Buy Food "Cheap", Eat Cheap Food

I had an interesting conversation with my son this morning.  I was concerned about his habit of using his spending money to buy junk food after school.  His response is that it's too expensive to buy healthy food on his small budget.  A new study by the USDA challenges this widely held belief. 

My Dad always said "When you buy food cheap, you eat cheap food!"  This is still true.  The trick is in how they calculate "cheapness".  Junk food often wins on a price per calorie basis.  However, if you look at the price per edible weight or cost to meet nutritional recommendations, it is better to stick with healthy foods.

Regardless of who wins on the purchase price, I have long argued that it is still more expensive to be sick from years of eating junk.  Similarly, I discourage the practice of forcing children to keep eating when they are no longer hungry.  You should avoid wasting food, but it is more of a waste to your health to keep eating after you are full.

Quick tips for eating healthy on a budget:
1. Get most of your protein from beans and lentils (mmmmmm, that good ole navy bean!)

2. Fresh is best (try growing your faves).  If you must, frozen plain vegetables are the next best thing (NOT sauced up varieties loaded with salt and fat).

3. Watch those "healthy" labels carefully for sugar content.  Something can be vegetarian, vegan, halal, kosher, gluten free AND loaded with sugar! (tricky, tricky, tricky)

Check out the story on NPR Here.  You can link to the full USDA report Here

Peace & health,

Dr. Safiyya

Coffee: #1 Plant Medicine in the World

A new study shows that coffee can reduce the risk of death by 10%!  Other studies have already shown a lower risk of diabetes, colon cancer, depression, and dementia.  I guess that is why coffee is the most widely used plant medicine in the world!

Since it is a medicine, there are risks along with benefits.  Discuss your coffee use with your doctor if you have certain medical conditions like abnormal heart rhythm, high blood pressure, anxiety, migraines or insomnia.  Because there are other components in the coffee that have benefit besides caffeine, these benefits don't apply to caffeine alone, or highly processed energy drinks.  The antioxidants and flavenoids in the whole coffee bean likely contribute to the health benefits.

Coffee is no substitute for proper rest, so organize your time so that you get the proper amount & quality of sleep.  Don't forget to put the coffee grounds in your compost pile so you can make "black gold" for your home garden!

Peace & health,

Dr. Safiyya

 

Coffee May Reduce the Risk of Death from Heart Disease, Stroke, Diabetes

By MIKAELA CONLEY (@mikaelaconley)

May 16, 2012

Hey, coffee lovers, here's another reason to defend that java habit you just can't kick. A study published today in the New England Journal of Medicine found that coffee drinkers are less likely to die from several common health conditions, including heart disease, stroke, diabetes, accidents and infections than non-coffee drinkers are.

Researchers from the National Cancer Institute conducted an observational study from data that included 400,000 adults ages 50 to 71. People who drank three or more cups of coffee per day had a 10 percent lower risk of death than the non-coffee drinkers.

"Coffee is one of the most widely consumed beverages in America, but the association between coffee consumption and risk of death has been unclear," Neal Freedman, lead author of the study and an investigator in the National Cancer Institute's division of cancer epidemiology and genetics, said in a statement.

"We found coffee consumption to be associated with lower risk of death overall, and of death from a number of different causes,'' he said. "Although we cannot infer a causal relationship between coffee drinking and lower risk of death, we believe these results do provide some reassurance that coffee drinking does not adversely affect health."

And it may not be caffeine that is the protective ingredient. Those who drank caffeinated and decaffeinated coffee had similar health results, which suggests there is some other component in the coffee, not the caffeine, that plays a role in protecting one's health.

Several studies have found that coffee reduces the risk of several other medical conditions, including stroke, depression, dementia and several other cancers.

More than half of American adults drink some form of coffee each day, according to the National Coffee Association, and caffeine is the most frequently consumed stimulant in the world.

Despite the promising benefits, Dr. Cheryl Williams, a registered dietician with the Emory Heart & Vascular Center in Atlanta, said she would advise patients that coffee does indeed contain properties that may promote health, but it also has properties that can negatively affect health. Caffeine can raise blood pressure, she said, and boiled coffee lipids may increase already-high blood cholesterol.

"Overall, more research needs to be done to truly understand the compounds in coffee and their biological activity and effect on health," said Williams.

Drinking coffee is "fine," said Keith Ayoob, associate professor of pediatrics at the Albert Einstein College of Medicine in New York.

"It can be part of a healthy diet and lifestyle and may even contribute to such a lifestyle," said Ayoob. "I wouldn't want it to push out nutritious foods, but in and of itself, there is no reason to suggest that drinking coffee is negative, and it may be beneficial."

The study authors did note that coffee drinking was also associated with smoking, poor diets and alcohol consumption, but Ayoob noted that this doesn't necessarily mean coffee is bad for your health like some of the others.

"You're picking up on a long-term lifestyle, for better or worse," said Ayoob. "[But] just because coffee drinking is accompanies smoking, inactivity, etc. doesn't mean it's bad, it means coffee is hanging around some bad company."

ABC News' Dr. Veronica Sikka contributed to this report.

Hunger in the 'Hood

I considered writing my own commentary to the article below, but it explains pretty clearly a point I have been making to patients and friends for a while.  Don't assume everything being sold as food should be eaten.  The people putting out these processed "foods" could care less whether their product kills people, as long as you don't drop dead right away.  Read on...

What? Poverty + Malnutrition = Starvation AND Obesity?
Written by Jill Ettinger   

John Robbins wrote in his seminal book The Food Revolution that there are as many people on the planet currently suffering from obesity-related illnesses as there are those suffering from hunger-related illnesses. And, ironically, both have two critical factors in common: malnutrition and poverty.

While it may seem impossible that obesity sufferers are as nutrient deficient as individuals without enough food to eat, it's true. A 2007 study titled "Poverty, obesity, and malnutrition: an international perspective recognizing the paradox" found food insecurity's contradiction is that not only can it lead to the more common vision of the gravely malnourished sufferers of undernutrition, but also, overnutrition, which the researchers estimate that by 2015 will take over as the leading cause of death from noncommunicable diseases in low-income communities, surpassing the effects of undernutrition.

Starvation has long been the poster child for poverty and malnutrition. Literally. Sally Struthers brought the issues of malnourished African children to television sets throughout the 1980s, begging Americans to help relieve their suffering while the millions of couch potatoes watching the depressing commercials snacked their way into their own malnourished state.

Particularly in the U.S., a growing number of obese individuals (one-third of all adult Americans, according to the Centers for Disease Control and Prevention) and a rising rate of families struggling to find food parallel. According to Feeding America, in 2010 14.5 percent of American households were food insecure. Often, the two are affecting the same individuals (three of the top ten states with the highest obesity rates and highest poverty rates are the same: Alabama, Arkansas and Mississippi). How can this be?

Overnutirition leads to the obvious diet-related illnesses like obesity, heart disease, hypertension and diabetes, but it's also a breeding ground as well for vitamin deficiency generated illnesses like chronic skin conditions, poor vision, gout, mental disorders, digestive disturbances and even certain types of cancer. What happens is this: When healthy foods are substituted with mere empty calories in fast/processed/frozen foods—often the only choice in low-income neighborhoods (and in many school systems)—the body stores much of the useless stuff (trans fats, processed sugars, refined grains and flours) in the body as fat until it can determine what—if anything—can be done with it. Hunger persists because the body has not filled its nutrition quota for the day. That's why you may have noticed that you can eat an entire bag of Doritos and still feel a voracious hunger—because your body actually received very few nutrients. That can certainly pack on the pounds.

But further compounding the issue are the number of chemicals (from pesticides applied to the crops to the additives, artificial flavors and preservatives added to the finished product), called endocrine disruptors, which have been shown to cause obesity and diabetes, among myriad other health issues. Making it difficult to lose weight, these chemicals throw off the body's hormonal systems that regulate insulin distribution and the body's ability to metabolize.

Inexpensive processed foods are nutritionally inferior to fresh, whole fruits, vegetables, grains and even organically-raised animal products. Diets lacking in these—whether other foods are present or not—inevitably lead to malnutrition and the slurry of health issues common with both starvation and obesity.
And what's more, experts suggest there is enough food on the planet right now to feed everyone healthy, nutritious food. But multinational corporate conglomerates that dominate the food industry, distribution and even health care, have made it increasingly more difficult to allocate food where its needed most, and make the perceived cheap, tasty, processed stuff more accessible than pure, fresh, whole foods.

If we are to combat the issues of malnutrition in our country and around the world, we can start by opting out of the corporate food system, growing our own, supporting local food manufacturers and sharing these resources. We can help to support educational and charitable organizations that bring healthy, fresh fruits and vegetables to the nation's sprawling "food deserts." And we can help to heal our soil—where many of the vital nutrients originate—by always choosing organic and non-gmo foods.

Keep in touch with Jill on Twitter @jillettinger

Resources:
http://www.ncbi.nlm.nih.gov/pubmed/17964317
http://news.harvard.edu/gazette/story/2011/04/twin-dangers-malnutrition-and-obesity/
http://www.nobledrugstore.com/blog/diseases-condition/vitamin-deficiency-diseases
http://feedingamerica.org/hunger-in-america/hunger-facts/hunger-and-poverty-statistics.aspx
http://calorielab.com/news/2011/06/30/fattest-states-2011/
http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm

Black Fat

 Why Black Women are Fat

The linked article from last Sunday's New York Times suggests that Black women are fat because they want to be. I disagree.

I understand that European standards of beauty have affected the mind of almost every Black woman I know.  For some (but not most), this has resulted in a total about face, wanting to be as unlike a European as possible.  However, I reject the notion that we are fat because we want to be. Consider another thought provoking possibility.  It relates to the content of the article referenced in my last post.

There are lots of people on the other end of the black fat equation getting rich while we die. Black people are suffering disproportionately from illnesses that are associated with carrying excess weight. We could break down the costs of obesity many ways- food costs, more expensive specialty clothes, lost days at work, lost cognitive function, lost income when a breadwinner is disabled or dies, costs of medication, surgeries & hospitalization., higher insurance premiums, and on, and on.

So many people are making money off of our health problems, maybe we should look into whether the idea that it is good to be heavy came from within our community. Obesity is a big fat bandit, robbing us of our economic power, family structure and vitality.  Are we victims of various forms of marketing (brainwashing) that has us thinking we like being this way? Don't be too quick to answer- if it could happen to doctors with pain medicine, it could happen to people who have much less knowledge about health.

My experience has taught me that there's another obvious reason that black women are fat- we don't know what fat is (from a health perspective).  I screen all of my patients for obesity and probably annoy many by alerting them if they pick up extra weight.  I also try to remember to congratulate those who show improvement by adopting a healthier lifestyle to reduce their weight.

Most of the Black women I follow have heard my point of view about weight.  I am not your mate, I am not concerned about your appearance.  My concern is your health. If we shifted our focus away from variable opinions about what constitutes an acceptable appearance, and kept our focus on how to achieve and maintain optimal health, we may finally begin to make progress on this issue. When I diagnose a woman with overweight or obesity, it is a mathematical diagnosis based on the BMI (body mass index).  This calculation (check yours here) compares your weight to your height.  Population studies have shown that risk of death is at a low point with a BMI of around 22, starts rising after a BMI of 25, rises more steeply over a BMI of 30, and become dangerously (morbidly) high over a BMI of 40. If doctors kept things objective by taking the appearance assessment out of the decision making process, more people would have an early warning that their current lifestyle habits are not "pro-life" choices.







So here's an easy action item for those interested in improving their health. BUY A SCALE.  Get on it no less frequently than once every 2 weeks.  If you know you've been overindulging, get on it once a week so you can correct a 5 pound gain before it turns into a 15 pound gain.  This isn't about obsessing over your weight, it's about awareness.  Many of us lack awareness with respect to our weight.  They say knowing is half the battle.  Don't stop getting on the scale because you didn't like the trend you are seeing.  Instead, use the information and commit to at least maintaining whatever weight you are now. You have to patch the hole in the boat to keep it from sinking, then fine tune your plan to get back to shore.

I am looking forward to your comments, and expect that not all of them will be positive :)

Peace & health,

Dr. Safiyya

Painful Medicine

"OxyContin: Purdue Pharma's painful medicine"

My son was the first one to bring  the above article to my attention a couple of months ago.  I guess it's funny how they get to know your soap box issues. The craziest thing about this important health article is the magazine in which it was published: Fortune.  The article outlines how pharmaceutical companies like Purdue Pharma deliberately targeted primary care doctors like myself to get us feeling more comfortable prescribing potentially dangerous narcotic drugs.  Their sales team figured out that if they could suddenly have 20,000 family doctors prescribing their medication instead of say 2,000 specialists, they would hit the jackpot. That's exactly what they did.  Their profits shot through the roof.  OxyContin generated $3.1 billion in revenue in 2010.  That is nearly 3 times what they made in 2007, when the company plead guilty to a federal criminal count of misbranding the drug "with intent to defraud and mislead the public," and paid $635 million in penalties.  Sounds like the company made a pretty good financial gamble to me. I guess they can let the doctors like myself  deal with the thousands, if not millions of victims in their wake. Trust me, unless your doctor is collecting $100 cash for your 3 minute visit to assess your pain, they probably aren't the one making out like a bandit.

Narcotic pain medicines are very useful drugs.  After all, if you get filleted like a fish for a major operation, or are suffering from a painful cancer, you may very well need some Oxycontin.  However, the power of  these drugs is their ability to change the very way your brain functions.  It is not an uncommon occurrence for a person to start needing pain medications leading up to a hip replacement surgery and then long after their hip should have healed, their brain and body's dependence on the narcotic has only increased.  This has led to the high profile and everyday addicts most of us are familiar with.

I decided some time ago that as a general rule, I do not prescribe narcotic pain medications.  My patients that require chronic pain management are referred to a pain management center.  Some of them have ongoing pain that is difficult to treat.  Others have a physical problem that is being treated with the pain medication, but the problem might not be pain, but the dependence/addiction itself.

It should really enrage doctors and patients alike to read an article like this and make that connection between their behavior and the fat-pockets of business-savvy pill peddlers.  Every person who has found themselves in this quandary should demand answers from the regulators, the drug companies, and the physicians who, ultimately become the front line "tool" that is used to ensnare the public.  As physicians, we have to be more aware that people are selling a product with a dollar value on it based on our prescribing habits.  We should always carefully weigh whether the benefit to the patient warrants the risk to them, their families, and society as a whole. This applies not only to narcotic medicines, but all medicines, including antibiotics.

As patients, try to remember that it is hard work to maintain your health, with or without medications.  There is no easy way.  If you want the best chance at a life free of disease, without swallowing a fist full of pills every day, it is going to take a major shift in thinking and lifestyle.  The improvement you see will be directly related to the degree that your lifestyle is transformed.  I truly believe that our bodies have the potential to heal themselves, but I don't yet fully know how to do this.  One thing I know for sure is that the answer lies in a proper way of eating, thinking, feeling and behaving.

Please comment to share your experiences with these medicines or people who have become dependent on them.

Peace & health,
Dr. Safiyya

Do you have a D-ficiency?

In the last few years, I have been inundated with medical news and studies regarding the health problems that result from low vitamin D levels.  The new studies show a link between vitamin D deficiency and illnesses ranging from hypertension, weak immune systems, dementia, depression, colon cancer, and more.  Funny thing is, until a few years ago, the only thing I knew about vitamin D deficiency was that it typically results in rickets in breast feeding infants of darker skinned mothers.

While many people's first thought is to start drinking more milk, it turns out that milk isn't the main source of this versatile fat-soluble vitamin.  In fact, it is not naturally present in most foods.  The main source of vitamin D is the sun.  When ultraviolet rays strike the skin, it triggers your body to produce vitamin D.

Well, I decided to start checking the levels of my patients to see if this seemed to be a problem in my patient population.  If vitamin D deficiency could cause that many problems, seemed like you'd get a lot of bang for your buck if you correct it.  Little did I know that after checking the levels of nearly a thousand patients, I could count on one hand how many people had normal levels.  I'd expect Black people in Philly to be low in the winter, but vitamin D deficiency has consistently been the most common lab abnormality I detect.  Some people have levels so low, it's undetectable!  I could actually save the healthcare system a few dollars and stop testing people, assuming everyone I see is low.  Unfortunately, there's something about actually seeing the number that helps people feel committed to getting their levels up.

Will taking vitamin D supplements cure all your problems?  Of course not.  But it's definitely worth it to take into consideration that health recommendations should be tailored to the population being served.  People of color have natural sunblock (melanin) that predisposes them to low levels of vitamin D.  Our bodies are programmed for more sun exposure than most of us get, especially over winter in the north.  This sun-blocked effect is suggested by some scientists to be a potential cause of the high rates of high blood pressure among Blacks.

My advice?  Take a supplement in the winter, and at least for a month in the summer if you suspect your levels are already low. (5000 iu Vitamin D3 daily). The good thing is that since it is a fat soluble vitamin, it is a little more forgiving if you tend to forget a dose here or there.  As the weather warms up and the days are getting longer, try to find time to get at least 15 minutes of sun exposure directly on the skin.  Don't go crazy with the SPF 50 all over your body.  For the many Muslimah's out there who don't expose much skin, start scoping out a private area where you can get the sun your body needs without compromising your modesty.  If that isn't possible, consider taking a supplement year-round.

Let me know if you notice any changes in how you feel.  You may or may not feel the difference, but considering D-ficiency wouldn't be the only "silent killer", I would reach for this "low-hanging fruit" and correct those deficiencies you know you have.

Check out this link for more info: WebMD on Vitamin D Deficiency
You can find vitamin D for sale here: Fountain Med Supplements I recommend the liquid for families, so you can adjust the number of drops you use for the different ages in your household.  It doesn't have any particular taste.  My 4 year old just sticks out her tongue to get one 1000iu drop (when I remember).

Peace & health,
Dr. Safiyya

Welcome

Welcome to my new blog.  As a busy family physician, mother, wife and concerned citizen, I often come across health related information that I find interesting.  It is my hope to be able to share some of this information as well as my thoughts about on this may relate to you or your family.  I will also share some of my thoughts as a bit of a medical maverick.  I have owned and operated a solo family medical practice in Philadelphia, PA since 2010.

This blog will be a work in progress, so come along for the ride!

Peace & health,
Safiyya S. Shabazz, M.D.