Archives For Food

Food and long life

August 14, 2015 — Leave a comment

CutleryThere is so much in the news about food that it is hard to know what to eat. But there is reason to believe that food can play an important role in health. I’ve written about the connection between food and inflammation, the effect of food on the bacteria in the gut, how food can influence the course of a disease and the importance of telling stories about food.

Recent scientific papers in medical journals have suggested that spicy food is associated with a lower risk of death and that a Southern diet is associated with a greater risk of heart disease and stroke.

However, scientific studies about diet are difficult to interpret because they often depend on people keeping track of what they eat. It is also hard to know if other factors are influencing the results, which is why both of these studies can only conclude an “association” between the particular diet and the outcome and not a “cause”.

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Using art to heal

June 30, 2015 — Leave a comment

Health factors2Because Health is Life, our lifestyles are just as important to our health as going to the doctor or taking our medicines. In a paper published June 30, 2015 in the Annals of Internal Medicine, a study looking at survey data found that half the heart disease deaths in the US from 2009-2010 were caused by 5 factors all of which can be modified through healthy behavior: smoking, obesity, high cholesterol, diabetes and high blood pressure. But many of these behaviors are difficult to change and are influenced by our families, our culture and our community.

This picture shows that clinical care by doctors and hospitals accounts for only about 20% of health outcomes. The picture comes from a project called County Health Rankings developed by the University of Wisconsin Population Health Institute (and supported by the Robert Wood Johnson Foundation) that looks at health by county in the US. Addressing factors like cigarette smoking, income, education, employment, housing and clear air can help make communities healthier places to live.

We need to find ways to build healthier communities and the arts may be one way to accomplish this.

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microbiome2Remember in elementary school science class when we put samples of our hair and saliva in Petri dishes to see what grew? We even used cotton swabs to test the surfaces of our desks and bacteria grew in a few days. These experiments were designed to show us that we have lots of bacteria inside and on our bodies – and all around us. There are microbes (bacteria, viruses, fungi, etc.) everywhere in our “built environment” – the buildings we live and work in – as seen in this incredible animation.

Research suggests that the microbes in our guts play an important role in the development of disease. This collection of organisms, referred to as the microbiome (although technically the collection of organisms is called the microbiota and the genes of those organisms are called the microbiome), may play a role in the development of many diseases including diabetes, obesity, rheumatoid arthritis, asthma, allergies, Crohn’s disease, autism and cancer.

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Listen up

March 31, 2015 — Leave a comment

AudioLike millions of other people, I became hooked on “Serial”, the 12 episode podcast series that launched in late 2014 investigating the murder of a teenage girl in Baltimore in 1999 (that included phone conversations from prison with her personable ex-boyfriend who was convicted of the crime).

I don’t listen to a lot of podcasts but this was different. It was chatty, used a lot of personal stories and was the perfect thing to listen to while driving, walking or cooking. And I couldn’t wait for the next episode (nor could my 84-year-old mother or my 20-something daughters). Devoting over 10 hours to the program was not only easy but enjoyable. In the process we listeners also learned stuff – about the workings of the legal system, the nature of truth, the problems with first-hand accounts, the limitations of memory and much more.

It was like nothing I had ever experienced before and got me thinking about how we could use a similar strategy in healthcare.

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The gut and the brain

December 19, 2014 — Leave a comment

Gut BrainWe don’t normally think about the gut and the brain being connected. And yet many of us have gotten a stomach ache, nausea or diarrhea from stress or a feeling of “butterflies” from excitement. Or we may experience pleasure from certain foods or feel a need to eat when under stress.

The vagus nerve travels between the brain and other organs in the body and can transmit messages in both directions. The brain can send messages to the gut through chemicals (called neurotransmitters). The gut has its own nervous system (called the enteric nervous system or ENS) that controls digestion. But scientists now think that the ENS can also produce neurotransmitters to send to the brain.

The big question is whether the gut can actually cause symptoms and diseases of the nervous system.

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FODMAPs

October 10, 2014 — 1 Comment

FODMAP2A few weeks ago, I was asked if I knew anything about the low FODMAP diet as a treatment for inflammatory bowel disease (IBD). I was sure this was yet another fad diet (or that the name was misspelled – seemed like FOD should be FOOD, right?) .

Imagine my surprise when I found detailed information about the diet and its use in treating irritable bowel syndrome (IBS) on the Stanford Health Care website. Irritable bowel syndrome is a chronic condition that causes abdominal pain, bloating, gas, diarrhea and other symptoms in the gut. It turns out that FODMAP is an acronym for Fermentable Oligosaccharide, Disaccharide, Monosaccharides and Polyol. All of these substances are found in certain foods and are types of carbohydrates. Researchers in Australia found that these carbohydrates are not well absorbed by the small intestine in people with IBS. As a result, the substances stay in the gut rather than being used by the body and they pull water into the gut. The FODMAPs can also be fermented by the bacteria in the gut which produces gas. All of this can lead to a bloating feeling, pain and other symptoms.

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Food stories

October 6, 2014 — 2 Comments

veggies

Personal stories are very powerful.

Not just in magazines about celebrities but also in healthcare. In fact, there is a Department of Narrative Medicine at Columbia University (and at other universities) and several medical journals have created sections devoted to patient stories including the “Narrative Matters” column of Health Affairs.

I’ve written a lot about my fascination with food – how it affects inflammation, the psychology behind what we eat, how the food we eat affects the important bacteria in our gut (the microbiome) and more. I began wondering if food stories could be just as important as patient stories.

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Bacteria are our friends…but not all the time.

While I believe that we need to keep the bacteria in our bodies happy and that the improved cleanliness of modern life may be causing problems, there is also no question that bacteria are our enemies as well. You don’t have to look very far to see examples of how bacteria can cause serious illness or even death – meningococal meningitis, pneumococcal pneumonia, salmonella and tuberculosis to name a few. In most cases, antibiotics are required to treat these infections (or vaccines to prevent the infections).

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Loving your bacteria

April 18, 2014 — 3 Comments

pills.govWhen my kids were little, I used to joke that bacteria are our friends, so I didn’t worry much when their pacifiers fell on the ground. As an infectious diseases specialist I had also seen the harmful effects of using too many antibiotics – emergence of bad bacteria like MRSA (methicillin resistant Staphylococcus aureus) and development of diseases due to killing off of good bacteria (like Clostridium difficile colitis, a serious inflammation of the gut caused by antibiotics). So I also tried to avoid giving them antibiotics. New research suggests that bacteria may be more helpful than we ever knew.

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Think before you eat

February 26, 2013 — Leave a comment

We may be eating in unhealthy ways without realizing it. Even healthy foods can lead to problems in certain people – for example dairy products in people who are allergic to them or wheat in people who have celiac disease. But even if food does not cause a bad reaction in us, there is research evidence that we are not in as much control of what we are eating as we think we are.

The first problem is that we often eat without thinking. Dr. Brian Wansink at Cornell University has done some fascinating experiments (which he writes about in his book, Mindless Eating) that look at why we eat more than we think. In one experiment he had people eat bowls of soup while he watched them using hidden cameras. For some people, more soup was piped into the bowl (without them knowing it) as they were eating – it was a bottomless bowl. These people ate more soup than those who had a regular bowl. Similarly, he has shown in experiments that people will eat less food if they use a smaller plate. In yet another experiment, he went to a movie theatre where a first-run movie was playing just after lunch on a Saturday. He prepared popcorn in advance and made sure it was really stale but still safe to eat. He offered each person who bought a ticket a free soft drink and a bucket of popcorn (some buckets were medium in size and some were large but all were too big to finish). People who got the large containers, ate more popcorn (even though it was stale). He surveyed people when they were leaving the theatre and most people who had the large buckets said that they would not be fooled into eating more popcorn by a larger bucket.

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