Physician in white lab coat speaking to middle aged obese woman

Pro or Con: Is Obesity a Disease?

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013.

CLASSIFYING OBESITY AS A DISEASE IMPACTS WHETHER WE SHOULD FOCUS ON PREVENTING IT OR PAYING FOR THE TREATMENT OF OBESITY

Members of the House of Delegates of the American Medical Association (AMA) passed a resolution at their annual meeting this week that could be as significant as anything being considered by the US House of Representatives. The AMA Delegates voted in favor of classifying obesity as a disease, moving it up from its former designations as either a behavioral problem, chronic condition, health concern or complex disorder.

This vote was in direct opposition to the recommendations of their own Council on Science and Public Health.

The Council studied the issue and concluded obesity should not be considered a disease because there’s no good way to measure it. Body Mass Index is the measurement now used, but is considered too simplistic, especially since it cannot distinguish between excess weight from fat versus muscle.

As it turns out, obesity isn’t the only thing the AMA has a hard time defining. There is no universally agreed upon definition of what constitutes a disease, either.

This action by the world’s largest physician’s group is largely symbolic since the AMA has no legal authority over the insurance industry, which gets to decide which claims to pay. The resolution was, however, supported by other health groups including the American Association of Clinical Endocrinologists, American College of Cardiology, and American College of Surgeons.

After reviewing the widespread coverage of this decision, it was immediately evident that not everyone in the public health and policy arena agrees with the decision. To put it into perspective I’ve rounded up some of the Pros and Cons to help you decide whether this new designation will help or hurt our national problem with energy imbalance.

PROS: If obesity is a disease the benefits are it may

Reduce the stigma that it’s caused by poor personal habits

Result in expanded coverage by health insurance

Force physicians to raise the issue with their patients (more than half of obese patients have never been told by their doctor that they need to lose weight)

Encourage more obesity prevention programs in schools and the workplace

Support efforts to restrict the sale of certain foods and beverages to those receiving food assistance

Increase research to find a cure or more effective treatment for obesity

Qualify expensive treatments for IRS tax deductions

CONS: If obesity is a disease the disadvantages are it may

Increase stigma towards those who don’t seek treatment

Raise health insurance premiums paid by individuals and employers

Run up the cost of care for the 1/3 of Amercians who are obese and seek treatment

Increase the sales of ineffective and untested products

Support taxes and restrictions on certain foods and beverages

Undermine personal responsibility to change one’s eating habits and activity level

Shift attention towards expensive drugs and surgery and away from programs aimed at preventing obesity

If you’d like to read more about this evergreen issue, here are some past posts worth revisiting:

  • Prejudice Against the Overweight and Obese
  • Obesity and What We Buy at the Supermarket
  • 3 Anti-Obesity Drugs Now Available in U.S.
  • Reflections on Obesity and Weight of the Nation
  • Metabolic Syndrome is Worse than Obesity
  • Research on Mindless Eating Offers New Insight into Obesity
  • Update on Dieting and Weight Loss News
Woman on table having abdomen examined by physician

Crash Diets and Gallstone Attacks

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can read the post here.

STONES IN THE BILE DUCT CAN CAUSE GALLBLADDER ATTACKS IN PEOPLE ON VERY LOW CALORIE DIETS

If you want to reduce your weight, lowering your caloric intake is an option. If you want to reduce your risk of gallbladder attacks while losing weight, don’t lower your caloric level too far.

Crash diets have been proven to increase gallstone attacks.

Crash Diets and Gallstones

A new study from researchers in Sweden followed 6,640 people for one year who were losing weight on diets with different caloric levels. The “crash diet” included liquid meals providing 500 calories a day for six to 10 weeks. After that phase, those dieters gradually resumed eating solid food and followed a maintenance diet for nine months with an exercise regimen.

The other dieters followed a “low calorie diet” with between 1200 and 1500 calories a day for the first three months. It also included two liquid meals a day, then transitioned to a weight maintenance diet of all solid food for the next nine months.

As reported in the International Journal of Obesity, 48 people on the crash diet developed gallstones requiring hospital treatment while only 16 people in the low calorie group did.

One reason offered for this difference in gallstone attacks is that the people on the crash diet lost more weight. They had an average loss of 30 pounds at three months compared to 17 pounds for the low calorie group and an average loss of 24.5 pounds at the end of one year compared to 18 pounds for the others.

Even though obesity is a risk factor for gallstones, losing weight too quickly just makes the problem worse.

What Causes Gallbladder Attacks?

The gallbladder’s function is to hold bile, a liquid made in the liver, and release it during digestion when needed to help breakdown fats. Bile contains water, bile salts, protein, bilirubin (a waste product), cholesterol and fat.

The most common type of gallstones is made from cholesterol. When there is too much cholesterol in the bile it can harden into small pebble-like substances – or stones.

During rapid weight loss the liver secrets extra cholesterol into the bile, and that can increase the risk of gallstone formation. It is also believed gallstones are formed when the gallbladder does not empty completely or often enough, which is the case when eating a very low fat diet.

Bile travels through ducts, or tubes, to get from the liver to the gallbladder to the intestines. If there are stones in a bile duct that block the flow of bile it can cause inflammation. That can lead to the fever, jaundice and the pain commonly associated with a gallstone attack.

Who Gets Gallstones?

In addition to being overweight and losing weight too quickly, simply having gallstones is a risk factor for developing more. Other contributing factors identified by the National Digestive Disease Information Clearing House include:

Female – Women are twice as like as men to develop gallstones

Family History – There is a possible genetic link to gallstone problems

Diet – The more cholesterol and fat in your diet, the greater your chances of making gallstones

Ethnicity – American Indians have a genetic predisposition for gallstones and Mexican-Americans men and women also have higher rates

Cholesterol-lowering drugs – Drugs that lower blood cholesterol levels may increase the amount of cholesterol in the bile

Gallstone attacks typically occur after eating a meal and can mimic signs of a heart attack, so getting a proper evaluation is critical.

If your pain is in your lower back, see my post about kidney stones to see if they are a problem for you.

overweight woman measuring waistline with tape measure

Prejudice Against Overweight and Obesity

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

STUDIES SHOW GROWING ANTI-FAT BIASES FOR OVERWEIGHT CHILDREN AND ADULTS

Two-thirds of Americans are overweight or obese. We reached the point where the majority of us were exceeding our healthy weight in the 1990s. We also have very high rates of fat prejudice in this country. So the question that begs to be answered is, if the majority of Americans have been bigger than average for the past 20 years or so, who is perpetuating the anti-fat bias?

Anyone who has ever circulated a fat joke via email or liked one on Facebook can raise a hand.

Two studies published this month made me think it’s time to turn the mirror on ourselves.

It Takes A Village

Long before children have the math skills to calculate their body mass index (weight/height2 x 703) they show an aversion towards overweight children as playmates. (Body mass index, or BMI, is a measurement used to determine one’s weight classification. A BMI below 20 is considered underweight, between 20-25 normal weight, 26-29 overweight and above 30 is obese.)

Researchers at the University of Leeds in England found children aged 4 and 7 would select a normal weight child or one in a wheelchair before choosing an overweight child as a friend. The scientists discovered this through the use of illustrated storybooks. They created three versions of a story, each with a central character named Alfie. He was either normal weight, overweight or in a wheelchair in the different versions. After hearing and seeing the stories the children in each group were asked if they would befriend Alfie. They were far more likely to choose normal weight or disabled Alfie, with just one out of 43 children saying they would like overweight Alfie as their friend.

The same experiment was done with a female character named Alfina and produced similar results. In both cases older children expressed more negative views towards the overweight child, including seeing him or her as less likely to win a race, do good school work or get invited to parties.

These findings suggest children pick up on the social stigma against overweight people from adults and the media at a very young age as. The authors of the study concluded, “We have a real habit of equating fatness with bad and children are reflecting that back to us.”

Physicians Against Fatness

The second study on fat prejudice that came across my desk this week was done on medical students. It didn’t involve story books.

Researchers at the Wake Forest School of Medicine in Winston-Salem, North Carolina had over 300 third year medical students complete the Weight Implicit Association Test (IAT). This test is a validated measure of implicit preferences for “fat” or “thin” individuals.

The value in measuring implicit biases is that they occur at an unconscious level. They reflect our first reaction or initial emotional response to someone before our conscious thought emerge.

The students also completed another test to identify their explicit preferences, which are the ones we are consciously aware of.

The results showed that the majority of students had implicit weight-related biases, with more than twice as many showing anti-fat bias compared to anti-thin. The majority also reported they preferred thin people to fat people in the explicit test, with males twice as likely to report explicit anti-fat bias. Among students with a significant weight-related bias, only 23% were aware of it. More than two-thirds of them thought they were neutral.

The authors suggest these findings may be due, in part, to the fact medical students are learning about the dangers of obesity and may feel they should prefer thin people over fat. Or they may believe body weight is under an individual’s control so they may hold a negative view of someone who doesn’t do something about it.

Unfortunately, these results are very similar to those obtained when non-medical students take the tests, and they reflect the attitudes of the general public. Even those of kids in kindergarten.

Lead author Dr. David Miller said these biases can affect the doctor-patient relationship and must be overcome to improve care for the millions of Americans who are overweight or obese.

A good place to start may be by looking in the mirror.

two women and a man working in a community garden

Health Benefits of Starting a Garden

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can read the post here.

OUTDOOR GARDENING OFFERS MANY BENEFITS BESIDES FRESH GARDEN VEGETABLES

Don’t you love it when something you’ve always believed to be true is actually proven by research? I’m one of those people who believes outdoor gardening is good for the mind, body, and soul. Now a growing body of evidence supports this notion, too.

I’m not just talking about planting garden vegetables so you can reap all of the nutritional benefits that go with them. Studies show starting a garden is good for you no matter what you grow, or where.

Gardening and Weight Control

The latest study to support my theory was published this month in the American Journal of Public Health. Researchers from the University of Utah found people who tended community gardens weighed less than their neighbors, siblings and spouses who didn’t.

Community gardens have already been shown to provide social benefits to those who till them and nutritional benefits to all who eat the harvest. This study confirms that those who get their hands dirty also have lower body mass indexes (BMI) and lower odds of being overweight or obese.

The study only looked at a small community in Utah, so cannot be interpreted to be true for the population at large, but I think we can expect to see similar results when a larger study is conducted.

Another thing the study does not answer is whether lower weight people are drawn to gardening, or whether gardening makes them lighter? What do you think?

Gardening and Mental Health

A study just published in Psychological Sciences, the journal of the Association for Psychological Sciences, made a strong case for the benefits of gardens, even if you don’t til them. It found people who live near parks, gardens or other green space report a greater sense of well-being than city dwellers who don’t get to see much outdoor greenery.

The researchers analyzed data collected from households in the United Kingdom and found individuals who lived in greener areas reported less mental distress and higher satisfaction with life. This more positive outlook held up even across differences in income, employment, marital status, physical health and housing type.

This study did not prove that moving to a greener neighborhood will make you happier, but does support findings from other research that shows short bouts of time in green space can improve mood and cognitive functioning.

Since April is National Garden Month, I can’t think of a better time to get outside and do some gardening. Whether you plant vegetables, flowers, herbs, shrubs, trees or grass, starting garden is good for your health!

Psychological Benefits of Gardening

  • Nurture your natural instincts
  • Cultivate your sense of patience
  • Explore your creativity
  • Relieve your stress
  • Lessen your anxiety
  • Improve your mood

Physical Benefits of Gardening

  • Eat more fresh produce!
  • Strengthen your muscles
  • Burn some calories
  • Breathe in fresh air
  • Make vitamin D from sunshine
  • Sleep more soundly

What’s growing in your garden?

Problems with Hypothyroidism Run in the Family

Problems with Hypothyroidism Run in the Family

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can see it here.

WEIGHT GAIN IS JUST ONE SYMPTOM OF AN UNDER ACTIVE THYROID SO GET THYROID FUNCTION CHECKED

Back in the days when the majority of American adults were not overweight, those who were would often blame it on a “sluggish thyroid.” While it is true that weight gain is a symptom of an underactive thyroid, I don’t hear that excuse much anymore.

Could it be that now that two-thirds of the population is carrying extra pounds, people have decided they don’t have problems with hypothyroidism?

In an odd twist of fate, they just might be wrong! It is estimated that 1.5 million Americans over the age of 12 have do not produce enough thyroid hormone, with half of the cases undiagnosed. The chances of developing hypothyroidism increase with age and women are five times more likely than men to suffer from it.

It’s worth knowing all of the symptoms caused by a low thyroxin level since unexplained weight gain is not the only issue linked to thyroid health. Heart disease, infertility and osteoporosis are also on the list, along with diabetes, arthritis and anemia.

Symptoms of an Underactive Thyroid

All of these symptoms are not experienced by everyone with an underactive thyroid, but these the most common ones.

  • Persistent Fatigue, Drowsiness
  • Weight Gain, Water Retention
  • Cold Intolerance, Low Body Temperature
  • Constipation
  • Thinning or Loss of Hair
  • Depression, Moodiness
  • Joint and Muscle Pain
  • Heavy or Irregular Menstrual Periods
  • Dry Skin, Brittle Nails
  • Puffy Face and Eyes

Diagnosing Problems with Hypothyroidism

Many of the symptoms of hypothyroidism are the same as those for other diseases, so a diagnosis cannot be based on symptoms alone. Your physician will need to review your personal medical history to look for other signs of thyroid dysfunction and ask about your family history since thyroid problems are familial.

TSH Test – This test detects the amount of Thyroid Stimulating Hormone (TSH) in the blood and is the most accurate way to measure thyroid function. TSH levels rise and fall based on how much thyroid hormone is being produced to meet your body’s needs. A result showing TSH above normal levels indicates hypothyroidism and a reading below normal means hyperthyroidism, or over-active thyroid.

T4 Test – This test measures the actual amount of circulating thyroid hormone in the blood. In hypothyroidism, the T4 levels are lower than normal.

Restoring Thyroid Health

Hypothyroidism can be almost completely controlled by taking a synthetic form of the hormone thyroxin. The hitch is getting the dose right, taking the medication properly and avoiding interference from other medications.

That means you’ll need to have your TSH level checked every 6-8 weeks after beginning treatment so adjustment can be made in the dosage until it is right for you. Once the TSH levels are stable, you will need to have them monitored the rest of your life since your condition can, and will, change with age and other changes in your health status.

There is no special diet for treating hypothyroidism. As for the excess weight, once you’re on the right medication, your metabolism will start working properly again and the weight should come off. You’ll also feel more energetic so can resume regular exercise.

Nutritious snacks like cheese and vegetables help kids eat less and feel more satisfied

Good-For-You Foods Make Best Snacks for Children

This post was originally written during my 2 1/2 year tenure as a blogger for Family Goes Strong. This site was deactivated on July 1, 2013, but you can see the post here.

STUDY FINDS KIDS EAT LESS WHEN NUTRITIOUS SNACKS ARE SERVED

I’ve never met a parent or grandparent who didn’t want their little ones to eat more good for you foods. That wish stems from a lesson we all learn from our personal battles with food. Simply put, it’s a whole lot easier to start out life with good eating habits than to try to establish them later.

Amen to that.

Now we can turn to snacks as a way to help our children eat better and prevent obesity says a study published in the Journal of Pediatrics. The researchers set out to discover whether different types of snacks for children would make them feel full, yet consume fewer calories. And the winner was cheese with cut-up vegetables!

Some Background on Snacking

Thirty years ago American children ate about one snack a day. Now they eat three. Along with those extra snacks they have put on some extra weight. Nearly one-third of our children are overweight or obese.

Since snacking is part of the culture our children are growing up in, trying to restrict or forbid it is fruitless (pun intended). But changing what kind of snacks we offer them is not. The goal is to select snacks that help meet nutrient requirements without exceeding caloric requirements.

Highlights from the Snack Study

201 children in grades third through sixth were in the study. The participants and their parents were told the children would be asked to watch some cartoons and answer questions about the characters at the end and be given snacks to enjoy while watching. Measurements of body mass index and information about food allergies were obtained.

The children were assigned to one of four “snack food groups” and screened in 24 separate experimental sessions with 5-11 children in each. During the sessions the children were given a bottle of water and identical plates of food. They were told they could eat as much as they wanted of the food provided, and asked how hungry they were in the beginning, middle and end of the 45 minute period.

The snack food options included a plate with either:

  • A tube of plain potato chips and a medium bag of crunchy cheese flavored snacks
  • 6 Laughing Cow cheese wedges and 6 Mini Babybel cheese rounds
  • 2 cups each of raw bite-sized broccoli, baby carrots and bell pepper strips
  • A combination of 6 cheese wedges and 6 cheese rounds and 1 cup of each vegetable

The food on each plate was weighed at the outset and any uneaten food was weighed at the end to determine exactly how much each child ate. No child finished it all. Parents completed a questionnaire designed to measure family mealtime habits and levels of engagement.

Surprising Results About Snacking and Kids

Children who consumed the cheese and vegetable snack ate 72% fewer calories than those eating chips and needed significantly fewer calories to achieve satiety compared to them.

The children eating the combo snack consumed roughly the same number of calories from vegetables as the children who only got vegetables, so they did not replace the vegetables with cheese.

Overweight and obese children and those from low-involvement families had a bigger reduction in calories compared to normal weight children and those from high-involvement families.

Key Conclusions About Snacks to Make for Kids

Offering cheese and vegetables as a snack leads to eating fewer calories than when salty, high-fat chips are served and provide good sources of fiber, calcium and protein.

Eating cheese and vegetables as a snack may encourage healthier eating habits in children, especially in those who are overweight.

A higher level of engagement between children and adults at mealtime is correlated with healthy weight in children.

Don’t you wish someone had given you some mini cheese and baby carrots when you came home from school?

Myths about dieting and best weight loss diet make news

Update on Dieting and Weight Loss News

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can view it here.

MYTHS ABOUT DIETING AND BEST WEIGHT LOSS DIET MAKE NEWS

News about how to lose weight is always newsworthy, even when there is nothing new to say. But that doesn’t matter. We are fed a steady stream of information about dieting and weight control to keep the conversation going. Wouldn’t it be nice to hear a broadcaster say just once, “There will be no weight loss news tonight.”

I know I’ve had my fill.

Last month we had the unique opportunity to hear about the best weight loss diet and the top obesity myths in the same news cycle. You can’t beat that for intrigue!

What’s True About Weight Loss?

The annual list of the best diets from U.S. News & World Report arrived with the usual excitement, followed by reflexive disappointment. Whether the goal is to lose weight, get healthy or control disease, the best diets in each category still require making better food choices and keeping track of them. Nothing new there.

The top weight loss diets were all about common sense things like eating more vegetables and less meat, taking smaller portions of food and bigger amounts of exercise, and being more focused on your food than your social networks when eating. Is there anyone left who doesn’t know that?

What’s Not True About Weight Loss?

The other story grabbing headlines last month was about obesity myths. Apparently everything we’ve told about dieting and weight loss isn’t true, or at least it hasn’t been scientifically proven.

Researchers at the University of Alabama wanted to set the record straight, so looked for the studies to back up the most popular beliefs about obesity. They reported their findings in the New England Journal of Medicine and said “false and scientifically unsupported beliefs about obesity are pervasive.”

Did you know there’s no proof that taking more physical education classes will curb obesity in kids or that eating more frequently throughout the day will help? With or without proof, it seems pretty obvious to me that the advice isn’t working. But it’s still news.

What Can We Do About Weight Loss?

Why not take a break from all the weight loss news and act on what we already know? There are no game-changing discoveries around the corner. Nothing new is in the pipeline that will make the task easier. And there is never going to be a magic potion that will melt our fat away.

It’s time to stop talking about dieting and weight loss and start doing something about it. We could really surprise all those researchers if we were successful in spite of the myths!

Some other thoughts on the issue can be found here:

  • Technology Beats Temptation in New Weight Watchers Plan
  • 3 Great Tips for losing Weight
  • 5 Sure Steps to Achieving Weight Loss
  • Choosing the Right Diet Plan
  • 8 Ways to Lose Weight This Spring
  • 10 Cheap Diet Solutions for Safe Weight Loss
  • What Fads Diets for Weight Loss Have You Tried?
Parents can play a major role in preventing childhood obesity

Childhood Obesity: 5 Things Every Parent Should Know

This post was written as a guest blog for Family Goes Strong. You can read the original post here.

PARENTS CAN PLAY A MAJOR ROLE IN PREVENTING CHILDHOOD OBESITY

Childhood obesity has more than tripled in the United States over the past 30 years. It affects children in every state and from every socioeconomic group. As of 2008, more than one-third of children and adolescents in the U.S. were overweight or obese.

When a problem becomes that prevalent there is a danger of not taking it as seriously as we should. But the risks of obesity are too great to ignore. Preventing excess weight gain in children may be the most important way we can protect their health and quality of life.

With more than 30 years of experience helping families deal with childhood obesity, I know there is no simple solution to this problem. But there are some things every parent should know as they consider their options.

5 Things You Need to Know About Childhood Obesity

1. Your child’s relationship with food is established in the first five years of life

When solid foods are first introduced to a child between the ages of 4 and 6 months, they begin their relationship with food. For the next year parents must learn to interpret the subtle signals their children use to express how hungry they are and what they like until they can tell you themselves. The goal is to allow the child’s internal sensation of hunger to govern how often and how much they eat. Their evolving taste preferences should allow them to accept and refuse different foods without threat of punishment or reward. If this is done consistently, in an eating environment where no bias or judgment is expressed about any food, children will grow to trust their feelings of hunger and appetite by the time they start school.

2. What is eaten at home is more important than what is served at school

Children spend far more time eating at home or out with their parents than they do in school. What children experience during meals with their family is far more important than the institutional feeding that goes on in schools. If parents don’t like the selections available on school menus, they can pack a lunch for their child to eat instead. But if a child is being exposed to new foods in the cafeteria that are not available at home, they have no choice but to eat what is served at home.

3. Weight loss in parents is the biggest predictor of children’s weight loss

A recent study looked at 80 parent-child sets with an overweight or obese 8-12 year old in each. The participants were assigned to one of three different programs to help their child lose weight. Features of the three programs included having the parents change the home food environment, limit what the child ate, and lose weight themselves. The researchers found parents’ weight loss was the only significant predictor of children’s weight loss. These results are consistent with other research showing how important the example set by parents is to successful weight loss in their children.

4. Genetics are a factor in obesity, but age of onset is more important

There is no test we can take at birth to tell us who will become overweight or obese as an adult. If one or both parents are obese, that does increase a child’s risk of also becoming obese, but it is not inevitable. Research from the Children’s Hospital and Medical Center of Cincinnati found that being obese during the teen years is a stronger indicator of who will be obese in adulthood than being obese in early childhood, regardless of whether the parents were obese. Preventing obesity in adolescents is one of the best ways to prevent obesity in adults.

5. Treat overweight and obesity in your child as a health concern, not an image problem

All children need to learn how the food they eat and their level of activity can affect their health. The conversation should be the same for an overweight child and one who is not, just like talking about the importance of wearing seatbelts and getting immunized. When the focus is on staying healthy, not appearance, your child is less likely to develop emotional issues about their weight.

Metabolic Syndrome Causes Greater Disease Risk Than Obesity Alone

Metabolic Syndrome is Worse than Obesity

RISK FACTORS FOR HEART DISEASE, STROKE AND DIABETES INCREASE WITH METABOLIC SYNDROME

Metabolic Syndrome is what you have when you are overweight, and most of your excess weight is around your middle. Along with that apple shape you also have to have any two of these other conditions: high blood pressure, high blood sugar, high triglycerides and too little HDL, the good cholesterol.

The American Heart Association estimates that nearly 35% of American adults meet these criteria. This means only about half as many people have Metabolic Syndrome as those who are just overweight. But Metabolic Syndrome is far worse. It doubles your risk for heart disease and stroke and increases your risk for diabetes by five times.

How to tell if you have Metabolic Syndrome?

The quickest way to tell if you have Metabolic Syndrome is to use a cloth tape measure to take an honest reading of your waist measurement. Place the beginning of the tape on top of one hip bone and bring it around your back, over the other hip bone, on top of your navel, then reconnect it at the hip bone. The tape should make a circle around you that is the same distance from the floor all the way around. Do this without pulling too tight or holding your breath. Now compare your reading to the values below to see if you are at risk.

Waist circumference: Women greater than 35 inches, Men greater than 40 inches

Medications: You use prescription drugs to lower cholesterol and to lower blood pressure

If your waist circumference is too large but you aren’t on two prescriptions, here are the numbers you need to have to avoid starting on medications and qualifying for Metabolic Syndrome.

  • Triglycerides: less than 150mg
  • HDL Cholesterol: over 50mg for women, 40mg for men
  • Blood Pressure: less than 130/85
  • Fasting Blood Sugar: less than 100mg

How do you treat Metabolic Syndrome?

There is no single treatment regimen for Metabolic Syndrome. Each risk factor – your weight, waist circumference, cholesterol and blood sugar levels and blood pressure – must each be managed in the best way possible to bring them back into a normal range.

The one common denominator to treating all of the risk factors, other than to quit smoking, is a healthier diet and more physical activity. Even if only a small amount of your excess weight is lost, a better diet and more exercise will improve your other numbers, and that’s important.

A study published this month in the Journal of the American Dietetic Association found that increasing the fiber content of the diet did more to lower the risk for Metabolic Syndrome than reducing the intake of saturated fat and cholesterol. Of course, controlling fat intake is important, but if you want to focus on foods you can add to your diet in place of some other foods you’re now eating, go for more high fiber whole grains, beans, vegetables, fruits, nuts and seeds. They belong in your daily diet for lots of other reasons that are good for your health, anyway, so why not get started?

Is your muffin top putting you at risk for Metabolic Syndrome?

Goals for Food Day matter every day of the year

Registered Dietitian’s Food Day Pledge Takes Aim at What’s Wrong With Most Advice

Food Day Pledge from registered dietitian lists 10 Things she will not do when giving food advice

Today is Food Day, a day to promote “healthy, affordable food produced in a sustainable, humane way.” This I support. But some of the lofty ideas, biased language and unsupportable premises offered by the promoters I do not.

For example, the 6 Food Day Principles strive to both limit subsidies to agribusiness and alleviate hunger, even though you need the first to first to accomplish the second. The official Food Day cookbook, Eat Real, is described as a collection of delicious, healthful, easy-to-prepare recipes, yet includes “Braised Kohlrabi with Fennel & Leeks” and “Yogurt Panna Cotta with Cranberry Pear Sauce,” which just don’t sound real enough for most people I know.

Therefore I am taking a different approach. As a registered dietitian and cultural anthropologist, I have prepared a pledge of the ten things I will not do on Food Day, or any other day of the year, because I believe they are contrary to health promotion and a sense of fairness to all of the people in America who need to hear messages about good nutrition.

Food Day Pledge From a Registered Dietitian

I hereby pledge not to:

  1. Blame any single food, beverage or ingredient for obesity. It’s a complex issue with many biological, environmental, behavioral and social implications. We don’t have all the answers but the shot-gun approach of targeting one thing as the cause doesn’t help.
  2. Use toxic language to describe otherwise edible food. Terms like “toxic,” “garbage” and “junk,” have no place in the conversation when a food is not spoiled or is otherwise safe to eat.
  3. Hide vegetables in other foods in order to get kids – or anyone else – to eat them. Only in America could such an idea flourish.
  4. Presume that the food supply and/or diets of Americans were actually better at some other time in history than they are right now. We simply weren’t micromanaging everything we ate in the past as we are today since most of history was dominated by a need to stay one step ahead of starvation.
  5. Submit to the idea that food advertising and brand marketing are more powerful than individual choice. They may lead us to the product, but we buy based on education, income and circumstances.
  6. Profess that we know all that there is to know about our nutritional needs and how to meet them. The science of human nutrition is young and still evolving, so I will always be ready for more breakthroughs.
  7. Let the rapid rate at which news travels via the Internet undermine the slow and methodical pace of scientific discovery. Changes in dietary guidance are not based on single studies or viral videos.
  8. Forget that most Americans do not live near a farmer’s market or other local source for year round produce. Frozen and canned vegetables are two of the best values in the grocery store.
  9. Ignore the fact that there is no such thing as “The American Diet.” Food consumption survey data is at best a fuzzy snapshot of what some people ate for a few days of the year, as best as they could remember and describe it. That does not tell the whole story.
  10. Overlook the uniqueness of each person’s diet as a reflection of his or her cultural, ethnic, religious and socio-economic heritage and, most importantly, personal tastes.