When I was little, my mother hardly ever bought us sugar cereals. Sure we used to get them on camping trips - sometimes - because of those handy little mini value packs, but if I ever really wanted a hit I had to swindle a bowl of Count Chocula or Trix from my friends.

Now as you all know, I get the Canadian Food Inspection Agency email alerts for undeclared allergies, toxins etc found in Canadian food. Anyways. Today there was an alert about a happy sugar cereal: Kellogg’s Holiday Froot Loops (why the bad spelling of fruit? why? does bad spelling just appeal more to children?).

It seems that our poor Kellogg’s has accidentally added some milk proteins to the cereal and omitted including this fact in their ingredient list. Which is somewhat ironic (and I admit made me laugh) because I’d say about 99% of people eating Froot Loops will add milk to their cereal anyways.

Now I realize, as an allergy sufferer myself, that this really isn’t a laughing matter. People could get very sick, even go into anaphylactic shock from eating a tainted Loop. But for me at least, it would be sort of like getting an alert that read: WARNING. UNDECLARED ALMONDS HAZELNUTS AND WALNUTS IN SKIPPY PEANUT BUTTER. Funny for me (as I am allergic to all of them), but it would send my brother (who is not allergic to peanuts, but allergic to the other tree nuts) to the hospital within minutes (not least because he eats peanut butter by the jar full).

So, er, what’s the moral of the story? Sign up for the CFIA Hazard Alerts or FDA notifications or whatever your country has to offer. Guaranteed to be life-saving or purely entertaining! Straight to your inbox!

A certain person in my life who will remain nameless - let’s just call him the Dude - gets pretty stressed out when he goes to the doctor’s office. Not that you could tell from the outside. Raised in the California sunshine, the Dude is seemingly as chillaxed and cool as people come. But one step inside the medical clinic and his blood pressure goes through the roof. Which makes it pretty hard for a doctor to assess his actual blood pressure.

Funnily enough this syndrome actually has a name - White Coat Hypertension. The term was coined in 1983 by Giuseppe Mancia and his colleagues at the University of Milano-Bicocca in Italy after they showed that blood pressure can drop 27/15 mmHg (millimeters of mercury) after a doctor leaves their patient’s hospital room.

So today, the Dude is sporting a portable blood pressure cuff that will measure his asystolic/diasystolic pressure for 24 hours as he moves through his normal daily routines. This is called ambulatory (walking) blood pressure monitoring, which some cardiologists argue is the single best predictor of cardiovascular disease/damage/mortality compared to doctor’s office/casual at-home readings. Nice.

It will be interesting to see the Dude’s assessment; white coat hypertension was previously thought benign, as blood pressure drops to normal once the patient leaves the doctor’s office. But a growing body of evidence suggest that those who with WCH might be at increased risks of cardiovascular disease. For example, a 1996 study in the Lancet found that patients with WCH show similar cardiovascular functioning/abnormalities to those with consistently raised blood pressure. Likewise, the 1998 paper from the British Medical Journal found that patients with WCH had thicker walls surrounding their left (whole body pumping) ventricle. This is a sign of heart stress/over working.

Bad.

So if his BP profile is like, low and healthy and healthy all day long and really only spikes with an MD in the room, then maybe he can escape treatment. But if he’s edging towards the upper boundaries of normal (between 130/80 to 140/90) does this mean pills/a salt-free diet for the Dude? Well maybe he could just try transcendental meditation? 

With all the happy family Thanksgiving times, I hung out with a lot of people who were pregnant or rearing tiny babies or both. At one point the conversation slipped to the dos and donts of preggers eating habits. It was unanimously confirmed that one should not eat sushi while pregnant, as the raw fish may contain parasites or pathogens that are harmful for baby. And no fun for you, of course.

Now let’s be clear here...I am not sure if I could actually go 9 months with no sushi. I am not sure if I could go 9 months without booze, but I guess I’ll have to do that too. One day in the far far in future.

But this all made me think..why why why with the no raw fish? I know that raw shellfish, disgusting filter-feeders they are, are likely to harbor toxic bacteria, such as paralytic shellfish toxin.

But why raw fishies? Sure they can have tapeworms and other wormy parasites? But a little deep freezing will deal with that.  And come on. If you eat at a restaurant called Sushi King, aren’t you just ASKING to get salmonella? And those darned Vibrio bacteria outbreaks..well...er....isn’t it WORTH the risk? I mean honestly...wouldn’t you just die for a nice spicy tuna roll right now (can you tell I haven’t had dinner yet?).

I guess I could just eat California rolls, unagi rolls and all the vegetarian rolls I can handle. That wouldn’t be so bad. Now only to find a fetus-friendly substitute for bourbon.

My desk is a total bleeping mess. I’d take a picture but it’s too horrible. Instead I can show you what it looked like many moons ago and tell you that It’s gotten exponentially worse since then.

So it’s quite obvious to me that I need some help - along the lines of the pretty desk organizing thingys they sell at The Container Store (go there and exclaim with me: “oooooh")- which alas, does not have a presence in this frozen land of igloos and dog sledding. Damn them.

So I turned to my cheap local alternative, Staples. But the ugliness of their Rubbermaid desk organizer ($4.55) wanted me to petition my local MP for style laws. Honestly, the only thing I want in Rubbermaid is my lunch, and increasingly less of it what with all the plastic leaching scares.

So I tried using my finely tuned google skills to hunt down some what stylish office accessories in Vancouver. And I opened up all these links in different tabs when I heard the voice of God emerge from my computer. I hopped around my tabs to find Him. That’s when I realized that the innocuous website http://www.details-worktools.com was in fact a company pushing the whole ergonomic and healthy work place idea to fight rampant obesity and the ensuing health problems.

(Related: “Introducing the At-Work Workout” March 14, 2007)

Like all other people in the annals of history who hear the voice of God I hastened to preach His gospel and emailed my officemates. Needless to say His Walkstation idea was a big hit (the company really likes plays on words I can tell. They also sell AdjusTables - get it?). And when one of them came across Lifehacker’s recent post about how Prolonged Sitting Causes Disease we were fast to recognize this coincidence for what it truly was: Divine intervention.

So here’s the word from on high. Even if you get the recommended 30 minutes of activity per day it’s all for naught if you sit on your tush for the rest of it. Simply standing up can more than double your metabolic rate. Hence the AdjusTable.

Here’s the study press release over at Eurekalert.

VIA Lifehacker

(Thanks Jonathan!)

So I just read this essay from the Economist about the rise of user-generated content HEALTHCARE sites. I mean we all Google our health concerns (thankfully an activity that is surprisingly accurate..so much that Google might develop its own health-tailored search engine), but here we are talking about organized forums for people with focused health concerns sharing stories and providing information.

I mean COOL. if I had a rare genetic disease - say Fish Odor Syndrome, which Katie and I discovered last week on a weirdo documentary - I’d want a place to discuss with other sufferers about their experiences and treatment plans. Such databases of people could also be really useful for the research community.

So all in all just kind of a warm fuzzy web 2.0 moment here. Diagnose, share, take pictures. It’s all about community, see.

(PHOTO: MELIHA GOJAK)
I’m a major potato skeptic. I say this knowing that many of my dearly beloved friends are potato adorers and will be hurt by this news.

But I dunno. I mean, I love a potato but as Anna and I discussed once, if I had to pick one member of the starch family, bread or rice would top my list. Sure I love a good potato whether it’s fried, mashed, in a bag or fingerling sized but I’d rather have pizza dough and sushi rice.

So imagine my horror to find that the BBC picked potatoes as the poster child for the news story “Starch ‘fuel of human evolution’.” They worked hard to justify their choice in the caption by saying that “the average Brit eats 500 medium-sized potatoes each year.” Still, the BBC’s audience these days is the world which I think is dominated by rice eaters these days. It’s the rize of riz people.

Regardless, the story is neat. Humans apparently have extra copies of the genes that produce the enzyme amylase, which is body’s first line of attack against starch (read about Anna’s DIY home experiment which studied amylase’s effect on jello-O pudding here). And the more a group of humans eat starchy goodness, the more copies of the AMY1 gene that makes salivary amylase they have in their genome. Or so George Perry and an army of scientists reported in Nature Genetics.

For example, the Yakut of the Arctic, whose traditional diet centres around fish, had fewer copies than the related Japanese, whose diet includes starchy foods like rice.

Essentially the moral of the story that I gleaned from the study goes like this: “Atkins, you’re full of bull, because there’s no way some unwieldy early hominin was lithe enough to feast on meat 24/7. It’s far more likely that they uprooted tubers with their newly minted fingers to fuel their rapidly growing brains and their ensuing rise to smoother bipedalism and worldwide domination.” But that just might be me. 

The last year or so that I was living in Britain, you couldn’t watch the news without seeing at least one story about a woman campaigning their local National Health Service to receive the wonder breast cancer drug Herceptin. The drug was new and very costly ((21,000 pounds per year in the UK, around $50,000 in Canada) and not yet approved in the UK. But Roche, who makes the drug, had its PR claws out, informing women about the treatment, who then took their cases to the highest courts in the land (the media, of course); in one case the health minister actually intervened to give a woman Herceptin. It was a PR nightmare. The drug was approved months later by NICE, the body that decides which drugs are cost effective enough to be offered on the NHS.

While controversies still swarm around the drug in both Canada and the UK - mostly due to its high cost and how to fund it - one thing is certainly not debated: current evidence suggests that Herceptin really works. This 2005 analysis from the New England Journal of Medicine found that Herceptin and chemotherapy together could reduce recurrence by 52% and death by 33% in two years of follow up. In January of this year, a study from the Lancet in the UK found that women given Herceptin for early stage breast cancer found similar results (34% reduced risk of death, 36% reduction in risk of new cancer events). 

I mean WOW! 50% reduction in future cancer events. That’s awesome!

But what about the fact that you can also get a 50% reduction in relapse of breast cancer just by eating at least 5 servings of fruit and vegetables a day and doing 30 minutes of walking, six times per week. Yes, you heard me...the WHEL study, (this segment on about 1500 women) on dietary patterns and breast cancer survival, found that women who follow this moderately health lifestyle (about a third of their group did) can do just as much for their cancer survival prognosis as by taking Herceptin. Their 10-year morality rate was just 7% - half that of women who ate less fresh produce and/or did less exercise.

But, you see, there is no miracle pill here. There is no powerful pharmaceutical company with a multi-billion dollar marketing budget to ACTUALLY CALL UP WOMEN PERSONALLY and tell them what a healthy lifestyle can do for them. Nope. And really, it’s pretty hard to get people excited about incredibly boring sensible advice. Wouldn’t it be hilarious to see a lawsuit from women who said that gym memberships were too high? Work days too long? Vegetables and fruits prohibitively expensive? The streets not safe enough for walking after dark? A dearth of bike paths?

I am not saying that women should be told just to exercise, eat an apple and pray; Herceptin can obviously save the lives of women facing more very aggressive cancer. But the imbalanced perception of a “miracle” drug versus the impact of lifestyle changes kind of cheeses me off.

You know how American politicians (at least the Democrats) and health care advocates are always on about what an AWESOME deal Canada gets on its prescription drugs because of collective government bargaining with drug companies instead? Well....now Canadians are all going on about how much better the New Zealand government haggles with BigPharma because they do it on a NATIONAL level and Canadian drug programs are administered by individual province. I guess the grass IS always greener. Especially when comparing yourself to a small island nation with annual rainfalls in excess of 10,000 millimeters per year in some places.

I digress. This nation-wide bargaining has obvious payoffs: on average, New Zealanders pay 50% less for common medications such as cholesterol-lowering statins and SSRI antidepressants than Canadians. That’s a big ol’ difference and if Canada can adopt a national registry of drugs, then DO IT.

But see here’s what I think. Big Pharma is all about being nice to a nice country hanging out alone at the bottom of the Pacific. Reducing prices even further for a country that likes to sell its already pretty cheap drugs via the internet to the Cash Cow* that is their southerly neighbor? Not so much.

*moo

Yesterday a study was published in the New England Journal of Medicine all about how our social networks seem to influence whether we become obese - or lose weight (free full text if you want it). It was an opportunistic study that used the data from the 12,000 people in the long term Framingham Heart Study in Massachusetts. For this particular analysis, they used 32 years worth of data.

By analyzing the BMIs of friends and family over time (who were given as emergeny or information contacts in the original questionnaires), the team found that people who gain weight seem to drag their friends with them.

My first reaction was, well OF COURSE that makes sense. Obesity, while containing a large genetic quotient, tends to be about lifestyle choices. Lifestyle choices tend to be shared by social circles; social circles tend to be in the same geographic or socio-economic neighborhood, which is also a predictor of obesity...and badda bing badda boom! A bunch of fat friends.

My interest was actually piqued upon reading the New York Times this morning, and finding they had a discussion board about the story they ran on the study yesterday.

The discussion board is TERRIFYING. I’ve read most of the comments; I COULD NOT PULL MY EYES AWAY. There certainly are a lot of people in America who are angry about obesity - either because they themselves feel attacked, stigmatized and blamed for their weight OR because they just want obese people to quit eating Ho-Hos and go for a walk already. In fact, many of commenters criticized the study because it was just so OBVIOUS, that it couldn’t possibly be, like a REAL cause of obesity or whatever. There were few level heads to go around.

A large portion of writers were angry about this study because they found it to be, yet again, more blame, another reason to steer clear of fat people and rightfully mock them. One person said they felt like they might wake up tomorrow and have less friends. Others attacked the study as pseudo-science, anecdotal bullshit, STOOPID (sic). One man even demanded that the lead author pay back the money he received to conduct the study.

Most seemed particularly angered by the use of the word “contagious”. And I agree, it might not have been the most prudent choice of words from the NYTimes. And suggesting you ditch your fat friends is, urm, kind of mean. But what is shocking about the scaling up smaller social experiments on eating habits to a longitudinal, epidemiological approach?

I mean:

1) This study from 2006 found that people eat more when they are in the company of their friends, not strangers or alone.
2) Or take this 1994 study, which found that family dinners are larger than solitary meals, and friend-social dinners are larger and of longer duration than solitary meals; and longer duration meals = more food intake.
3) Meals size increases by a power function to the number of co-eaters and we can eat up to 75% more with lots of friends or family compared to when we are alone.

It’s not to say that fat is contagious, but social forces are obviously HUGELY powerful determinates of how much we eat, when and where. And just as important a part of understanding the rise in obesity as genetics, food availability, portion sizes, the shift to more sedentary jobs, cars and suburbs. And lambasting a study because it made you FEEL BAD, is not appropriate criticism.

(PHOTO: RASHMI SINHA/NCI/FOOD AND CHEMICAL TOXICOLOGY)

So I recently wrote a story for the LA Times on the dangers of barbecue. In a nutshell: reserachers find that chemicals form during hot cooking (grilling) of meaty foods, and in barbecue smoke that cause cancer and bad stuff, but you have to eat a lot of well done meat to see the effects. But certain genetic variance in the speed of certain metabolism enzymes can seriously up the risk. Still you probably need to to eat well or very-well done meat on a regular basis to see the increase in breast, prostate, stomach and colorectal cancer.

But what IS well done? One thing I didn’t mention in the article was the database of carcinogens (heterocyclic amines or HAs) that has been developed by Rashmi Sinha and her colleauges at the National Cancer Institute. Sinha has spent a large part of the last decade cooking burgres, steaks, pork cutlets, chicken breasts, whole chicken, hot dogs and sausages to different degrees of doneness and then measuring the levels of certain HAs. Very well done barbecued chicken breasts are the worst, if memory serves.

Anyways.

To compliment the database Sinha developed a series of flash cards that showed the inside and outside colour of cooked meats so that they could get a better idea of HA consumption from people answering survey questions. With every survey came the cards and so the science was improved.

So take a look at the above examples. And then make sure you always answer "1" until the end of time.