Navigating Healthcare – Patient Safety and Personal Healthcare Management

The Food Industry – New Tobacco

Posted in Nutrition, Preventative Healthcare by drnic on June 23, 2009

Its a radical idea but a recent article in the NY Times (How Food Makers Captured Our Brains) lends some credence to the idea that the food industry is behaving much like the tobacco industry was some years back (and probably still today). They engineer their food and the contents to make it as addictive as possible. This is done with no regard to health or health consequences. Their desire is to hook us to their product making us want more. Dr Kessler (Pediatrician that has served two presidents in his role at the FDA) has recently published a book: The End of Overeating: Taking Control of the Insatiable American Appetite)

My original supposition that I have shared with others was centered on sugar as the key ingredient akin to Nicotine – addicting and the reason why my kids have always preferred <INSERT: name of Fast Food Chain> Hamburger when compared to a home cooked Hamburger. But it is likely more about the combination of foods that is achieving this level of addiction:

food companies certainly understand human behavior, taste preferences and desire. In fact, he offers descriptions of how restaurants and food makers manipulate ingredients to reach the aptly named “bliss point.” Foods that contain too little or too much sugar, fat or salt are either bland or overwhelming. But food scientists work hard to reach the precise point at which we derive the greatest pleasure from fat, sugar and salt. The result is that chain restaurants like Chili’s cook up “hyper-palatable food that requires little chewing and goes down easily

The Snickers bar, for instance, is “extraordinarily well engineered.” As we chew it, the sugar dissolves, the fat melts and the caramel traps the peanuts so the entire combination of flavors is blissfully experienced in the mouth at the same time.

As he points out much of this is not about will power but the daily challenge we face in the over stimulated world of food. Knowing your own triggers (good and bad) is a great place to start. I know my own personal bad trigger is in the evening…I’ve been good all day and want to sit back and unwind and have big urge to head for anything sweet. My strategy is to deflect to an alternative in my case some type of herbal tea. This works well int he winter but is not as easy in the hot summer months when hot tea is less attractive. As with many things this is a journey not a destination. Who knows someone might have a good suggestion for an alternative that suits me – let me know I’ll share any that I receive.

There are no quick fixes and we and our children face this challenge on a daily basis but understanding what is affecting us and developing coping mechanisms can be a great start.
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Aspirin Use in Primary Prevention – Meta Analysis

Posted in Healthcare Information, Preventative Healthcare by drnic on June 15, 2009

Aspirin has long been seen as a wonder drug with a low incidence of side effects and some significant positive effects on health. In particular the potential to reduce incidence of heart disease. SO much so tat Bayer and other manufacturer’s offer a low dose version of Aspirin that is targetted to the general public for heart disease prevention. But recent meta analysis of multiple data sets by Dr Colin Baigent from Oxford University suggests that the data does not support the general use of Aspirin in otherwise health individuals and  catch all prevention for heart disease. The material was published in the Lancet (subscription required) and reviewed on Medscape (free membership required) – as Dr Baigent put it:

We have shown for the first time that the very same people at higher risk of heart disease are also at higher bleeding risk with aspirin, which is a very important piece of information and should influence the way in which aspirin is used.

So what to do given the latest evidence. There are many strategies and tools to use and no one size fits all. In fact based on the evidence in the meta analysis:

Medicine has moved on in recent years, and we now know that we can safely reduce risk of heart disease by lowering cholesterol and blood pressure, and the drugs used to lower these risk factors are probably safer than aspirin. A person wanting to lower their risk might well consider taking a statin or an antihypertensive first and only after that add in a less safe drug like aspirin.

The guidelines have not been changed and no doubt the guideline committees will review the latest data to determine if the guidelines need to be changed but int he meantime reviewin individual circumstances, family history and your own tolerance and experience with the various choices will influence decisions.

The major increased risk shown with Aspirin therapy was that of “major bleeds” which increased from 0.07 to 0.10% per year (absolute of 0.03% increase). These increases did not depend on other risk factors, age etc. And there appeared to be no “significant” trend in the positive effects of Aspirin in people at very low, low and moderate risk. There was an accompanying editorial from a clinical group out of Utrecht in the Netherlands that tried to provide some guidance on the relative risk and who should take Aspirin but the data and advice was disputed by Dr Baigent .

So review the choices, understand the risk and make your own choices based on consultation with your doctor and reviewing the updated findings and material