It's time to show we really mean it, America!

A couple weeks ago, I posted an optimistic piece about health trends moving in the right direction. And though I haven't looked at any more recent data than what I referenced then, I'm going to remain optimistic that the trends are continuing. However, one thing will prove whether my optimism is still warranted:

OUR RESPONSE TO THE TWINKIE RE-LAUNCH!

Coming back soon to a supermarket near you: 37 indecipherable ingredients in all their glory. They will have been gone for 20 months by the time they return. The challenge goes out to all of us: let's get them back off the shelves in less than 20 months by simply not buying them, and kill this sorry excuse for food once and for all.

WHO'S IN?

Get Some Sleep!

We tend to equate health with food. And it's true food plays a big, important role in being healthy (or not.) But if you stop there, you risk overlooking other factors that could play even more important roles.

My beloved health coaching professor and founder of Institute for Integrative Nutrition, Joshua Rosenthal, coined the phrases 'primary food' and 'secondary food.' Secondary food is, well, food. Primary food is everything else we feed on each day: relationships, jobs, exercise and, you guessed it, sleep. These things are primary because they're actually more important than what you eat. Primary foods affect what you eat, and they determine how what you eat affects your body.

America doesn't get enough sleep. Probably not news for anyone reading this, but it gets more interesting. We typically associate a lack of sleep with exhaustion, lack of energy, difficulty concentrating, etc. Beyond the gagillion cups of coffee, we don't really think about how it affects our appetites and the kinds of foods we crave - perhaps because if sleep deprivation is chronic, its effects have become the norm for most of us.

Shannon Wheeler; New Yorker Cartoon

There are two hormones in our body that control our appetite by communicating with our brain. Leptin tells the brain enough food has been consumed and we can stop eating. Gherlin tells the brain we're hungry and to keep eating. Given these two definitions, one would think the only thing that could influence leptin and gherlin would be (secondary) food. But primary food, and sleep in particular, does too. Heavily.

Sleep deprivation suppresses leptin and stimulated gherlin. So our brain tells us to eat even if we really don't need to. What's worse, sleep deprivation increases activity in areas of the brain that seek pleasure, so we crave unhealthier and higher-calorie foods. And without proper sleep to aid in better decision-making, those are likely the ones we'll reach for. It's like a quadruple whammy!

And it's a slippery slope. Sleep deprivation leads to poor eating habit leads to obesity leads to Type 2 Diabetes leads to heart disease leads toooooooooooooooo.......

So hopefully the point has been made to get some sleep as a big step in the healthy direction (and there could be worse advice to be given, right?!?!) But then the question is how do you know if you're getting enough? Here's a rough guide:

Sleep requirements depend on age. Newborns sleep 16 to 18 hours a day, preschoolers need 11 to 12 hours, and elementary school children need 10 hours. Adolescents should get 9 to 10 hours, though most teenagers sleep only about seven hours. Given the opportunity to sleep as long as they want, most adults average about eight hours a night.

Now here's what's crazy. We've all gotten used to the ridiculous swirl of conflicting messages about what we should and shouldn't eat (though hopefully I've helped you cut through some of them!), but here's some more confusion for you, this time relating to sleep.

Studies show that people who sleep between 6.5 and 7.5 hours a night live the longest. And those who sleep 8 hours or more, or less than 6.5 hours, don't live quite as long. There is just as much risk associated with sleeping too long as with sleeping too short. The big surprise is that long sleep seems to start at 8 hours. Sleeping 8.5 hours might really be a little worse than sleeping 5 hours. 

Huh?! You just have to laugh. Here's what I'll say, and at the end of the day, the same goes for the food you eat.

We are all different. Listen to what YOUR body is telling you.

I have a colleague who really only needs a handful of hours of sleep. If that's all I got I would be a useless mess, but it works for her. Most of us need a lot more. And you know who you are - you really don't need some guide to tell you.

Just be careful not to keep yourself awake at night worrying about how much sleep you're not getting!

Ode To Dr. Gately

Our beloved pediatrician is retiring this month. I just mailed what's probably my last check to him. It covered our co-payment for a visit a few weeks ago. At the time I had no cash on me, and Dr. Gately doesn't accept credit cards.

Dr. Gately has been practicing out of the ground floor of his brownstone for decades. It's not a modern office. There are dust balls under the chairs. There's a weird pink bathtub in the bathroom filled with filing cabinets, and the door sticks. The eye charts are worn; the patched glasses are themselves patched. And there's no nurse, only a wonderfully charismatic office manager/receptionist/accountant - you name it, she does it - named Bernadine, who knows my voice when I call. She laughs heartily over just about everything. But don't cross her: she'll tell it like it is.

Dr. Gately accepts nannies bringing your kids to sick visits, though you better be there to pick them up. If it's a well visit, mom or dad must come or he'll refuse to see you.

Dr. Gately is not for everyone, but he was for me.

I've never been shoed out of the office prematurely. In fact, on multiple occasions, I've had to tell him we really need to go! Even more important, unless really, really sick, my kids would jump for joy when I said we had to go to the doctor. They associate Dr. Gately, and therefore all doctors, with all things good. Such a healthy perspective for little ones to have.

The check I just mailed was for a visit Maggie and I made straight from the airport, coming back from a trip to Portland to meet our newest niece/cousin. Maggie had been playing the night before with her older cousins and something happened to her hand - we're not sure what. They all went to sleep crying. Our flight was the next morning. Maggie was favoring her hand big time, so I knew it wasn't a game. I got off the plane at 4pm and called Dr. Gately. They close at 5pm. We didn't get there until after 6pm. He stayed open for us. Both he and Bernadine were there to greet Maggie. Because that's just who they are.

Doctors get you at your most vulnerable. They should be the most comforting people and provide the most comforting environments in the world. Yet doctors' offices can feel like factories - you wait, then you wait somewhere else, then you have your eight minutes and often forget the questions you meant to ask, and then you're out. That's not health care. That's checking a box.

Thank you, Dr. Gately, for never just checking a box. You took the time to know my kids, and everything you prescribed (medicine, advice or otherwise) was based on that knowledge. You made my kids feel invulnerable. And even though they aren't, for them to feel that way at three and five is just fine with me.

The Control We Have Over Our Health Care System

The tremendous number of problems this country faces over our health care system can seem too overwhelming to ever be fixable. But perhaps one of the reasons we haven't cracked the puzzle is because our diagnosis is off. Despite everything we've been led to believe, it may not be because we're unhealthier than ever before.

According to the Health Care Cost Institute, an academic institute started two years ago, the rising health care spending of Americans under 65 in the last two years has been driven entirely by rising prices; not by more use:

The unit price of inpatient care jumped 5.9% last year, while the price for outpatient services increased 9.6%. And between 2009 and 2011, the fee for an outpatient visit to the emergency room rose 17%; the price of radiology services rose 12%. 

And again, despite what we've been led to believe, these prices may not actually be the dirty work of the evil health insurance companies or of the runaway Medicare program. A few months ago, Time Magazine published an article entitled "Bitter Pill: Why Medical Bills Are Killing Us" all about the financial practices of hospitals. Hospitals, which we (okay, at least innocent I) just assume by the nature of the services they provide are solely motivated by the prospect of making the sick well, are actually quite motivated by money - and lots of it.

To be fair, hospitals are businesses and they, like any other, deserve to make money and if they are "for profit," deserve to make a profit. But the lengths to which they go to do so make you think more than just twice. Especially since their customers (aka patients) are arguably more vulnerable than the customers of any other business - sick, scared and, when it comes to medicine and treatments, largely uneducated. Why else would they pay $77 for a box of gauze pads, $108 for Bacitracin and $18 for Accu-chek diabetes test strips when they only cost $.55 on Amazon? Apply those kinds of mark-ups to actual medical procedures and it spells DEBT for the average American incredibly quickly. That stress alone is surely enough to send one right back to the hospital. (Perfect strategy for a repeat customer, actually!)

More disturbing in the Time article was the exposure of incredibly large variances in costs between a procedure in one hospital, and the same one in another. Depending on the procedure, a 20% variance can mean thousands of dollars. I know when I go to Whole Foods, the same milk may cost a dollar more than if I buy it at Costco, but I didn't know I could save thousands on heart surgery 50 miles up the road. And if I need heart surgery, is price-shopping what I should be focused on? Or should I instead by finding a surgeon with whom I feel comfortable entrusting my life or that of my loved one. Surely the latter, no?

And still more disturbing was that, when pressed, many of the interviewed hospitals admitted the fees they charge are just starting points for negotiation. So... just like when I'm buying a faux Gucci at an NYC street fair? I don't know many great hagglers, but those I do get off on the game. The problem is that health isn't a game.

In this world, there are those you trust implicitly, those who always leave you with a little question in your mind, and those you don't trust at all. Hospitals always fell into the first bucket for me - in fact, Children's Hospital  in Boston saved my life when I was 18 months old and then saved one of my best friend's daughter's life six years ago. But I'm sad to say hospitals in general, after having read this article and a few others that have trickled in since, now fall into bucket number three.

I'm certainly not going to solve this alone, and nor are you. But we're not powerless either. Each of us can do our damnedest to steer clear of hospitals and their exorbitant price tags. Obviously, not everything is preventable, but a LOT more than you think is. 

To quote Dr. Andrew Weill, with most subjects, the deeper you go, the more complicated it gets. With nutrition, however, it's the opposite. Prevent the preventable with healthy relationships, real food - especially fruits and veggies, exercise and water. Because they can't charge us for goods and services we don't use. 

Superfoods: More super than other foods?

Check out a recent article from Mother Jones, questioning the efficacy of certain so-called 'superfoods.' The loose definition of which is a food that packs a huge health punch, brimming with a disproportionate share of vitamins, minerals, anti-oxidants, phyto-chemicals, you name it. I had to laugh a little to myself when I was reading this. Here I am part ad agency exec, and part health coach. And yet I've even found myself influenced by great food marketing from time to time.

Foods we never heard of five years ago are now positioned as the ones that will save us all from ourselves and the world. If you have a hard time figuring out which ones, you can often just look for the really exotic sounding ones you don't quite know how to pronounce.

Here's the thing: while these foods may be truly fabulous, the more fabulous fact is if you eat lots of fruits and veggies - the "normal" kinds you've eaten since childhood like broccoli and blueberries - it should be 'superfood' enough. (The not-so-fabulous fact is that this country doesn't actually GROW enough fruits and veggies to satisfy our daily recommended minimums. But let's ignore that for now.)

Superfoods have been in the produce section of our supermarkets forever, yet we're being brainwashed into thinking we need to jump from the middle aisles directly in a bowl of chia seeds to survive.

We don't.

So eat those gojis and that quinoa if you like them. They are good! But don't get overwhelmed by them and their brethren. Keep it simple! And then if you want to experiment with the more exotic, by all means go for it.

Now please excuse me while I go grab a bottle of premium water with 100% naturally-occuring electrolytes.

The GMO Debate: When Peer Pressure Is A Good Thing

Bravo, Connecticut!, the first state to pass a bill requiring food manufacturers to disclose the use of genetically modified ingredients.

But there's a catch.

That bill will only become an enforced law if at least four other states, and at least one of them bordering, agrees to do the same. Peer pressure at its finest! Unfortunately, my beloved New York fell victim to intense lobbying on Monday and unexpectedly went the way of California, who was unsuccessful in passing the bill a few months back.

But why the catch?

Because it would be an economically unwise move otherwise. While they want to do right by their residents, they also need to do right by their businesses. Among other consequences, smaller CT businesses could really suffer if CT were indeed the only state to require labeling - food manufacturers would be less including to play ball with them. But if they were one of at least a handful, the tables start to turn and it becomes increasingly economically unwise for the food manufacturers not to play ball.

Forgive the game analogy, but it seems silly enough to be a game, doesn't it? When you take a step back, it's almost unreal. The request isn't to end genetic modification (yet.) It's simply that its use is disclosed. The consumer then gets to make the decision if it's good, harmless or bad. Seems pretty logical to me. But politics have a way of trumping logic; this particular time (not the first or the last, unfortunately) it's our health that's in the middle.

Now of course, I get it. The worry is that by labeling, people will assume it's a warning: GMO's are bad. Maybe so. But tough luck. If GMO's really are harmless, take the money you're spending on lobbying government officials, and spend it on consumer education instead. To be honest, I'm neither convinced they are or they're not. That doesn't matter. What matters is my right to know if I'm eating them. I can then do my own research if I'm so inclined. Or not. The fact is there's a ton of food on the market with ingredient lists as long as the Nile chock full of stuff we can't pronounce and don't even try to. Most of it wouldn't be characterized as good. But for better or worse (depending on whose side you're on!) many choose to look the other way. Choose is the operative word.

So, Connecticut, be the little state that could! Bully away! Pressure your peers into doing right.

Real Food Grows and Dies

I have thrown out many an egg, many a head of lettuce, many an apple. Perhaps I bought too much or perhaps they got buried somewhere way back in the fridge, left to wither or rot. Regardless of the reason, it always irritates me - partly because it's terrible to waste food. And partly because this kind of food - the real kind - ain't cheap.

But better to have real food going bad every once in a while, than to stock up on only food-like stuff that magically remains fresh, months after purchase (and don't just pick on the poor old Twinkie; the finger can easily be pointed a thousand other ways as well.)

Just before Christmas, I received a big can full of popcorn at work. You know the kind that's split in three sections: yellow-ish, neon orange and caramel. I put it outside of my office for anyone to eat other than me. (Yes, yes, I should have just thrown it out, but what's done is done!) It wasn't all gone by the time the office closed for the holidays (proud of my co-workers!), so the cover went on. And it sat there ever since. Un-reopened. Until yesterday. And...




...it looked exactly like it did six months ago. Didn't smell. Hadn't rotted. No mold. So I had to do it. I picked a piece from each kind that was left - orange and caramel - and popped them in my mouth. Fresh and crunchy as they were six months ago. Scientifically impressive, perhaps. But actually quite disturbing.





Put simply, if food doesn't decompose, it means our bodies can't metabolize and digest it. While my popcorn may have started out as real food (corn, at least I hope), it lost its privilege to be labeled as such after everything was added to it in order to make it last for, well, maybe forever.

Our culture has made "health" into a big, powerful industry. Nutritional claims, crazy diet schemes, magic pills and formulas. One day it's this. The next day it's that. They've made it (intentionally?) complicated to know what's right and wrong. What's bad and good. But it's actually quite simple. As often as you possibly can:

EAT REAL FOOD. The kind that grows and dies.