Kidneys and Covid19

The divide on whether to open is coming down to politics not medicine--specifically, who hates Donald Trump. But maybe it should come to whether you care about your kidneys. Take a look at the comorbidities of those who died of or with (which seems to be a lot of it) this novel SARS virus--diabetes, hypertension and obesity. Specifically, diabetes. About a third of those with diabetes (which is often related to both hypertension and obesity) will develop chronic kidney disease. The kidneys can't filter your blood and you may also have nerve damage. It's a disease that affects the same people vulnerable to this virus--over 60, high blood pressure and member of a minority group. A chronic condition means usually it's controllable by changes in life style and medication, and nagging from the doctor.

The very people who aren't seeing their doctors or are afraid to call, are the ones you're putting in danger by hanging on to your hatred of Donald Trump so you can blame him for the virus and the shut down. End the shut down; save your kidneys.

And please, Trump haters, stop acting so morally superior by accusing conservatives of wanting people to die by going back to life and work. You are the problem. . .

More money for obesity research?

"For decades, experts at CDC, National Institutes of Health (NIH), U.S. Department of Agriculture (USDA), U.S. Department of Education, the Administration for Children and Families, and the Food and Drug Administration (FDA) have been researching and developing strategies to prevent and address obesity among children and adults nationwide." (The State of Obesity, 2018)

And apparently their strategies aren't working except to ask for more money to fund more research to pay more government workers. 1999-2000 30.5% adults obese; 2015-2016 39.6% obese. I don't find that impressive. Don't cut our budgets--we need that money to address obesity! To fail bigger!

Looking through the research, I see. . . racism is embedded.

• The differences between blacks and whites are called INEQUITIES.
• The differences between black males and black females (more likely to be obese) are called differences.
• The differences between Asian American men (more likely to be obese) and Asian American women are differences.
• The differences between Asians and whites (more likely to be obese) are called differences.
• The differences between rural (more likely to be obese) and urban are called differences.
• The differences between first generation and second generation (twice as likely to be obese) are called differences.
• The differences between Filipino Americans (more likely to be obese) and Chinese Americans are called differences.

Episode 3: Hormones and Hunger

https://www.youtube.com/watch?v=Yo3TRbkIrow

Why it isn’t just eat less move more.

“Metabolic endocrinology appears to be only slightly more complicated than a nuclear reactor and brain surgery combined. No single hormone controls body composition, appetite, and hunger — and your individual hormonal profile may be relatively unique.

What’s also notable is that dieters who lost more weight on the diet had more significant changes in their appetite. They were probably hungrier while losing that weight.”

http://www.precisionnutrition.com/leptin-ghrelin-weight-loss

https://www.youtube.com/watch?v=kOCPyheVesM  Robert Lustig on sugar at Google

https://www.youtube.com/watch?v=gmC4Rm5cpOI  Robert Lustig at Ted Talk on sugar

Sugary Fatty Foods

are as addictive as heroin and cocaine.  Leptin.  Ghrelin.  Whole bunch of things controlling your appetite.

https://www.youtube.com/watch?v=z_M6N2YvhK8

Or was it exposure to DDT?  Obesogens?

http://www.the-scientist.com/?articles.view/articleNo/44278/title/Obesogens/

“The biological basis of obesity is further highlighted by the vigorous defense of weight following weight loss. There are at least 10 circulating hormones that modulate hunger. Of these, only one has been confirmed as a hunger-inducing hormone (ghrelin), and it is made and released by the stomach. In contrast, nine hormones suppress hunger, including CCK, PYY, GLP-1, oxyntomodulin, and uroguanylin from the small bowel; leptin from fat cells; and insulin, amylin, and pancreatic polypeptide from the pancreas.

After weight loss, regardless of the diet employed, there are changes in circulating hormones involved in the regulation of body weight. Ghrelin levels tend to increase and levels of multiple appetite-suppressing hormones decrease. There is also a subjective increase in appetite. Researchers have shown that even after three years, these hormonal changes persist (NEJM, 365:1597-604, 2011; Lancet Diabetes and Endocrinology, 2:954-62, 2014). This explains why there is a high rate of weight regain after diet-induced weight loss.

Given that the physiological responses to weight loss predispose people to regain that weight, obesity must be considered a chronic disease. Data show that those who successfully maintain their weight after weight loss do so by remaining vigilant and constantly applying techniques to oppose weight regain. These techniques may involve strict diet and exercise practices and/or pharmacotherapy.”

http://www.the-scientist.com/?articles.view/articleNo/44288/title/The-Changing-Face-of-Obesity/

Five no-no white edibles

I ran into a friend last night we see only in the summer.  She’s lost about 20 lbs since I last saw her and looks and feels great.  I asked her how she did it, and she said she gave up 5 white things.  1)  White sugar, 2) white flour, 3) white rice, 4) white shortening, Crisco, 5) and white potatoes.  To give up sugar she said she had to detox for 2 weeks, and got headaches and the shakes.  Wow.  Sugar was never my problem, I’m a potato chip and cheese crackers gal, and I didn’t eat a lot of rice (although now I am eating brown rice), and flour was only if I baked, of which I don’t do much.  Potatoes are a powerhouse of nutrition—so I still eat those on occasion.  She’s hoping to get off all her medications.  Her doctor said she was obese and laid down the law.  I couldn’t even get a doctor to tell me I was over weight when I complained about leg pain.  I’ve been using an exercyle, but she uses some sort of trampoline thingy because she has bad feet and it provides a nice cushion.  She loves it.  We both expressed some concern about our wrinkles.  Fat is such a great crease filler!  She has beautiful skin, and no wrinkles at all on her face (so far with 20 lb gone), so we’ll see.   I’ve lost 30 lbs., and only gave up my “triggers,” those things that make me eat more (I bear no responsibility—ha, ha) like peanut butter, cheese, and potato chips, plus any meal that needs a few pieces of bread to hold it together. So I’m eating a lot more fruits and vegetables, more beans, brown rice, onions, red cabbage, dark lettuce and greens, more fat free yogurt and less meat, fewer potatoes. I’ve added 35-40 minutes a day of exercise.  I hate exercise.  In 6 months I think I’ve had French Fries twice and maybe potato chips once. I added in my dark chocolate drink, which satisfies a lot of cravings. Every BODY is different.  Find your spot and stay there.

2013 at 165 lbs and counting (it went up)

2015 ca. 140 lbs (not sure of the date)

Why are people fat?

I see a lot of speculation and research on why people are fat--everything from fast food, to TV, to women returning to the workforce in the 1970s, to antibiotics in childhood, to genetics. So when I look at pictures of paintings from the 17th century, or photos of my family reunions in the 1920s, and no one had fast food, everyone had physical work, there was no modified or processed food and they look just as overweight in middle age as today, I do wonder what the researchers are missing. Frick Hals portrait

Rick Warren’s new book, The Daniel Plan

                         

Today Gretchen Carlson interviewed Rick Warren about his "The Daniel Plan" which is about healthy eating and exercise, and she specifically asked what he thought about the Obamacare mandate requiring Christians to violate their conscience and teachings, and after telling her Christians had the first hospitals he moved right back to talking about his book and didn't answer her question which included a clip of Cardinal Dolan on NBC.

One of the guests with Warren commented on obesity and brain function. Compared to people of normal weight, overweight people’s brains look 8 years older and obese people’s brains appear 16 years older. Warren has lost 65 lbs.--so maybe that was his problem with answering a very clear question.

http://bebrainfit.com/lifestyle/drains/the-toll-being-overweight-takes-on-your-brain/

Don’t blame First Nanny.

Michelle Obama is getting a lot of blame for the unpopular features in some school lunch programs, First Nanny, etc. and maybe that's a popular political stance for the anti-Obama crowd, but this type of government manipulation of food and nutrition goes waaaay back, first for farmers to pay for over production after WWII, then the low-come and poor, and the last two decades for the middle class purchasing processed and food-away-from home. Here's testimony from early in the GW Bush administration (2003). At that time it was thought "educating" people through labeling, media campaigns, health literacy and promotion would reduce obesity. And perhaps it did, because obesity in children slowed down about 10 years ago.

http://www.surgeongeneral.gov/news/testimony/obesity07162003.html

Looking back 40 years to the 1960s, when many of us in this room were children, just over four percent of 6- to 17-year-olds were overweight. Since then, that rate has more than tripled, to over 15 percent. And the problem doesn’t go away when children grow up. Nearly three out of every four overweight teenagers may become overweight adults.

I’m not willing to stand by and let that happen. American children deserve much better than being condemned to a lifetime of serious, costly, and potentially fatal medical complications associated with excess weight.

Richard H. Carmona, M.D., M.P.H., F.A.C.S.
Surgeon General
U.S. Public Health Service
Acting Assistant Secretary for Health
Department of Health and Human Services

July 16, 2003

The food police are coming

Here is a frightening prospect:

"To have any chance of release from obesity's ever-tightening grip, the NATION will REQUIRE broad based efforts in every corner of society: homes, schools, community organizations, all levels of GOVERNMENT, urban design, transportation, agriculture, the food industry, the media, medical practice, and, without question, biomedical research."

JAMA Sept. 19, 2012 p. 1095

Any chart of the growth of the restaurant industry can show you the relationship between the modern women/feminist movement and obesity.   So maybe it’s up to moms to rein in the eating out, to spend a bit more time in the kitchen preparing food instead of opening packages, and stop driving the kids everywhere.  Actually, the childhood "obesity epidemic” stalled over a decade ago, but that hasn’t stopped the government intrusion in our lives.

The researchers can glamorize or sympathize, but the fact remains, a woman employed outside the home whose time is valuable, turns to restaurants/fast food outlets to feed her family.  Many women know nothing of the time short cuts or economic savings women of my generation learned from our mothers.

“The researchers acknowledge that food prepared in the home is nominally cheaper than purchasing food in restaurants. But in view of the value of time that must be devoted to shopping and cooking, as compared to the high-calorie, low-cost, mass-production meals available at ever-increasingly convenient locations (with ever diminishing travel and waiting time), the fast-food option appears to make good economic, if not health, sense.”

http://www.nber.org/digest/feb03/w9247.html

Who’s fault is it?

       

[snark] I know who ordered that pizza, who bought that bag of chips and forced open my mouth. Yes, someone in the 1% who needs to be taxed more so I'll eat more fruits and vegetables which I grew in my backyard.

Have you ever looked at photographs of the over 50 crowd in 1910 or 1950—before the days of fast food restaurants, or 32 oz. bottles of coke?  Yup.  They are fat.  What’s different today is how heavy the young people are.  For that I think we can give thanks to the women’s movement of the 1970s, and less time playing outdoors. Women in the 1970s didn’t really calculate how much of their income was being taxed at a confiscatory rate [tacked onto their husband’s rate], and they were tired after working and driving, so they began taking the kids out to eat.  The restaurant industry and the processed food industry responded to the market, and so the next generation barely knew how to make a white sauce or hard cook an egg.  That gave rise to cooking shows and gourmet clubs and more food advertising, which lent itself to more and more government regulation.

See how neatly this all fits together?  Instead of blaming an industry or an agency, just eat less and move more.

The obesity challenge

Today I was watching a very interesting program on the cable channel Biography about George Lucas. A lot of it was old footage of the development of his early films like American Graffiti (1973) and Star Wars (1977). Lots of fun to watch. However, the old clips of 37 years ago showed how thin he was in his 20s, a beanpole really . . . and how heavy he is now. Not obese by Columbus standards, but certain chunky. Plump. Chubby. I wonder what the government can do about this. Michelle, the CDC, hundreds of foundations and non-profits, all sorts of government grant money are being thrown at this problem. And he's not poor. Not a minority. He's rich, got health care. Gosh. Won't that skew the stats? JAMA is reporting that the government is so impressed by what it's been able to do with taxing cigarettes (although since it's been taxing tobacco for 360 years I'm not sure it's all that successful and hurts primarily the poor), that it wants to use the same methods for fighting obesity that it has used for fighting nicotine. I guess you won't be able to eat with anyone else in the room. Second hand calories, you know.

It takes a Romanian village

Matthew Dalton has an article in the WSJ today about fighting obesity, and why the "village" approach (i.e., government control) is needed. Except the fat women were gathered in a Romanian village. I don't know why they think these Romanian women didn't have "walk to school" days when they were children or that they should stay away from those Big Macs down the street.

"Instead of hoping that individuals can muster the self-discipline on their own to avoid processed foods, fast food and days without physical exercise, the idea is that governments must actively work to change environments and reduce the menu of harmful options available in everyday life.

As a result, hundreds of towns in Europe and elsewhere have adopted a version of this strategy, aimed particularly at preventing children from becoming overweight and obese. They hired dietitians to counsel children and their families in schools, organized walk-to-school days, hired sports educators and built new sporting facilities. The U.S. government, meanwhile, is increasing its funding for cities and towns to pursue so-called community-based obesity prevention, in an effort to gather data about which kinds of tactics work best."

Last night our condo association had its annual potluck. I overate. Now, why would a sensible, healthy eater who goes to exercise class 3 times a week, and eats 3-4 vegetables for lunch do that? Because everything tasted good and the fellowship was great, and it was 2 hours past my regular meal time. The artichoke dip was particularly wonderful both as an appetiser and a dessert. I'm not all that far removed from the village square in Romania.

So what about the government hitching a ride in your grocery cart or camping out in your pantry, telling you what to eat and when? This isn't about safe or nutritious food, you know. We're way past that. This is about control of every little aspect of your life.

I'm not sure if anyone understands the chemistry and biology and culture of obesity. But every time I read Junk Food Science by Sandy, I learn a little more. And she's not writing about food that's junk--it's the science.

Eating pumpkin ice cream reading obesity research

After a lunch of lightly grilled, prepackaged organic vegetables (broccoli, carrots, red cabbage), I had a dish of pumpkin ice cream with some peanut butter on top. While eating the dessert I was reading "Transforming Research Strategies for Understanding and Preventing Obesity" by Huang and Glass in JAMA, Oct 15, p. 1881. Before I go into detail, let me ask you a few questions, and please don't argue or go off topic, just answer about you and you only; no one else:

• Has the federal government made you fat?
  
• Has your state or local government made you fat?
  
• Did your educational institutions--high school, college, grad school--make you fat?
  
• Has your income, whether high or low, made you fat?
  
• Has your peer group made you fat?
  
• Did your mother's diet before you were born make you fat?
  
• Has the location of your super market or grocery store made you fat?
  
• Has the lack of fresh fruits and vegetables where you shop made you fat?
  
• Has the lack of a farmer's market in your neighborhood made you fat?
  
• Has lack of exercise opportunities made you fat?
  
• Has the zoning where you live made you fat?
  
• Did the farm, town or city where your great, great grandparents lived and worked make you fat?
  
• Have USDA policies affecting land use made you fat?
  
• Has building design of your home or work place made you fat?
  
• Has the elevator in your building or the parking lot for your car made you fat?
  
• Has food labeling or lack of it on restaurant menus made you fat?

I've been up the scale and down the scale, and no one but me can determine whether I'll be obese or not. But there's a whole bunch of government money out there just waiting to call me a liar.

Using the tobacco taxes as an example of how top down punishment by the federal government can stem the obesity tide of the predicted $860 billion in health care costs, the writers of this article (both NIH employees), are pointing the way for Uncle Sam to join you at the dinner table, the restaurant, the grocery store, the snack bar and the tailgate party before the OSU football game. And he won't be a fun or an invited guest.

Clearly, education about personal responsibility for health and weight has failed, the authors report. We have evolved, but not enough. Our bodies are not equipped for an obesogenic environment. After working their way through maternal feeding patterns, lack of P.E. in schools, public snack machines and sedentary behavior, the authors pounce on the real problem. You'll be glad to find out it's not your genes, your taste buds, your cravings, or your lack of will power. It's the government--all levels from cradle to grave, from bike path to freeway, from safety to quantity.

At the governmental level, policies regarding food, agriculture, education, transportation, urban design, marketing, and trade all play a role in increasing the accessibility and availability of high-fat and high-sugar foods vs fresh fruits and vegetables and in decreasing opportunities for physical activity. The lack of access to preventive care is also a major concern. Historical U.S. policies that led to social inequality and segregation have, in turn, resulted in inequalities in the built environment, leading to disproportionate rates of obesity among the poor and minorities.

"Trust me, I'm from the government." These are the same guys from the government who don't require country of origin on your canned goods, and have no way to check the quality or adulteration of foodstuffs imported from Mexico and China, the most recent culprits that sent people to the hospital. But we're supposed to hand them billions in government grants for "cross-disciplinary hypotheses to research on upstream (trendy word = bad capitalists) policy interventions and their downstream effects on food and physical activity behaviors, investment in capacity building and rigorous training of a new generation of multilevel scientists, and global perspective on obesity research." What does cross disiplinary look like?

medical geography
epigenetics
psychoneuroendocrinology
advanced neuroimaging tools
socioenvironmental factors
spatial data
expression of genes
population patterns
food marketing
taxes on unhealthy food
public transportation
crime free neighborhoods
behavorial economics

and of course
the United Nations World Health Organization

Please note you free market and capitalist morons, your government knows best: "Neoclassical economic theory promised that allowing individuals to pursue their individual passions and desires with a minimum of constraint would lead to aggregate prosperity. However, this theory may be flawed in the case of food and activity preferences. If humans have built-in biological propensities at odds with their environment, top-down approaches may be needed to achieve population obesity prevention goals."

And here comes Obama rama dom dom.