Jacqueline Santora Zimmerman

Dietetic Internship update

Fri, 02 Oct 2009 22:22:57 GMT

No time for a separate update, so here's the note i wrote to my former coworkers.

---------------------------------------------

Hi all,

I just wanted to say hello and let you know how things are going - and of course I want to know how you are too!

The internship is going very well, but it's VERY busy. I just finished my third week at The NY State Psychiatric Institute. It has been great so far, but the pace is obviously very different from STB. I am usually running around the 3 main inpatient units, trying to keep with nutrition assessments on the new admissions. Two units have people with schizophrenia, depression, anxiety or bipolar disorders, and the third is a smaller unit with mostly depression and eating disorders. To be in the hospital, all patients are in some type of research study, so there's clinical staff, research staff and students (residents from Columbia Medical school) all working together. It makes for a fast-paced and interesting dynamic. One of the psychiatrists remembers interviewing my friend Milana for her residency.

I've spent a good amount of time with the eating disordered (EDO) patients. There are 4 of them right now, and my supervisor runs a weekly lunch group where we take the EDO patients out to lunch. The point is for them to challenge themselves and practice making food decisions on their own. We are there to insure they choose something high enough in calories, answer questions and support them through the meal. Most of them are in the weight gain phase of treatment, which means they are eating 3000 calories per day. Their metabolisms are so screwed up - they are hypermetabolic - that some don't gain weight even eating that much. It has taken a few interactions to realize how sick they are - most of them look thin, but otherwise can be totally friendly, normal and chatty. Obviously, they must be healthy enough to go off the unit for lunch group, so I wonder if anyone realizes that we are not just a group of girls going out to lunch.

I've learned a lot about psychiatric medications, and that many basically cause metabolic syndrome: a combination of type 2 diabetes (or insulin resistance), obesity, hypertension and high cholesterol. To make matters worse, a lot of people start off being overweight. Many patients are lucid, but still lack practical knowledge regarding what to eat or how to make better choices once they leave the hospital.

In other news, today we had class at Kingsbrook Jewish Hospital in Brooklyn and heard a lecture on geriatric nutrition. We also sampled lots of nutrition supplements (like Ensure and other more specialized types). It's definitely important to know what you are recommending to people. Some weren't too bad, but some were really quite terrible...I will definitely think twice before ordering those for patients! The other class I am taking is Nutritional Epidemiology - very interesting. I am learning that it's really hard to collect good data on dietary intake because so many things come into play - season, lots of people under reporting their intake, the fact that there cannot truly be a control group (everyone needs to eat something!), etc. I've learned a lot about statistics and what are (or are not) reasonable statements to make based on the type of data you have.

I hope all is going well with you and STB. I have to say I don't miss the Private Equity Update, but I do miss your company. :)

take care,

Jacqueline

The long black week

Mon, 24 Aug 2009 19:03:37 GMT

Matt Suddain, Sunday Life

Cold turkey ... Could you give up coffee for a week?

Just how hard could it really be to give up coffee for seven days? Very, finds Matt Suddain.

Day zero

My last cup. I savour every inky drop. Oh, black ocean of possibility with your bobbing boats of inspiration. That's good, write that down. Feature idea: read the 10 great novels of the 20th century and write about them - Ulysses, In Search of Lost Time, The Clan of the Cave Bear. TV idea: women vie for the hand of a millionaire. Eventually they learn that the man has a degenerative illness and will require a lifetime of care. Also, he has no money. Delicious. Factoid: coffee was discovered by goats. According to legend, an Abyssinian goat-herder saw his herd acting frisky after they'd eaten red cherries from a shrub. He tasted the fruit and was later spotted dancing with his goats. Movie idea: Dances with Goats?

Day one

Green tea to start the day. Tea has caffeine, too. Where is it? When caffeine intake is reduced, blood pressure drops, causing the infamous withdrawal headache. The headache can last up to five days but can be alleviated with analgesics and with caffeine. Well, duh. The withdrawal subject may also become nervous, irritable, restless, lazy, dopey, sleepy and grumpy - also known as the seven dwarfs of caffeine withdrawal. In my case this gang has been joined by dizzy, cranky, punchy and blurry. Idea: read five great novels. Start Proust's In Search of Lost Time.

Day two

A tad cranky. Some tea makes me feel better. Flatmates say nine cups is cheating. Things get out of hand, tea everywhere. To do: buy flatmates flowers. Headache persists, a dull stabbing in frontal lobe accompanied by desire to stab. Normal? Doc says yes, it's normal, and that in two weeks I'll be able to replace the effect of caffeine with a short run. Suspect he's in the pocket of the jogging industry. Idea: new doctor. My neighbour plays his stereo all day. One of those hipster chumps who's into dressing like a pirate. Mag idea: hipstersexuals - more-than-gay-enough.

Day three

Feeling bad. Two pots of green tea and I'm leaking like a Russian sub. Flatmates confiscate my teapot. Find backup teapot. More screaming. They catch me sucking the juice out of tea leaves. Have to drag me off. V. embarrassing. Synapses no longer firing. Idea: can't remember. Return to bed. Ah sleep; black ocean of possibility with your ... boats ... Factoid: each year some 7 million tonnes of beans are produced worldwide. Most of it is hand-picked. By monkeys. (Note to self: fact-check this fact.)

Day four

Feeling the hate. Also the pain. Told taxi driver that the reason so many immigrants come here is to ruin his day. Caffeinated lip-balm confiscated by flatmates. Threw In Search of Lost Time out window. Factoid: originally, coffee beans were a food. East African tribes would grind coffee cherries together and create a paste with animal fat. Rolled into little balls, the mixture was said to give warriors energy for battle. Hell yes!

Day five

Hate. Pain. All will pay. Idea: torture not so bad. Idea: see indie-boy about his stereo. Kill him. TV idea: Celebrity Island. Take celebs to a deserted island. Leave. Never go back. Oh god, I miss coffee - the ritual, the equipment. Coffee has the sexy nomenclature of a fetish: crema, macchiato, extraction. Coming off coffee is similar to being a binge drinker, but with none of the exquisite amnesia. I remember haranguing taxi drivers and hapless cinema attendants with a frightening clarity. I remember calling my flatmate a "trout-sucking troll". I'm a monster. The recovering coffee drinker wakes with the hangover, but also the memories.

Day six

Feel a little better. Headache faded. Will to kill diminished. Feel sad. Morning in bed. Flatmates bring me soup. Finish reading a history of coffee. Coffee is one of the world's most vital primary commodities. About 6.7 million tonnes of coffee were produced in 2000, and 7 million is expected by next year. The collapse of the International Coffee Agreement led to a pricing crisis from 2001 to 2004, during which many coffee farmers lost their livelihoods. That was just a pricing issue. Imagine the global impact if the coffee industry collapsed. Productivity would plummet, violent crime would rocket and fragile workers, deprived of their breakfast lattes, would turn to crack. Armies would wage war over dwindling stocks, leading to mass slaughter, headaches, irritability and the apocalypse. This is critical. Decide that I must resume drinking coffee. Immediately. Not for pleasure, you see, but for the economy.

Day seven

My first cup! Like a rebirthing. Oh, hot black wave of pleasure, welling like a slop of warm bathwater from within. Oh, cascade of burning sparks redolent with possibility. Idea: what do people love? Guns. What else? Celebrities. Hunting the Stars! Bindi Irwin to host?

Source: smh.com.au

School Food FOCUS!

Fri, 21 Aug 2009 14:15:49 GMT

http://www.nytimes.com/2009/08/19/dining/19school.html?_r=1

A little more than half way down they refer to "Food Options for Children in Urban Schools" which is FOCUS, the organization my prof started with some colleagues. I have been the FOCUS "intern coordinator" and have been providing support to their Policy Working Group since January. It is an exciting time for changes!

Sugar's Renaissance

Thu, 30 Jul 2009 14:24:59 GMT

From Dr. Weil:
"Sugar Making a Comeback
Sugar is now healthy and natural? Once reviled as the bane of teeth and waistlines, cane and beet sugar are now enjoying something of a renaissance in processed foods, and are being touted as natural and healthful. A story in the March 20, 2009, New York Times pointed out that sugar is replacing high fructose corn syrup (HFCS) in products such as the tomato sauce on a Pizza Hut pizza called "The Natural," and in a new soda called "Pepsi Natural."

My take: Cane or beet sugar is, I believe, somewhat better for you than is HFCS. There is evidence that the latter sweetener is more likely to promote weight gain, and it may also disturb liver function. So replacing HFCS with cane or beet sugars in processed foods is indeed a modest improvement.

But "real" sugar is just the lesser of two evils here, and it is definitely possible to consume too much, leading to weight gain, type 2 diabetes and a host of other ills. One of the best moves you can make for your health is to get away from concentrated, processed sweeteners of all kinds and learn to appreciate the natural sweetness of fruits and other whole foods. In the meantime, perhaps the best aspect of this "real sugar" renaissance is the fact that the stuff is more expensive to manufacture than is HFCS from subsidized corn, which means perhaps we'll see less sweetening of any kind used in foods."

My thoughts exactly. I have been irked but somehow not surprised by the advertisements for sugar. Some of them aren't too obvious - I had to point out what Snapple is doing to some people. Snapple's "better stuff"ad campaign includes phrases like, "Healthy Green Tea, Tasty Black Tea, Real Sugar, The Best Stuff on Earth" I immediately thought they were advertising that their product has sugar instead of high fructose corn syrup. But maybe that's because I think about this stuff all the time.

I would choose sugar over HFCS, but it's still refined sugar. It's not a "health food" or a 'health ingredient." Get a grip, people!

i also have found some irony here, something along the lines of:

     "Let's advertise the fact that we're not messing up our food anymore!"
     "Great idea! then we can mess it up again and advertise that, but make it sound improved!"
     "Then we can add some other random healthy things like B vitamins and advertise that!"
     "Then we can remove some of the stuff we added, and advertise that it's now natural!"
     "Then we can.....etc etc"

Letter to a coworker who insists that drinking water with meals is bad for digestion

Mon, 27 Jul 2009 14:14:00 GMT

I don't feel I did a very good job in explaining this last week, so I am going to try again. I am sure I will encounter other people with these same questions, so this is actually very helpful for me to do! If you have any questions please ask me - i need to learn how to answer these questions. And if you think I am dead wrong about something, I would like to know, so I can do some research on it! :)

So, why doesn't drinking water with meals negatively impact digestion (or, "dilute digestive juices")? First, enzymes are themselves proteins, and are not water-soluble (a steak does not dissolve in water). Water in no way disables enzymes. Second, as I mentioned, water is necessary for the the breakdown of molecules. For example, in order for 2 amino acids to break apart, a water molecule must be used up in order to end up with 2 stable amino acids. One hydrogen from water joins one amino acid, and the other hydrogen and oxygen atoms join the other amino acid. This is called hydrolysis; the opposite is called condensation (when amino acids are joined together into proteins, water is created). Water is also helpful in mixing up stomach contents, keeping it liquidy so it may be pushed through the intestine. Water is helpful to absorb water-soluble vitamins and electrolytes from food. Water has a minimal impact on diluting stomach acid - a healthy GI is able to compensate very well. Keep in mind that stomach acid is only one part of what aids digestion - yes, it is important, but it is only a piece of the puzzle.

It is important to understand that if you have a normally-functioning GI tract, your stomach empties its contents into the small intestine at regular intervals. It doesn't dump it out all at once. The majority of digestion takes place in the small intestine, not the stomach.** Most enzymes are secreted by the pancreas directly into the small intestine. If your stomach has done a good job of mixing, water will be regularly dispersed in the contents. The mixing and dispersing of food particles helps increase the surface area on which the pancreatic enzymes will work. [That being said, I have not seen any evidence indicating that drinking more water has an effect on increasing blood sugar at a faster rate.] Water is allowed to flow freely in chyme (name for the mixture of food/liquid after it leaves your stomach) without negatively impacting enzyme activity. Again, since enzymes are proteins, they are not deactivated or diluted by water.

Some people with achlorhydria (low stomach acid) think they should not drink water with meals, because it dilutes what little acid they have. This is unfortunate, since they would be much better off by drinking water and supplementing with betaine hydrochloride or glutamic acid hydrochloride to increase stomach acid, rather than lowering water intake. There is little evidence to suggest that lowering water intake with meals aids digestion in this case - they still have low stomach acid, whether there is more or less water does not have much of an effect. Water has a minimal effect on diluting stomach acid of a person with a healthy GI tract. In the case of achlorhydria (hypochlorhydria), the point should be to increase the stomach acid not lower water intake with meals. Low stomach acid has the greatest impact on protein digestion and vit B12 absorption. Also of a concern is the role stomach acid plays in food safety - it is our first line of defense against ingested pathogens.

As far as absorption is concerned, nutrients are absorbed throughout the length of the small intestine as chyme is pushed through it. Chyme is liquidy and it should be - the majority of water is not reabsorbed until it reaches your large intestine. If chyme were not liquidy, I can only imagine the discomfort that may ensue as solids were pushed through the small intestine! And you'd probably end up constipated...yuck. This also depends on what you have eaten, since certain foods will hold onto water, or be pushed large intestine faster than others (faster usually means less water has been reabsorbed = softer bowels). Now, you has asked how much water is necessary with meals? I don't have any research to quote you right now, but my opinion is: probably not very much, because your body will draw water from itself if you do not provide it. The body can easily compensate for more or less water, as long as you are generally hydrated.

In conclusion, there ARE conditions during which drinking liquid while eating is not a good idea. If you have frequent acid reflux/heartburn, or have been diagnosed with GERD, it is best to drink your fluids between meals. The reason for this is that liquids will increase the overall volume of the stomach contents, which can put pressure on the lower esophageal sphincter (LES). This pressure can exacerbate reflux. Certain types of foods can relax the LES also, including peppermint, spicy foods, fatty foods, chocolate and caffeine. These foods contribute to relaxing/opening the LES and your stomach acid leaking out = worsening of acid reflux/heartburn symptoms.

If drinking water/liquids between meals makes you feel better, by all means continue to do so! I personally do not like feeling overly-full, so I usually wait until after eating to drink most of my liquid (that way I can better gauge how full I feel). I just wanted to explain why if you chose to drink water with your meals, you are not inhibiting your digestion.

- Jacqueline

**The only thing that is actually digested in the stomach are proteins. Fats and carbs are digested in the small intestine. There is a very logical, biological reason for this. Enzymes are themselves proteins - if you mix protein-digesting enzymes with other enzymes, the former will digest the latter. Also bear in mind that the human body is composed of proteins - what is to keep trypsin, pepsin and other protein-digesting enzymes from digesting your own body tissue? The stomach has 2 main ways to prevent this: first, it has a very thick lining of mucous, and second, the enzyme made in the stomach lining is not activated until it comes into contact with stomach acid. Stomach acid also helps to unwind (denature) the proteins, which increased the surface area on which the enzyme can work.

Dietetic Internship

Mon, 20 Jul 2009 02:47:03 GMT

Finally got my fall site placements!! (er, mostly)

NY State Psychiatric Institute: Sept 14 - Oct 23, 168 hours

City Dialysis - 112 hours

Pediatric rotation (location pending) 112 hours.

i am psyched about the Psych institute (pun intended)...

Summer Reading

Wed, 01 Jul 2009 19:26:23 GMT

First on my summer reading list was the latest Sookie Stackhouse novel by Charlaine Harris: Dead and Gone. It's book 8 in the series and HBO's True Blood is only on book 2. So much happens in the intervening novels...i wonder how long the show will be on, and if it will last until this book? In short, it was a fun first read to celebrate the end of studying for the summer.

I am currently reading "Lewis Carroll in Numberland: His Fantastical Mathematical Logical Life" by Robin Wilson. I am half was through and am enjoying it immensely. For one of my favorite authors, I don't know too much about his life. I own 2 different biographies but haven't gotten around to reading them yet. Apparently Charles Lutwidge Dodgson was an extremely accomplished mathematician. At the age of only 23 he won the Christ Church (at Oxford University) Mathematical Lectureship, which he held for 26 years. There is a good deal of math and logic in his writing - but it never REALLY stood out to me until now.

This book is filled with puzzles and games, brainteasers that Charles created for his own amusement and for his 10 brothers and sisters. He was the 3rd oldest child and the oldest boy. He spent a good deal of his youth (before going away to boarding school) creating a "Family Magazine" which contained his stories, poems and those of his siblings. He also started experimenting with photography when he was quite young. The author goes as far as saying that if Dodgson had not written the Alice books, he would be best remembered as, "a pioneering photographer, one of the first to consider photography as an art rather than as simply a means of recording images." He photographed many, many subjects: his parents, brothers and sisters, locations and, of course, Alice Liddell and other children.

This brings me to a sore point: reading about the FACTS - rather than the myths - of Lewis Carroll's life erases any notion of pedophila from my mind. I never believed he was a pedophile, but I must admit there was a lingering shred of doubt. I doubt no longer. In the context of his life, his stories and photos do not appear as anything other than what they are: stories and photographs of an incredibly smart, whimsical man, who grew up entertaining his siblings - and who later delighted in telling stories to his friends' children and writing to them. That he wrote "Alice's Adventures Underground" for Alice Liddell no longer appears as any great act of devotion (into which many have read deeper meaning). He was always writing stories and letters to his siblings, both as a preteen and while he was away studying at Oxford.

ANYWAY, the book is fun so far - filled with puzzles and brain teasers, codes...supposedly he devised an easy method to find the day of the week for any given date in history! (Haven't gotten to that yet). Oh, and in case you were wondering, the name Lewis Carroll comes from a play on his own name: Latin for Lutwidge (his middle name) = Ludovicus and the Latin for Charles = Carolus.

The Thriller

Fri, 26 Jun 2009 13:55:38 GMT

Darkness falls across the land
The midnight hour is close at hand
Creatures crawl in search of blood
To terrorize y'all's neighborhood

And whosoever shall be found
Without the soul for getting down
Must stand and face the hounds of hell
And rot inside a corpse's shell

The foulest stench is in the air
The funk of forty thousand years
And grizzly ghouls from every tomb
Are closing in to seal your doom

And though you fight to stay alive
Your body starts to shiver
For no mere mortal can resist
The evil of the Thriller

No matter how weird he became, I will always remember dancing around to Michael Jackson when I was a little girl. I think he was the first musical artist I was a fan of - can't decide whether it was him or Madonna.

EDIT: My mom just reminded me that at my birthday party when I was 7 or 8 we played "pin the glove on Michael Jackson"!

Something my boss sent around...

Wed, 24 Jun 2009 19:26:31 GMT

Excerpts from an actual 8-K SEC filing (http://sec.gov/Archives/edgar/data/746515/000119312509135706/d8k.htm)

1. In the 10-K, you note that as of December 31, 2008, EXPD incurred approximately $14 million of cumulative legal and associated costs related to the DOJ investigation, of which $10 million occurred in 2008. What were your Legal costs associated with the Federal antitrust class action lawsuit and/or the European Commission’s request for information beyond those related to the DOJ investigation and what were your total legal costs for all of 2008 compared to 2007? Do you anticipate any incremental legal expense associated with the European Commission’s additional request for information at your U.K. subsidiary in connection with the ongoing freight forwarder investigation? What do you expect your total Legal and associated costs in 2009 to look like compared to 2008?

Legal costs for the Federal anti-trust class action lawsuit and the European Commission’s Request for Information (RFI) have been a relatively small part of the $14 million of legal fees incurred related to anti-trust investigations. The lion’s share of legal expenses have primarily been related to the U.S. Department of Justice’s (DOJ’s) anti-trust investigation. While legal expenses have abated, relative to levels being incurred a year ago, we still expect to have some ongoing legal expenses during 2009 related to each of these aforementioned proceedings. Without being trite, as we’ve addressed this topic before on more than one occasion, an attempt to predict the magnitude of these expenses at this juncture would be pointless as we feel the ongoing questions asking us to predict future legal spend have been. We understand everyone’s interest in the topic, it is something we are keenly interested in as well. We would hope, however, that everyone understands that if we actually knew enough to be able to predict our legal expenses, that would be an associative discussion which would follow a much more serious disclosure. At that juncture, legal fees would be of lesser concern.

When you come from a frame of reference, as we do, where $0 spent on legal expense would be the most preferred alternative, having to predict anything beyond that, by its nature, would become inherently and incredibly biased towards our own wants, desires and expectations. To us, this is somewhat akin to being asked to predict how many minutes after being force fed a dead frog we would throw-up…and the operative word is “force,” as we’d never elect to do either on our own. In both cases (the legal fees or swallowing the dead frog) we’re certain we would eventually throw up. In neither case do we know exactly how much money or how much time would pass before we did. In both cases, however, our gut check, no pun intended, is not very much and not very long! It should go without saying that given our druthers, we’d rather not spend the legal fees or eat the dead frog in the first place. Sometimes you don’t get the luxury of deciding what you have to eat. When you do, and it’s unpalatable, it should be obvious that you would eat as little as possible. What we are certain of is that if we were talking about being force fed dead frogs and not incurring excessive legal fees, people would be content accepting at face value that it would be as little as possible. Please rest assured, however, that whatever our legal costs are during the next year, while they will be more than we want, they will be the least amount that we can spend to completely and competently comply with ongoing requests or requirements of the various government and/or civil authorities overseeing these various proceedings.

7. Can you outline any specific things that the company is doing to curtail expenses in this very difficult economic downturn? Do you have a corporate aircraft fleet? If so, have you downsized that fleet?

If you compare our operating income percentages with those companies whom the analysts designate as our peer group, you will note that our operating income percentages are much higher, nearly double of most of those within the market defined peer group we are thrown in with. We have also done responsible, measured things when times were good. Perhaps the most significant thing we can point to is having had the good fortune to have developed a corporate culture and a compensation system that reinforces the need for constant productivity improvement by tying people’s individual compensation to direct operating profit, on a cumulative basis. As a consequence, we’ve always done many of the things people are just getting around to doing now in an attempt to tighten their belts. We initiated a hiring freeze last year. There are, of course, reasonable and logical exceptions that need to be made in instances, for example, where new business comes on—trying to handle new business with inadequate resources flies in the face of one of our 2009 corporate goals—“Don’t do anything stupid”. Our hiring freeze is also a “Don’t do anything stupid” (D2AS) kind of hiring freeze. “Don’t do anything stupid” also means that we don’t take steps in the name of short-term profitability that will weaken our long-term capability to meet the service needs of our customers nor damage our greatest asset—our employees.

Earth to the DMV...

Mon, 22 Jun 2009 05:07:45 GMT

Tonight we took my grandmother out for her 98th birthday. At dinner she tells us she just renewed her driver's license...it now expires in 2017.

She was driving up until last year - and she was a good driver. She has 20/20 vision now that she had her cataracts removed, which is all the DMV requires! But seriously, folks...shouldn't there be some actual test of driving ability? or reflexes or something??

Zicam

Thu, 18 Jun 2009 18:50:30 GMT

Another reason to choose supplements/remedies carefully! People just assume herbal/homeopathic remedies or supplements are safe. The FDA has little to no control over what is sold.

http://www.nytimes.com/aponline/2009/06/17/health/AP-US-MED-Remedies-Homeopathy-Patient.html

and

http://www.nytimes.com/2009/06/17/health/policy/17nasal.html?em

one of my friends from college was born without a sense of smell - she has never known what it is like. I can't imagine how weird it would be to not smell anything.

And the Forecast Is . . .

Thu, 18 Jun 2009 17:38:52 GMT

[from the NYTimes a few years ago...so appropriate!]
By MICHAEL RUBINER

Wednesday in New York : Rain. Heavy at times. Followed by periods of precipitation.

Thursday : Lingering showers throughout the day. Chance of rain 800 percent.

Friday : Moist. Damp. Sodden.

Saturday : Rainish. Showery. Precipitacious.

Sunday : Light rain followed by heavy rain followed by pouring.

Monday : Unseasonably rainy in the morning. Uncharitably rainy in the afternoon. Unconscionably rainy in the evening.

Tuesday : Endless showers broken up by occasional flooding.

Wednesday : Remember "Waterworld"? Like that, only with more rain.

Thursday : Not sunny. The opposite of sunny. Just forget about sunny, O.K.?

Friday : Clearing just long enough for you to make weekend plans. Followed by obscene amounts of rain.

Saturday : Take a wild guess.

Sunday : Incessant, spirit-crushing rain. The kind of rain that makes it futile to get out of bed in the morning. The kind of rain that seems as if it will never end. And guess what? It never will. Ever. Do you understand?

Monday : Please go away.

Tuesday : Ample, brilliant sunshine throughout the day. Wait - did I say sunshine? I meant rain. Really hard rain.

W&W Day 3 - Physiology, Genetics and Environment

Fri, 05 Jun 2009 02:26:38 GMT

I wish i could recreate the class, but it's just not possible. A lot of it was review, but still great. This will probably come out as a rambling jumble of ideas. i often don't post because i seem to take a loooong time to put coherent ideas together and i am usually just too exhausted to expend the effort.

Anyway, we talked about causes of obesity: lifestyle, genetic, behavioral, environmental, metabolic. By the end, i realized that i have probably been subconsciously underestimating both genetic and environmental factors. For example, we touched upon nutritional genomics and fetal programming. We mentioned the 1945 Dutch famine, and the Dutch Famine Birth Cohort Study. Children of women who were pregnant during this time were found to have a greater chance of becoming obese, having diabetes and heart disease (suggesting that they were programmed to retain calories). These children were also born small, which sounds logical during a famine. What is really fascinating is that the children of these children were also born smaller than average. The famine had some kind of lasting genetic effect.

Now, I don't think this means that someone in that type of situation is doomed - obviously, not every person became an overweight adult. It's just one of the many factors to consider in understanding why it can be so difficult to lose weight. Sleep also plays a larger role than we realize. The composition of our diets today are so different - so many additives, added sugars, etc. We also discussed food as an addiction. The DSM IV criteria really do seem to apply in some cases. Also talked about whether obesity is a disease or a risk factor.

One of the more interesting discussions took place during the break and after class. I asked one girl who had attended the Institute for Integrative Nutrition (IIN) about it. I have been so immersed in nutrition science and environmental/policy issues lately, and I am curious what the numerous holistic/nutrition "certification" programs are being taught. First, I just don't see how you can become a nutrition educator in a 6-month program. Yet people from IIN go out and set up practices and have clients, etc. I think they must be good at giving the basics and empowering people to start a career and be good businesspeople. It's sort of retarded that I (and many other students) don't even feel qualified at this point - there is still so much to learn, but i have to remember how much I have learned already and focus on that.

I want to take a holistic approach in my practice. But I don't think i need a "program" to teach me that. It's a mindset in counseling people - an approach that takes the whole person into consideration - emotional and physical. I am realizing more and more how the American Dietetic Association is "in bed" with the food industry, but it's just something we have to recognize and deal with. I am also realizing how there are many different schools of thought in this field. There are RDs working for every food company out there. And there is just so much money in it, if you can do that kind of work. A woman who contacted a classmate about being a spokesperson for high fructose corn syrup (and how it's totally the same as sugar, as shown by industry-funded research) was an RD. What is up with that? How about taking a look at both sides? Oh wait, i forgot that no one is funding independent research....Food science aside, HFCS is found mostly in highly processed products. I think it was Andrew Weil who said that HFCS is the hallmark of a low quality food.

ok, long ramble here. i could go on and on.

P.I.R.A.T.E.S.

Thu, 04 Jun 2009 02:24:14 GMT

just got this in a Vassar Alumnae/i eNewsletter:

Pirates!

The serenity of a peaceful spring Sunday was shaken on May 10 when Vassar fell victim to an invasion of pirates — members of the Bard College student group P.I.R.A.T.E.S. (People Interested in Restoring a Tradition of Excellence at Sea), that is.

According to Madison Fletcher, a Bard freshman and a participant in the raid, the pirates were of the friendly variety, attempting to bring some cheer and entertainment to Vassar students during the frenzy of finals. “When we raided this year we knew that the kids had finals the next day but we figured that we could bring some comical stress relief,” she says — “and I believe we did to some. It really is just playful fun.”

P.I.R.A.T.E.S. was founded in the fall of 2003 by two Bard freshmen who hoped to use their fledgling group to screen pirate movies, throw pirate-themed parties, and raid Vassar. P.I.R.A.T.E.S. cofounder Josh Klein-Kuhn, Bard ’07, recounts that on their first raid, upon “slunk[ing], en masse, onto campus,” the “two large vans’ worth” of pirates “ran around the quad, demanding booty.” They then created a scene in ACDC [the all-campus dining center], where several “fair maidens went shrieking in, followed closely by bloodthirsty pirates, who chased them around the serving area.”

This year’s raid, in contrast, was somewhat tamer. The Bard students, bedecked in swashbuckling apparel, cruised a 17-man paper ship through the quad, crying “Barrrrrd!” along the way. After the requisite staking of (peaceful) conquest flags, which bore the letter “B” imposed over a skull and crossbones, the incursion concluded on the steps of ACDC, where the pirates reveled in traditional piratic greeting and cheer. “We even had a few Vassar students join in,” Fletcher notes. “We made them ‘walk the plank.’”

Women and Weight

Wed, 03 Jun 2009 18:17:19 GMT

Just had my second class of the short summer course i'm taking: Women & Weight. It meets 4 mornings a week for this week and next. Kind of intense!

Anyway, it seems to be a very interesting course, which seeks to examine why women (more than men) internalize the issue of weight, and how we (as future health professionals) can help. It is co-taught by a psychoanalyst and a nutrition therapist who handles a lot of clients with eating disorders. Here is the course overview:

Class 1: Introduction and Overview: the scope of the work
This was yesterday. One of the most interesting and disturbing exercises we did was to write whatever words or phrases came to mind upon hearing the word "fat." Shocking how many we came up with, and how negative they were, and how most of the physically descriptive ones applied only to women.

Class 2: What do we Understand About Her: Psychology
Today we talked about lots of different approaches to therapy, including the classical Freudian psychoanalysis but also others such as the realtional approach and self-psychological approach. Although i was a psych major, it's been a while...The case studies we read were very interesting, mostly illustrating how food becomes the substitute for something missing in the person's life (control, caring/love, rebellion, etc) and how that was addressed in therapy. A lot of these are really psych issues, but it's important to understand and be able to recognize when a client's needs are beyond the scope of our training as nutritionists. Oh, but i should mention that the course is open to everyone, so it's not just nutrition students.

Class 3: Why She is Fat and Getting Fatter: Genetic, Physiology and the Environment
Class 4: Why She is Thin and Getting Thinner: Bulimia and Anorexia
Class 5: How Does She See Herself? Body Image
Class 6: How Does the Word See Her? The Social and Cultural Message
Class 7: How Do We Help Her: Interventions
Class 8: Where Do We Go From Here: Integration

Stupid News

Sat, 23 May 2009 17:00:45 GMT

There are little TV screens in the elevators at work. They show Captivate Network (http://www.captivate.com/) weather and news blurbs, stock quotes, Word of the Day, etc. Things you can read in the 30 - 60 seconds you are in an elevator. I often wonder what news items they choose to display.

For example:

Last week i was informed that while attractiveness is helpful in getting a job, actually having a brain and being smart is also useful for getting a higher salary.

Who knew??! And here I've been spending all this time in beauty salons....i'm going to run out and start developing my brain now.

Thanks for the insight, Captivate!!

How does the new Enterprise measure up?

Mon, 18 May 2009 18:54:24 GMT

http://gizmodo.com/5253324/how-big-is-the-new-enterprise-compared-to-galactica

(no spoilers)

notes to myself...omega 3s: best fish/worst fish

Sat, 16 May 2009 17:23:24 GMT

(also from Dr.Weil.com)

Best sources: wild-caught Alaskan salmon, canned sockeye salmon, sardines, herring, and black cod.

Worst fish choices:
1. Large predatory fish. Shark, swordfish, tilefish, king mackerel, and white (albacore) tuna may have high levels of mercury. Pregnant women and children are particularly vulnerable to the effects of contaminants, and should avoid these species. (Small-catch tuna is OK, as it has high levels of omega-3s.)

2. Omega-6 rich fish. Farm-raised tilapia is one of the most highly consumed fish in America, yet it has very low levels of beneficial omega-3s and very high levels of potentially detrimental omega-6 fatty acids. Omega-6 fatty acids are pro-inflammatory, and inflammation is known to cause damage to blood vessels, the heart, lung and joint tissues, skin, and the digestive tract.

3. Farmed salmon. Avoid farmed salmon (also called Atlantic salmon), which is what you typically find in supermarkets, restaurants and fish markets. While less expensive than wild salmon, farmed salmon is lower in omega-3s and may contain residues of antibiotics and other drugs used to treat diseases in fish farming pens. What's more, levels of PCBs and other contaminants in some farmed salmon have been found to be much higher than those found in wild salmon.

Folic acid & allergies and asthma?

Sat, 16 May 2009 17:17:55 GMT

Folic Acid May Tone Down Allergy, Asthma Symptoms

The higher your blood levels of folic acid, the less chance you may have of developing allergies or asthma. While that conclusion needs to be confirmed by further studies, researchers from Johns Hopkins have reported that folic acid may help regulate immune system responses to allergens (ragweed pollen, dust and other substances that set off sneezing, wheezing) and also reduce the symptoms of allergy and asthma. The Hopkins team reviewed the medical records of more than 8,000 people ages two to 85, tracking the effect of levels of folate (the naturally occurring form of folic acid) on respiratory and allergy symptoms and on levels of IgE antibodies, the immune system proteins that rise in response to allergens. They found that individuals with higher blood levels of folate had fewer IgE antibodies, fewer reported allergies, less wheezing and a lower likelihood of asthma. The findings were published online ahead of print in the Journal of Allergy & Clinical Immunology. The investigators are planning a study comparing the effects of supplemental folic acid and placebo in people with allergies and asthma.

http://www.drweil.com/drw/u/WBL02139/Take-this-Potent-BrainProtective-Nutrient.html

Fri, 01 May 2009 18:49:01 GMT

Nothing that new, but interesting all the same. I wonder if the original article addressed the solubility of the compounds in food. I'd think that whether a compound is fat soluble or water soluble also comes into play, and might be the reason why boiling is ok for some veggies but not others.

Cooking Boosts Vegetable Antioxidants

The way you prepare and cook vegetables can influence the amount of antioxidants available to you at mealtime. The healthiest methods overall appear to be microwaving and “griddling” or cooking veggies on a flat metal surface without any oil.

Spanish researchers looked into how different cooking methods affect antioxidant content by analyzing the nutrient value of 20 different vegetables after boiling, pressure-cooking, baking, microwaving, griddling and frying. Results of the study published in the April 2009 Journal of Food Science showed that the greatest antioxidant losses occurred in cauliflower after boiling and microwaving, in peas after boiling and in zucchini after boiling or frying. Antioxidant levels remained high in green beans, beets and garlic after most cooking methods and they actually increased in celery, carrots and green beans after cooking, no matter what method was used (although no increase was seen in green beans after boiling). Artichokes were the only vegetable that maintained antioxidant content no matter what cooking method was used. Given all methods tested, the greatest antioxidant losses stemmed from boiling and pressure-cooking.

Interesting blurbs

Wed, 29 Apr 2009 03:37:28 GMT

from Dr. Weil.com

Not Enough Vitamin A and C May Increase Asthma Risk
British researchers recently reviewed 40 studies and concluded that individuals with asthma apparently don’t get enough of either vitamin A or vitamin C. This doesn’t mean that low levels of the two vitamins cause asthma. Instead, from their analysis of the pooled results of studies conducted between 1980 and 2007, University of Nottingham researchers reported that there’s a consistent association between the risk of asthma and low levels of vitamin C and, to a lesser extent, low levels of vitamin A. This contradicts findings from a study published last year that found no association between antioxidant vitamins and asthma risk. The Nottingham investigators found that people with severe asthma had levels of vitamin C reflecting only about half the recommended daily intake and that low circulating levels of “C” in the blood and low dietary intake of foods providing vitamin C were associated with a 12 percent increased risk of asthma. As for vitamin A, the average intake among asthma patients was 182 micrograms per day, less than a third of the recommended daily intake.

Low GI Breakfast Helps Burn Fat
Want to get more out of your workout? You could try eating a breakfast of foods that rank low on the glycemic index (GI), a measurement of how easily the body converts carbohydrates into glucose (blood sugar). Foods with a low GI ranking aren’t quickly metabolized to glucose. British researchers tested the effects of low vs. high glycemic index breakfasts in a small group (only eight) of sedentary young women in order to gauge the effect the meals had on fat oxidation during exercise. The low GI meal consisted of muesli, skim milk, apple juice, an apple, canned peaches and yogurt. The high GI breakfast included corn flakes, white bread, jam, skim milk, margarine and a carbonated glucose drink. Three hours after breakfast the women spent 60 minutes walking on a treadmill. After the low GI breakfast, they burned 55 percent more fat than they did after the high GI breakfast. Because this study was so small, more research is needed to confirm its findings. Results were published online in the March 25, Journal of Nutrition.

Just not enough time

Sat, 11 Apr 2009 23:17:35 GMT

My sis-in-law just mentioned that i haven't been posting about classes - or well, anything! Classes are great, it's just that there's too many of them this semester. 3 classes at TC and 1 online, plus working is just driving me nuts. But this is really the last semester that will be like this, so i am starting to see the light. In fact, after the 2 papers i'm working on right now, 2 of my classes will require significantly less work...so that's good.

Currently i'm stressing over finding out about admission to the dietetic internship for next year. After April 20th i will feel much better (or worse, but we're not even considering that possibility...aaghh)

Anyway, for the record, my classes this semester are:

Seminar in Nutrition Education - a culminating class, each student leads one session. I did mine on adolescent nutrition, now i just have to finish writing up my 10pg lit. review.

Nutrition Counseling - really love this one, nutrition counseling is more than just telling people what to eat, brings in a lot of psychology - my original love.

Social Policy and Prevention - an elective in the health edu. dept. Good class, lots of discussion on current issues in health care, but too much reading/work for an elective!

Microbiology - partly online. I have my exams scheduled at the proctoring center at Hunter College: May 7, 22 and June 12. Yes, i know that last one is the day before Springfest but there was nothing I could do about it. Now i just have to make sure i can have all the reading/studying done before then. Too bad Springfest is at a dry site because I will really be ready to celebrate at that point!

I love Target...

Tue, 03 Mar 2009 16:03:59 GMT

...here's why:

I just placed an order online. Recently I realized my wardrobe has almost no professional-looking items (suit/blazers, etc). All Isaac Mizrahi stuff is on clearance (this is the best quality line Target has, and sadly i think it's being discontinued). There's a limited selection of colors and styles, but all sizes are available. If i end up keeping everything, I will be getting:

- black blazer
- Suit: jacket with matching pants AND skirt
- spring vintagey-looking coat
- corduroy dress

All for $100.

Another interesting read

Thu, 29 Jan 2009 20:30:24 GMT

Babies Know: A Little Dirt Is Good for You

http://www.nytimes.com/2009/01/27/health/27brod.html?ref=health

don't eat anything with peanut-product in it!

Thu, 29 Jan 2009 19:57:32 GMT

...including Jenny Craig nutrition bars and Keebler crackers.

yipes!: http://www.nytimes.com/2009/01/29/us/29peanut.html?ref=health

Yipes again (but for a different reason!): http://www.nytimes.com/2009/01/28/dining/28bacon.html?em