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michelle, my first lady

Dear Michelle,

I have been worried about your husband Barack’s eating habits. From following him on the campaign trail during these very arduous times, it seems that news items abound about him chowing down on ribs, chili dogs, pizza and pastries. Yes, I know that he needs to go meet and greet his constituents and that he is eager to support small business owners around the country. This does mean that he must go and find where the people gather–and that is often in settings that involve the communal act of the serving and eating of food.

I deeply appreciate that he is of the people and can get down and chow down with the common folk. I also know he is a very generous guy and stories have reported that he is sometimes buying goodies to bring back to his hard-cranking campaign workers or public servants in the numerous locations where he has touched down.

Michelle Obama - white house kitchen garden

Michelle Obama’s White House Garden

 

I do not mean to undermine his profound need for nourishment to keep him going, but it seems that a lot of yellow and red light foods are speeding their way down his own gullet–with obvious gusto–and with no traffic infractions being incurred. Just for those of my readers who don’t live in the world of nutrition education, the traffic light metaphor refers to a system of identifying foods as either green, yellow or red light signifying always, sometimes or rarely ever to be eaten.

I am reminded that when Barack’s friend and mentor, former President Bill Clinton was in office, his legendary appetites were the subject of much attention and downright mockery. I remember hearing he lusted for Philly Cheese Steaks. So, why are your husband’s eating habits not garnering the same scrutiny? Unfortunately, unlike pudgy Bill, it is because he is thin–actually, it is worse than that. He is skinny. I say, unfortunately, because being skinny can sneak up and bite ya. I imagine it must have been a bit disconcerting for you when that burly pizza parlor owner, came right over and just picked poor Barack right up off the ground with that big bear hug.

With all the attention on obesity, we forget that the non-obese can suffer health consequences as well and are equally vulnerable to the effects of poor diet, smoking and stress–which I know are issues your husband contends with. These can be more detrimental than just extra pounds alone. I think I heard that he has quit smoking–so that is good.

I will assume that when at home, our dear President consumes lots of White House grown organic vegetables, and grass-fed, hormone-free animal products prepared by some of the best chefs in the land. And, that he plays basketball and does other activities to stay fit. Hopefully, he also has a team of massage therapists and other holistically-oriented practitioners to assist with his well-being. Maybe he just eats these ‘red light ‘ foods when he is on the road–like kids who go crazy for sweets at other people’s homes when such foods are forbidden in their own.

Believe you me, I do know that it is impossible to control our husbands’ behaviors. Here I am a nutritionist, and my own hubby has quite the pedestrian sweet tooth. No amount of my homemade kale chips can keep him from occasionally going out and finding a bag of Cheeze Doodles and the perfect dish of ice cream. I bet Hilary knows what I mean. Still, I am wondering, if given your highly touted platform and efforts regarding the urgency of improving nutritional status and decreasing the burden of illness on our nation, whether Barack could and should be modeling more healthful eating behaviors.

I was troubled by a story I heard on the radio just last week. NPR reported on what Obama and Romney were doing to sustain their non-stop high-energy requirements on the final leg of the campaign. This was right before Hurricane Sandy changed the agenda. They interviewed some campaign assistant who started out by saying that when Barack got off the plane that morning, he headed right over to get some Krispy Kreme doughnuts. You probably don’t know that I have a little, shall we say, vendetta against Krispy Kreme, so you may want to read my posts, Kicking Butt with Krispy Kreme and Magic Doughnuts–The Nutritionist’s Nemesis. So, upon hearing that, I was all ears.

It got worse. I was shocked to then hear Barack himself saying something to the effect that all that nutrition stuff is your thing, but he doesn’t care. It is an election year and the White House will be giving out lots of candy for Halloween. My, I don’t know how you felt about that, but I was disappointed to hear such an off the cuff remark that indicated to me a disregard of the real importance of proper nutrition in improving the health of our citizenry.

To really turn the tide on the dire consequences attributable to the Standard American Diet  (SAD) will take more than lip service. It will take courage to exhibit true leadership in this matter–and leading by example. Sugary sweets are not a substitute for the relief this electorate truly seeks, and perpetuating good-natured excuses and exceptions for our food behaviors will not reduce our massive health costs and its drain on our economy. That quick sugary fix will ultimately lead to a massive crash in mood and energy.

Never you mind. Your husband still has my vote. Yet, I am writing this with trepidation as the election is still a few days away. I do wish for him to have four more years–healthy years– in office. I hope it will not take a quadruple bypass surgery for him to appreciate and attend to the benefits of a healthful and vegan diet as it did his friend Bill. It would have been nice if while stumping in North Carolina he had stopped in at that wonderful restaurant, The Laughing Seed Cafe that I mentioned in Forks on the Road.

Though Barack might not need them, the future of health care, Medicare and Social Security are seriously on the line right now–and we need him to make sure that those programs are there for those of us who will. Perhaps too, with a second term, he can work to integrate some more holistic preventive health measures into Health Care reform. Please, keep up your good work and see if you can get Barack to eat his beets. I read that he does not like them. Do let him know that betalain-rich beets are blessed with many health benefits. Great for the cardiovascular system and the lowering of high blood pressure. And, that makes those beautiful red gems a nice little aphrodisiac food too–wink wink

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

Respectfully,

In health, Elyn

P.S. Congratulations on your beautiful new book, American Grown, The Story of the White House Kitchen Garden and Gardens Across America.

Related Recipe: Minted Spring Pea Salad from American Grown courtesy of Eating Well Magazine

American Grown (Michelle Obama book).jpg

Michelle’s My Plate

My Plate Grace

We hope we live long and strong.

by Obama Family

just today

Just today, I got an email informing me that the way to eat carbohydrates more efficiently and prevent the insulin resistance associated with diabetes is to take Cinnamomum Burmannii, Berberine, Pterocarpus Marsupium, 4-hydroxy isoleucine, #5 – R-Alpha Lipoic Acid (R-ALA). These substances are available in combination in pill form. Well, that sounds nice and easy, I thought. Now just how could I obtain some of these little Burmanniis and Marsupiums for all of the inefficiently carbohydrate-eating, diabetes-prone poor folk. I wished nutritional supplements were available to my clients. I’d settle for some R-Alpha Lipoic Acid.  IMG_3170

Just today, I did not attend the bariatric conference that I went to last year and described in How Can You Say No to a Brownie.  Therefore, I missed the session on Diet Strategies: Which work and which don’t. I guess I will have to wait, along with the rest of the world, on that breaking news.

Just today, I culled through the medical records of a number of clients at the Health Center, collecting data for a project I am working on. Medical records are literature. They contain the stories of lives weathered by poverty documented by scads of lab results, vitals, hospital discharge papers and consult notes. Lives marked by the chronic health problems of diabetes, hypertension, pain, extreme weight, and hospitalizations. Conditions tended to by a boatload of pharmaceuticals, prescribed in an oft crapshoot manner.

Just today, I missed the webinar I had registered for with Renegade Chef Ann Cooper. Without an ounce of rocket science, she is feeding kids healthy foods in schools. I was disappointed. This would have brought some hope and inspiration.

Just today, I received an e-health report from the American Academy for the Advancement of Science describing that 50% of people with hypertension do not have it controlled. I thought about all the records I had just pored over. Most of those with uncontrolled hypertension are on one to three hypertensive medications.

Just today, I wished again–this time for stress reduction programs for my clients. I left my office near tears. I dreamed about a new line of work.

Just today, on my way home, I heard a news story that the US Army had declared a service-wide stand down to bring attention to the problem of suicide in the military. Army bases around the world were shut down for mandatory suicide prevention training.

Just today, I took a walk. I thought about processed food. I use tweezers to extricate it from my clients’ lives though I could use something a bit stronger–like a Jaws of Life. I wondered about a stand-down calling for a moratorium on the low-quality foodstuffs that glut our food supply. I decided that we need a National Day of Nurturing and Nourishment.

Just today, my amazing, earth-moving niece Shanti shared some stories about the beautiful and remarkable greening, gardening, and food work she does with the Clinton Housing Development Company and Cultivate HKNY in the midst of New York City.

Just today, going to pick up my daughter from crew practice, I drove along a quiet road with the sun setting spectacularly on one side while the harvest moon rose beautifully over the other. Arriving home, I read the team’s paperwork asking me to sell David’s Cheesecakes, Grandma’s Pies and cookie dough for a fundraiser. My heart sank. My inability to broker in sugar will cost me some bucks as I will have to choose the buyout.

Just today, I wrote this blog. As I was calling it a day, an old friend posted information about an organization doing wonderful work. I was glad to learn about One.org which is working with women to address childhood malnutrition and putting nutrition on the global agenda.

Just tonight, I shut out the light, deciding I would do a new little campaign at the Health Center. I will call it One Day One Way encouraging people to take back their own health. By the light of the moon, I wished you all good night.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

my plate

My Plate Haiku

If only we could
Change the world on that one day
By feeding our hearts .

by Julie

a bushel and a peck of ways to address childhood obesity

It seems that we spend a lot of time fixing things that should not have ever become so broken. Not only time is wasted but a lot of resources– that seem to be rather scarce these days.

As this relates to the care and feeding on the physical, emotional and spiritual levels of human beings, we certainly have been drawn off course. Some significant digressions from what should have been a rather intuitive matter or a natural symbiotic relationship with the natural and nurturing environment have occurred.

Healthy Children

Healthy Children (Photo credit: Korean Resource Center 민족학교) drawing by 13 yo Suzy An, Irvine, California

Though early humans expended much of their energy trying to procure food for survival, they still seemed to have had time for other endeavors as well–like discovering fire, inventing the wheel and designing clothes. Nomadic cultures certainly had to find to go or take out food solutions. One would think that at this stage of the game, we too should be able to both nourish and progress.

Listening to the persistent conversation about the problem of obesity one might think evolution-wise we were still inventing the wheel. The top experts in the field are engaged in the mandate to ferret out the problem and find solutions, huge research projects are undertaken, big monies are allocated, programs are created, public health campaigns are rampant. The hunt is on and it has been going on for decades. This time its pursuit is not roaming bison or wild turkey but the reclaiming of our natural homo sapien form and functioning. So far, we seem to have only snagged the primordial beast of ‘eat less and exercise more’.

I wonder if this all has to be so difficult. Where and how did we stray so far off course? How did we allow the school food situation to get so bad? Other nations with way fewer resources have maintained a large degree of nutritional integrity, even if in the form of some hearty gruel. Jamie Oliver, a simple lad from England, has managed to bring nourishing food into kids’ cafeterias.

Today, sadly aware that September is Childhood Obesity Awareness Month, I venture into the childhood obesity debacle to suggest that maybe we can shift the focus, listen to our inherent wisdom, reclaim our cultural connectedness and tweak the approach, to save some of the expended resources that we are currently draining. I know these are complicated matters but perhaps there really are more holistic solutions.

Here are some possibilities:

ð  Legislate paid maternity leave of a valuable length. The United States is one of only three countries in the world that do not offer paid maternity leave. The other two are Swaziland and Papua New Guinea. Most countries provide paid leave of between 14-22 weeks. Norway allows 44 weeks, while Canada allows 50. Mothers here who do get to stay home for a meager six weeks after the birth of their babies generally are those whose jobs provide disability insurance. Wow. What a warped difference in consciousness. maternity leave comparison

ð Implement more generous, equitable and flexible time-off policies. Without time for parents to establish healthy routines, many important aspects related to family and child health are neglected. Additionally, one cannot even begin to discuss weight matters without acknowledging the role of stress on our eating and metabolism.

ð Promote and normalize breastfeeding. It is important to understand the nutritional, metabolic, digestive, and immune implications of replacing human breastmilk with artificially manufactured milk substitutes. Updated 2020: Infant Feeding History Revised

ð  Revisit infant feeding recommendations. Our early feeding practices rely on the introduction of cow milk and soy-based proteins, processed grain cereals and juices as babies’ first foods. Infant feeding recommendations promulgated by physicians professionally under-educated on nutritional matters and baby food manufacturers seem almost sacrosanct in our society. Decades-long infant feeding guidelines are based on often misguided attempts to compensate for and mitigate the negative effects of depriving infants of species-specific breastmilk. The digestive imprinting and physiological adaptations to our first foods provide important clues as to children’s feeding inclinations. Ignoring this stage is short-sighted.

Update 2020: Somehow I missed the memo. While I had known the American Academy of Pediatrics had through the years strengthened their stance on promoting breastmilk as babies’ first food, I did not realize that in 2017 they updated their 2008 guidelines on starting solid foods. Notable changes are recommendations for extended breastfeeding, no juice during the first year, and an increased variety of introductory solid foods instead of just iron-fortified cereals. First foods to give your baby.

ð  Appropriately nurture children’s developing food palates–like other food-conscious cultures do). This means we should not be catering to children’s unformed palates. Doing so dwarfs the development required to appreciate more sophisticated and healthier foods, tastes and textures. Overexposing children early to an onslaught of sweet and chemically-produced tastes inhibits acceptance of the wide variety of foods required for a balanced diet and predisposes them to serious health problems. How the french feed their children;

ð   Stop advertising and marketing food to children. Over thirty-five years ago, Michael Jacobson of the Center for Science in the Public Interest and Action for Children’s Television petitioned the Federal Trade Commission (FTC) to restrict advertising aimed at children–in large part due to its effects on children’s dietary preferences and intake. The FTC agreed that such practices were inappropriate. However, the food, toy, and advertising industries pushed back and unfortunately pressured Congress to halt taking action. Today, 17 to 20 billion dollars are spent annually on the marketing of non-nutrient foods to children.

ð Remove unsavory ingredients from the food system. While our FDA continues to hold to its stance that artificial food dyes and preservatives in our food are safe, other countries have begun to take progressive action to remove these substances from their products–even those made by American manufacturers–for the sake of their young citizens.

ð  Redesign supermarket and drug store layouts so that they do not cater to 4- year-olds’ sensibilities. Next time you shop, pay attention to how many cartoon character endorsed products are populating the food aisles, especially at the eye-catching “end caps” and checkout counters.

ð  Direct adequate funding to school meal programs. School lunch in Japan.

ð  Respect recess. Put it back in the schools if it has been taken away. Provide it daily and preferably before lunch. Children innately know how to move. We just have to ensure that they have the appropriate time and space to do so.

ð  Integrate relaxation/yoga/resilience training and cooking/gardening/movement curriculum at all grade levels.  

ð  Protect farmers and subsidize fruits and vegetables.

Well, using agricultural measurement, I think that is enough for now. If we truly and intelligently wish to address this matter–and to heal what should have never become so broken–we have to restore the capacity of those best equipped to nourish and protect our children–the parents, farmers, cooks, teachers and schools. And yes, it may require the funding, creation, and implementation of policies on a larger-scale which will facilitate that as a nation we are prepared to do so.

May we love our children a bushel and a peck.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, with a hug around the neck, Elyn

My Plate

My Plate Haiku

Smooth peanut butter

Spread on a peeled banana

Snack time perfection. by Gretchen

the dance of diabetes

It is a modern dance though it has its roots in classical forms. It was originally choreographed for just a handful of dancers but now it is staged for many. In recent years it has been performed all around the world. I have seen it many times.

Martha Graham–photo by Yousef Karsh

The curtain rises and the stage is empty. Slowly, alone and in pairs, the dancers enter–men and women. They are dressed simply in tights and leotards, all in tones of soft browns and grays, with one wrist wrapped in a band of red fabric. The dancers inhabit their space with sparse yet defined movements, engaged with each other, but each portraying a distinct set of steps.

Suddenly, one of the dancers contracts his center and extends one arm forward, palm facing upward. While he curiously studies the fingers of the upturned hand, his other arm reaches behind and then quickly arcs overhead coming full circle its palm slapping down against the other. As palms meet, the dancer deepens the contraction, a pained look grabs his face. Grazing his fingers along the wristband it unfurls in a flutter of scarlet fabric. He straightens and assumes his previous movements–the colored cloth now flowing behind his every step.

This contraction of the body, where the torso curves forward over the controlled pelvic area is a fundamental movement in modern dance. Martha Graham–the mother of modern dance– developed the gesture from observing the physical manifestation of grief in the body.

Soon, another dancer stops. This time a woman. She too contracts her center, contemplates the fingers on her upturned palm and follows also with the circling arm, the jolting slap and the unfurling of the scarlet rivulet of cloth. And, so it goes. In syncopated rhythms, new dancers initiate the pattern while those already afflicted repeat it over and over. Their eyes now remain fixed on their upturned hands that lead them forward.

As the tempo of the music intensifies so does the frenzy of the dancers now marked in red–about 10 percent of the performers. They respond to the dissonant notes that punctuate the melody while the others maintain a more composed presence. The noise of the slapping of the hands amplifies. Sporadically, they also clasp fist in hand drawing their arms in toward their torso or legs. Again the contraction of their bodies and the grimaced faces. Continually, they return to their earlier movements but always with one palm upturned and leading their way.

As the dancers’ paths intermingle, the rivers of red become intertwined among all of them. There is a flurry of color amid the neutral gray and brown hues. Some of the grieved are gently lifted up and held in the air or are tenderly embraced while others dance quietly alone extending their arms upwards calmly or angrily beseeching the heavens. A few tuck the wounded hand behind their backs, tethering its gestures and move on without it–though the red trail remains.

Eventually, the music regains a slower pace. The dancers all resume the steps of the first part of the piece regaining semblance of movements of everyday life and common interactions. Slowly they each quietly walk off stage. The lights dim.

This is the representation of the experience of diabetes. Its steps are hard to master and its care is tempting to ignore. Unsuspecting individuals in unprecedented numbers, an abrupt diagnosis and suddenly a life marked by the demands of modern blood-letting. Rather than preferring to allow one’s life fluid to course through the body unseen and uninterrupted, diabetes requires a more intimate relationship.

The hand must reluctantly but gracefully present itself. Fingers must be pricked, poked and squeezed multiple times a day begging the deliverance of the droplets of our inner essence. The sacrificial digit must be chosen and its offering must then be measured with precision to determine blood sugar levels. Numbers digitally displayed on a meter determine one’s destiny for the day as well as for the tomorrow. Medications are quickly and somewhat arbitrarily prescribed–some of which are delivered by measured injections to various parts of the body.

Food becomes more enemy than friend and each bite becomes suspect and open to investigation. Kidneys, eyes, and toes–and yes, hearts, are no longer private property but are open to the purview of medical technicians. And yet, the dance of life must go on. Interestingly, Martha Graham once stated that the mission of her work was to “chart the graph of the heart”. In essence, diabetes monitoring requires the same.

Not everyone appreciates modern dance. This is an unsettling piece. But, diabetes can be re-choreographed as its treatment is improved and, more importantly, as its causes are prevented.

Sharings on the experience of managing diabetes respectfully welcomed.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

My Plate

My Plate Haiku

Food is medicine

Farmers are doctors, Cooks priests

Eat, pray, eat, pray, love.

By Gordon

 

 

oh mother

I was hoping not to have to work today. It is Sunday and I promised myself a little repose. So there I was actually lounging on the couch this morning when the news of New York City Mayor Michael Bloomberg’s announcement of the New York City Health Department’s Latch on NYC breastfeeding initiative filtered into my airspace from an NPR podcast.

breastfeeding

breastfeeding (Photo credit: sdminor81)

Clearly, the launch of this voluntary program for New York City’s hospitals was timed to coincide with World Breastfeeding Week. The story started off nicely enough with a rational presentation of the benefits of breastfeeding and informed that 27 out of 40 New York City hospitals have already signed on to the recommended policy. But, it then whacked me with a tirade of the backlash (and responses) to the initiative–bemoaning that women do not want to have their parenting decisions enforced, especially by a man–and specifically not by health policy promoting Mayor Michael Bloomberg.

I rolled over and groaned into the cushions. My hopes for a relaxing day were shattered. I intended to glue my attention to the Olympics–one of the rare times I surrender to watching TV– but this report was going to interfere. Having discussed the topic of breastfeeding previously, I had no choice but to respond to this in a timely manner. Water polo and volleyball could wait, but this must be addressed before track and field and gymnastics takes to the screen.

In brief, Mayor Bloomberg did not make up these policies, and in fact, they are not mandated. These are recommendations consistent with the guidelines of the Baby-Friendly Hospital Initiative. Other larger jurisdictions have already implemented these policies. The intention is not to take choice away from women or to impound life-giving nourishment. It will not send women back into the kitchen chained to the stove with babes pulling on the teat as some editorials that I read implied.

Instead, it is a long-overdue remediation of a situation that separated the human species from their species-specific milk and compromised in both subtle and profound ways the health of many moms and babes. The superiority of human milk, as compared to artificial milk or formula, for human babies is not disputed and its immuno-protective properties are well established. There are many other benefits as well of mother’s milk as a substance and breastfeeding as a method.

What is not as well-known is that formula companies have participated in the disruption of this mother and child feeding relationship for many years and that this has promoted a cultural ignorance about the benefits of breast milk and a communal lack of wisdom regarding supporting women in this most natural of human behaviors. Big corporations have been the beneficiaries of immeasurable profits by influencing infant feeding using extreme measures by literally getting invited right into the hospital.

Pregnant women are wooed with coupons, samples, and free merchandise. New moms are given goodie bags with loyalty promoting formula brands. What formula a baby is started on has nothing to do with the baby or the doctor, but by whatever company got their hands on those tiny sucking lips first. Where else does this marketing intrusion occur so blatantly in matters related to health?

Women’s efforts to nurse have been sabotaged in hospitals for decades by babies being given sugar-water or formula without consent. Birth attendants including doctors and nurses not educated in lactation have also impeded the mother’s success at nursing. The result is a society that for decades has been led to believe that nursing is difficult, inconvenient and an impediment to maternal freedom. What has created barriers for mothers choosing to nurse is not nursing, but a lack of education, limited support, pathetic maternity leave policies, lack of comfortable places for nursing and pumping and a prudish culture that has turned to feed at the breast into a lascivious act aggravated by laws that even make nursing in public illegal in some places.

If you wish to discuss enslaving factors as regards women’s choices, this is what people should be concerned with–not the new policies. Of course, there will be some situations where babies will require formula, and there will be women who will choose formula feeding for a multitude of reasons. But, I am pretty sure the locked cabinet that the policy suggests will not be in the hospital basement by the janitors’ supplies and that women won’t be found dragging their IV poles down the hall in desperate search of a contraband formula to sate their starving babies. And, I strongly doubt that nursing staff will be utilizing methods of intimidation to enforce breastfeeding.

This is just an opportunity to fully educate and inform and to take the profits out of our babies’ bellies. It is one of a long series of efforts by many health care professionals to enhance the health of women and children in both the short and long-term. This is not rocket science nor is it evidence of a nanny state. If we as mothers have to choose our battles–this is not the one to wage.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

Related Posts: Blessed Feeding; To She Who Loves Us; A Winning Goal; Breastfeeding Redux

photo (3)

Cathy’s My Plate

My Plate Haiku

Blueberry bushes

Three children with empty pails

Pluck, pluck, crunch, exhale.

by Michael

private health

My dilemma was really excited. We hadn’t been to a conference in a while. Usually, I try to keep my nutritional dilemma quiet and out of sight. But, last week as I was heading to a meeting of the New York State Public Health Association I figured nothing would be too controversial, so I relaxed my grip on it a bit as we headed out. It was an unusually warm morning and as I rolled down the car windows, my dilemma, riding shotgun, stuck its head out into the fresh air, giddily taking in all the sights and smells like a golden retriever.

golden retriever

We arrived at the hotel, easily found a parking space and the right room, and settled in. I applauded the availability of Tazo Tea and forgave the choice of bad white bagels. I knew there was some consciousness on the part of the Association to be mindful of the food so I appreciated that there was an alternative to the usual sugar-laden breakfast pastries.

The title of the conference was “Transforming Communities through Public Health Practice”.  The keynote speaker was  Michelle Davis, Deputy Regional Health Administrator for the  US Department of Health and Human Services.

As I sat through the morning, I checked the program to remind myself of the focus of the day and why I had chosen to apply my limited continuing education benefits here. Though I mainly do my nutrition and health thing privately within the confines of my small offices, working with one member of the public at a time, I also try to promote health messages to a larger audience as well. I practice what I term stealth health–introducing information or programs that enhance well-being in both supportive and unsuspecting ways. Here was an opportunity to listen and learn from others who are out there doing community transformation. This is what motivated my choice–to be with my peeps–like-minded people doing great things in this arena.

As an attendee I learned of the new goals of the Healthy People 2020 initiative; I heard about some worthy activities happening on the local scene; and, I sat in on an interesting session that reviewed a relatively well-funded menu labeling education campaign that encouraged consumers to choose fast food meals containing 600 calories or less. The initial results were apparently somewhat disappointing though the evaluation data was limited. The research ironically showed that those who did not receive the message curtailed calories more than those who did.

I thought I had my dilemma well-leashed, but in retrospect, I realize it was already starting to whimper and whine. However, it was not until I attended the first session of the afternoon, “Development and Implementation of  Formal Policies and/or Local Legislation to Increase the Availability of Non-Sugar Sweetened Beverages in Public Buildings: Reports from the Field” that its bark became disruptively loud. The session was facilitated by two women who had overseen a project of the NY State Association of County Health officials wherein monies and other resources were allocated to a handful of county health departments to assist their county governments in achieving this goal.

They effectively reviewed how the different counties applied their efforts–which really were intended to decrease the availability of sugar-sweetened beverages (SSBs). They described media campaigns, seltzer water promotion activities, revenue concerns, working with government officials from the top down and with procurement managers from the bottom up. They discussed vending contracts and how these are virtually impossible to change until the contract runs out. They explained the challenges, push back and resistance that each county encountered and the small changes that were made. This was an absolutely positive action, but it required that they had to play nice politics with these good public dollars.

I suppose I know this is how the process works but the cumulative view of the public health community working so hard for such small gains–even in the public sector–turned my dilemma rabid. It circled wildly, foamed at the mouth and even raised its hand and expressed its opinion. To calm it back down, I had to go get it a fruit kabob at the next break.

Who do we still have to convince at this stage of the game that vending machine revenues will not outpace health care spending? Who do I need to invite into my office to hear the daily stories of health compromised by tepid health care policies and timid action? How many cases of people addicted to Mountain Dew, Pepsi, and other such SSBs must I detail as evidence to show how they suffer from rotted teeth that cannot be repaired; ravaged digestive systems bandaged with a plethora of damaging antacid medications; excessive weight that has literally brought them to their knees; anxiety propelled by excessive caffeine; and, destroyed glucose control that relegates them to a life with diabetes? Is it not tragic how many are children and young adults are already affected?

I always say that if I was the ruler of the food planet, I would remove sodas immediately. There is a heavy toll on health from such irresponsibly marketed products available for consumption with the clink of just a few coins in most public places–not only here but around the globe. And, though soda addiction knows no boundaries, as usual, the economically poor, are disproportionately affected. Recently, a client of mine told me that the school bus company that he works for removed soda vending from the employee break room. Cannot our own government agencies venture such a commitment? Bearing such witness, I am perforce required to display the amount of sugar in various SSB bottles wherever I may be. Right now in the lobby of the health center, I have such a display with associated handouts. People truly gasp when they see the load of sugary stuff that otherwise stays dissolved in the highly acidic medium.

This week, just a few days after the episode at the hotel, a fifteen-year-old boy who has lived a large part of his life in a home for troubled youth was brought to see me–ostensibly for his high weight problems. He was accompanied by a case manager–and another boy who came along. We had a pretty good chat and among other things, we talked about his soda drinking. I told him I really felt sodas were toxic substances that deserved some type of poison label. He asked me if I had a Sharpie. I said, of course, dug it out for him–and he drew me a page full of well-executed skulls and crossbones. I thanked him profusely for his contribution to my crusade. Who knows, perhaps through this experience of participation, he will become a stealth health advocate. When we were done, I gave him and his little buddy two water bottles that I had actually picked up at the conference.

Afterward, I realized my dilemma had been watching the whole encounter from under my desk. It pawed at me and looked me squarely in the eye. It bemoaned that private health is truly a deeply public health matter and vice-versa, and with its tail between its legs, it quietly crawled away.

Let me know what you think about this issue. Thanks.

In health, Elyn

My Plate

My Plate Haiku

Lagoon watercress

Peppers my tongue

With spring joy.

by Roxanne

dolls with faith

Moth by Sandy Mudge

The other day I took a walk around my picturesque village. I was thinking about it being Eating Disorder Awareness Week and wondering what I would write about. I knew I wished to offer something for this annual recognition week that starts in the last week of February–but I wasn’t sure what. Passing the old Victorian houses that line the narrow lanes of this old place, I was feeling perhaps more like a gothic romantic than a modern nutritionist.

This year, the theme that informs the week is “Everybody Knows Somebody”. This speaks to the fact that given the high prevalence of eating disorders in our society, chances are everybody most likely does know someone–whether they realize it or not. Eating disorders are intangible in their essence. They share many elements of an old gothic novel–a vampire story perhaps.

When eating disorders tighten their grip on an individual–as undernourishment and starvation deepen–they can figuratively and literally suck out the lifeblood. But, outward appearances usually do not identify those with any of the different complex types of eating disorders which we simplistically categorize as anorexia, bulimia, and binge eating. Related and variant disorders exist as well. And unfortunately, just as with vampires, we may not realize until it is too late, that we actually know someone who is affected. Recognition of these conditions and resources dedicated to their treatment are abysmally low and this is why Eating Disorder Awareness Week is extremely important.

Though my job is to help people re-nourish, balance intake and make peace with food and eating, I recognize that sustenance needs to occur on many levels. Working with those who suffer, I get to be privy to the underside of these debilitating conditions. When I am up close and personal with my clients, I more easily see that they are not fully embodied, as their illness has detached them from their physical form. It is subtle of course, but they have a fragile, ethereal quality. This does not dismiss the fact that people with eating disorders tend to be extremely intelligent, highly productive, deeply empathic and exceedingly capable.

What is most painful for me to witness is the profound isolation, loneliness, and secrecy that these disorders engender. This cruel disease finds its oft very lovely victims scrounging for food at markets alone late at night; avoiding the pleasure of sharing satisfying meals with friends; preparing meals for their children yet not partaking themselves; and, loathing self so profoundly that they apologize for the space they inhabit. The survival of these disorders depends ferociously on the preservation of deep and dark secrets.

Frustrated by my knowing that there are many right in my little community who suffer alone and invisibly and that there is a serious dearth in services–even more so since New York State cut funding to eating disorder programming a few years ago–I recently formed a small program in conjunction with a local holistic health center. I forced myself through my own usual hesitation and trepidation led by one strong intention–to see if I could create a space where people could find a place for a moment of peace, where they could allow themselves to be safely seen–and to share in a cup of tea. The first session was attended by seven courageous people who came out of the woodwork where they usually hide.

The work of two women inspired me to even consider this. One is Shannon Cutts, a survivor of her own 15 year-long battle with anorexia and bulimia, who wrote the book Beating Ana and started the program MentorConnect. She brought to the table the healing component that emphasizes the importance of social relationships as an antidote to the pervasiveness of these illnesses. I recommend her work highly as a complement to other care.

The other is Mary Ellen Clausen (and her husband Dan) whose own lives were touched by their daughters’ eating disorders. On a wing and a prayer, they created a welcoming space called Ophelia’s Place, where people can just come for some coffee, chocolate, comfort, and care. From the ‘Our Journey’ page on their website, “We are learning to listen harder, “fixing” less, and believing that the struggle is where the healing begins. We are learning to “model” healthy behaviors and challenge the “norm”. We are learning to replace blame and judgment with love and unconditional support. We are learning forgiveness. We are learning that recovery is a process and part of that process is an understanding that living life can and must co-exist through the eating disorder.”

This message is important for me to touch base with as I continually try to anchor my own work in this area. Today, with a client of mine I tried to fix too much. This is a frequent challenge for me–meeting the mandate of reaching for adequate nourishment with some sense of urgency and being prescriptive–while also trying to provide that crucial piece of support and mirroring forgiveness. I find this work very humbling and it demands leaps of faith for all involved.

When I returned home from my walk, I happened to check my little Facebook page. Someone I know had posted a link to the website of my old friend, Sandra Mudge. who I had not been in touch with for many years. One click led me to her fantastic, whimsical, provocative and sacred artistic creations.

With a portfolio of paintings, collages and photographs–and some other media–Sandra’s heavenly work seems to captures the delicate and ethereal essence of eating disorders–exactly that which I was trying to express–something more representational than descriptive. In her fine art section are a series of pieces of beautiful dresses–doll clothes of taffeta, silk, and lace adorned with fragile firefly and butterfly wings–but they are empty of the little girls who should be wearing them –who should be fleshing them out with life, vitality and childhood innocence.

As Sandra, Mary Ellen, Shannon, and many others continue with their powerful talents to ‘transform helplessness to hopefulness’; and, when faith is summoned, and stories of recovery are shared, more ‘dolls’ can be restored to their full life potential–and they can then take flight.

So this week, stop for a moment to think about the somebody who you may know. If this is you, please seek help, have faith and never give up hope.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

Related Posts: Stopping Traffic, Muse of the Girl, Nourish Thyself Well Day, A Meteorological Change of Plans, Size Me Down

Related Resources: National Eating Disorders Association, Bulimia.com, The Representation Project

 

Empty My Plate

 

My Plate Haiku

In the dark places

I ask courage to believe

I am beautiful.

by Anne-Marie

swept away

Arch of Cabo San Lucas

I don’t work in the easiest of places. I often dream that I have a job–well, I wouldn’t even call it a job because it would be so pleasant–working in a spa in Cabo San Lucas in Mexico–pushing the little buttons on the blender at the organic juice bar in the crystal waters of the pool. My own Vitamin D needs amply fulfilled by that luscious warm sun as I dispense my little quinoa pearls of wisdom to my very well-heeled clients. My muscles are toned by long walks on the sandy beaches and I teach mindful eating classes using the freshest and juiciest mangoes just picked from a nearby tree to seduce my students’ senses.
Such imaginings deepen my own diaphragmatic breathing and soften my gaze until that little bubble on the electronic medical record program on my computer informs me that my first or next patient has arrived.

I do not wish to complain. I consider it a privilege to do what I do. I believe I sit in a rather unique position as far as seeing the magnitude of the health crisis that is upon us and the consequences of our communal diet and way of life. So often, when I am following the story about food, diet, weight, etc.–no matter where– it seems either abstract and haughty in that scientific or academic way, or judgmental and blaming. The sensationalized situation becomes very up close and personal and takes on a different hue in my little office–where day after day I receive a fair amount of clients– often in quick succession. Sometimes, I wish I could give the scientists, academics, and critics a peek in.

Most people don’t ever get to see a nutritionist. It is unlikely that you have. It is not like going to the dentist–which is a prescribed semi-annual event (except for the millions who unfortunately don’t have access to dental care) the doctor or the therapist. Perhaps it should be. It would be a lot more fun to come to see me twice a year than the dentist. Access to nutritional services is usually reserved for those with a few types of medical conditions or for those with enough money and energy to fine-tune their bodies.

Interestingly, nutritional services have historically been provided in-house in the Community Health Center where I work, along with some other ancillary services like podiatry, ophthalmology, social work, and dentistry. This multi-service type facility is actually rare in our health care environments. Its purpose is to facilitate access to care for patients–and access indeed they do. My clients do not have cars parked in warm and dry garages that they hop into. Instead, they walk, trudge, take a bus– or two, or call and wait for medical transportation. I am continually shocked that so many arrive at my door to discuss this abstract concept called nutrition. Though any patient is eligible to see me, my schedule is padded with the extreme cases that the doctors are more apt to refer. Extreme becomes a relative concept–and many nutritional concerns are overlooked.

As I navigate the raging waters, the intensity increases imperceptibly at some times and quite obviously at others. Like natural phenomena that are categorized by a numerical rating system–hurricanes, white water, etc.–I think our health issues may require something similar. I wonder if my office chair should indicate what kind of conditions it can endure and if it should come equipped with life jackets. Some of what I encounter has to do with sheer weight but not all of it–though I rarely have a day without clients over 300 lbs.

Off the top of my head, let me see if I can briefly describe somewhat what cast upon my shore just within the last two weeks. The 19- year-old male–366 lbs; a 29-year-old woman, 5’2–378 lbs; a 35-year-old male with extremely elevated cholesterol levels; a 7-year-old boy with compromised growth due to ADD medications; a 13-year-old boy with gastric reflux; a 28-year-old male with a blood pressure of 160/110; and, a 23-year-old male-390 lbs who barely leaves his home. This is a very tiny sampling. It excludes the middle-aged diabetics and hypertensives, pregnant teenagers, and folks with mental health and substance abuse issues whom I see regularly.

Then, there was the 15-year-old girl with triglyceride levels of 442 (which I would have not believed except that she had a prior lab with a similar result)–when normal is less than 150. She entered my office at 3 PM with her parents. When I asked her what she had eaten that day, she told me a bottle of Mountain Dew, a granola bar and a Snapple Iced Tea. She had bought all of this just before her appointment. She had not gone to school that day. She had already finished the soda and the granola bar–showing me the wrapper. Her dad was holding the iced tea that they were still sharing. Within six minutes of our acquaintance she informed me in no uncertain terms, that no matter what I may say, she was going to have Burger King on Friday. The mother challenged me on why I was asking her about shopping and cooking. This was near the end of an already very long day–my late day. It took me about fourteen minutes to discover that this child drinks close to twelve cans of soda on many days. Diets high in sugar are a cause of high triglyceride levels. Though I was grabbing onto my chair, and despite the fact that finally the mom smiled at me–it was too late. I capsized.

Though this family seriously challenged my inner buddha, for the most part, I find my clients present themselves authentically– and that their eating behaviors and nutritional problems are consequences of many various conditions that they did not know how to or did not have the resources to control. Like most of us, they are living the hand they were dealt and eating the food that they can access and afford. They are generally unaware as to what could go so terribly wrong. Despite my sympathies, I still feel like a shipwreck survivor. Some serious stuff is going down and people are hurting.

However, the universe works in mysterious ways. Exactly one week after my encounter with the girl with the dangerous triglyceride levels, another family presented–this time a mom, dad, and their twelve-year-old son. This family had recently awakened to their capacity to make better food choices. They joyfully filled my tiny space and shared the amazing changes they had made. They described how they felt, how their bodies had responded and the new foods they were eating. The boy was pleasant and confidently told me that he no longer drinks soda. He plays some sports for fun, loves to move and is in a dance troupe with some friends. They have made some videos on youtube. As they spoke, I crawled onto the dock, shifted the lever on my chair to the lounge position and laid back to bask in the afternoon sun. There was nothing for me to do but listen and affirm. Now, this I can do.

Please drop or throw me a line!

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

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Grandpa’s My Plate image by falco/pixabay

 

 

 

 

 

 

My Plate Buddhist Saying

Drink tea and nourish life

With the first sip, joy; with the second sip, satisfaction; with the third sip, peace;

With the fourth, a Danish.

by Jewish Grandpa

The Twinkie Affair

Today, I was about to sit and write about a little train of thought that had been following me around this week. I thought I had some more serious things I wanted to discuss, including returning to the subject I raised in To She Who Loves Us Before She Meets Us, on the consequences of taking away women’s power in the birthing of babies. But, I figured I would just tap out this other idea first even though I was questioning its relevance, significance, and general cohesiveness.

I had planned on talking about the very interesting work of an old friend of mine, whom I had recently reconnected with. Quite coincidentally, just as I had cleared away my other duties of the day and was gearing up for a mid-afternoon snack to fortify my writing, I got an email from this very friend, asking if I had seen Mark Bittman’s tofu recipe in the NY Times today. She sent me the link.

After returning from snacking, cleaning the cat litter box, emptying the compost and bringing in the spring water, I curled back up on my computer and found myself in the Dining and Wine section of the Wednesday Times. I did not see the tofu recipe but was quickly sucked in by a few other articles.

One was about a spontaneously created cafe in the Hurricane Irene flood-ravaged town of Schoharie, NY. My life was touched by the hurricane so the story of survival in nearby Schoharie is meaningful to me. Miraculously, food prepared and provided by angels from near and far has swirled its way into the town, first amassing under a cluster of trees and then with the coming of winter at a local DAR Hall. These offerings give those whose homes and lives were affected a free lunch and a sense of continued community. Just as spontaneously as this epicenter of nourishment created itself, so did a sign that named the cafe, Loaves and Fishes.

Next, was an amusing piece about a vegetarian New Yorker on assignment in the Midwest–the meat capital of the country; and, also–though still no mention of tofu–a Mark Bittman editorial on the decrease of meat consumption in the past few years. Of course, those would speak to me.

Just as I was about to get back to work, one more thing caught my attention. By the time I hit the publish button tonight, this may already be old news to you, but apparently, Hostess Foods is declaring bankruptcy and the fate of the Twinkie is in serious jeopardy. Before my eyes, I could tell the food world was in a tizzy. The article, musing about a world without Twinkies, actually interviewed a renowned baker and pastry chef who I know from my own little community. That seemed silly. What would he have to say about Twinkies?

English: Hostess Twinkies. Yellow snack cake w...

Image via Wikipedia

But for me? Don’t I have to say something academic, relevant or amusing about the Twinkie affair? And, don’t I have to say it really soon or my writings will be considered as fresh as a stale pastry? Unlike Twinkies, my words do not contain the ingredients that will ensure their shelf life into the next millennium. Instead, they will be moldy by Monday. Well, here it is. You have heard it here probably second, third or fourth. I have no quick or witty assessment of the situation and I will probably defer to those who do. Like to Michael Pollan discussing Twinkies vs. Carrots.

It is a dilemma that stories from the food, nutrition and eating world amass very quickly. My queue of articles that I want to address or reference gets longer and longer every day. Pete saves podcasts for me or reads me articles straight from his Kindle; friends from afar send me links to interesting or absurd articles; radio stories infiltrate my driving commute; my professional networks post really relevant material; and, blogs I follow are deserving of mention. On top of that are the real-life stories that I am privileged to hear from my clients every day. No story is purely personal. There is always a larger cultural context such as explored in this powerful and sensitive NPR story about a woman’s struggle to lose weight. There is much to react to. I cannot keep up.

So, for now, I must continue at my own small-town pace. I thank you for your patience. I’ll get back to the piece that includes my old friend, a Mayan elder– and, actually, now that I think about it, it may have everything to do with Twinkies; back to the mommas–and, as I have promised before–all the menopausal women. Time for dinner.

In Health,  Elyn–A once upon a time Twinkie eater. How about you?

Related Post: Faur, Faur Away

my plate

My Plate Haiku

Spread peanut butter

On whole grain sweet dark bread

Raspberry jam-yum.

by Barb–who is currently doing an Ayurvedic cleanse and dreaming of this.

visions of sugar plums

When I arrived at my office on Monday morning, a bag was hanging from the door handle. My first glimpse through the plastic made me think the bag contained cucumbers, maybe small pickling ones. I was a little puzzled as I did not think December was the season of the giving of cucumbers, but even so, I was all for it. I put the bag aside and started my day. I figured the answers to the questions the cucumbers posed would present soon enough.

Sure enough, a short while later, Marie, my hallmate, friend, and partner in the quest to nourish the needy, came by to tell me that a mutual client of ours had brought me some bitter melon. Bitter melon? Oh yes, of course. My East Indian client had told me months ago that he would bring me something. I reached for the bag and untied the knot. Staring me in the face were five of the strangest cucumbers I had ever seen. I suddenly felt like the gamekeeper of little tiny crocodiles.

Article featured image

Bitter Melon Food Republic

A quick google search informed me that I was now sharing my office with five Momordica charantia, the most bitter of any fruit, and though they come in various shapes and sizes, I was in the company of the sub-continent phenotype. Moments later, Marie, who is a nurse and thus always quick to action, was back in my office with a red plastic plate and a white plastic spoon. She grabbed one of those emerald babies and took immediately to its dissection. With the red, green and white color palette, it seemed like some ancient Christmas ritual. I was not sure she knew what she was getting us into. This was not your momma’s ordinary cucumber and I was still not convinced it was vegetable, not animal. I winced as she made the first vertical slice.

As she did, an intense, I suppose bitter odor filled the room. I would not say it was completely unpleasant, but now I was more afraid we might be dealing with a controlled substance. Eviscerated, the dear little bitter melon did not look dissimilar to other members of the squash or melon family. As it was pretty narrow, the insides were filled mainly by the seeds surrounded by a little flesh. Marie went right for the seed and then wondered if she should have exercised more caution. I dabbled in the skin and flesh. Little tiny ‘microbites’ seemed sufficient for now. We then googled how one was to prepare these things, which I was determined to do in honor of my client who had gone to the trouble to bring them to me. I considered regifting but thought better of it.

The amazing Internet proposed a multitude of recipes for my little warty friends. Teas, sauces, curries, stir-fries, and cocktails were all possible. Even desserts apparently–though I wondered if they would be deserving of the extra “s”. Marie, who was not yet hallucinating, left me alone to ponder. Shortly after, as luck would have it, my other hallmate, the psychiatrist, who is from India, happened by. I invited him in to show off my gift. Of course, bitter melon. He was familiar and well-versed in this botanical wonder. He gave me a few suggestions including stuffing the little buggers with any nice savory filling. He said all parts could be eaten but some people don’t enjoy the seeds. Further research did inform that some types of these seeds can indeed induce difficulties in susceptible individuals.

As the day proceeded, the sacrificial fruit lay exposed right next to me on my desk. Though I had been aware of bitter melon’s powerful anti-diabetes properties since it increases insulin sensitivity–which was why my client and I had even discussed it –my experience with it had been seeing it used in various glucose support supplements. Spending a day with one was a different story. Just seeing it, touching it, and most potently, smelling it made it obvious that this was a powerful healer–like many plants are. Maybe not too dissimilar from hot chili pepper, its acrid scent wafted into my lungs, blood, and brain.

Bitter melon contains many biologically active substances and has many medicinal uses. Its benefits are quite impressive. Besides its role in diabetes, it has anti-parasitic, anti-viral, anti-malarial, cardio-protective, anti-dysentery and anti-cancer properties. After a short time in its company, I would not doubt any of these. So informed, I carried these big green pills home with me. To be honest, visually they gave me the willies and I was cautious about their use. I enjoy the taste of bitter to some extent and gladly ingest all types of bitter greens but my lack of experience with this incarnation of bitter gave me some pause. Still, I jumped right in and sliced one thinly into that evening’s dinner of a seitan stir-fry. As my family sat to eat, I gave fair warning. Blended on my fork with other foods it found some welcome in my mouth. I am open to a future relationship though I may leave that to other Asian cooks. And, if I ever do have a nematode worm or diabetes, I would gladly consider its use.

Due to my nutritionist vibe in my work settings, I am often excluded from excuses for food excess events. Just the other day I was walking down the hallway with a co-worker. A nurse approached us and said just to my co-worker, “I have coffee cake back in my office. Go have some.” Years ago, this obvious slight would have stung, but now I am rather used to not being invited to play in all the reindeer games. Someone did give me some lovely little Ghiradelli chocolate squares but besides the bitter melons, those were my only holiday treats. Oh, but Miss Henry from my post, Lose 14 Pounds in Three Years did tell me she was bringing me some Sweet Potato Pie.

Well, anyway, so it goes. In the spirit of this holiday season, I wish you both peace in the world and in your hearts, and wonderful visions of sugar plums–which it turns out were once sugar-coated coriander but now seem to be a confection of almonds, dates and dried apricots (see recipe) and the gift of health.

I would love to hear from you and could use some new holiday Haikus.

In health, Elyn

My Plate Haiku

The children were nestled all snug in their beds                                                                   

While visions of sugarplums danced in their heads. by Clement Clark Moore