Unhealthy Food Choices: Privilege or Right?

This photo was featured on the L.A. Times opinion blog referenced below. I'm using it here to illustrate a point.

Today's rant is brought to you courtesy of an L.A. Times opinion blog post that one of my friends shared today on Facebook. For those of you short on time or interest, I'll spare you the details and get to the point: A Florida senator wrote a bill to restrict what recipients of federal aid can buy with that money. By federal aid, the senator means food stamps or what we call "EBT" where I live. The bill would prevent the use of EBT in restaurants or on most foods not found in the meat, dairy and produce aisles. The Times' editorial board has called the bill socialistic. Some Times readers commented that recipients of food stamps are eating on the taxpayers' dime and therefore, don't have the luxury of free will when it comes to what to buy.

The Times hasn't asked what I think, but I have my own blog so I get to share my opinion anyway.
I have never set foot in the state of Florida so I can't speak to its system. But I am a native of California's Central Valley and know a thing or do about how public assistance works here.The food-stamp program has changed a lot over the last few years. Marketing efforts have given it a new image. It's now officially called CalFresh, which complements CalWorks, the new name for cash aid. If you visit the CalFresh website, you'll see the state wants recipients to make good food choices and strives to educate them on how to stretch those free food dollars the furthest. In addition to being able to use your EBT card at Jack in the Box, you can also use it to buy cheap fresh fruits and vegetables at our local farmers' markets. Welfare has come a long way, baby!

Despite all this education and glitzy marketing, obesity still reigns supreme. Local university researchers are amazed at the number of children with obesity-related co-morbidities such as high blood pressure and Type 2 diabetes. Sadly, most of those obese children come from homes with CalFresh assistance. And their obesity is evidence that healthy eating is not the norm. This proves that education (the Times' suggested solution) alone is not the answer. Knowing what to eat and feed to your family and actually taking the time to do it are two different things.

My knee-jerk reaction is to say forget choice and dictate every singe morsel purchased with public funds, if for no other reason than to serve the taxpayers' best interests. Obesity is expensive. Obese children become obese teens and later, morbidly obese adults. Obesity-related illnesses are expensive to manage and treat. But that reaction comes from the perspective of my inner 200-pound child, who still remembers the emotional and physical challenges of growing up poor and obese.

As much as I want to save our future generation from the curse of obesity, I know that children are at the mercy of the adults in their lives. American adults will stop at nothing to get what they want when they want it. I can remember as a child, seeing people in the grocery store parking lot trade food stamps for cigarettes. If this Florida bill were to gain steam and become law, food-stamp recipients wouldn't instantly become Jamie Oliver's newest converts. They would just find a way to trade those EBT dollars for the unpermitted foods they want. Instead of trading food stamps for cigarettes, people would start trading them for jelly doughnuts and potato chips.

So, if I'm saying education isn't the answer, and mandating the purchase of healthy foods isn't the answer, then what IS the answer? I wish I knew. If I did, I could use my public relations background to market it and pat myself on the back all the way to the bank.

Nutrition education and activism must continue, and each of us must lead by example. When we step up to the plate to make better choices for ourselves, we serve as an example to those around us. So the solution lies within each of us and what we buy at the store for our household, because that dictates the food served in our home and to our household guests.

Dinner time at your house may be the first time your child's favorite playmate ever lays eyes on roasted asparagus or green beans that weren't victimized by the canning process. That playmate might bravely try that asparagus, like it and go home and tell his family about it. And who knows? Maybe asparagus will makes its way to their dinner table the following week. You never know. So the next time you have company over for dinner -- whether adult friends or kid friends -- consider making dinner instead of ordering takeout, and watch for the ripple effect.

AP: Liver Disease Plagues Overweight Kids

This story from the Associated Press is sobering. Docs are finding the need for children to have liver transplants is increasing, thanks to obesity. As a fat kid, I knew the mantra of the time that I would grow out of it, that I was just big-boned or my personal favorite, that I may be big but at least I was healthy, was a gigantic load of crap.

Too bad it's taken 20 years for medical professionals to put two and two together on that one.

Cooled off...sorta

It's taken a couple of days but I think I can finally address the topic of the 12-year-old who had Lap-Band surgery in Mexico with some measure of civility. At least, I hope I can.

What disturbs me most about the case is this girl's mom and the apparent lack of accountability on the part of both of them. Mom has a fat kid, so her first step is cosmetic surgery (tummy tuck and lipo). When that fails, Mom takes daughter (now 12) to Mexico for bariatric surgery.

Now everyone is happy. Mom says daughter is a compulsive eater and she likes the band because whenever she overeats, she throws up (nice way to train for bulimia, I suupose). Mom likes that her daughter is finally thin and fashionable.

My personal favorite of all the comments Mom made were those related to why she didn't have her daughter go through the process in the states: Money. Nutritional and psychological counseling were too expensive. Really? Compared to a tummy tuck ($3K-$6K), lipo ($1K) and Lap-Band ($9K in Mexico)? Why do I have a hard time buying that story?

I was a fat kid -- not a chubby kid, a FAT kid. I understand how cruel children and adults can be to obese children. It's not a fun life, but is cosmetic and bariatric surgery the answer? I don't think so. A 12-year-old is not mature enough to understand the dangers/consequences of such decisions. The key to long-term weight-loss success is developing a healthy relationship with food and learning to balance consumption with exercise. What has this little girl learned about that? And how is she supposed to learn when Mom's answer to everything is surgery?

12-year-old gets Lap-Band in Mexico

I need a moment to gain my composure on this one...but until then, watch the clip and leave your opinion:

http://www.cnn.com/video/#/video/us/2007/08/07/ochoa.tx.lap.band.kvue

Point to ponder: Childhood obesity

I was thumbing through a copy of Bariatric Times at a friend's house earlier today when an article on childhood obesity caught my eye. The article itself wasn't that earth-shattering but there was a profound quote from a source that hit home with me.

Loosely paraphrased, it read, "The key to treating childhood obesity is to understand that the afflicted come from homes where overeating and inactivity are allowed or encouraged."

Interesting perspective. I read those words and find them logical and succint. A lot of efforts toward reducing childhood obesity focus on educating and motivating the children but don't seem to target changing the environment at home. I wonder how effective it is to teach little Johnny the importance of making wise food choices and exercise if he goes home each day to a harried household where dinner is from the nearest drive-through and served in front of the Nintendo Xbox.

Any thoughts?

Number of children hospitalized for Type 2 diabetes soars

My friend just sent me this link from Yahoo News that reports a 200% rise in the number of children hospitalized with complications from Type 2 diabetes.

Experts quoted in the article link the increase to the epidemic of childhood obesity, which seems to get worse each day. But a couple of people question the validity of the study's findings. One doc questioned whether the children were properly diagnosed. Another points out that the distinction between Type 1 diabetes and Type 2 diabetes has only been around since 1997, meaning the "soaring" numbers could just be from increased recognition rather than increased incidence.

Check out the link and tell your thoughts.

My thoughts on Shrek

I had hoped some readers would offer their opinions on whether Shrek is a bad influence in the anti-obesity movement before weighing in with my own, but it seems I will have to be the first.

I find it interesting that anti-obesity groups would rather spend time and energy nitpicking the government's choices instead of creating programs that promote their purported goals. Then again, maybe nitpicking the government is the only way they know to promote their own agenda.

The question at hand is whether the government erred in choosing Shrek as its "spokesman" to encourage children to be more active when the character is also involved in the endorsement of McDonalds Happy Meals and sugary breakfast cereals.

According to an Associated Press article released Thursday, the Campaign for a Commercial-Free Childhood says the upcoming Shrek sequel has too many promotional ties with unhealthy foods.

"There is an inherent conflict of interest between marketing junk food and promoting public health," Susan Linn, the group's director, wrote in a letter sent Wednesday to Health and Human Services Secretary Michael Leavitt.

"Surely Health and Human Services can find a better spokesperson for healthy living than a character who is a walking advertisement for McDonald's, sugary cereals, cookies and candy," Linn, an instructor in psychiatry at Harvard Medical School, was quoted as saying in the article.

I have to give Linn credit for her idealism. In a perfect world, there would be numerous healthy role models for children. But our world isn't perfect. And let's be realistic here: Kids listen to cartoon characters, whether adults like that fact or not. I remember first trying canned spinach as a kid to mimic Popeye, and my niece and nephew begging for cucumbers and tomatoes because of VeggieTales.

Based on that experience, I'd say the government is smart to use a cartoon character in its anti-obesity campaign. So what if Shrek also endorses Happy Meals and candy? If kids can remember that McDonald's has Shrek Happy Meals, then I'm sure they can also remember Shrek's recommendation that they exercise at least an hour a day.

Is Shrek a bad influence on kids?

Please share your thoughts on the following Associated Press story on MSNBC.com:

Associated Press
A children’s advocacy group wants the Department of Health and Human Services to oust Shrek, the animated ogre, from his role as spokesman for an anti-obesity drive.

The Campaign for a Commercial-Free Childhood says the soon-to-open “Shrek the Third” has too many promotional ties with unhealthy foods to justify using Shrek as a health advocate.

“There is an inherent conflict of interest between marketing junk food and promoting public health,” Susan Linn, the group’s director, wrote in a letter sent Wednesday to HHS Secretary Michael Leavitt.

“Surely Health and Human Services can find a better spokesperson for healthy living than a character who is a walking advertisement for McDonald’s, sugary cereals, cookies and candy,” said Linn, an instructor in psychiatry at Harvard Medical School.

HHS spokesman Bill Hall said the department had no intention of halting the public service ads, which were launched in February.

The ad campaign — which seeks to curtail childhood obesity — is a joint project of HHS, the Ad Council’s Coalition for Healthy Children and DreamWorks Animation SKG, creator of the three Shrek movies. It features ads in which Shrek, a stout and often clumsy ogre, and his fellow characters urge children to exercise at least an hour a day.

“Shrek is a very well known character in the target population of this campaign,” Hall said. “We have always promoted a balanced, healthy diet, which does not necessarily exclude the occasional treat.”

Linn’s organization — a nationwide coalition which monitors marketing aimed at children — said “Shrek the Third,” which opens May 18, has promotional deals with dozens of food products, including Mars Inc.’s Snickers and M&M’s candy; PepsiCo Inc.’s Sierra Mist drink; and Kellogg Co.’s Fruit Loops, Frosted Flakes, Pop-Tarts, Cheez-Its and Keebler cookies.

The film also has a tie-in with McDonald’s; there will be Shrek-themed promotions of Happy Meals and DreamWorks will create animation for some McDonald’s commercials.

“Why would young children follow Shrek’s advice about healthy living and ignore his entreaties to eat Happy Meals and Pop-Tarts?” Linn wrote. “If government agencies are serious about combating childhood obesity, they should stop cozying up to industry and start taking real steps to end the barrage of junk food marketing aimed at children.”

Penelope Royall, the HHS deputy assistant secretary for disease prevention and health promotion, stressed that the public services ads were using Shrek to promote exercise, not foods.

Foundation pledges $500M to battle obesity in kids

The Robert Wood Johnson Foundation announced early this month that it would commit at least $500 million over the next five years to tackle the problem of childhood obesity, reports ABC News.

The money will be used to fund grants for anyone with ideas on how to fight the nation's growing problem. The concept has prompted me to brainstorm my own solutions to the problem. It's easy to sit back and complain about the epidemic of childhood obesity, but solving it is a different story.

I'd love to hear your thoughts on the subject. If you have an idea, please share it. Maybe we can put our heads together and figure out something to put into practice here in Tracy to improve the health of our children.

Sweet Drinks Put Kids' Health at Risk

According to a WebMD article, drinking lots of soda and juice sets the stage for health problems later in life for children.

The article, which cites a recent study published in the December issue of "Pediatrics," says children who consume large amounts of surgery drinks may suffer from diabetes and obesity as early as the age of 13.

One nutritionist quoted in the article was quick to say the study doesn't mean that all soda is bad — it's just that kids get too much soda too often.

"There is no kid-sized soda bottle, and few 6-ounce glasses at home," said Leslie Bonci, director of sports nutrition at the University of Pittsburgh Medical Center. "So kids get used to drinking soda in whatever size glass they have at home, whatever size bottle or can -- and that is not a single serving, it's a tureen.

"And no child needs to be consuming a tureen of soda," she says.

She also said that soda and juice is calorie-dense but doesn't fill kids up.

"Nobody drinks half of a 20-ounce bottle of soda and says, 'Whoa, I'm stuffed!'" Bonci says. "The kids consume a lot of calories and are not feeling full. So every other aspect of food intake may stay the same."

Poll: Widespread delusion among parents about kids' health

A poll of Canadian parents show they drastically discount the size of their children, a Scripps Howard News Service story reports.

"Parents seem to be looking at the health of their own children through rose-colored glasses," said Dr. Ruth Collins-Nakai, president of the Canadian Medical Association, which commissioned the survey.

The poll found that only 9 percent of parents believe their children are overweight. Researchers found that 26 percent of the children of the parents polled were actually overweight or obese.

Here is the full article:
Poll: Widespread delusion among parents about kids' health
By ANDRE PICARD
Toronto Globe and Mail
21-AUG-06

A new poll shows that only 9 percent of Canadian parents believe their children are overweight or obese. That is markedly less than the 26 percent who are, in fact, overweight or obese, according to data collected by a federal agency, Statistics Canada.
"Parents seem to be looking at the health of their own children through rose-colored glasses," said Dr. Ruth Collins-Nakai, president of the Canadian Medical Association, which commissioned the survey.
Over all, Canadian children rated poorly in the eyes of adults, with only 6 percent garnering an "A" for overall health among respondents.
But, again, those surveyed had a much higher opinion about the behavior of their offspring, with 40 percent of them earning top marks.
Collins-Nakai, a pediatric cardiologist, said she worries that the self-delusion of parents is cushioning kids from reality and will lead to poor health outcomes.
"I have a very real fear we are killing our children with kindness by setting them up for a lifetime of inactivity and poor health," she said.
The CMA, which represents the country's 62,000 physicians, releases an annual report card to measure public feelings about the health system.
The overall grades vary little from year to year, with two-thirds of Canadians giving the system high marks (A or B).
What is new this year is the report card's focus on child health, a central issue at the CMA's policy convention this week in Charlottetown, Prince Edward Island.
The group is expected, among other things, to call on Ottawa and the provinces to adopt specific targets for improving child health, and to support the adoption of a Charter of Children's Health.
The survey asked what immediate initiatives should be taken to improve the health of children.
Respondents showed broad support for mandatory physical education from kindergarten to grade 12 (92 percent), a mandatory school curriculum on the benefits of physical activity and healthy diet (87 percent), and removing all junk foods from schools (81 percent).
In the poll, parents showed a desire for better nutritional information and warning labels on food, tax breaks on health foods and tax deductions for the fees paid by children participating in sports. The survey also found lukewarm support for a ban on junk-food advertising and opposition to junk-food taxes.
Guido Van Rosendaal, chair of the council on health care and promotion of the CMA, told the conference that Canada has to begin by setting specific and aggressive public-health goals related to child health.
Delegates were also presented with sobering statistics showing that Canada has an infant mortality rate of 5.3 per 1,000 live births, a perinatal mortality rate of 6.3 per 1,000, and a maternal mortality rate of 4.6 per 100,000 live births. These data place Canada in the middle of the pack among developed countries.
Landon Pearson, a former senator and longtime activist now associated with The Landon Pearson Center for the Study of Childhood and Children's Rights at Carleton University in Ottawa, told delegates that Canada has to move beyond the "vague splendid goal of healthy, happy children" and set real targets to improve childhood health.
(Distributed by Scripps Howard News Service, www.scrippsnews.com.)

Importance of Vitamins and Minerals after Gastric Bypass Surgery

Led by Dr. Monica Ganz
People who’ve had malabsorptive procedures (Roux En Y and duodenal switch) are in danger of vitamin and mineral deficiencies because certain vitamins and minerals cannot be absorbed by the new digestive tract through ingestion.

Vitamins are essential for the release of energy from carbohydrates, fats and proteins. B-12, for example, is a vitamin that can’t be replenished once a person has become truly deficient in it.

Minerals don’t furnish energy but are vital in many other physiologic functions. The body stores and reuses minerals so deficiencies aren’t easily detected.

Many post-ops become deficient in iron and calcium.

Iron
Iron deficiency occurs because the pouch empties too quickly for iron to be absorbed and because RNY and DDS patients have their duodenum – where 50% of iron absorption takes place – bypassed. Symptoms of iron deficiency include fatigue, feeling cold, pica (compulsive eating of non-food items), tongue fissuring and pagophagia (compulsive eating of ice).

Supplements should be in the form of 18mg of ferrous fumerate or amino-iron, which is most absorbable. Taking iron with vitamin C (such as diluted orange juice or even a chewable vitamin C) to help its absorption. Food sources of iron include liver, oysters, shellfish, organ meats, lean meats, poultry and fish (best meat sources), dried beans and vegetables (best plant sources), egg yolk, dried fruits, dark molasses, whole grains and enriched breads and cereals.

Calcium
Calcium deficiency occurs because post-ops can’t eat enough of calcium-rich foods, and the mineral is absorbed in the duodenum. Symptoms of calcium deficiency include fragile bones and hypertension.Supplements should include 1200mg of calcium citrate (plus vitamin D) per day, four servings of dairy products per day. For each missed serving of dairy products, supplement with an additional 500mg of calcium citrate. This is why many post-ops are encouraged to take up to 2400mg per day.Another problem is that calcium deficiency is hard to detect because the body will leach the necessary calcium from the bones. Dexa bone-density tests are the best way to find out whether a post-op’s body is leaching calcium from the bones. Some people also notice teeth problems, such as a loss of enamel.

Vitamins most commonly found deficient in post-ops are vitamin B1 (Thiamin), vitamin B-12 and folic acid.

Thiamin
Thiamin is necessary for the breakdown of glucose for energy, nerve function, good digestion, normal appetite and good mental outlook. Deficiency is rare in the U.S., except in alcoholics. Symptoms include beri beri, fatigue, poor appetite, constipation, depression, etc. Supplementation is as easy as taking a chewable multivitamin (Bariatric Advantage, Optisource, etc.).

Vitamin B-12
Vitamin B-12 aids in the formation of mature red blood cells, synthesis of DNA, stimulates appetite, promotes growth and releases energy. Food sources include liver, kidney, dairy products, fish, clams, oysters, salmon and sardines.Gastric bypass post-ops MUST supplement with B-12 because the pouch doesn’t supply the intrinsic factor required for absorption. Signs of deficiency include pernicious anemia, tiredness and neurological disorders.Supplements can be by mouth, injection or nasal spray. Monthly injections are the safest best.

Folic acid
Folic acid is necessary for formation of red blood cells. Deficiency happens because of poor dietary intake, low iron and alcoholism. Symptoms of deficiency include rapid heartbeat, fatigue, anorexia, pale skin, paranoia, or sore, inflamed tongue. Food sources include soy, leafy greens, organ meats, mushrooms, oatmeal, red beans and wheat. Supplementation is usually as easy as taking a good multivitamin.