breast feeding redux

Poster advertisement for Nestle's Milk by Théo...

Image via Wikipedia

So, here is what happened. Last week I wrote about breastfeeding. On one level I was addressing the possible connection between most babies’ first food and the increased incidence of weight issues in children. On another, I was speaking to the very low rates of breastfeeding in this country and the implications of that as well.

Right after I posted, my friend who is a wonderful adoptive new father responded that breastfeeding was not a viable option for his baby. I felt bad. I know a lot of adoptive parents. And, having worked in maternal and child health for many years, I know there are some real situations that make breastfeeding not possible for some. There are many women who have really tried but for different reasons have not been able to nurse. I hope I did not appear insensitive. As a health counselor, I am very sympathetic to one’s personal experience– but I also know that our low breastfeeding rates are not caused by these exceptional types of cases.

In my discussion, I had decided to not make apologies or to outline the contraindications to nursing in the limited words I afford my writings. Most materials related to breastfeeding already do so. I had wanted to challenge the oft-repeated message that breastfeeding is challenging, but mainly I wanted to bring the topic of breastfeeding to the table. As a nutritionist, I consider breast milk a quintessential component of the human diet. Once I did, I thought I was ready to move on–but as I lingered in the post post aftermath and received some thoughtful responses, I considered that how we feed our babies is a way too overlooked issue in this huge conversation about food, culture, and weight. Breastfeeding is discussed in breastfeeding circles among women who are nursing. Beyond that, not many people ever think about this very important topic–even some parents to be. Most people in our culture have never really seen a baby nursing at the breast. I am highly attuned to watching for nursing babies–and I rarely get a sighting (except for my multi-cultural workplace that offers pre and postnatal care.)

I worry about what a world would look like that really no longer knew how to instinctually nurse its young. So, during the past week, I thought a lot about recent natural disasters where water and food supplies are not available–what happened to the formula-fed babies in the wake of Hurricane Katrina; I considered the tragedy of the melamine-tainted formula in China that affected 300,000 babies; I wondered about the plastics that every formula feed involves through either bottle or artificial nipple; and, I lingered on antibiotic resistance and even genetic modification of formula. As I was doing all this a few things happened.

Firstly, quite coincidentally, I came upon an article called Cows Genetically Modified to Produce Human Milk. Writer Erika Nicole Kendall in her blog, the Black Girl’s Guide to Weight Loss does not seem to miss much regarding our confusing cultural cuisine–and one need be neither black, young, female or overweight to appreciate the topics she very thoughtfully explores and exposes. Here, she tells about a recent exhibition in China where technical achievements are touted as part of the country’s five-year plan. Fascinatingly, in ancient China, emperors and empresses drank human milk throughout their lives. Apparently, presented at the exhibition were a herd of cows that have been genetically modified to produce human milk–which apparently contains the anti-microbial, anti-inflammatory agents and the hormones and digestive enzymes particular to the real stuff. The milk purportedly will preserve and improve the immune systems and central nervous systems of children and will address decreasing breastfeeding rates in that country. Must I explain the irony here? http://blackgirlsguidetoweightloss.com/news-feed/cows-genetically-modified-to-produce-human-milk/

Then, mon cher French ami who is always on topic in spite of mothering three young children–who she nursed in succession–sent me an article on breastfeeding in France. I learned that France has the lowest breastfeeding rate in the Western world. Mon Dieu. I was shocked and rather nauseated by the story. The nationwide gist is that breasts are for your husband–not your baby. French doctors apparently are in collusion with this imperative of preserving the sexual function of its countrywomen rather than supporting their maternal inclinations. Accompanying comments mocked those who promote breastfeeding as the breast police. Really? Does fighting tobacco advertising and helping people to quit smoking make one the lung police? http://www.guardian.co.uk/commentisfree/2011/apr/01/france-breast-breastfed-baby-death

And, lastly, just Tuesday night, I watched the first episode of Jamie Oliver‘s second season of the Food Revolution. As he was stymied by the Los Angeles City School District to get into their schools for filming, he invited the public to bring him samples of the foods that the kids are being served there. In the opening scene, he is shown surrounded by a group of people who are presenting to him all types of horrific-looking junk that is splayed out on a table. A woman in the group is carrying a few month old beautiful baby girl. He reaches for the baby who gently accepts his arms. He reminds us how totally pure and perfect our babies come into this life. Seeing this gorgeous little being surrounded by this landscape of low-quality food was a powerful juxtaposition–it is the way I also see the situation.

Before school food, infant formula is the ingredient template that constitutes most of a child’s diet for most of its first year. Aside from added vitamins and minerals, the following are what milk and soy formulas are made of in some variation: non-fat milk, lactose, vegetable oil, whey protein, high oleic safflower oil, soy oil, corn syrup solids, soy protein isolate, sugar, and coconut oil. Interestingly, as most formulas now try to mimic the beneficial lipid profile naturally found in breastmilk–mortierella alpina oil and crythecodimium coluni oil are what are used to make them closer than ever to breast milk.

So, I decided, it was a worthwhile effort to pursue this conversation a little more–in the name of restoring, reviving, encouraging a resurgence–a redux of what I consider to be our natural birthright. The right of babies under most circumstances to be sustained on the foodstuff designed for their biology, presented in a form supportive of their neurological wiring and physiologically and hormonally consistent with that of the other member of the feeding dyad–their mother. The rest of the population may benefit as well–even the men.

And, in case some shared wisdom on this motherly art is sought, please check out this very thorough Breastfeeding Tips and Guide lovingly prepared by Sara Spencer. It contains some nice videos including a great one on feeding twins.

I am just wondering, were you breastfed?

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

blessed feeding

Apr5

Image via Wikipedia

It was one of those mornings. One minute I am simply getting dressed for work, the next I am hopping around with only one leg in my tights, trying to find pen and paper to grab what I can from another nutrition-related radio story. On that particular day, it was an NPR story entitled, Some Baby Formulas May Cause Faster Weight Gain.

The story which ran on January 24, 2011, starts out by saying that breastfeeding can be challenging, so most babies are on formula. It was about a small study comparing cow’s milk formula and predigested protein formulas– which are very expensive and used mainly for babies with significant digestive issues including cow’s milk allergies. The research suggested that at 7 months of age, the cow’s milk formula babies weighed two pounds more than breastfed and predigested formula babies. The study only observed that the babies drinking the cow’s milk formula took a longer time to be satiated and therefore drank more. There was no explanation given for this.

Interviewed for the story was Dr. Nicholas Stettler, a pediatrician at Children’s Hospital in Philadelphia. He starts out by saying that formulas have been proven safe and effective, and if infants like them and eat them, they’ll maintain their health and weight. He then goes on to say that babies who gain too much weight in the first weeks and months of life are 5 times more prone to obesity and its inherent health risks by age 20–and that formula babies often gain too much. He concludes by advising that, “Parents should work closely with their pediatricians to make sure their babies don’t gain too much or too little. In this case, average is best.”

All in all, it wasn’t worth the hopping. None of this was exactly news to me and if anything I was surprised at the limited analysis of the results. However, it touched on an issue that I feel quite strongly about–the dismal state of affairs regarding breastfeeding in this country and its many implications.

Ironically, on January 20th, just four days before, Surgeon General Regina Benjamin announced the “Surgeon General’s Call to Action to Support Breastfeeding“. Outlined clearly in the announcement and its accompanying report are the many benefits of breastfeeding and the attendant health risks of not doing so. Clearly known in the medical and nursing community is that there are many physical and emotional benefits for both nursing moms and their babies and that babies who are not breastfed are at increased risk for diarrhea, ear infections, more serious lower respiratory infections, SIDS, childhood leukemias, asthma, diabetes, and obesity. Lactation experts and women who do breastfeed understand that human milk is species-specific for human babies, and its composition perfectly designed for proper and progressive growth. Mother’s milk changes composition during each feeding as well due to differences in the foremilk and hindmilk and naturally provides nutritional, immunological and satiety factors.

In the introduction to the report, Department of Health and Human Services Secretary Kathleen Sebelius writes, “For much of the last century, America’s mothers were given poor advice and were discouraged from breastfeeding to the point that breastfeeding became an unusual choice in this country.” I appreciated the admission. Tucked in the report amongst the many reasons for our pathetically low breastfeeding rates was this paragraph: “A recent survey of pediatricians showed that many believe the benefits of breastfeeding don’t outweigh the challenges that may be associated with it and report various reasons to recommend against it.”

This seems pretty shocking given the following. Comparing formula-fed babies to those who were breastfed exclusively for four months, the rates of hospitalization for lower respiratory tract infections are 250% greater; for GI infections including diarrhea are 178% greater; and, for necrotizing enterocolitis in premature babies 138% greater for the formula-fed babies. The economic impact of just these three illnesses that breastfeeding can prevent, costs this country 3.6 billion dollars per year. In cultures where babies have unlimited access to the breast and constant maternal contact, the prevalence of psycho and sociopathic behaviors are very low. What is the economic cost of those disorders?

Though the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life, this recommendation does not translate into proper education, promotion, and support. Hindering the promotion of breastfeeding in this country is the perpetuation of the idea that the decision to breastfeed is a personal one and we should not make women feel guilty for not breastfeeding. Also, as a non-breastfeeding society for a few generations now, the cultural belief system is that most babies are raised on formula and they are fine. Additionally, like nutrition, obstetricians, and pediatricians– who are best poised to promote this clearly biologically superior milk–may not receive much training on breastfeeding and there is an awkwardness about women and breasts–even in the medical community.

The moment that baby opens its little mouth and receives artificial milk, it is unwittingly committed to a different path than its breastfed nursery mate. Immediately, that baby becomes a consumer of a highly and often deceitfully marketed corporate product; is more vulnerable to various illnesses and diseases with short or long term health implications; compromises its innate ability to self regulate feedings, and now in this weighted world, must work with its pediatrician to strive for average.

The Health Center where I work serves a large and diverse international clientele. I feel very fortunate to encounter daily a multi-cultural perspective. Last week, as I was walking past the main waiting area, two young women were nursing their babies. One woman was Mexican and the other was Burmese. This was not shy, covered up nursing. Both, were one breast exposed unabashedly doing what women have been doing for thousands and thousands of years. Confidently nourishing their young. How challenging can it be?

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

kyuushoku

Mar21

Lunch in a Japanese primary/elementary school:...

School lunch in Japan Image by Currawong1 via Flickr

Though the menu indicated that today’s lunch was called “Mix It Up Day”, I was not sure what was getting mixed up. To me, it looked like school lunch as usual, except that pizza was not the main entree. Working with the School-Based Health Program, I am usually in one of three of the district’s elementary schools on Fridays which is always Pizza Day unless it is Pizza Bagel Day. But, today was a Wednesday.

I headed into the lunchroom to see what was being rearranged or diverging from the norm. “Good afternoon. What’s for lunch today?”, I politely asked the lunch lady placing the black styrofoam containers on the white styrofoam trays that the children clutched as they moved down the line. “Chicken and cheese”, was the response.

Unable to see the contents hidden beneath the patterned cellophane wrap, I tried another gentle inquiry. With no clearer answer, I realized I’d have to figure it out on my own. On my investigational forays into the school lunchrooms, I’ve learned I must always smile broadly, express benign interest and not ask too many questions.

A few steps down, another lunch lady was in charge of two additional meal components–applesauce and puce green overcooked broccoli mush. Using a metal measuring cup she slopped the oozing applesauce into one of the bare compartments on each of the children’s trays. The broccoli mush, considered an optional rather than a required component, just lay in its big tray, ignored. Reminiscent of poor Oliver’s experience in the orphanage in Dicken’s England, I wondered could there not even be a small effort towards more attractive food preparation and presentation.

Continuing my quest to better understand the school lunch scene, and still needing to discover what that main course consisted of, I moved to stroll among the children who were already seated to eat. I found them contending with a dinner roll, two or three battered half dollar-sized circles–which I think was the chicken, and three battered mozzarella cheese sticks. Only one girl’s tray contained the broccoli mush.

While making my way around and talking with some of these students, I surreptitiously surveyed the number of chocolate v. white milk containers, the contents of the lunches brought from home, what was actually being consumed and the waste filling the garbage cans. Finding the subject matter less than appetizing, I maturely suppressed my prone-to-gagging inner child and focused instead on digesting my observations. I could not discern how this day’s menu was mixed up in any noticeable way from others. Certainly, it was no better.

During my drive home, my attention was grabbed by the news being broadcast about the tragic events unfolding in Japan in the wake of the 9.0 magnitude Fukushima earthquake and resultant tsunami. Suddenly, Mix It Up Day took on a new ironic meaning. I began to think of all the children who would not be having school lunch there on this crazy day or for many days to come.

Listening to the news, I remembered that I’d recently received an online article describing school lunches around the globe. I felt certain that Japan must have been one of the highlighted countries. This country of such rich food culture and ritual could surely challenge the widely held belief that we must serve kids low-quality food because that is what they will eat. I arrived home and found what I was looking for.

School lunch in Japanese is called kyuushoku. The lunches are all prepared in the schools, often by mothers of students who serve in this role on a part-time basis. The meals are eaten in the classroom with the teacher. All parents contribute to the cost of the school lunch program and are invited for lunch at times throughout the year. The children, clad in clean aprons, rotate the job of serving the food and no one can start eating until all have received their share. This is in sharp contrast to the chaotic, cacophonous cafeterias or “cafeteriums” that define school lunch programs in this country. Recently, I had asked a young girl what she thought about my coming to eat with her in the cafeteria. She astutely replied that I would get a headache.

In Japan, local foods are sourced with regional pride, children grow and harvest some of the vegetables that are used by the school, and everyone receives a printed menu that tells what food groups are provided by the meal. Typically provided foods include rice, rice noodles, miso soup with tofu, grilled fish, seafood stir fry, potato croquettes (korokke), stuffed omelette (omurice), daikon radish, sweet yams, bread, and milk. Forty-five minutes are allotted for lunchtime which is followed by recess. Kyuushoku is a well-planned, healthy, and respectful way of feeding the country’s children.

But now, in that topsy-turvy ravaged part of Japan, lunchtime will really be mixed up for millions of Japanese school children in a way more profound than whatever was intended by today’s menu makers. I pray that their bellies be filled with at least some warm rice or noodles. And, I honor the care and intention that defines how Japan tends to the feeding and nourishment of its young. It would serve us well to do the same.

Any school lunch experiences to share?

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

Updates 2020/Related Resources: Kyushoku Confidential; Unpacking Japan’s Healthy School Lunches; Gohan Society – Japanese School Lunch (watch the video)

If you are still considering how to donate to relief efforts, please check out the Save the Children website at http://www.savethechildren.org. (inactive link)

Japanese My Plate

My Plate Haiku

Did you really think

That you could hide fish in rice?

Oh, the green paste burns.

by Francesco Marciuliano

from I Could Pee on This and Other Poems by Cats

i surmise with my little eyes

Mar9

A few years ago, I worked at a college full of bright and creative students. While there, I was invited to serve on a panel for a discussion on “Food: Society and the Environment”. During the event, one young woman in the audience asked me to describe the conditions I encounter in my practice as a nutritionist. Then, and still, I consider this a very insightful and important question, relevant to the issue of how we are feeding ourselves–on the personal and societal level– and what are its implications.

I have worked in medical and community environments as a nutritionist for many years, during a period marked by an increasingly modified and aggressively marketed food supply. At the time of that panel presentation, I was working at both that small, predominantly female college and a large Ob/Gyn office– so my clients were mainly women, ranging in age from about eighteen to forty. And, at the Ob/Gyn office, many of them were pregnant.

A history of poor dietary habits exerts its influence on the health of a society in more subtle ways than the common indicators of end-stage problems like diabetes, stroke and heart disease—but those are the conditions that get the ink. However, increasingly and alarmingly, I see many health issues with dietary or nutritional antecedents affecting young and middle-aged adults. Likewise, I see conditions once only ascribed to aging, presenting in younger people. Perhaps to best appreciate this– if you are more fully ripened– imagine yourself sitting in a college campus student union or going to a Lil Wayne concert. You are not having lunch at the senior center.

I would rather present this in a more artistic format, but for now, I must submit to a mundane bulleted list–along with this lovely painting of Summer by Cezanne. It consists of the conditions that I encountered while serving this young adult population–and only those which knocked on my door with at least occasional frequency–not rare occurrences.

High blood pressure
Type 2 diabetes and insulin resistance
Heartburn and reflux (GERD)
Constipation, irritable bowel syndrome (IBS), and digestive disorders
Gall bladder conditions
Moderate to severe obesity
Menstrual irregularities
Thyroid dysfunction
Polycystic Ovarian Syndrome
Food allergies
Behavioral disorders
History of frequent illness in childhood
Eating Disorders
Depression and Anxiety
Toxemia of Pregnancy—a syndrome associated with high blood pressure and kidney involvement
Gestational Diabetes
Recurrent yeast infections
Severe skin inflammations
Orthopedic Problems

Bouncing between the two work settings, on most days I had at least one client starving and struggling with an eating disorder and one who weighed more than 250 lbs—who may also have been struggling with an eating disorder. As the numbers on the scale were both decreasing and increasing, so was the volume of the diatribe against the body. Both were distressing to witness–as was considering young, diseased gall bladders.

Some of these conditions are interrelated; and many are exacerbated by stress–another marker of dis-ease affecting our youth. The prevalence of these conditions also means that many of this millennium generation is on at least one medication, including those that treat depression, anxiety, blood pressure, heartburn, inflammation, behavior, and hormones. The use of these medications will result in increased prescriptions for erectile dysfunction and osteoporosis medications for this generation as well.

My contention is that young children who are exposed to processed foods, do not develop the ability to appreciate the more distinct and varied flavorings of more natural foods—especially those of the plant kingdom. Therefore, these more healthful foods are not incorporated into their food vocabularies. These young children grow into big kids and young adults, quickly accumulating the years that their bodies are exposed to altered, nutrient and enzyme-deficient foods.

Craving the whole foods that our bodies and brains require by design in order to function, an underlying “true” hunger festers and grows. The hunger is either pursued voraciously or feared and denied. Even in the middle ground, before too long, this compromised nutritional state can take its toll and the above conditions can manifest.

One of the difficulties of inspiring behavioral change in regard to eating and nutrition, and in explaining how food matters, is that it is not very easy to show direct cause and effect between food choices and health outcomes. Many might argue that they would prefer to just eat happily and without dictates—even at the cost of a possible slightly premature end.

Could considering the consequences that physically and emotionally damage us decades before the final blow serve to amend such an attitude? Attention to dietary change has become essential. Through positive food experiences may we begin to show that nutrition can prevent not only life-threatening conditions but life-limiting ones as well.

Any thoughts on this? Any reflections of how you eat/ate at this phase of your life? Please let me know.

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

Pop Smarts

Feb21

Pop-Tarts Image via Wikipedia

Last week was a rather discouraging one for this persevering nutritionist. I knew it was bad, as on Friday I found myself contemplating stopping at a Dunkin’ Donuts and just drowning myself in one of those massive confectionery pond-sized drinks, weighted down with heavy donut shoes.

The final straw so to speak had occurred just moments before. On Fridays, I work in some elementary schools. As I was packing up my Mary Poppins basket musing on the students I had spent my day with, an announcement came over the loud-speaker. The principal was congratulating a boy for his lack of tardiness or absenteeism for the month of February. His reward was that he’d get to share a Burger King lunch with her.

Really? Why don’t you just shoot me in the foot? Well, maybe this boy was being given his fair reward. All the other slackers who had managed to show up on this day got a greasy, square piece of pizza, a cellophane-wrapped bag of carrots (which is more appealing than most of the veggie offerings) a blob of half-frozen mushy blueberries–the ice crystals were visible– and a chocolate milk on their non-recyclable styrofoam tray. That should teach them not to miss school.

The night before I had been at a charter elementary school. I was a presenter with two other speakers on healthy choices for school success. I had been excited that the school had focused a parent meeting on this important topic and was glad to have been invited. Despite good intentions on behalf of the school, only six parents out of a student body of 300 attended. Still, we did our thing.

Out of my Mary Poppins basket, I passed around, along with some other nutrition shockers, a well-worn packet of Pop-Tarts with an attached baggie filled with the eight and a quarter teaspoons of sugar that it contains. I asked the participants to look at the long list of gruesome ingredients as I talked about nutrition and brain health. After the talk, a staff person approached me. She meekly told me, that if kids get to school late, and miss the provided breakfast, they are given Pop-Tarts. Given the rewarding of non-tardy behavior to only one recipient at the other school, I surmise that no small number of kids are getting their brains doused with such artificial intelligence here. I felt like I was going to cry. (We did come up with some alternative ideas for the school though.)

Oh well, no biggie. Maybe I was just sensitive because the day before that I had a new eating disordered client who was restricting herself to three hundred calories a day. Or, maybe it was the young diabetic who I had spent many teaching moments with, who came in the day before that with a high blood sugar of 227 and told me that she had a beef patty, some Pringle-like potato chip I had never heard of, three Oreos and a large-sized can of Arizona Green Tea for breakfast.

Perhaps, most disheartening though was the doctor who totally ignored my concerns about the severe dietary deficiencies of a patient we shared–whose support I really needed to facilitate her care. Like the scenarios I described above, this is really nothing new to me. Doctors untrained in nutrition, give short shrift to diet, except for some lip service when it comes to blood pressure, weight, and cholesterol. I am rather used to being ignored by physicians.

I do not expect my clients, my students, and even school administrators to fully get this whole food and nutrition thing given current conditions. Those with eating struggles would not have them if they were easily understood. Individual schools are not easily able to remedy foodservice and budget limitations. Teachers have many other matters to attend to.

But, I do really expect that by now, even conventionally-trained medical providers would appreciate the connection between diet and health and would give attention to meaningful dietary assessments in supporting the treatment of their patients. It is recognized that patients whose doctors inquire about their smoking habits and are told to quit have higher smoking cessation success. To help turn the tide on the nation’s health crisis, doctors’ true embracing of dietary health is essential. Last week, I really needed that doctor to express to our patient who was in the office, concern about her eating and to provide to her some basic nutritional support. Instead, out the door, the patient went, with a prescription for one more drug in hand and no mention of my recommendations. I slumped in my chair.

Usually, I can handle situations like this with more aplomb. Maybe I am just a bit depleted in B-vitamins which lowered my resilience. Never mind. Time to re-fortify. Onward.

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

have it your way at Red Chinese Sorghum Mutton Noodle

Jan31

Happy Chinese New Year. It is the Year of the Rabbit, but things may not be so cute in bunny land no matter what astrological system you ascribe to. Last month there were reports of a shift in the astrological alignments apparently due to an Earth wobble or precession. This wobble or twist of the Earth’s axis is caused by the gravitational attraction of the moon on Earth’s equatorial bulge. I may not know a lot about astrology, but I do know about anatomy, and with the sudden burgeoning of obesity amongst 325 million people in China, I suspect that equatorial bulges may, in fact, explain the wobble.

About twelve years ago I caught a segment on television, perhaps on 60 Minutes. Lay’s Potato Chips were being imported to China for the first time and a massive marketing campaign was underway to introduce these thinly sliced, deep-fried and salted tubers served in a colorful and crinkly bag. One early morning as millions of people in some enormous city were bustling to work on foot and bike, a very large display of cardboard boxes was stacked at the entrance of a market. The boxes were marked with lots of Chinese letters–and Lay’s. People were being stopped in their busy tracks and asked to sample this wonderful new product. Many of them were holding small paper bags of peanuts–their centuries-old “on the go” breakfast. The chips got a mixed review.

This segment was followed by a piece on the rapid increase in childhood obesity in China. Apparently, within ten years of the introduction of American fast food into China, ten percent of urban youth were overweight. Featured was a military boot camp-like program where about one hundred rank and file uniformed kids were being led sternly through a highly supervised exercise program. This did not look particularly fun, but to the Chinese government, this was no laughing matter.

Five years ago, I attended a conference sponsored by the American Heart Association on obesity. A Chinese physician who now practices in the US was one of the speakers. He said, that twenty years prior–about 1985–when he attended medical school in China, it was extremely rare to encounter diabetes. For his training, he had to travel to a far off province to find a study case. He explained that now, diabetes is so rampant in China, that it is a significant drain on the Chinese health care system, and subsequently on its total economy.

As I sat to write this, my original thesis was that the US had purposefully set out to fatten up, sicken and slow down the industrious Chinese with fast food as an economic dominance tactic– but my research now makes me wonder if it was payback for what the Chinese had done to us–in retaliation for what we had done to them. Chinese cooks and restauranteurs had long ago figured out how to alter their cuisine to meet and oversatiate the American palate– happily to their own economic advantage. Consider that the first privately owned restaurant only opened in Beijing in 1980; while the first Chinese restaurant opened in this country in San Francisco in 1849. According to http://factsanddetails.com/china, there are more Chinese restaurants in the US than the top three large fast-food chains combined. Can that be?

I am often apt to echo Eric Schlosser’s Fast Food Nation rant against food additives and flavorings and how their application to our food supply has fostered an epidemic of food addiction that afflicts even very young children. But, was not the MSG that peppered our Chinese take-out and addled our brains perhaps the grandfather of all such flavor enhancers? Had the Chinese immigrants who were so mistreated here, literally found a way to have us eating out of their hands? Nowadays, Thanksgiving is the only day of the year that Chinese restaurants here are not busy–apparently, it’s a big day for Chinese weddings.

One of the more difficult parts of my work is weaning folk off of General Tso’s Chicken, Beef and Broccoli, and pork fried rice. Big grown men look at me with sad puppy dog eyes and whimper like puppies too. They whine, well how come Chinese people aren’t fat–(or didn’t use to be)? I respond harshly, make them do a hundred jumping jacks and tell them to walk home.

The second that China loosened its restrictions on the West, American fast food conglomerates were ready to flood its shores with a deluge of the additive-enhanced foods we specialized in–and the modern, more prosperous populace was ready and eager to be seduced. The first American fast-food chain to set up shop was Kentucky Fried Chicken in 1987. Apparently, what has been attractive to the Chinese diner is the cleanliness, efficiency, and courtesy of the western establishments where customers get escorted to their tables. This gesture (perhaps along with the under 5-yuan menu) has put western establishments way above their Chinese competitors who actually serve food more accommodating to the Asian palate. However, once exposed to our mischievously enhanced food products, there is no looking back. Even the big Chinese national chain, Red Chinese Sorghum Mutton Noodle could not withstand the heat. Perhaps Confucius say: Kill enemy softly.

Though I know this is not breaking news, it is still hard for many people to fully comprehend the effects of these “manipulated” foods on our bodies. They have contributed to the alteration of the global waistline and median blood sugar level. It is really difficult for me to explain this to the many kind and gentle adults and children who sit before me as clients. How could we imagine that we are sold food that fosters a profoundly unnatural, addictive relationship? But, we are.

Well, I have a few more people in this country to tend to and then I may have to head over to China. Until I arrive, they may need to use some of those ghastly Chinese manufactured plastic food models that they ship here to teach us about food and proper portion sizes. Once there, I’ll have to convince them to reclaim their own cultural snack food of peanuts–or hua sheng. I am told that they do still magically appear if you say pi-jin–the word for beer. One thing I won’t have to contend with there is fortune cookies-the alluring end to an Americanized Chinese meal. Apparently, they originated in Japan and are not at all part of China’s culinary traditions. Still, I must remember, the stakes are high. The wobble may just make this the Year of the Hippopotamus if they do not act quickly.

I leave you with an old Chinese proverb: Wherever smiles happen and happiness is celebrated you’ll find Lay’s Potato Chips. So tell me, how are you going to celebrate?

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

I Speak for the Fat People-last part

Jan18

I heard a heartening story about a man and his joy-spreading tactic. Essentially, he spends half of his time acquiring special little chocolates and the other half, gifting them to people as morsels of universal love. I am either becoming a very cynical nutritionist or a very empathic human being. The collective psyche is longing for the morsel of joy even at the expense of the perfect waistline. The truth is that we have appetites and hungers because we are merely human, not because we are bad people. However, when all of these human tendencies accumulate into extra pounds, getting rid of that weight is very difficult.

A few years ago, I attended a conference on an obesity-related topic. During one of the workshops, the speaker, a physician and researcher at a major university, presented a case study of a postpartum woman with a body mass index (BMI) of 30–thus classified as borderline obese. He instructed the audience of professionals to brainstorm how to counsel this woman. The exercise had me squirming from the get-go. As the attendees were dead-ending in their attempts to describe a reasonable approach, the presenter intervened. He said, “Let me offer this idea. I am often in my office at my desk and on the phone. I could just sit there and talk on the phone, but instead I stand and pace as I am talking.” My agitated brain said, “Yes, let’s file that idea to use.” Not with my clients but in this article. I could picture Homer Simpson stuffing one more donut in his face while muttering “Ah, vigorous pacing. That’s the ticket.” I wondered when was the last time this guy got out of his office and realized the experiences of real people, including real fat people and real postpartum women.

TARTA DECORADA HOMER Y BART SIMPSON (Photo credit: YOCUNA ARTE EN AZUCAR)

Hardly are all designated cases of overweight problematic. Some in the field maintain that the goal is for all individuals to attain an “appropriate” BMI. Short of that, they will be at risk for various health problems. My intuition and much science beg to differ. Many people are fine–if not perhaps better off–with a little extra weight on them. Pavarotti once said, “The reason fat people are happy is that their nerves are well protected.” My own observations reveal that the neurotically thin tend to be more frayed than their rounder counterparts. Besides, BMI is just a tool. At times it is a cruel tool—or at least a not very nice one. It makes no allowance for age, fitness, or even natural body type–nor pregnancy-related metabolic changes. Whether we like it or not, our bodies will shift and change as we age. Nature, with no ill intent, seems to want to round us out a bit as we mature. That is how we get to be grandpas and grandmas. Appropriate BMI does not necessarily confer lack of health risks–only ones of a particular nature.

Do not get me wrong. I am not undermining the seriousness of the obesity crisis that we are facing. I understand its consequences perhaps more than most. I see the implications of weight that people struggle with on a daily basis and I strive to alleviate the challenges through educational, lifestyle and nutritional support. I bemoan the forces that are propelling our society into ever-expanding levels of girth, especially those that are now affecting our children.

Still, I feel a need to call TIME OUT! To stop the madness that makes those who are the statistics speechless. To stop pointing the finger merely at the individual without an understanding of the deeper forces that are at play. There are multi-factorial causes that lie at the root of the weight gain epidemic. Many are so abstract or insidious that it is very difficult for the experts—let alone an ordinary individual–to understand what is going on. Though overeating, bad eating, food addiction, and poor lifestyle choices are definitely a part of it, the magnitude of the communal weight gain doesn’t seem to make sense based on calories alone. In the causative mix lie politics, hormones, pharmaceuticals, poverty, nutrition misinformation, dieting, food sensitivities, sensory science, profits, changes in the components of our food, environmental toxins, personal and spiritual alienation and lifestyles spinning out of control. There are strange bedfellows in each and every fat cell.

Now, back to our friend the Lorax. For the record, the Lorax, our venerable spokesperson, was rather portly himself. Based on his picture, I’d put him at a BMI of about 27. I’d describe him as neither apple nor pear-shaped but rather pickle-shaped. According to Dr. Seuss, “He was shortish. And oldish. And brownish and mossy.” The final message of the Lorax in his plea to save the environment was UNLESS. “Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.”

I too am rather shortish. Oldish, brownish and mossy may someday also describe me. For now, my intention is not to imply an ultimatum. It is, however, to bring a greater sense of compassion and understanding–and a broader lens to the discussion and to the approaches to care.

I do not intend to deny the role of personal responsibility—be that for everyone. It is a big piece of the puzzle. Though it is critical that we address the current weight epidemic–we should not do it with an assault on the fat people. We must not slap everyone silly in an attempt to squeeze them into a size six dress or Speedo swimsuit. Besides, who would be left to sing the blues? And though I’d have been happy to find my grandmother at the gym, it could not replace the experience of cuddling up on her big, warm lap with wonderful smells wafting in from the kitchen.

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

Hunger tiptoes in

From bellies, hearts or minds

Feed me now she calls.

by Eva

I Speak for the Fat People: middle part

Jan14

Let’s put the issue of overweight into perspective. If we look at weight historically, I’m pretty certain that from the beginning of time, there have been fat people. We have all seen the pictures of early Cro-Magnon and Neanderthal men. Even those quintessential hunters and gatherers seemed capable of packing on a few pounds. After them came Confucius, King Henry the Eighth, Mamie in Gone with the Wind, Jackie Gleason, Pavarotti, Aunt Bea, and my grandmother. Chances are your grandmother was fat, too.

English: Luciano Pavarotti in Vélodrome Stadiu...

Pavarotti Image via Wikipedia

Since our early beginnings, human beings have come in varying shapes and sizes and large-size was not necessarily an aberration of medium-size. It is good that there are large-sized people. A world without them would mean a world with fewer great opera singers, chefs, women of ample bosom, football players, construction workers, and cuddly grandmothers.

It is not very difficult to become fat. You do not have to go out of your way to try. If Chinese youth can become fat, then anyone can. Only about 4% of the population has naturally model-thin bodies. That means that many models are starving themselves in order to be models. It also means that the rest of the size 2 wannabes are expending a lot of physical and mental energy in the pursuit of thinness. Carolyn Knapp, in her book Appetites, tells the story of a woman who describes the angst she feels putting on her stockings every morning. She wonders what she could have accomplished in her life with the time she has spent worrying about her weight.

There are the naturally skinny–and then there are the neurotically and pathologically skinny; and the metabolically hyper-activated skinny–those who sustain themselves on a steady diet of excessive caffeine and nicotine—or maybe extensive exercise. For the rest of us, the possibility of becoming overweight is just around the corner. We are physiologically and neurologically wired to pack it on. The ability to store fat came in pretty handy a time or two during our multi-millenial evolution. We have about 107 compensatory mechanisms that prevent us from starving to death. A bunch of those certainly kicked in to save our forefathers when they were unable to kill a bison. In people who attempt to starve themselves toward thinness, the body fights back–it regains the lost weight plus more, and then absolutely refuses to budge.

In addition, we are wired for comfort. Research shows that the food habits that sustain us are those that we developed while still wrapped in the loving veil of early childhood. Whether that happened to be gazelle, chicken soup, mashed potatoes or cheeseburgers, you will probably turn to those foods as an adult. Believe me, the corporate world certainly knows this. The Happy Meal ensures that today’s toddlers will become tomorrow’s adult fast-food consumers. The concept of comfort foods is one I hear a lot about during my spy missions. Women have confessed to me that they would choose a good loaf of bread over sex. The quality of the sex is not indicated in this context.

Then, of course, there are our natural temperaments as well as good old genetics. I listened once to the tender story of a woman who was adopted as a child. She never met her birth mother, but she possessed a very old, poor quality home movie that she believes is of her mother. Though she struggles to see the face better in search of subtle resemblances, it is the woman’s thighs that confirm her finding. She states, “Look at the thighs. Those are my thighs.”

On top of all this, let’s sprinkle on a life change, or just daily, chronic stress. Take your pick. Break-ups, abuse, graduate school, poverty, working long hours, caregiving, depression or menopause are possible choices. And, God forbid you should simply possess a deep sensuous life-affirming passion for cooking and eating.** Throw any of these on your plate and if your primal wiring wasn’t enough to enlist you, then current circumstances will. Even the once-thins can become the now-fat–especially in this current milieu where food is literally out to get ya. Not even the high school cheerleader is immune. Any emotional state that is heightened, increases for many, the desire to seek food for a reward. When one is working their way up the weight chart, it is because they are possessed by physical or emotional hunger or physiological changes that they can neither understand nor control.

I can hear you begin to protest that it has to be more than just this. Aren’t we soooo bad? We ate the piece of chocolate cake (and we loved it). How could we? How dare we? That translates into four hours of floor mopping according to the calorie expenditure charts. That must be fair penance for the crime. As a spy, my days are peppered with the monologues and dialogues of self-hate and recrimination that people utter like a mantra before and/or after each foray into eating. The guilt is palpable. We must have all been ____________ in a previous lifetime. (insert your own response.)

(one more segment to follow)

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 Resources 2010: The end of overeating. Taking Control of the Insatiable American Appetite (David A. Kessler, MD); Born Round: A Story of Family, Food and a Ferocious Appetite (Frank Bruni)

I Speak for the Fat People: first part

Jan12

I speak for the fat people. Like Dr. Seuss’ Lorax who spoke for the trees, someone must speak for the fat people. Unlike the trees who needed a spokesperson because they had no tongues, you would think that the fat people would be able to speak for themselves. Of course, fat people have tongues. If they did not have that taste bud laden sensory organ, they would not be fat. Given the current weight of the world, this group should not be particularly hard to hear. However, in the huge public dialogue about weight and obesity, the fat people are merely statistics. There are no real people behind the statistics, and this is where they have lost their voice. Therefore, they are stripped of any ability to speak with authority on the topic.

I am not a statistic. Though I have had some years where I toed the chubby line, for the most part, I have done my part in tipping the scales toward societal svelteness. Besides my obligation as a citizen to keep the fat numbers down, as a nutritionist, it is my professional responsibility to pull people out of the fat pool and to keep them from falling in at all.

It is no big secret that the medical and nutritional community has not done a great job in their role as bariatric (the science of obesity) lifeguards. I myself do not have a great track record of turning people into mere shadows of their former selves. But, I have spent my career as a nutritionist hearing the stories and struggles of the fat people and observing the ways of food and eating that define this turn of the century. I am a spy in the house of girth.

The fat community does, in fact, have some spokespeople. There are magazines, journals, and websites edited by those (mainly women) who have spent one day too many in the deprived and depraved world of dieting. There are professionals and individuals who are doing incredible and poetic work about re-informing and re-educating on misconceptions about weight and health and respectful self-care. Still, many of these efforts are marginalized or featured in venues that only topic-obsessed people like myself pay attention to. Even Roseanne Barr once said, “It’s OK to be fat. So you’re fat. Just be fat and shut up about it.” For every individual or undertaking that sings the praises of fat, there are thousands of counter-voices screaming the imperative to whip it away.

Therefore, I believe I must use my credentials to speak out. I hope that the fat people can accept me, a thin person–who is often cold and prone to osteoporosis–and an ex-stress and emotional eater to be their voice. Born of thin mother and fat father, I will try to do the cause justice.

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.

(to be continued)

In health, Elyn

Related Resources (2010): (Frances M. Berg); Intuitive Eating (Evelyn Tribole and Elyse Resch); Health at Every Size (Dr. Bacon); Dances with Fat(Ragen Chastain)

feeding things

Jan5

Sunflower Seed Kaleidoscope Image by Tobyotter via Flickr

Why are the birds at my feeder giving me attitude about the milo, millet, cracked seed with oil sunflower seed food, squawking that they will only eat plain oil sunflower seed? Picky, picky, juvenile, ungrateful little peckers. Sure, I’ll get out the ladder in the freezing cold and go change it–which I did.

Chico, the cat, is never satisfied. How can it be that after so many years together, his humans cannot understand his hearty appetites and food preferences? Why must he always settle for such mundane fare as cat food? He knows that I know he enjoys cantaloupe served diced on a plate at the table, so what’s up with this dry crap in the cracked bowl on the floor?

Last week, after our usual morning argument about breakfast, I left the kitchen in a huff, saying, sorry, Chico, this is not a restaurant, and that is what I am serving today. He followed me into the living room, and as I bent over to put my shoes on, he head-butted me in the butt. Lucky for him he is the most amazing, adorable and hysterical cat in the world.

Chico

Luna, the other cat, will only drink out of the bathroom sink. A trip to the toilet is never a solitary experience. If you’ve not tripped over her as she comes careening out of nowhere to leap onto the sink from the toilet bowl, you must then negotiate the faucet flow, your own flow, and the toilet paper roll, all simultaneously as she tends to her hydration.

My daughter scoffs at the most important meal of the day and today, I watched as my dear husband tried to mix his whey protein powder into his bowl of oatmeal–trying to kill two dietary imperatives with one spoon. Why must this all be so difficult?

Meanwhile, the fire belly newt, Everest, that we have had for nine years is without complaint, happily chowing down on his Freshwater Flakes from the first and only 2.2-ounce container that we ever bought. I am trying to read from the label but some of it has already faded. It contains a natural something or other formula and is made ONLY with Fresh Seafood. Seriously, he is only two-thirds through this small canister–in nine years! The price sticker is still on it. The bottle cost $5.89. Every few days I say, “Oh, the newt!”, and sprinkle a few flakes into his grungy tank. Don’t misread this. He and I have a very special bond. Today as a treat, I gave him a couple of Newt and Salamander Bites. My he loves those. That 1.2 oz container is only half empty and says on the label–soft sinking pellet diet.

There is just so much meowing, barking, whining, chirping, oinking, mooing, hissing and howling going on these days about all this food and eating stuff. Can’t all species just get over it and agree to this simple amphibian flake and pellet diet?

Ah, well. Time to go make myself some lunch. Please comment if you love Chico (he does have quite the following) or any other finicky mammal.

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

the nutritionist's dilemma

a nutritionist's musings on the realities of eaters and eating

Archives

breast feeding redux

blessed feeding

kyuushoku

i surmise with my little eyes

Pop Smarts

have it your way at Red Chinese Sorghum Mutton Noodle

I Speak for the Fat People-last part

I Speak for the Fat People: middle part

I Speak for the Fat People: first part

feeding things