising a child is no longer an abstraction.

Legal adoption appears to be the only situation where one can reasonably and consistently assume that one’s responsibility as father or mother for their child given up, is safe, across all jurisdictions.

In other situations, as the case above, it appears to be “donor beware.” Mothers and the state routinely may seek child support from a father regardless of any prior understanding and, apparently, even with a written contract.

To the degree that the interests of the child, who is not a party to such contracts, bear weight, this may be understandable, if not wise.

Any man asked to help a woman get pregnant who does not want to be psychologically or economically responsible for his offspring would do well to either say no, or seek legal advice in his state.

The father in this case may pay dearly for his ignorance, despite his good intentions.

For Holiday Cheer, We Made MCN Beer!

By Erik Madrid

As the popularity of craft beer amongst drinkers everywhere continues to rise, so does the popularity of an age-old hobby: homebrewing beer.

In a report earlier this year, the American Homebrewers Association estimated there are approximately 1 million Americans currently brewing beer at home.

Homebrewing beer has many benefits:

  • It is a fun and affordable hobby
  • It allows beer enthusiasts to learn much more about beer
  • One can be much more creative in making the beer they want to drink
  • It’s a good way to make sure there’s always a supply of fresh quality beer on hand

At the MCN Corporate Office in Seattle, three of the company’s employees collaborated on homebrew recipes this past year – Erik Madrid (Physician Recruiting Manager), Erik Halse (Peer Review Product Manager), and Aaron Schultz (Accounts Receivable Coordinator).

Team Rainwater Brewing (as they’ve dubbed themselves) collaborated on two batches of homemade beer served at the company holiday party. On tap at the corporate office were seasonal Gingerbread Ale and an IPA (India Pale Ale).

The basic ingredients used in Gingerbread Ale and IPA.

Both the crafting of a recipe and the process of brewing beer can be as simple or as complicated as the brewer decides to make it. The four core ingredients making up any beer recipe are: water, malted grains, hops, and yeast. Simple enough, right? Not so much.

There are hundreds of unique types of grains and hops and several different strands of yeast to choose from. Mixed and matched in different quantities, and brewed using a wide variety of methods is what allows for such a diverse mix of beer styles; and is why within any one style, two beers can have incredibly different flavor profiles.

Factor in optional ingredients like fruit or spices and the possibilities are truly endless. Some extreme brewers craft delicious recipes using outlandish ingredients like jalapenos, bacon, and oysters (yes, oysters!).

The basic steps of homebrewing beer: 

Erik Halse (left), and Aaron Schultz, (right) check the H2O Temperature for the Mash.

The Mash: The grains are mixed with hot water (typically between 148-155 degrees) and allowed to soak/steep for one hour. This process is called the mash, and is done in a mash tun. During the mash, the grains are broken down and the fermentable sugars are extracted from the grain.

Homebrewers often use converted water coolers with false bottoms to easily maintain the temperature for the duration of the mash and then strain the liquid off.  After the initial mash is drained, additional hot water is added to the mash tun to rinse off any residual sugars – a process called sparging. The mix of malted grains make up the backbone of the beers flavor profile and contribute the color to the beer.

The Boil: All of the sugary liquid (referred to as wort: unfermented beer) from the mash and the sparge are collected in a kettle and brought to a boil. The wort is boiled for at least 1 hour, which allows for any of the naturally occurring micro-organisms and bacteria living in your water or the grains to be boiled off.

Erik Madrid, a homebrewer for a year and a half, has already brewed over 25 batched of beer.

The other big part of the boil stage is the addition of your hops, spices, or other adjunct ingredients (honey, fruit, etc) and getting all those flavors to come together just like a good soup.

The frothy wort of the Gingerbread Ale.

Hops contribute 3 key elements to beer: bitterness, aroma, and their natural preserving qualities. Hops added at the beginning of the boil contribute more towards bitterness and flavor; while hops added to the end of the boil contribute mostly towards aroma.  You can take 1 variety of hop and get a totally different flavor and/or aroma in your beer depending on exactly when and how much you add during the 60 minute boiling period.

 

 

Pitching the yeast: Yeast is a living organism whose role in making beer is to eat all the fermentable sugars, poop out alcohol, and fart out CO2. The 210 degree temperature of boiling wort would kill the yeast. Most strands of yeast used to make ales prefer temperatures closer to room temperature. Once the boil is finished the temperature of the wort is quickly brought down to a range ideal for the yeast being used. anitization of all equipment becomes crucial at this point and for every stage from here on out. The chilled wort is transferred from the boil kettle into the fermentation vessel, at which point the yeast is added (pitched).

Fermentation: A restaurant grade bucket or a glass carboy are the most popular fermentation vessels used by homebrewers. Once filled the fermentation vessel is sealed off with a plug and an airlock that allows some C02 to escape while the yeast is actively eating through all the fermentable sugars, but prevents any bacteria from entering the fermenter. For most standard alcohol content ales, your typical fermentation takes about 2 weeks.

While optional, most brewers prefer to transfer their beer from the first vessel to a secondary fermenter. In doing so, spent yeast that settles to the bottom of the fermenter is left behind, preventing the dead yeast cells from imparting any unwanted flavors in the beer.

Gingerbread Ale bottled for secondary fermentation.

Getting the beer off his sediment also improves the clarity in appearance. These stages are referred to as primary fermentation and secondary fermentation.

Bottling or Kegging: Once fermentation is complete, the beer is siphoned into either individual bottles or a keg to be carbonated and then served. Carbonation will occur naturally in bottles, as there is still a small amount of yeast eating the last of the sugar content in the beer, but now the C02 created is no longer allowed to escape.

Using the bottling method takes between 2 and 4 weeks for the beer to properly carbonate and prime. Alternatively, the beer can be transferred into a keg and hooked up to a C02 tank for force carbonation. A high amount of C02 pressure is infused into the keg for a couple days until the desired carbonation level is reached.

MCN Holiday Beer Ready to be served!

Drinking: If you can’t figure this part out for yourself, we’re in trouble! Now, if you’ve gotten this far and haven’t become thirsty enough to grab a beer, then you must be at work.

Seriously though, give any beer you’re drinking the justice it deserves and pour it into a glass before consumption. The aroma and the color are part of the experience, and you just can’t get that from the bottle.

If you’re drinking a homebrew, remember to leave the last little bit behind in the bottle – the residual sugars and yeast that have settled after carbonation is complete are not the last thing you want to remember about the beer.

 

For the MCN Holiday Party, Aaron and the Eriks have brewed up a Gingerbread Ale and an IPA. The Gingerbread Ale is a Brown Ale with nutmeg, cinnamon sticks, cloves and candied ginger added throughout the boil to create a flavor and aroma profile very similar to gingerbread. The IPA was brewed with a mixture of a variety of hops to create a nice crisp and bitter flavor profile typically associated with a good Northwest IPA.

Interested in homebrewing? Ask Team Rainwater about equipment, recipes, tips, and more at MCNTalk@mcn.com or comment below.