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Deciphering Food Labels

If you have ever dieted, you probably read food labels. Nutrition starts with studying food packaging information. When looking at labels, start with portion size. Compare the two labels below. Both have the same serving size—½ cup. However, if I ate the entire can of Brand A I would consume 840 calories and 3720 mg of sodium. An entire can of Brand B will net me 315 calories and 805 mg of sodium. Both provide lots of fiber, but I don’t want to think of what would happen if I ate all of Brand A.

BRAND A CANNED BAKED BEANS                             BRAND B CANNED LENTILS

Nutrition Facts

Serving Size: ½ cup

Servings Per Container 6

Amount Per Serving

Calories 140  Calories from Fat 10

% Daily Value

Total Fat 1g                           2%

Saturated Fat 0g            0%

Trans Fat 0g                0%

Cholesterol 0g                        0%

Sodium 620 mg                     26%

Total Carbohydrates 28 g            9%     

 Dietary Fiber 5g        20%

Sugars 11g

Protein 6g

Vitamin A 0%      Vitamin C 2%

Calcium 6%          Iron 10%

 

Ingredients: water, prepared white beans, sugar, maple cured bacon, mustard, salt, vinegar, corn starch, onion powder, caramel color, tapioca, maltodextrin, autolyzed yeast extract, bacon fat, natural flavors, natural smoke flavor

Nutrition Facts

Serving Size: ½ cup

Servings Per Container 3.5

Amount Per Serving

Calories 90     Calories from Fat 0

% Daily Value

Total Fat 0g                           0%

Saturated Fat 0g            0%

Trans Fat 0g                0%

Cholesterol 0 mg                   0%

Sodium 230 mg                      9%

Potassium 230 mg                 7%

Total Carbohydrates 13g            4%

Dietary Fiber 4g         16%

Sugars 0g

Protein 8g

Calcium 4%    Iron 10%

Thiamine 6% Riboflavin 4%

Niacin 4%       Phosphorus 15%

Magnesium 8%           Zinc 10%

Ingredients: organic lentils, water, organic tomato puree, sea salt, organic onion, organic garlic, organic bay leaf

Nutrients are listed under calories.  These include fat, cholesterol, sodium, carbohydrates, protein, vitamins and minerals.  Fat, cholesterol, and sodium are first because we need to strive for less of these. Current recommendations are to limit saturated fat and avoid trans fat.

Labels must list amounts for calcium, iron, vitamins A and C. The listing of other vitamins and minerals is voluntary unless the product carries a health claim about a specific nutrient. Brand B’s label provides more information than is required by law.

The % daily value is based on a 2000 calorie per day diet. Assuming I need 2000 calories daily, if I ate ½ can of Brand A beans, I’d get a lot of sodium.

Ingredients must be listed by weight in order—starting with the highest. Brand A’s ingredient list has a few items that I’d prefer not to consume, especially compared with those in Brand B. Note that Brand B did not have to add natural flavors because it started as a natural food.  Is adding natural flavor an oxymoron?

For those monitoring sugar intake, note that sugar has many names. High fructose corn syrup, fruit juice concentrate, glucose, maltose, dextrose, sucrose, honey and maple syrup are all sugars.  If corn syrup is the first listed ingredient, then that is what you are eating the most of in that salad dressing.

One guideline I live by is that if I can’t pronounce an ingredient, perhaps I shouldn’t eat it. Maltodextrin found in Brand A is a carbohydrate made from a starch that is absorbed rapidly like glucose. Do I really need that?

When it comes to nutrition, simplicity reigns.  Choose single-ingredient foods are you are likely to avoid additives.  What can be simpler than fresh fruit or vegetables? Dried beans, fish, eggs, nuts or dried fruit don’t have complicated food labels.  Not all single-ingredient food is healthy, such as cane sugar or lard, but you get the picture.

Knowing what is in food can help us make better choices.  Eating a healthy diet is like training to be an athlete. It takes education, preparation, and practice. Spend some time educating yourself, develop a plan of action and make a commitment to yourself. Read food labels. You are worth it.

Further Resources

Information from the FDA about how to read food labels:

www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm

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I enjoy looking at health statistics. In my world, data are my friends. Data are tools that help me make choices. For instance, the odds that I will be killed in a shark attack are nearly one in 4 million; my chances of dying from a heart attack are one in five. Given these odds, I am focusing on maintain a strong heart and clear arteries. However, despite these odds, I am not going to jump into a frenzy of sharks, whereas I might skip my daily walk.

Back to health statistics, I was looking at the leading causes of death in the United States. Here are the number of deaths for the top ten according to the National Center for Health Statistics:

  • Heart disease: 614,348
  • Cancer: 591,699
  • Chronic lower respiratory diseases: 147,101
  • Accidents (unintentional injuries): 136,053
  • Stroke (cerebrovascular diseases): 133,103
  • Alzheimer’s disease: 93,541
  • Diabetes: 76,488
  • Influenza and pneumonia: 55,227
  • Nephritis, nephrotic syndrome, and nephrosis: 48,146
  • Intentional self-harm (suicide): 42,773

This list looks very straight forward, but is it? In a paper published in the BMJ (May 2016), Martin Makary and Michael Daniel reported that medical error is the third leading cause of death in the U.S. They estimate a death rate of above 400,000 annually. This high-ranking killer is not included on death certificates and thus does not show up in rankings as a cause of death.

This is scarier to me than jumping into a shark tank. When we are sick, we are vulnerable. Even if we trust our doctors, we are still at the mercy of a system that is bigger than our primary care providers. Between our medical team, pharmacy staff, insurance, labs, and so on, there are lots of opportunity for medical error.

You aren’t entirely helpless. There are measures you can take to minimize your risk of being a medical error victim. The U.S. Department of Health and Human Services has published the following 20 tips by the Agency for Health Quality and Research:

What You Can Do To Stay Safe

The best way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results. 

Medicines

Make sure that all of your doctors know about every medicine you are taking. This includes prescription and over-the-counter medicines and dietary supplements, such as vitamins and herbs.

Bring all of your medicines and supplements to your doctor visits. “Brown bagging” your medicines can help you and your doctor talk about them and find out if there are any problems. It can also help your doctor keep your records up to date and help you get better quality care.

Make sure your doctor knows about any allergies and adverse reactions you have had to medicines. This can help you to avoid getting a medicine that could harm you.

When your doctor writes a prescription for you, make sure you can read it. If you cannot read your doctor’s handwriting, your pharmacist might not be able to either.

Ask for information about your medicines in terms you can understand—both when your medicines are prescribed and when you get them:

  • What is the medicine for?
  • How am I supposed to take it and for how long?
  • What side effects are likely? What do I do if they occur?
  • Is this medicine safe to take with other medicines or dietary supplements I am taking?
  • What food, drink, or activities should I avoid while taking this medicine?
  • When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed?

If you have any questions about the directions on your medicine labels, ask. Medicine labels can be hard to understand. For example, ask if “four times daily” means taking a dose every 6 hours around the clock or just during regular waking hours.

Ask your pharmacist for the best device to measure your liquid medicine. For example, many people use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, like marked syringes, help people measure the right dose.

Ask for written information about the side effects your medicine could cause. If you know what might happen, you will be better prepared if it does or if something unexpected happens.

Hospital Stays

If you are in a hospital, consider asking all health care workers who will touch you whether they have washed their hands. Handwashing can prevent the spread of infections in hospitals.

When you are being discharged from the hospital, ask your doctor to explain the treatment plan you will follow at home. This includes learning about your new medicines, making sure you know when to schedule follow-up appointments, and finding out when you can get back to your regular activities.

It is important to know whether or not you should keep taking the medicines you were taking before your hospital stay. Getting clear instructions may help prevent an unexpected return trip to the hospital.

Surgery

If you are having surgery, make sure that you, your doctor, and your surgeon all agree on exactly what will be done. Having surgery at the wrong site (for example, operating on the left knee instead of the right) is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. Surgeons are expected to sign their initials directly on the site to be operated on before the surgery.

If you have a choice, choose a hospital where many patients have had the procedure or surgery you need. Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition.

Other Steps

Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care.

Make sure that someone, such as your primary care doctor, coordinates your care.

This is especially important if you have many health problems or are in the hospital.

Make sure that all your doctors have your important health information. Do not assume that everyone has all the information they need.

Ask a family member or friend to go to appointments with you. Even if you do not need help now, you might need it later.

Know that “more” is not always better. It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it.

If you have a test, do not assume that no news is good news. Ask how and when you will get the results.

Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources. For example, treatment options based on the latest scientific evidence are available from the Effective Health Care Web site. Ask your doctor if your treatment is based on the latest evidence.”

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coffee

Coffee may provide many health benefits

Drinking coffee is on my list of healthy things I do for myself. For most of my life, I was not much of a coffee drinker. However, the potential health benefits from drinking the black brew caught my attention. I began drinking it after reading compelling research showing that coffee seems to protect the liver. After failing two rounds of hepatitis C treatment, I needed to protect my hepatocytes until better medications were available. Drinking caffeinated brew while avoiding alcohol were two habits I practiced, along with following a healthy diet and daily exercise.

Science has since added to the list of benefits that drinking a moderate amount of coffee may give us. Generally, a moderate amount of coffee is 3 to 5 cups daily. I am referring to 8 ounces of straight black coffee, not a 20 ounce creamy, sugary blended espresso concoction. Yes to espresso; no to sugar and fat.

Here are some of the good things that drinking coffee may do:

  • May improve brain performance and reduce risk of dementia
  • Associated with reduced risk of stroke and heart disease
  • Lower risk of liver cancer
  • Decrease the risk of Parkinson’s and type-2 diabetes
  • May reduce inflammation
  • Studies show other possible benefits of coffee, but the research is not as convincing.

Is there a downside to drinking coffee? If drinking moderate amounts, generally, no. However, caffeine may trigger migraines and other types of headaches. Consumed late in the day, coffee may cause insomnia. For years, experts made much of caffeine’s diuretic effects. We now know that coffee is a mild diuretic, so mild that it won’t dehydrate you. Plus, the water in coffee provides hydration.

The bottom line: If you drink no more than 3 to 5 cups of coffee daily, enjoy every drop. It won’t hurt you, and it may improve your health. Just be sure to not undo those health benefits by adding sugar and cream to that cup of joe.

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Knowing Can Help and Hurt Me

health

You don’t know what you don’t know.

I learned something recently.  Describing someone as a “real trooper” is spelled “trouper” and not “trooper.”  I didn’t believe it, so I looked it up on Merriam-Webster.  I expressed my surprise to a colleague and he said, “Living is learning.”

My response is, “What else don’t I know, and more importantly, what else do I have wrong?” I am sure it is a lot. Sadly, you don’t know what you don’t know.

Here are some things I’ve learned about knowing:

What I know can change. For instance, when I was in nursing school, I learned about blood pressure, what was normal, and what is cause for concern. The normal ranges have changed with less than 120/80 mm Hg as the optimal goal. Although more attention is given to the upper number (systolic), both are important. The risk of death from coronary artery disease and stroke doubles with every increase of 20 mm Hg systolic or 10 mm Hg diastolic among people from age 40 to 89.

I can be wrong. I can be wrong in so many ways. First, I can be wrong because I learned something incorrectly.  Second, I can be wrong because something has changed. Third, I can be wrong because I am not listening well, and I haven’t accurately understood the issue. And fourth, I can be wrong because I am close-minded. This is the worst kind of being wrong because it is born out of arrogance.  Being open-minded is a gift.  So is admitting when I am wrong, and trying to set the record straight.

 Learning is a lifetime process. Learning is the best way to be alive. I welcome the opportunity, even when I find out that I was wrong about something. Learning that I am wrong can be the best kind of learning, because it opens me up to countless wonders.

Not knowing can be magical. There is lots I will never know. Uncertainty can be a magnificent place to be. Rainer Maria Rilke wrote in Letter to a Young Poet:

“I want to beg you, as much as I can, dear sir, to be patient toward all that is unsolved in your heart and to try to love the questions themselves like locked rooms and like books that are written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.”

Want to know more about your health? Here are some more health tools and calculators for the curious:

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Can You Trust Your Lab Test?

lab test

Can You Trust Your Lab Test?

Do you expect your lab test to be reliable?  Is it your belief that the results are a vital tool for the diagnosis of medical problems. Do you think that the FDA regulates all lab tests? If so, you need to know about lab-developed tests, or LDTs.

LDTs are diagnostic tests that are designed, manufactured and used solely within a single laboratory. They are not distributed or sold to any other labs or healthcare facilities to perform on their own. LDTs are often developed because a commercial test is not currently available. Some examples are certain cholesterol tests and genetic tests looking for Alzheimer’s risk or Huntington’s disease.

LDTs are not subject to strict FDA regulations the way other lab tests are.  The FDA found that some of these tests failed to perform adequately, or worse, they caused harm. In an FDA report (November 2015), the FDA found, “We examined events involving 20 LDTs that illustrate, in the absence of compliance with FDA requirements, that these products may have caused or have caused actual harm to patients. In some cases, due to false-positive tests, patients were told they have conditions they do not really have, causing unnecessary distress and resulting in unneeded treatment. In other cases, the LDTs were prone to false-negative results, in which patients’ life-threatening diseases went undetected. As a result, patients failed to receive effective treatments.” These findings were sufficient to cause the FDA to consider regulation of LDTs.

In January 2017, the FDA put further regulation of LDTs on hold. They concluded, “Many stakeholders, in addition to FDA, have indicated that there is a public health need for greater oversight of LDTs…Extensive stakeholder feedback further confirmed the importance of balancing the unique qualities of LDTs, while still providing a reasonable assurance that such tests are analytically and clinically valid…”

 In short, the FDA found the need but LDTs are still largely unregulated. If your doctor orders an LDT, discuss the pros and cons of this.

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Dancing in the Rain for Exercise

Dancing in the rain

When it is raining, play in the puddles

I live in northern California. After years of drought, no one dares to complain about the rain. However, it is interfering with my daily walks, which is my primary exercise. Fortunately, I also do Jazzercise, where a 30-day challenge is motivating me to lace up and drive through wind, rain, mud slides, and mild flooding. I’ll do anything for a free t-shirt.

Actually, the t-shirt is only part of the motivation. It feels good. I am also exercising for my heart, brain, liver, cancer prevention, diabetes prevention, and so on. The benefits of staying fit are endless.  In short, I move to feel good and to stay alive.

According to the Centers for Disease Control and Prevention (CDC), the minimum amount of daily exercise that adults need is:

  • 2 hours and 30 minutes of moderate-intensity aerobic activity (i.e., brisk walking) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

OR

  • 1 hour and 15 minutes of vigorous-intensity aerobic activity (i.e., jogging or running) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

OR

  • An equivalent mix of moderate- and vigorous-intensity aerobic activity and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

If you want more health benefits, strive for:

  • 5 hours each week of moderate-intensity aerobic activity and strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

OR

  • 2 hours and 30 minutes each week of vigrous-intensity aerobic activity and strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

OR

  • An equivalent mix of moderate- and vigorous-intensity aerobic activity and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

Be sensible. If you are new to exercise, check with your healthcare provider before starting a new fitness routine. Remember to drink water, apply sunscreen and avoid injuries. Pain is NOT gain. However, sore muscles may occur. Heat, cold packs, and stretching may be beneficial. Remember to consult a doctor for injuries and discuss a back-up fitness plan for common injuries. Avoid exercise when ill.

Start small. A physical fitness plan should be safe and fit your needs. A reasonable beginning regimen might be to walk a few minutes, stretch, and stop for the day. Always allow a day of rest between weight training workouts.

Set a goal. Gradually work up to a goal. If the long-term goal is to walk 30 minutes five days a week, then start with 5 minute walks 3 days a week until you can do this effortlessly. Do not overdo it as this may sabotage your chances of reaching your goal.

Find your passion. If you find something you enjoy, you are more likely to be successful at it. Fortunately, there are many types of activities from which to choose. Walking, hiking, swimming, dancing, bicycling and weightlifting are some common recreational activities. Yoga, Tai Chi, Pilates, gardening and playing with children are forms of exercise.

Develop an excuse-proof plan. Physical fitness is more likely to be successful if it is portable, and not dependent on the weather, and fits any budget. Put the radio on your favorite oldies station and dance to your heart’s content. Take a walk in a park, even if it is drizzling.  Jump in some puddles like you did when you were a kid.

Exercise can be fun. The benefits are unquestionable. I am living proof. It was hard at first, but now I can’t imagine my life without it.

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