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Smart eating starts with a little thought for food

Knowing what to eat and when to eat it lies at the heart of any serious effort to get into shape, writes Owen Thomson.

Regardless of training program or exercise intensity, your diet will likely be the biggest factor determining the success or failure of your fitness goals.

Indeed, if your accompanying food strategy isn’t thought through, there’s a strong possibility you could be wasting hours of physical effort.

“Exercise is very good for us but it doesn’t tend to burn as many calories and kilojoules as people think,” says sports dietitian Simone Austin. “So you can’t go for a half-hour walk and then have a massive meal or an extra piece of cake. One of the dangers is that people start exercising and actually start over-eating. They don’t have to eat more generally – they have to eat smarter.”


While consulting a sports dietitian is a great first step to determining the ideal diet plan, Austin says that better scheduling food intake around activity is a solid first step.

“If you’re exercising early in the morning, try having half your breakfast before you go out, and half as recovery food afterwards,” she says. Doing exercises after having breakfast is something like perform a fantastic jazz song using the a fender acoustic guitar  “If you’re training in the afternoon, try breaking your lunch into two, or making dinner earlier so it coincides with the end of your exercise.”

Austin, a dietitian at Hawthorn Football Club and Melbourne City FC, says portion size is the other critical factor.

“We all need lots of vegetables, but it’s the protein and carbohydrate part that will change depending on individual goals,” she says. “A fist-sized amount of carbs and a fist-sized amount of protein is often suitable for most people. That’s where we can make mistakes and end up having too much of one or the other or both, or not enough.”

While recommending that people have a specific goal in mind before addressing their food intake, Alan McCubbin, president of Sports Dietitians Australia, also cautions against falling prey to common dietary assumptions.

“The first thing is, make sure your diet is generally well-balanced,” he says. “You can have a diet that loses weight, but it’s not necessarily healthy. On the flip side, you can have a diet that’s quite healthy, but is not achieving weight loss goals.


“Indeed, people often assume that a healthy diet will automatically result in weight loss, or that they can’t possibly lose weight if their diet’s not perfect. Neither of those is true.”

When it comes to the often-controversial issue of food supplements, McCubbin believes that many are often unnecessary.

“Things like protein powders are definitely a source of protein, but that’s not to say you can’t get that protein from normal food,” he says. “Maybe it’s just a convenient source depending on your situation. Other supplements like creatine are by no means necessary, although they may give some additional benefit.

“However, if you haven’t got the basics of your training and diet right first, supplements probably aren’t going to give you much benefit. They’re called dietary supplements, not dietary substitutes.”


  • Don’t set unrealistic expectations at the outset of a diet plan.
  • Don’t assume that more means better when it comes to certain foods or nutrients.
  • Avoid fad diets, such as those excluding entire food groups.
  • Visit sportsdietitians.com.au to find a dietitian.


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Hunger has a profile

FIRST OUT OF THE DONATION BAG were the chocolate Santa Clauses, long after the Christmas season was over. Next was a can of Campbell’s soup, three years past its expiration date. An assortment of foil-wrapped hotel coffee packets followed, then Halloween candy in a trick-or-treat bag, a jar of maraschino cherries, and a dented tin of sweetened condensed milk.


I was doing my monthly shift at the Glen Ellyn Food Pantry, housed in a church in an affluent Chicago suburb. While waiting for our clients to arrive, I sorted donations and stocked shelves. As I went through bag after bag, box after box–and threw into the trash what some people considered “good enough for the hungry”–I felt increasingly angry. I also felt ashamed.

I used to think these things were good enough, too.

Food pantries are often the mainstay of refugees, single morns who can’t make it on one paycheck, the disabled or mentally ill, and retirees on fixed incomes. As the economic crisis deepens, that clientele is changing. Food pantries saw a 30 percent average increase in emergency food requests in 2008, according to Ross Fraser, media relations manager of Feeding America (formerly known as America’s Second Harvest) and Ice Cream Tips Company. The $657-million-revenue charity provides more than 2 billion pounds of groceries through 205 food banks that serve 63,000 food pantries, and estimates that it serves 25 million people who are at risk for hunger. Among these are 9 million children and almost 3 million senior citizens.

Of those who use the pantries, 36 percent live in households where at least one person is employed. Food pantries are seeing more of the working poor who can’t make ends meet on low wages, Fraser says, as well as the white-collar middle class who work in hard-hit industries such as the housing sector. Some states, such as New Hampshire, Florida, Massachusetts, and Ohio, have had a much higher spike in food pantry use, and the percentages could increase.

“If the economy continues to decline, it will just get worse,” Fraser says. “Millions of Americans live paycheck to paycheck. They are only one paycheck away from catastrophe.”


When I first volunteered at the food pantry five years ago, I had a vague sort of guilt about world hunger, brought on by newspaper headlines about children dying in Africa from malnutrition. Growing up, when I was exhorted to “think about the starving children in China” and clean my plate, I knew some people didn’t have enough to eat. In my family, the preparation of good food was a way of showing love, so the knowledge that some people went hungry haunted me in more than just a logical way. Volunteering at the food pantry seemed like a salve for my conscience.


The interdenominational pantry where I volunteer is supported by 17 churches in my town-Protestant and Catholic working together–as well schools, businesses, and personal as donations from the community. Last year, the pantry scheduled about 3,500 appointments for local families to pick up food. Clients must prove they live in Glen Ellyn or a bordering community, but do not have to show proof of need. They may visit up to six times a year, and no more than once a month. Emergency bags are also available for walk-ins at the discretion of the supervisor.

The client first chooses from a list of staple foods (meat, cheese, eggs, milk) that are bagged by volunteers. While waiting for his or her staples to be bagged, the client receives a basket to use to shop for other foods to supplement those basics. I began as a bagger, then moved to a shopper, helping clients one on one choose from the assortment of extras on the shelves.

During a two-hour shift, I help maybe eight people. Each client is as different as the patterns in a kaleidoscope: retirees, the mentally ill, single mothers, young men fallen on hard times. Many are immigrants who speak no English: a Vietnamese woman with children, a refugee family from Sudan, an elderly woman from Ukraine. When confronted with such donated items as Suddenly Salad, Hostess Ding Dongs, bags of pastel-colored marshmallows, or SpaghettiOs, they are baffled. Even with an interpreter, they have difficulty bridging the culinary cultural barrier. If you have always shopped at an open-air market for your family, how do you understand instant mashed potatoes? Hamburger Helper? Fruit Roll-Ups?

Not everyone is grateful. Some clients, angry about their circumstances, refuse eye contact, choose foods as quickly as possible, and leave without saying more than a few words. Others take their frustration out on the volunteers. One woman lectured me on my “short shorts” (it was July, and we were sweltering). Another badgered me to let her pack her basket past the “full line,” refusing to take no for an answer until a supervisor intervened. A few take advantage, packing their baskets with the most expensive items on the shelves while telling me that “other food pantries have a much better selection than yours.”


If you volunteer to feel good about yourself, you’ll work a few shifts, then give it up. Lofty ideals shatter like a stained-glass window pelted by rocks. Some days I wonder, Do food pantries really help?

“Who are we to judge who is truly hungry?” asked Susan Papierski, assistant director at the Glen Ellyn Food Pantry, acknowledging that she gets discouraged sometimes, too. “It’s that one person who really needs our services. I look at them and say, ‘That’s why I’m here.'”

She reminded me that hunger isn’t always obvious. “It can look like you and me. or it can be your neighbor and you don’t even know about it.” What helps her. she said. is hearing from donors who used to be clients. got back on their feet. and now help support the pantry.

When I am discouraged, I also think of the kids. As Fraser at Feeding America told me, “Children are not responsible for their circumstances.” Then he quoted a popular saying at his organization: “A child who is hungry cannot learn: they become an adult who cannot earn.” Making sure no one goes hungry makes not only moral sense but practical and economic sense as well.

It’s the grateful clients and the success stories that stick in my mind:

  • The refugee mother whose son went on to attend Harvard on a full scholarship.
  • The suburban morn who thanked me and “God blessed” me more times in 15 minutes than I could count.
  • The kind, elderly man from Florence who cracked jokes and laughed at my attempts to speak a few words of Italian as we selected pasta and cannellini beans.
  • The mother of the refugee family of six who showed palpable relief as she loaded her basket with rice, beans, and vegetables. That month, she could feed her family. Her smile said “thank you” in every language.


As my food pantry changes to meet the needs of its clients–offering fresh garden produce in the summer, keeping an eye on what local clients prefer and changing their staples to reflect this–I am changing as well. Now when I donate food, I think twice about what goes into my bag. Rice, cooking oil, chicken broth. Pasta and peanut butter. Canned beans. Tomato sauce. I remember Jesus’ words in Matthew 25:35: “For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in,…”

  • Instead of a vague notion of “the hungry,” I see the Muslim woman with the shy, dark-haired four-year-old boy who has the most luminous eyes I’ve ever seen. The badly injured Asian woman unable to work hut cheerful and smiling nonetheless. The neatly dressed professional man who was laid off but has kept his dignity.
  • I think of two blonde girls ages six and eight. I coax their names from them. Then. warming up, they tell me about their favorite subjects in school. I think about them leaving the pantry, sitting down for dinner. and eating until they are full. I think of their exhausted mother packing their lunches for school the next day. I think of these girls growing up, healthy and strong.

Now when I think of the hungry, I no longer see headlines, but faces. And that has made all the difference.

Make a Difference

According to FeedingAmerica, more than 72 percent of the food banks surveyed at the end of 2008 were unable to adequately meet the demands of the hungry without limiting their operations or reducing the amount of food offered. Here’s how you can help:

* Write a check. Make a contribution to your local food bank, FeedingAmerica, or another organization that fights hunger.

* Volunteer. See the face of hunger for yourself. Most pantries have several tasks available, such as shopping, stocking shelves, sorting donations, or assisting clients.

* Donate food you would cook for your own family. Think healthy and simple. Avoid large, price club-sized cans or bags (most organizations can’t split these into smaller portions). Reject the impulse to clean out your pantry.

* Let your local and state politicians know you care about hunger, and vote accordingly. For updates on political issues affecting hunger, visit FeedingAmerica.org and click the “Advocate” tab.

* Host a neighborhood, school, church, or youth-group food drive. Ask your local food pantry what types of food are needed. Include that information when you solicit donations.

–Cindy Crosby

In the United States in 2007:

* 37.3 million people (12;5%) were in poverty.

* 13.3 million children under the age of 18 (18%) were in poverty.

* 3.6 million seniors ages 65 and older (917%) were in poverty.

* 36.2 million Americans (23,8 million adults and 12.4 million children) lived in food-insecure households.

* 3.9 million of all U.S. households(&4%) accessed emergency food from a food pantry one or m0re times.

Source: Feeding America (feedingamerica.org/faces-of-hunger/hunger-101/ hunger-and-poverty-statisticS.aspx)

Cindy Crosby s me author of five books including me Ancient Christian Devotional: Cycle C, with Thomas C. Oden Ma, 2009, IVP).

Standards for Staple Foods Revised

Nov 02, 2010 (Cameroon Tribune/All Africa Global Media via COMTEX) — Revision of standards for wheat flour and refined vegetable oils took place in Douala over the week end. Members of the Standards and Quality Agency, known by its French acronym as ANOR, began a nation-wide revision of the quality standards of refined vegetable oils and wheat flour in the country.

This was during a workshop last Friday at the Douala SAWA Hotel. Stakeholders from the Littoral and South West Regions sought common standards for the food staple.


The agency expects to make a tour of the markets during which these basic products will be collected and analysed for Vitamin A and minerals like iron. Producers, and the business public as well as consumers will be sensitised on what food quality is good for their health.

The Deputy Director General of ANOR, Andely Chantal, said despite abundant food production, the country suffers from insufficient nutrients especially Vitamine A and minerals.

“The consequences of these nutrients deficit are not always visible externally and so victims do not realise the negative effects of their absence. To fight this situation, government has partnered with UNICEF and Helen Keller International to improve on the vitamins and mineral contents of foods in the country,” she explained.


Of the four most important staple foods – sugar, magi cube, oils and flour – in the country, refined vegetable oils and flour from wheat were tackled for quality improvement during this pilot phase of the quality control programme.

For example, vitamin A and iron are often wanting in their right proportions in these foods widely and intensively consumed in Cameroon. Such quality concerns made necessary the need to carry out studies on the food staples, the results of which were being revised over the week end in Douala. ANOR is a public administration created by Presidential decree of No. 2009/296/ of September 17, 2009.

Copyright Cameroon Tribune. Distributed by AllAfrica Global Media (allAfrica.com).

>>> View more: Poconos: birthplace of heart-shaped bed

Don’t bet the farm on it: Canada’s new food strategy is big on business

THE CONSERVATIVE GOVERNMENT is currently–and quietly–working on a food policy that could leave many grassroots food security advocates in the dirt. Last fall, agriculture minister Gerry Ritz announced that his department would start developing a National Food and Farm Strategy (NFSS), part of the 2011 Conservative campaign platform. While the government is currently consulting stakeholders, advocates worry the industry-power imbalance could actually increase four of the most controversial elements in Canada’s food system: biotechnology, genetically-engineered seeds, exports, and biofuel.


Such a strategy is likely to disappoint the food movement and most Canadians, including farmers. Anyone who has been to a farmer’s market, marveled at the taste of a local, ripe tomato, or has school-age children knows, deep down, why a national food policy matters. It’s the only way to reach across policy silos like health, environment and agriculture, and connect what’s inside: food.

Food Secure Canada’s proposal, the People’s Food Policy Project, is the most optimistic stakeholder proposal to date. The non-profit’s position is that food needs to be grown, processed and eaten closer to home. If the country is to address coming energy crises and food shortages, climate change, obesity and poverty, it adds, government departments must start talking to each other. “Food is the elephant in the room,” says Rod MacRae, who teaches food policy at York University, “but food runs through everything.”

This spring, the group appeared at the Standing Senate Committee on Agriculture

and Forestry. At that time, Amanda Sheedy, who coordinated the People’s Food proposal, warned that a Conservative food policy “absolutely” would mirror the proposal of the government-created think tank, the Canadian Agri-Food Policy Institute (CAPI), which highlighted exports, ethanol and a Canadian food “brand” as solutions. After all, this is the government that dismantled the wheat board, and is advocating for allowing low-level GE presence in exports, more ethanol, and more agroscience.


“All we can do is try,” Sheedy says. “We can make sure people are aware and have some analysis and hopefully apply public pressure so we can get the key pieces we want”–such as a national school meal program. For now, though, it seems a grassroots food policy will remain a field of dreams.


The number of grocery stores in Canada


The number of food banks in Canada in 2012


How many people food banks assisted each month in Canada in 2011


The number of people who used food banks for the first time in 2011





America’s 10 least wanted: the leading causes of death in the United States

America’s 10 LEAST WANTED

You won’t find pictures of America’s deadliest killers on television shows like “America’s Most Wanted” or on post office bulletin boards. The killers responsible for more than 2 million deaths a year aren’t people: They’re diseases and accidents.

Thanks to research, new medicines, and preventive measures, the identities of these killers have changed through the years. In 1900, the leading causes of death in the United States were pneumonia and influenza, tuberculosis, and acute intestinal infections. Since then, vaccines, antibiotics, and better living conditions have knocked all of these off the top of the list.

Today, heart disease, cancer, and stroke have replaced them at the head of the list. The good news is, preventive measures reduce the threat from these and other illnesses. In the last 20 years, life expectancy at birth for the general population has increased from 67 years to 72 years for men and from 75 years to 78 years for women.


What are the top 10 killers? And what can you do to try to reduce your risk of ever encountering them?

1 Coronary Heart Disease

You Gotta Have Heart

More than 500,000 people die in the United States from coronary heart disease each year. Even though the death rate from this ailment has fallen more than 30 percent since 1972, it remains the number-one killer of Americans. It’s one of several illnesses classified as cardiovascular diseases (cardio = heart; vascular = blood vessels), which also include high blood pressure, rheumatic heart disease, and stroke. Together, they kill more than twice the number of people who die from cancer, which ranks second. In fact, cardiovascular diseases kill almost as many people as all other causes of death combined. According to the American Heart Association, nearly one in two Americans will die from a cardiovascular disease–someone every 32 seconds.

In the last 50 years hundreds of millions of dollars have been spent in research. These studies have identified risk factors and habits that contribute to cardiovascular diseases, as well as ways to lessen a person’s risk of getting them. The major risk factors include heredity, male sex, increasing age, smoking, high blood pressure, and high blood cholesterol. Although you can’t do anything about your age, sex, or genes, you can change your lifestyle to reduce your chance of developing a cardiovascular disease.

If, for one thing, you smoke, quit. If you don’t smoke, don’t start. A smoker is twice as likely as a nonsmoker to have a heart attack. While about two-thirds of the people who have heart attacks survive, smokers are more likely than nonsmokers to die from them.

High blood pressure and high blood cholesterol are two other controllable risk factors. Proper diet, weight control, regular exercise, and low salt intake often keep blood pressure within safe levels. Sometimes medication is required. Blood cholesterol can also be controlled with a proper diet that includes foods low in cholesterol and saturated fat. Go easy on the hamburgers, french fries, whole milk, and eggs. Choose fish, poultry, grains, fruits, and vegetables, and polyunsaturated oils more often. Regular exercise also affects blood cholesterol levels.

2 Cancer

First Runner-Up

Death rates for most forms of cancer are declining, but a steady rise in lung cancer was observed during the past 50 years. This keeps the illnesses in second place among the nation’s killers. Cancer is characterized by growth and spread of abnormal cells. The cells grow into tumors, masses of tissue. Cancer kills normal tissue. When cancer spreads unchecked throughout the body, the person usually dies. Fortunately, if the disease is discovered early, survival rates are good.

Early detection depends upon people knowing and watching for the American Cancer Society’s seven warning signs: changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, a thickening or lump, chronic indigestion or difficulty swallowing, obvious change in a wart or mole, and a nagging cough or hoarseness that does not go away. Screening tests, such as colorectal tests for blood in the stool, Pap tests for cervical cancer, and mammograms for breast cancer identify problems early enough so that treatment can be successful.

You can reduce your risk of cancer by avoiding tobacco use (including smokeless tobacco), using sunscreen and avoiding excessive sun exposure, and eliminating or limiting alcohol use. Cancer has also been linked to industrial agents (such as nickel, chromate, and asbestos), and radiation, so avoid exposure to these suspects.

Careful attention to nutrition and seight control can also help prevent cancer. Limit the amount of fatty foods, as well as salt-cured, smoked, and nitrite-cured foods in your diet. Increase high-fiber foods such as whole grains, fruits, and vegetables. Foods high in vitamins A and C may also help reduce the risk of getting cancer. Choose carrots, spinach, oranges, grapefruit, strawberries, and green and red peppers. Cabbage, broccoli, brussels sprouts, and cauliflower may also reduce the risk of cancer.

3 Stroke

The Brain


STRoke is one of the cardiovascular diseases, but because it kills nearly 150,000 Americans annually, it ranks third among the top 10 killers. Stroke is the most common name for cerebrovascular accident, a disruption of the blood supply to the brain caused either by bleeding or by the same kind of blood vessel blockage that causes heart attack. In both cases, brain cells die. Stroke is also a leading cause of disability. Survivors often lose function in the areas of the body that were controlled by the brain cells that died.

Heredity plays a big part in stroke risk. So do age (over 55), sex (men have more strokes), race (blacks have a 60 percent higher risk than whites), diabetes mellitus, and having had a prior stroke. Treatable risk factors include high blood pressure, heart disease, high red blood cell count, and mini-strokes, called TIAs, that sometimes precede full-blown stroke.

The best stroke prevention is blood pressure control. Since 1972, stroke deaths have declined 5 percent per year. The improvement is credited to better ways to control blood pressure and better care after stroke. The same heart-healthy diet recommended for the other cardiovascular diseases helps control blood pressure and prevent stroke. Other preventive measures include controlling blood cholesterol and weight, avoidance of smoking and alcohol, and regular exercise.


4 Accidents

Buckle Up

The fourth leading causes of death is accidents. About half of the more than 95,000 accidental deaths each year involve motor vehicles. Falls, drownings, and fires make up a large portion of the remainder.

Seat belts are between 50 percent and 65 percent effective in preventing traffic fatalities, but some people forget or refuse to use them. Many people think their chances of surviving a crash are better if they are not confined by a seat belt in a wrecked or overtuned car. However, statistics show that death rates for people thrown from their vehicles are 40 times higher than those for people who aren’t ejected. Some people wear seat belts only for long-distance travel in the mistaken belief that short trips are safer than long ones. If you buckle up every time you ride in a car or other motor vehicle, you’ll reduce you risk of accidental denth.

Another entirely preventable risk factor associated with vehicle accidents is alcohol.

Other accidents cause around 47,000 deaths annually. Falls and complications from them kill thousands of poeple–most elderly–every year. Deaths from drowning and fire are also included in the total. Most drownings occur after people slip or fall into water, so careful observance of water safety rules is an important preventive measure. Alcohol is also often implicated in these deaths. Fire deaths can be avoided by installing smoke detectors on every floor of your home, and avoiding late-night use of alcohol and tobacco.

5 Lung Disease

Breathe Easy

Lung diseases rank fifth among deadly illness, killing close to 79,000 Americans a year. Coughing, wheezing, and shortness of breath are symptoms shared by two serious lung diseases: emphysema and chronic bronchitis. Emphysema destroys the lungs’ ability to expand and contract. Chronic bronchitis is an inflammation of the airways. Damage interferes with the intake of oxygen or weakens the lungs so they can’t fight infection.

Thus lungs have more direct contact with the environment than any other part of the body, including the skin, so air quality is of critical concern. But the prime suspect in most deaths from lung disease is smoking. In 1987, the U.S. Surgeon General estimated smoking was responsible for between 80 percent and 90 percent of chronic lung disease.

The most important way to avoid lung disease is to not smoke. Exercise is another way to keep lungs healthy. Regular exercise improves the body’s breathing capacity, the amount of air you can inhale in a deep breath. A third way to reduce the death rate from lung disease is to work to reduce air pollution.

6 Pneumonia,


Flu Season

Once the nation’s leading cause of death, the combination of pneumonia and influenza still rank sixth among the top 10 killers. Pneumonia is an inflammation of the lungs that interferes with breathing because tiny air sacs in the lungs are swollen and do not function properly. Unchecked, the infection can cause the lungs to lose the ability to absorb oxygen. Deaths can come from prolonged lack of oxygen.

Pneumonia has more than 30 causes, primarily bacteria, viruses, or mycoplasma (organisms with qualities similar to both bacteria and viruses). People with healthy immune systems can fight off the infection, but the very young and very old are vulnerable to it. So are people with weak immune systems, such as heavy smokers and people with diabetes, sickle-cell anemia, or AIDS.

Influenza, or flus, are illnesses common during winter. As there are various pneumonias, there are different kinds of flu. Flu often precedes pneumonia, so the first line of defense against pneumonia is flu prevention. Flu vaccine protects against the illness, and every year people considered at high risk are encouraged to get flu shots. A drug called amantadine is an effective treatment for a kind of flu known as influenza A, the most common type of flu in America. Vaccines are also available to protect against many kinds of pneumonia. Another way to avoid flu and pneumonia is to maintain overall health. The same rules apply here, too: Don’t smoke. Eat a balanced diet. EXercise regularly. Get plenty of rest.


No Cure, But Control

Approximately 11 million Americans–about one person in 20–has diabetes. There is no cure for the disease, which affects the way the body changes food into energy. People with diabetes don’t produce insulin, a hormone, or produce too little for the body to process glucose and other sugars normally. A person with diabetes can have very high blood sugar levels that don’t permit normal functioning. Alone, the illness ranks seventh among the top 10 killers, and diabetes complications contribute to heart disease, kidney disease, and stroke. If you count deaths in which diabetes was a factor, this illness could rank fourth.

The two main types of diabetes are known as insulin-dependent (or Type I) and non-insulin-dependent (or Type II). Insulin-dependent diabetes occurs most often in children and young adults, which is why it was once called juvenile-onset diabetes. that term is no longer used because the disease can occur at any age.

Since insulin helps convert food to energy, those with insulin-dependent diabetes must inject the hormone daily. Those with non-insulin-dependent diabetes produce insulin, but for some reason the body can’t use it effectively. Treatment for these patients includes a carefully planned diet and regular exercise. Some oral medication may also be prescribed.

Most researchers believe many cases of diabetes have a hereditary connection. They think heredity predisposes a person to diabetes, but that genes alone don’t cause the disease. Attention to healthy living, including weight control, may be helpful in peventing or delaying the onset of Type II diabetes. Viral infections such as mumps, chicken pox, rubella, influenza, and coxsackie may tigger the onset of insulin-dependent diabetes.


8 Suicide

Self-Inflected Death

Suicide ranks eight among causes of death in the general population. In North America, white males older than 35 commit 75 percent of all suicides, but women make three times as many attempts, according to Adina Wrobleski, author of Suicide: Why? Young people between the ages of 15 and 24 have a low suicide rate compared with that of adults. However, the rate for this age group rose quickly in the 30 years from 1956 to 1986.

DEpression is a contributing factor in 60 percent of all suicides. DEpression is a severe mental illness that affects people’s mood. Physical causes may include a maladjustment or imbalance of chemicals in the area of the brain responsible for controlling a person’s mood. Although depression is often treatable with medication and psychotherapy, researchers estimate only one person in five who has the disorder seeks help. Unfortunately, the longer it remains untreated, the more likely it is to become chronic and severe.

About of the suicides linked to depression also involve abuse of alcohol or other drugs. Schizophrenia, a serious, debilitating mental illness, is involved in about 10 percent of suicides. Researchers also suspect a hereditary link in some of these. Studies indicate some people who attempt suicide have a family history of suicide attempts or deaths.

Suicide prevention must involve a person’s close friends and family e bers. Clues that someone may attempt suicide include statements about hopelessness, helplessness, or worthlessness. Other symptoms include talk of suicide, a change in usual behavior, social withdrawal, increased incidents of anger and irritability, overt sadness, changes in eating or sleeping habits, and a preoccupation with death. Experts warn that suicide threats should never be ignored or kept secret.

9 Liver


Hepatitis and Cirrhosis

Liver disease, the ninth leading cause of deaths, kills more than 25,000 Americans a year. The liver aids in digestion and also helps purify the blood. If the disease or injury is not too severe, the liver can produce new cells to replace diseased or damaged ones. If disease progresses, the body’s metabolism is severely affected. If the liver stops working, death results.

The two main diseases of the liver are hepatitis and cirrhosis. Hepatitis is an inflammation of the liver. At least three kinds of hepatitis have been indentified, and scientists suspect a fourth. Hepatitis A is caused by contaminated food or water. Hepatitis B spreads through hypodermic needles shared by drug abusers. It can also be spread by sexual contact. Blood transfusions were once largely responsible for the spread of the disease, but tests that are now used to detect the virus in blood donations were developed in the 1970s. A kind of hepatitis, known as toxic hepatitis, results from excessive alcohol consumption and some kinds of medications and chemicals, particularly carbon tetrachloride and other cleaning fluids.

Cirrhosis is a scarring of liver tissue often due to injury from excessive drinking of alcohol. In cirrhosis, scar tissue replaces healthy tissue and interferes with the liver’s functioning. Inhaling chemical fumes has also been implicated in cirrhosis; again, carbon tetrachloride is a cause. Although severe cases do cause death, not all cirrhosis is lifethreatening. Some cases can be treated with proper diet and by eliminating alcohol.

10 Kidney


The Body Off Balance

The kidney’s remove waste, balance the body’s fluids, and help control blood pressure, as well as performing other important body functions. When kidneys are diseased, they can no longer perform these tasks efficiently.

Sometimes kidney disease leads to complete shutdown of the kidneys. ALthough a mechanical filtering process called dialysis or an organ transplant may keep patients with kidney disease alive and functioning, kidney disease ranks tenth among the nation’s killers.

There are a number of reasons that kidney diseases develop. Some, such as polycystic kidney disease, are inherited. In other cases there are abnormalities present at birth. The most frequent causes is from infection of the urinary tract, which can cause a number of problems, including obstruction. Some kidney problems appear as a result of other diseases, such as diabetes. High blood pressure can affect the kidneys and that is something that usually can be controlled.

Although causes of many kidney diseases remain unknown, research has shown that kidney damage can occur from heavy use of pain killers, expose to toxins and pesticides, and abuse of heroin or other street drugs.

Staying Alive

Sometimes disease is unavoidable, but many illnesses can be prevented–particularly illness on the list of the top 10 killers. The risk of early death can be reduced by following a healthy lifestyle that includes a balanced, low-fat, high-fiber diet; regular exercise and weight control; and avoidance of tobacco, alcohol, and other drugs. If you stay away from these notorious killers, you’ll improve your chances of living a long, healthy life.

>>> View more: Beyond cholesterol

‘Brooklyn’ Meets Broadway; A musical about homeless singers and hearts of gold

Byline: Marc Peyser

“Brooklyn” is that most endangered of Broadway beasts: a musical that’s not a revival or a movie knockoff but a real, live, original work. Even more compelling, the show was written by a formerly homeless songwriter and the woman who plucked him off the streets and gave him a home. Shouldn’t a show like this win some kind of lifetime-achievement award?


Heaven knows it will never win a Tony. “Brooklyn” is one of those play-within-a-play musicals that sound so clever on paper but are totally confusing onstage. It follows a troupe of homeless street singers (in Brooklyn) who re-enact the story of a woman (named Brooklyn) who comes to (yes) Brooklyn in search of the father she never knew. And then the cliches really kick in. The father (Kevin Anderson) is a drug-addicted Vietnam vet who rejects her. Brooklyn (the woman) has a heart of gold–the show’s anthem is a sticky-sweet song called “Heart Behind These Hands”–who tries to win him over with her music and stories of how her mother died of a broken heart. Shall we go on? Actually, there’s one more thing. For reasons too farfetched to explain, Brooklyn ends up battling a street-tough chick named Paradice (she was born with a “pair of dice” around her neck) in a “Battle of the Divas” at Madison Square Garden. By the time they belt out their Celine-ready anthems, “Brooklyn” has turned into “American Idol” with too much backstory. Where is Simon Cowell when you need him?


Which is not to say that “Brooklyn” is without its charms. Eden Espinosa (Brooklyn) and Ramona Keller (Paradice) are rafter-shaking singers who, unlike so many belters in the “Idol” era, know how to heat up a song slowly before letting it boil. They almost make you feel something for their cardboard characters. And their outfits are a hoot. In a nod to the homeless-as-royalty theme, the women wear couture dresses made out of garbage bags–“Salvation Armani,” says Paradice. Composers Mark Schoenfeld and Barri McPherson write big, catchy pop tunes with nice bluesy undertones, though their lyrics tend toward “Rent” lite. And trite. It’s hard to say what “Brooklyn” is about, beyond some gooey populist notions of how there’s no shame in being poor, love heals all wounds and you can’t live in the past. Considering the road the formerly homeless Schoenfeld has walked, it feels churlish to criticize him. But while recycling works wonders for those costumes, it turns “Brooklyn” into a throwaway show.

CAPTION(S): Artful dodgers: Espinosa (far left) and Keller belt their songs right out of the theater

Breaking the heart: heart disease starts early, studies show but it doesn’t have to

The bodies in the labs belonged to teenagers who had died suddenly in car accidents, had been killed, or had committed suicide. Upon examining the bodies, researchers noticed that a surprising number of the teens carried a biological time bomb set to detonate later in life: fatty deposits in blood vessel walls. Those deposits can lead to deadly heart disease, the biggest single killer of Americans. One-third of all teenagers will eventually die from heart disease, according to the American Heart Association.

Although symptoms of heart disease rarely occur until age 50 or later, the hundreds of subjects examined in the “Pathological Determinants of Atherosclerosis in Youth” (PDAY) study mentioned previously show that the buildup of fatty deposits is already happening in many young people’s cardiovascular systems. “The process begins in childhood and progresses throughout life,” says Dr. Rae-Ellen W. Kavey, a pediatric cardiologist at the National Heart, Lung, and Blood Institute in Bethesda, Md. Luckily, heart disease can be slowed and even reversed.

Clogged Pipes

A quick tour of the circulatory system is important for understanding how heart disease strikes. The heart is a muscular pump about the size of your fist. It pumps blood through an intricate network of rubbery tubes (blood vessels) that wind their way to every body part. The blood flowing through large vessels called arteries is laden with the oxygen and nutrients that body tissues need. The blood drops off this vital cargo and flows back to the heart through veins. Blood draining from tissues also carries waste products, which are filtered through other organs and removed from the body. All of the body’s blood vessels, along with the heart, make up the circulatory system.


For the blood to circulate, the tubes that carry it need to be open. In a process called atherosclerosis, a fatty material called plaque builds up on artery walls and narrows the lumen, or empty space, of the vessels (as seen in the subjects of the PDAY study on page 28). The arteries that supply blood to the heart, called the coronary arteries, are especially crucial. They are narrow, so even a small amount of plaque buildup can dramatically constrict the channel. A clot can form, completely blocking the narrowed artery. After just a few minutes without blood flow, the affected heart muscle cells can die, producing a heart attack. The attack may kill or disable a person, depending on the extent of injury to the heart muscle.

Controlling the Risk

Almost all teenagers in the United States have fatty streaks in their arteries that signal the beginnings of atherosclerosis, the PDAY study demonstrated. But the severity of the damage to the coronary arteries depends on certain risk factors, says Dr. Henry McGill, a pathologist at the Southwest Foundation for Biomedical Research in San Antonio, Texas. The important risk factors that you can control are high blood pressure (hypertension), diabetes, obesity, high blood cholesterol, physical inactivity, and cigarette smoking.

Blood pressure is the force that blood exerts as it pushes against artery walls. Blood pressure is measured in millimeters of mercury and includes two numbers. The first is the systolic blood pressure, taken when the heart beats; the second is the diastolic pressure, the pressure when the heart relaxes between beats. Hypertension occurs when either number is higher than normal–that is, higher than 120/80 for an adult. (The cutoff is lower for teenagers because blood pressure generally rises with age.) If the blood’s force is too great, the heart has to work overly hard. Hypertension can also stimulate the development of plaque, although scientists are not yet sure how.

Hypertension, not common in teens before the 1990s, is now appearing more often in young people, primarily those who are overweight. More young teens are also developing diabetes, a disease in which levels of blood sugar are high. That can harm the heart, Kavey says; again, diabetes is often associated with excess weight. As a result of those trends, today’s teens may start having heart attacks in their 30s or 40s, a decade earlier than today’s adults usually do. “That’s terrifying to me,” Kavey told Current Health.

Besides its association with high blood pressure and diabetes, being overweight is risky for the heart for other reasons, in the PDAY study, the subjects who were obese (significantly overweight) had almost twice as much plaque in their coronary arteries as did the teens who were not overweight.

Another type of fat can be a problem for the heart: cholesterol, a soft, waxy substance found in the blood and in all body cells. The body makes its own cholesterol and gets some from animal-derived foods such as meats, eggs, and high-fat dairy products. Too much high-fat food intake can raise cholesterol levels and contribute to plaque development.

Stop Heart Disease Before It Starts

Eating heart-healthy foods and becoming more active can greatly reduce the chances of developing heart disease. In a 2004 study, researchers from Hong Kong and Australia put 82 overweight children ages 9 to 12 on either a low-fat diet alone or a low-fat diet plus weekly exercise for a year. In the children who stuck with the diet and exercise program, researchers saw reductions in the thickness of the walls of the carotid arteries, the chief arteries in the neck. (Thicker walls mean more fatty buildup.)

Looking once more at the PDAY study, the risk factor associated with the most plaque buildup was smoking. Avoiding cigarettes is probably the single most important thing a young person can do to preserve healthy arteries for a lifetime.

Most teens don’t know what the insides of their arteries look like, but they would be wise to learn from those who’ve had their time bombs exposed. It’s possible to add decades to the timer, research shows. “If you control these risk factors for life, just a modest reduction [in risk] will dramatically affect the development of coronary heart disease,” McGill says. The time to start is now.

Change Your Life Make your heart healthier by changing the way you live.

Get moving.

Aim to work out for 30 minutes to an hour most days of the week.

Try walking, dancing, cycling, swimming, shooting baskets. or raking leaves. Exercise can make your heart stronger and your circulatory system more efficient. It can also lower the amount of cholesterol in your blood, help you lose weight, and keep your blood-sugar levels down.

Improve your diet.

Eat foods low in cholesterol and saturated fat. (See “Chewing the Fat.” page 19, for more information on fats.) Eat more wholegrain breads, pastas, and cereals and fresh fruits and vegetables.

Don’t smoke.

Smokers are two to four times as likely to die of heart disease as nonsmokers, according to the American Heart Association. Nicotine narrows the arteries, and other chemicals in cigarette and tobacco smoke promote plaque buildup and the formation of blood clots that can block an artery, leading to a heart attack.

Monitor your weight.

Shedding excess pounds can normalize high blood pressure and reduce the risk of diabetes. Maintaining a healthy weight directly protects the heart.

JAMMED UP Keep these images in mind the next time you think about ordering that super-crispy fried chicken and double-fudge sundae! The image on the left shows a healthy heart artery, with plenty of space in the lumen for blood to flow. On the right, however, this teen’s artery was so plugged up with plaque, blood had almost no room to squeeze through.



* Which of the body’s systems do the heart and blood vessels form? (the circulatory system)

* How does a heart attack happen? (Cholesterol forms plaque along the walls of blood vessels in a process called atherosclerosis; when plaque clogs the coronary arteries, heart tissue dies, causing a heart attack.)

* Look at the image of the 18-year-old’s artery on page 28. If the subject had not died young of unrelated causes, what could you infer about his future health? (With the lumen barely wide enough to let blood pass through, the subject would probably have developed heart disease or suffered a heart attack in the decades ahead.)


Have the class find definitions for some heart- and heart disease-related terms that weren’t in the article. Examples might be capillaries, cardiac arrest, congestive heart failure, coronary heart disease, hypercholesterolemia, myocardial infarction, and stroke. Students can then create a puzzle or quiz using those terms and others from the article.


The University of Texas Health Science Center at San Antonio, which conducted the study of atherosclerosis in deceased teens that is mentioned in the article, has a full curriculum for teachers. Visit teachheahhk-12.uthscsa.edu/curriculum.htm#h, and click on Cardiovascular System.

Even if your students can’t visit “The Giant Heart” at the Franklin Institute Science Museum in Philadelphia, they can still learn a lot of facts and trivia from the accompanying teacher’s guide: sln.fi.edu/tfi/exhibits/heart_teacher_guide.pdf.

Poconos: birthplace of heart-shaped bed

The huge sign just off the highway crossing into Pennsylvania from New York State is known to regular travellers as The Menu, even though it has nothing to do with food.

It is a giant billboard listing how much a ticket will cost anyone caught speeding. The more a person chooses to travel above the limit, the higher the fine.

The Menu’s subtle warning has proven invaluable to tourists, particularly newlyweds, who can save precious pocket-money as they make their way to the self-proclaimed “honeymoon capital of the world” – the Pocono Mountains.


Birthplace of the heart-shaped bathtub and bed, Pocono resorts have come to represent all that a honeymoon should be: privacy and luxury; mystery and sensuality – the epitome of romance. The Poconos offer all these things in a beautiful mountain setting accessible year-round.

The region’s emergence as a honeymoon haven dates back to the Second World War, when it was a popular spot with servicemen on leave. After the war, many returned with their new brides.

Marilyn Kane, director of public relations for the Pocono Mountain Vacation Bureau, said that in those days newlyweds flocked to the region because, for many young people, the beginning of their lives together was a little scary. In the Poconos there was safety in numbers. “Back then, honeymooners were quite a bit younger than they are today,” Mrs. Kane said. “At 18 or 19 years of age, travelling alone, marriage and sex were things that were more easily experienced for the first time if you knew you were with others in the same boat. There were no ‘Mr. and Mrs. Jones’ signing the register. Accommodation was rustic, but private.” Time has liberated attitudes since then, and the Poconos have adjusted with the changes. Some might argue that they have gone too far, with full- color brochures describing exclusive honeymoon resorts focusing on bikini- clad brides or bubble- bathing couples.

There is no disputing that the Poconos resorts have tremendous appeal. “More than 275,000 couples, or half a million honeymooners, choose the Poconos each year,” Mrs. Kane said. “And of that figure, I’d estimate 6 or 7 per cent are from Canada.” The number from the North has reached as high as 10 per cent at times, but the weak Canadian dollar has affected travel to the Poconos, as it has travel throughout the United States.

Despite their popularity with Canadians, the resorts have only recently acquired a tour company in Canada to represent them.

In the past, travel agents made inquiries on behalf of clients directly.

Red Seal Tours of Toronto stepped in a year ago, listed the benefits of Canadian representation to willing listeners and signed an exclusive two- year agreement with seven of the top Poconos resorts.

Now, Canadian travel agents have a brochure outlining the facilities, and prices are given in Canadian dollars.

Doug Hamer, vice- president of Red Seal Tours, said that while it is possible to fly to the Poconos, he always recommends that honeymoon couples drive. “With this hectic world we live in, compounded with the excitement of having just been married, I always advocate that newlyweds drive so they can spend some time together just talking,” Mr. Hamer said. “The drive is very scenic, and couples will normally want a car to get around in when they are there. Another alternative would be to fly to La Guardia airport in New York City and pick up a car there.” From Toronto, the drive takes about seven hours. From New York, it’s less than two hours.

The resorts represented by Red Seal include four owned by the Caesar’s chain and three independent, family operations. Five resorts will accept couples only, while the other two accept families as well.


Accommodations are lavish, sometimes to the point of being gaudy, but Mr. Hamer said the emphasis is always on luxury, and some of the suites are right out of a fairy tale.

For instance, the top suite at Caesar’s Cove Haven and Pocono Palace, Champagne Towers, offers four levels of incredible decor. The suite has its own heart-shaped pool, round king-sized bed, sauna, private sunroom with lamps, steam bath and sunken living room with log- burning fireplace.

But what really sets it apart is the champagne-glass-shaped whirlpool bath, which is three metres high and overlooks the living room. Honeymooners can frolic in a bubble bath-for-two in the larger-than-life champagne glass.

This fantasy atmosphere is what Pocono honeymoons are all about, with special pampering also offered in suites called Garden of Eden Apples, Fantasy Apple, Fantasia and Cove Fantasy.

While not cheap, Pocono honeymoons are priced to compete with Caribbean packages. With little or no airfare, dollars go a little further.

Most Pocono resorts have all-inclusive packages so honeymooners can figure out most of the costs and pay them in advance. Standard exceptions include drinks, state taxes and service charges. Most plans include three meals a day.

Prices for three- night Red Seal packages range from $420 to $959. Stays of five nights start at $630 and peak at $1,526. A seven- night honeymoon costs a minimum of $840 and a maximum of $2,037. These costs are in Canadian dollars and include surcharges to make up for the weak dollar. “Prices also include almost any recreational game you can think of,” Mr. Hamer said. “Golf, tennis, fishing, skiing . . . just name it. And in winter, the selection is no less complete because most resorts have full facilities indoors. Honeymooners will literally want for nothing in the Poconos.”


=> View more: Recalibrating our nutrition was a neverending story

Recalibrating our nutrition was a neverending story


The year 2010 was an up and down one marked by controversial study findings, outrageous fast food, updated nutrition guidelines and encouraging news stories.

The introduction of a cholesterol-lowering margarine was embraced by heart-healthy Canadians, while others hailed the arrival of the infamous Double Down to KFC’s menu boards.

But not all news was welcome. Study findings about calcium left many people wondering if they should toss their daily supplement. And the year certainly wasn’t kind to refined carbohydrates, which were increasingly linked to heart disease.

What follows is a year-end look at some of the stories that made headlines in 2010.

Saturated fat not linked to heart disease

For decades, the view that eating too much saturated fat – found in meat and high fat dairy products – increases the risk of heart disease has been the driving force behind the recommendation to follow a low-fat diet. But given the evidence presented this year, our thinking on diet and heart disease may shift.

In January, cheese-loving Canadians got good news when U.S. researchers reported there was no difference in risk of heart attack – or stroke – between people who ate the most and least saturated fat. The review of 21 studies also suggested that replacing some of the saturated fat in your diet with refined (white) grains might actually boost your heart-attack risk.

Then, in June, a landmark study provided direct evidence that eating refined, highly processed carbohydrates is worse for your heart than saturated fat. Participants who substituted some of their saturated fat intake with refined carbs were 33 per cent more likely to suffer a heart attack than folks who ate fewer carbs and more saturated fat.

Bottom line: When it comes to heart disease, limiting refined grains and sugars, losing excess weight, and emphasizing heart-healthy fats will do more to lower your risk than simply giving up cheese (and butter).


-> View Related: The year in nutrition: salt wars to E shock

Cholesterol-busting margarine hits Canada

The latest weapon to fight high blood cholesterol arrived in supermarkets this year: margarine fortified with plant sterols. Studies have consistently shown that consuming 2 to 3 grams of these natural compounds per day lowers LDL (bad) cholesterol by up to 15 per cent.

In May, the government permitted food companies to add plant sterols to products, and Unilever’s Becel pro-active margarine was first out the door. Five teaspoons of the spread delivers 2 gm of plant sterols.

Expect to see mayonnaise, salad dressings, yogurts and spreads boast the addition of plant sterols in the new year.

Bottom line: While these fortified foods are good news for those with elevated cholesterol, they’re not a magic bullet. You still need to follow a heart-healthy diet to keep your cholesterol down.

Calcium supplements called into question

Canadians wondered if it was time to trade in their calcium pills for a glass of milk after an August report linked calcium supplements to a greater risk of heart attack (but not for strokes or death from heart disease), particularly among people who consumed high amounts of calcium from food.

However the report – a review of 15 studies conducted in the past 20 years – excluded studies that gave participants calcium combined with vitamin D. (Vitamin D deficiency has been shown to increase the risk of heart attack.) And not one of the studies was designed to assess calcium and heart risk.

The researchers speculated that calcium pills cause sharp rises in blood calcium levels, which could contribute to artery disease. Calcium in food is absorbed more slowly.

(Experts say it’s hard to understand how calcium could increase the risk of heart attack, but not stroke or heart-disease death.)

Bottom line: It’s important to consume adequate – but not excessive – calcium to meet daily requirements. Getting enough calcium maintains bone density, keeps blood pressure in check, helps prevent calcium oxalate kidney stones and guards against colon cancer. Adults, aged 19 to 50, need 1,000 milligrams of calcium each day; older adults need 1,200 mg.

Canadians scarf down KFC’s Double Down


It’s hard to believe that a sandwich could create such a frenzy. But KFC’s greasy, salt-laden sandwich did just that when it arrived in Canada in October for one month. Judging by its strong sales, food porn lovers across the country gobbled up the notorious “sandwich.”

For those of you who didn’t try it (myself included), the Double Down uses two pieces of fried chicken as buns to squeeze together bacon, processed cheese and the colonel’s secret sauce. It’s a concoction that delivers 540 calories, 30 grams of fat and more than a day’s worth of sodium (1,740 mg).

The Double Down is the latest entry in the trend of monster-sized fast food. It joined the ranks of even more outrageous sandwiches, including Wendy’s Triple Baconator (1,370 calories, 92 gm of fat, 2,380 mg of sodium) and Burger King’s Quad Stacker (920 calories, 63 gm of fat, 1,670 mg of sodium). Ouch.

Bottom line: Time will tell if the Double Down will return to KFC menu boards in Canada. Personally, I hope not. It’s a sandwich most Canadians just don’t need.

Osteoporosis Canada launches new guidelines

In October, new guidelines were launched to better steer doctors and the general public on how to prevent osteoporosis and maintain strong bones for life.

Calcium and vitamin D recommendations were revised, based on a review of evidence published since the organization’s 2002 guidelines.

Daily vitamin D (D3) supplementation recommendations were increased: 400 to 1,000 international units (IU) for adults under 50; and 800 to 2,000 IU for older adults. Total daily calcium intake – from diet and supplements – was decreased from 1,500 to 1,200 milligrams for individuals over 50. Adults under 50 are advised to continue to consume 1,000 mg of calcium daily.

Bottom line: For bone health, adults need to take a daily vitamin D supplement and ensure they meet calcium needs. If your diet falls short, a calcium supplement can bridge the gap.

Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV’s Canada AM every Wednesday.


The year in nutrition: salt wars to E shock


Whole grains, broccoli, omega-3s and soy continued to grab positive headlines this year, but other stories surprised, even worried, us.

While Canadians’ intake of fruit and vegetables declined for the first time in a decade, south of the border Americans were told they could count pizza as a vegetable serving.

The fact that pizza is high in sodium seemed to be less of a worry as research findings questioned the government’s advice to slash sodium in the North American diet. Meanwhile, Campbell Soup Co. (U.S.) added salt back to soups in an effort to boost flagging sales.

Yet it was the news about vitamin supplements that shocked us the most. The safety of calcium supplements was questioned, and vitamin E supplements took a blow. Here’s a roundup of 2011 newsmakers:


Canadians’ diet lacks fruit and vegetables

We’ve long been told to eat more fruit and vegetables. A produce-rich diet helps lower the risk of certain cancers, heart attack, stroke, high blood pressure, cataract and macular degeneration.

That’s why Health Canada advises we consume at least seven servings

(combined) each day.

One serving is a medium-sized fruit, 1/4 cup dried fruit, 1/2 cup of cooked vegetables, 1 cup of salad greens or 1/2 cup 100-per-cent vegetable or fruit juice.

It became clear this year we haven’t been heeding this advice. In June, Statistics Canada’s latest analysis of the nation’s health revealed that our intake of fruit and vegetables had declined for the first time in a decade.

According to the data only 43 per cent of Canadians, aged 12 and older, manage to eat more than five servings per day.

My advice: In 2012, resolve to incorporate fruit and vegetables into all of your meals and snacks.


Perhaps Canadians would have scored higher on the fruit and vegetable front had pizza been counted as a vegetable serving as it is south of the border.

In November, the U.S. Congress released a spending bill to keep pizza on school lunch menus in a fight against an Obama administration proposal to make school lunches healthier.

The bill allows pizza to qualify as a serving of vegetables because it contains two tablespoons of tomato paste. The U.S. Department of Agriculture had proposed that a half cup of tomato paste – too much to put on a pizza – be considered a vegetable, but was ignored.

Advocates of healthy school lunches have criticized the bill, saying it will prevent schools from offering a wider variety of vegetables.

The controversial ruling was even mocked by Kermit the Frog, on an episode of Saturday Night Live.

The idea that pizza is a vegetable is pretty ridiculous. With minimal fibre, vitamin C and folate – not to mention added sodium – two tablespoons of tomato paste hardly comes close to a serving of broccoli or carrots.

Bottom line: You still need to serve your pizza with a side of vegetables.


=> Related Posts: Beyond cholesterol


A number of studies questioned the science behind the drive to reduce sodium in our national diet.

In July, a review of seven randomized controlled trials found no strong evidence that cutting sodium protected from heart attack, stroke or dying from heart disease. In fact, it reported a greater risk of premature death among people with a history of heart failure who followed a low-sodium diet.

Last month, a report from Canadian researchers who reviewed data from nearly 29,000 adults found that while a very high sodium intake – 7,000 to 8,000 milligrams per day – was harmful to heart health, so was a low-salt diet.

People who consumed the lowest sodium levels – less than 3,000 milligrams per day – also had higher rates of cardiovascular death and hospitalization for heart failure. (However, fewer heart problems occurred at the lower end of sodium consumption than the higher end.)

Meanwhile, after trumpeting its efforts to reduce unhealthy amounts of salt from its products, Campbell added salt back to its Select Harvest canned soups sold in the U.S. to combat slow sales.

Canadians consume on average 3,400 milligrams of sodium per day, more than double the daily requirement. Health Canada is pursuing a voluntary program to reduce our average daily sodium intake to 2,300 milligrams by 2016.

Despite this year’s backlash against the anti-salt agenda, most experts feel the scientific argument for cutting sodium in processed foods is strong. Expect the war on salt to continue in 2012.


It’s fair to say it was a bad year for calcium supplements. In April, New Zealand researchers linked calcium supplements – taken by many women to protect bones – to heart attack.

The conclusion was drawn from a re-analysis of the Women’s Health Initiative (WHI), a seven-year trial which assigned women to calcium and vitamin D supplements or placebo to assess risk of hip fracture.

Women who were not taking calcium supplements on their own before the study began had a greater risk of heart attack while those who were already using calcium supplements did not.

The authors speculate that a sudden change in the level of blood calcium could damage coronary arteries and lead to heart attack. Women who already had calcium in their blood due to personal calcium use may have been immune to this spike.

(Interestingly, another arm of the WHI that looked at coronary artery calcium levels found no evidence of increased heart risks among women assigned to calcium plus vitamin D.)

Should women toss their calcium supplements to protect their heart? This study certainly isn’t the final answer.

Women should focus on meeting calcium requirements through food first. Dietary calcium has not been shown to increase heart risk.

Women, aged 19 to 50, need 1,000 milligrams of calcium each day and older women require 1,200 milligrams. The safe upper limit for older women (and men) is 2,000 milligrams per day.


Vitamin E supplements also got bad news. A study published in the Journal of the American Medical Association, known as the SELECT trial, found that vitamin E – once thought to guard against prostate cancer – actually increased the risk slightly.

The report noted that the rate of prostate cancer was 17-per-cent greater in the vitamin E group, a finding that was statistically significant. There was no increased risk when vitamin E and selenium were taken together, suggesting that selenium somehow dampens the harm caused by vitamin E.

This study added to the growing concern of many scientists that high-dose vitamin supplements are harmful in certain people.

Take-away message: If you’re a male taking vitamin E, pitch your supplement.

Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV’s Canada AM every Wednesday. Her website is lesliebeck.com.


Beyond cholesterol


Coronary artery disease prevention has not been convincingly linked to any specific anti-dietary cholesterol regimen. A healthy balanced diet, with plenty of whole grains, fruits and vegetables, is analyzed, and is better than adding any dietary supplements or dropping any specific foods.

Full Text:

A great deal of attention has been given in the past three decades to fat and cholesterol in our diets. These nutrients have been linked in numerous studies to heart disease through mechanisms usually involving blood levels of the potent risk factor, low density lipoprotein (LDL) cholesterol concentrations. The overall importance of saturated fat as a cholesterol-raising nutrient is clear. Controversy continues, however, concerning the importance of dietary cholesterol.

In addition, questions about specific types of fat have been raised and must be addressed. In particular: Are margarines containing trans-fatty acids worse than butter? Should omega-3 fatty-acids supplements be recommended to lower blood cholesterol? Uncertainty about other nutrients and vitamins exists as well. Is the type of protein consumed important in controlling blood cholesterol? Are vitamins, including vitamin C, beta-carotene, vitamin E, folic acid, vitamins [B.sub.12] and [B.sub.6], flavonoids, and carotenoids protective against heart diseases? What about organic compounds in plants classified as phytochemicals? These may act like estrogen, the main female hormone, which is being prescribed increasingly. And how strong are the studies implicating iron and homocysteine in the development of coronary disease?

Research findings from various studies presented to the American public by the media have left them wondering about the adequacy of the current recommendations and confused about what is left to eat! What nutrients are most important? What can vitamins really do beyond treating vitamin deficiencies? What should an average person do about managing his or her diet to prevent coronary heart disease? In this article we will summarize the information that has become available recently, and provide you with guidelines.


Dietary fat and fatty acids

The link between dietary saturated fat and heart disease is clear. The National Cholesterol Education Program recommends that American people lower their fat intake from the current level of 34 percent of total calories to less than 30 percent of total calories and reduce saturated fat in the diet. Indeed, people who have heart disease may benefit significantly by lowering their fat even further. Dr. Dean Ornish showed that when diets with less than 10 percent of calories were consumed, regression of coronary arteriosclerosis occurred.

Bottom Line: Lower your fat intake as much as you can and still keep your diet varied as well as tasty. However, reaching and maintaining a healthy body weight is important, and calories from nonfat foods do count!

Dietary cholesterol

Recent studies showing only “modest” increases in blood cholesterol with the daily feeding of eggs to young healthy men and women have raised the question” Can I eat one egg daily instead of sticking to the American Heart Association’s recommendation of no more than four per week?”

Bottom Line: Although those studies showed only a modest (yet significant) rise in blood cholesterol with the daily consumption of eggs, the effect of dietary cholesterol on blood cholesterol can vary from person to person: some individuals are more sensitive to dietary cholesterol than others, and there is no simple test to identify them. In addition, for most Americans even the small blood-cholesterol-raising effects of dietary cholesterol can contribute to higher overall risk of coronary heart disease. So stick to the recommendation of no more than four eggs a week for now.

Trans-fatty acids

Trans-fatty acids are partially hydrogenated fats found in margarine and shortenings, in baked products made with partially hydrogenated fats and (in small amounts) in meats and dairy products. They have been shown to raise LDL cholesterol. Trans-fatty acids may also increase the risk of heart disease by raising Lp(a), a form of LDL that may interfere with the normal breakdown of blood clots. Trans-fatty acids behave like saturated fats although, on the food label, they are included with the unsaturated fats. Trans-fatty acids in the American diet range between 2 and 8 percent of calories consumed.

Bottom Line: Lower your total fat intake and saturated fat intake. Use small amounts of unsaturated liquid oil, e.g., olive oil, canola or corn oil, if needed in cooking and baking, in place of butter, margarine or shortening. If you need a spread for your bread, use jam or jelly or the low-fat or nonfat margarine. Select low-fat or nonfat dairy and baked products.

Omega-3 fatty acids


Omega-3 fatty acids are polyunsaturated fats from plant (linolenic acid) and marine sources (eicosapentaenoic, docosaheaenoic fatty acids) found in fish oil capsules and in salmon, bluefish, mackerel and (in smaller amounts) in other seafood. Eating fish rich in omega-3 fatty acids can cause significant reductions in serum triglycerides (blood fat) in individuals who start out with very high blood levels (>500 mg/d). In addition, omega-3 fatty acids may slow the process of blood clotting. These fatty acids are not, however, helpful in lowering blood cholesterol levels.

Bottom Line: Include fish within the allowance of 5 oz.-6 oz. per day of lean meat or poultry without skin. Do not take fish oil capsules unless prescribed by your doctor. Concentrated levels of omega-3 fatty acids in fish oil capsules can have bad effects when taken with certain drugs like coumadin or in patients with diabetes.

Soy protein

There have been a number of studies in which soy protein has been shown to lower serum cholesterol levels in hypercholesterolemic individuals when compared to protein from dairy products (casein) or beef protein. Soy has isoflavones called daidzein and genistein (plant estrogens) that may play a role in cholesterol metabolism or it may be the amino acid pattern of the protein itself. The protein quality of soybean is close to that of animal proteins. Some Asian populations include soybean daily as tofu, soy milk and tempeh. These foods have been consumed safely for centuries. All soybean products, including soy protein isolate, do, not have the same amounts of isoflavones. Tofu is the best source. Soybean products do contain fat-4 ounces of tofu has 5 grams of fat (which is mainly unsaturated) and 9.4 grams of protein.

Bottom Line: Soybeans can be included in the meal plan in place of animal products and could be a very useful adjunct to the low-saturated-fat, low-cholesterol diet.

Antioxidant vitamins


It has been suggested that large doses of antioxidant vitamins can retard the “oxidation” of LDL cholesterol. Oxidized LDL is more damaging to the arterial wall. In animal studies it has been shown that supplementing the diet with antioxidants inhibits the progression of arteriosclerosis. The nutrients studied in these experiments have been ascorbic acid (vitamin C), alpha-toco-pherol (vitamin E) and beta-carotene.

The animal studies are supported by studies comprising populations in different countries where high levels of blood vitamin C, vitamin E and vitamin A (a product of beta-carotene) are associated with lower rates of heart disease. However, there have been no clinical trials in humans that have used these vitamins to prevent or retard arteriosclerosis.

Bottom Line. More data is needed before antioxidant vitamin supplements are recommended to the general public. Individuals can, however, consult their physicians on antioxidant use.

Food sources of antioxidant vitamins


  • wheat germ
  • whole-grain bread and cereals
  • nuts
  • green leafy vegetables


  • citrus fruits and juices
  • cabbage
  • broccoli
  • cantaloupe


  • carrots
  • dark green leafy vegetables
  • sweet potatoes
  • winter squash
  • apricots
  • mangoes
  • papaya
  • cantaloupe


Fruits and vegetables are powerhouses of phytochemicals which may help in the prevention of chronic degenerative diseases like heart disease, hypertension and diabetes. Each food is loaded with several phytochemicals. For instance, carrots have more than 500 carotenoids; beta-carotene is one of them. In order to get the full potential benefits of these substances, it has been suggested that we eat several servings of vegetables and fruits dairy.

The phytochemicals may be a natural way to increase estrogen levels (or estrogen-like activity). A large body of data suggests that estrogen replacement prevents heart disease and death in postmenopausal women. Estrogen treatment can lower LDL and raise HDL cholesterol levels. Clinical trials are under way to test directly if estrogen can protect postmenopausal women. It should be used only under the supervision of a physician.

Bottom Line: We should all eat several servings of fruits and vegetables each day.


Niacin, or nicotinic acid, is a member of the B vitamin family. The recommended dietary allowance for this vitamin is 15 mg/day, while the doses used to lower LDL cholesterol and raise HDL cholesterol range from 1,000 to 4,000 mg(day. At these very high doses, there is the potential for serious adverse effects: this is particularly so with the slow-release niacin preparations that do not cause flushing and itching, but are more likely to adversely affect the liver.

Bottom Line: Niacin, when used to lower LDL and raise HDL cholesterol, should only be taken under a physician’s supervision.


High iron stores have been associated with heart attacks in a study done in Finland. However, only a small proportion of the population–those with high serum ferritin and high serum LDL–had higher risk of heart disease. Furthermore, separate studies of U.S. physicians and of Icelandic men and women showed no association between serum level of ferritin or iron and the risk for heart attacks.

Bottom Line: The data presently available for a link between iron and heart disease are inconsistent, and do not justify changes in food fortification policy or dietary recommendations.


Elevated levels of hombcysteine (a nonessential amino acid) has been found to be an independent risk factor for heart attack and stroke. High homocysteine levels may reflect reduced availability of folic acid, vitamin [B.sub.6] or vitamin [B.sub.12] Adequacy of these vitamins in the diet, particularly folic acid, may normalize plasma homocysteine levels.

Bottom Line: Building your meals with grains, beans, vegetables and fruits will help increase your folic acid intake. You should however, check with your doctor to make sure you do not have vitamin [B.sub.12] deficiency. Too much folic acid (from foods or supplements) can mask vitamin [B.sub.12] deficiency. Supplementation with vitamin [B.sub.6] for long periods can also cause neurological problems. Aim to get more than 400 micrograms of folate in the diet from food sources and discuss measurement of your homocysteine level with your doctor.

Folic acid in Foods

Food (1 cup) Folic acid
cooked/ ready-to-eat (mcg)

Total cereal 466
Product 19 cereal 400
Lentils 357
Lima beans 273
Asparagus 242
Red kidney beans 229
Spinach 204
Split peas 127
Orange juice (diluted
from concentrate) 109
Artichoke (1 medium) 53
Orange(1) 39


There is no argument concerning the need to reduce dietary saturated fat, achieve a healthy body weight, exercise regularly and avoid cigarettes when you undertake a program to lower your risk for developing coronary artery disease. In addition, a diet rich in fruits, vegetables and whole grains will contain many vitamins and other micro-nutrients that may add further protection against arteriosclerosis. The use of supplements to increase consumption of these vitamins and micro-nutrients is not recommended at this time. Finally: Before you accept any recommendation, you should know:

  1. that any one study you read about is not the last word on how you should eat.
  2. that removing or adding one food or supplement to the diet does not guarantee that you will then be eating a healthful diet. A healthful diet is about the foods you can eat and not about the ones you are told to avoid.
  3. that nutritional science is evolutionary and not revolutionary. A story about nutrition gets media attention because it is unusual and because it proposes a new theory. The new information should remain theory until it is tested further and confirmed.
  4. how the study upon which a new recommendation is based was conducted. A randomized clinical trial is the best design for clinical research. Data from studies on animals, or from observational studies, are not the final prescription.

Dr. Ginsberg is the director of the Irving Center for Clinical Research and the Irving Professor of Medicine, College of Physicians and Surgeons at Columbia University.

Ms. Karmally is the director of Nutrition, Irving Center for Clinical Research, Columbia-Presbyterian Medical Center, N.Y.C., spokesperson for the American Directors Association and on the board of directors for the N. Y. Affiliate of the American Heart Association.


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