Carole Carson

Obesity Is a Family Matter

Twenty years ago, medical experts began sounding the alarm about the rising incidence of adult obesity and the attendant medical problems, such as diabetes, stroke, cancer and heart disease. (Mom and Dad weighed too much.) Then the spotlight shifted downward as surprising numbers of teenagers packed on pounds. (Jennifer, their 13-year-old weighed too much.)

Alarmed pediatricians then focused attention on even younger children when they began to see overweight toddlers and elementary school children in their examining rooms, particularly when those young patients showed signs of type 2 diabetes. (Ian, their 7-year-old, weighed too much.) And last year, members of the American Pediatric Society learned about the latest worrisome development--a rise in newborn obesity resulting from maternal obesity. (Their new baby girl, Isabelle, had a disproportionate amount of baby fat and a heart defect.)

In an effort to design meaningful interventions to reverse this epidemic of obesity among family members, researchers are seeking to understand the underlying causes, school officials are measuring fitness levels, pediatricians are testing for signs of heart disease, and at least one government, Mexico, is limiting access to fattening foods in schools. Below are highlights of recent developments:

The Detrimental Role of Parents and Schools in the Developing Childhood Obesity Epidemic: Findings from a study conducted at Binghamton University suggest that parents and schools, the two biggest influences on children, may be unintentionally jeopardizing their children’s health. Susan Terwilliger, clinical associate professor, observed third-grade children in four different schools in Binghamton, New York. She found that 70 percent of the children drank between two and five sweetened drinks per day and 42 percent ate two or more fast food meals per week.

Terwilliger concluded that parents and schools may unintentionally make decisions that endanger their children’s health. For instance, parents worried about germs might tell their children not to drink water out of the drinking fountain. As a result, children drink sugary juices and sodas instead of water. Likewise, schools concerned about their students’ academic performance often reduce or eliminate gym classes. As a result of these and other practices, Terwilliger predicts that children growing up today will not live as long or as healthfully as their parents.

California Students Flunk Fitness Tests: California students are continuing to perform poorly on fitness tests. Students were tested in six areas: aerobic capacity, body composition, abdominal strength, trunk extensor strength, upper body strength and flexibility. According to the study, less than 40 percent of students in grades five, seven and nine tested at “healthy” levels. In order to improve these numbers, the California State Superintendent of Public schools announced a new statewide initiative, California Action for Healthy Kids.

Obese Children and Teens Risk Heart Disease: Obese children and teens are more likely to develop heart disease, according to a study conducted at the Children’s Hospital and Research Center in Oakland, California. Researchers found that older teens showed signs of insulin resistance that can lead to diabetes as well as inflammation and oxidative stress, which often leads to blood vessel damage. Even though the teens were developing heart disease, they experienced no warning signs—they felt fine. Dr. Ashutosh Lal, head researcher of the study, stressed the importance of immediate intervention for these children to prevent long term, nonreversible heart disease.

Mexico Restricts Sale of Junk Food in Schools: At the start of the new year, officials in Mexico, the fattest country in the world, took action to help children trim down. Government leaders were prompted to act by alarming statistics: one in three children is overweight or obese. To combat the growing epidemic of obesity, the Mexican officials implemented measures to limit the amount of junk food available for purchase in schools. Among the changes—soft drinks were banned and fried foods were eliminated from school menus.

The good news is that all of the conditions leading to obesity among children and adults are reversible. The only question is whether we have the collective will, as we did with the precedent-setting anti-tobacco campaign, to take action before further harm is done to the health of at-risk children and young adults. Until then, just as the widespread use of tobacco did, the epidemic of obesity will continue to take its toll. We can, however, be confident that habits and social norms will change once we make a non-negotiable commitment to promoting the health of future generations.

Eating Done Right: Eggplant—Food of the Week

Isn’t eggplant an odd moniker for a purple vegetable? Just for the record, the eggplant is not really a vegetable. Technically, eggplants are considered fruit, and the first eggplants were small, round and white; hence the name.

Whatever its history, once you’ve discovered eggplant, you are likely to make it a staple in your kitchen. Because of its bland taste, eggplant absorbs surrounding flavors, thus making it a versatile ingredient in many dishes, and the texture of cooked eggplant makes the vegetable an excellent stand-in for meat. And last among its virtues? Eggplant is relatively low in calories.

Eggplant comes in several shapes and varieties, for example, ‘Black Magic,’ ‘Black Beauty,’ ‘Zebra,’ ‘Graffiti,’ ‘Chinese,’ ‘Indian’ and ‘Japanese.’ The white ones are called ‘Albino’ or ‘White Beauty.’ Although I eat all the varieties I can find, I prefer the smaller ones since I find their skin less bitter and tough. If I use the larger kind, I peel about half the skin off so that the vegetable looks striped.

Here’s a simple recipe for eggplant that you can serve as a main course. I found the recipe in The Oldways Table on page 65. It also appears on the Oldways Table website.

Oven-Baked Eggplant with Mozzarella and Fresh Herbs

Serves 6

3 large eggplants, trimmed and cut into 3/8-inch slices
1 tablespoon sea salt
1/2 cup extra-virgin olive oil
1 small onion, finely chopped
2 cloves garlic, finely chopped
1 pounds tomatoes, peeled, seeded and chopped
3 tablespoons finely chopped fresh mint leaves
2 tablespoons fresh thyme leaves
Salt and freshly ground black pepper
1/2 cup chopped fresh basil leaves
3/4 pound mozzarella cheese, sliced

Spread the eggplant on paper towels and sprinkle with the sea salt to release the bitter juices. After 30 minutes, pat the eggplant dry. Brush the eggplant slices with 5 tablespoons of the olive oil and cook over high heat on a gas grill or in a cast-iron skillet, about 4 minutes on each side. Transfer the grilled eggplant to a plate and set aside.

In a large skillet, heat the remaining 3 tablespoons of olive oil over medium-low heat. Add the onions and garlic. Sauté until translucent, about 8 minutes. Add the tomatoes, mint and thyme. Season with salt and pepper. Cook until the sauce is thick, about 35 minutes, stirring occasionally.

Preheat the oven to 400 degrees. Arrange a layer of eggplant in a lightly oiled baking dish and cover with ladles of the sauce, then a sprinkle of the basil and then a layer of the mozzarella. Continue until all of the ingredients are used up. Bake until the cheese starts to bubble, about 35 minutes. Serve hot.

Bon appétit!

P.S. Do you have an eggplant recipe to share?

Can This Food Prevent Obesity? (Trivia Question)

In a recently reported Canadian research study, two sets of mice were given Western-style diets high in sugar and fat. One group of mice got fat; the other didn’t. The mice that did not gain weight consumed one additional food. What was it?

1. Acai berries
2. Green tea
3. Olive oil
4. Tangerines
5. Vinegar

The answer is number 4. The pith of tangerines that mice consumed as part of their daily chow prevented weight gain and the medical problems associated with obesity (heart disease, stroke and diabetes). Researchers believe that “the naturally occurring substance nobiletin also helped to protect against atherosclerosis—the disease responsible for most heart attacks and strokes.” Excited about the results, researchers are continuing their experiments. Once news of this discovery circulates, tangerines may become the next superfood.

Eating Done Right: Quinoa Pasta—Food of the Week

Quinoa pasta is pasta made from quinoa flour rather than wheat flour. The Inca tribe considered quinoa grain (really a seed) to be a superfood because, in addition to being a complete protein, quinoa contains iron, magnesium, phosphorus and fiber.

Individuals with celiac disease or those who need a gluten-free diet can safely eat quinoa pasta, which can be purchased in traditional shapes (spaghetti, linguine, elbows, veggie curls and rotelle). Ancient Harvest makes quinoa pasta; you may be able to find other sources or make your own.

You can use quinoa pasta in any recipe that calls for wheat-based pasta. Below is a stir-fry recipe with a slightly different twist. I found the recipe on Ancient Harvest website and modified the ingredients slightly to reduce calories.

Spaghetti Stir-fry

2 cups (approximately 8 ounces) quinoa spaghetti
8 ounces steak or chicken, thinly sliced, or whole, shelled prawns
2 tablespoons olive oil
1/2 cup chopped green onions
1/2 cup thinly sliced green pepper
1/2 cup thinly sliced red pepper
1/4 cup thinly sliced celery
1/4 cup sliced mushrooms
1 8-ounce can sliced water chestnuts drained
1 clove garlic, minced

Prepare the spaghetti per package directions. Drain and set aside. In a large skillet or wok, stir-fry the meat in 1 tablespoon of the oil until done. Add the remaining oil, water chestnuts and garlic. Stir-fry for 60 seconds or until hot. Add the pasta and toss to combine. Stir-fry for 60 seconds or until the mixture is hot. Season to taste. Serve with soy sauce or hot sauce.

As you can see, many variations are possible with this recipe. Carrots, bok choy, zucchini, cabbage or broccoli florets can be substituted or added to the stir-fry. And because quinoa is a complete protein, meat can be omitted for a vegetarian stir-fry. Have fun experimenting in your kitchen.

Bon appétit!

Photo courtesy of Methylsoy

How Heavy Is Your Fitness Footprint?

When I hear strident voices arguing about the merits of the recent legislation on healthcare, I picture passengers arguing about the arrangement of deck chairs on the Titanic.

You don’t have to be a math major to figure out that the majority of American adults who are overweight (nearly 70 percent) are inadvertently putting themselves at risk for life-threatening, expensive-to-treat medical conditions. Surplus pounds increase the risk for diabetes, certain cancers and stroke. And having even one of four factors commonly referred to as the deadly quartet (obesity, diabetes, high blood pressure and high triglyceride levels) increases the risk of heart disease. Combined, they are a likely predictor of premature death.

The number of supersized children is also worrisome: nearly one-fifth of our nation’s 4-year-olds are obese. Since 1980, the number of overweight children has doubled; for adolescents the number has tripled. The long-term effects of childhood obesity (elevated blood pressure and cholesterol, joint problems, type 2 diabetes, gallbladder disease, asthma, depression and anxiety) will require intensive medical intervention. Researchers predict that this may be the first generation in the past two centuries to have shorter lives than their parents.

Given this context, those debating the merits of the reform to our “disease management system,” as Dr. Andrew Weil labels it, seem to be ignoring the reality that the ship is sinking.

Granted, we need to make medical care more accessible and affordable and reduce unnecessary costs. But far more importantly, we need to place people in lifeboats. We need to figure out how to reduce lifestyle-related diseases that trigger the need for expensive medical care in the first place. We need to lighten our fitness footprint.

I coined this term to describe the impact of our personal lifestyle on health and life expectancy, along with the global impact on the environment. A healthy body on a healthy planet is the goal. But this goal can be achieved only if we reverse the unchecked epidemic of obesity. As waists become thicker, footprints become heavier.

Measuring and taking stock can be life-saving. When I stepped naked on the bathroom scale one morning and it broke, I knew I had to lose weight. What I didn’t know was that 183 pounds on a 5-foot-2-inch frame placed me in the 90th percentile for heart disease, cancer and stroke—plus a few other conditions that had yet to show up on tests. (Evidently, most of the calories I burned were ones spent digging my grave with a fork and spoon.) After changing my lifestyle and losing weight, my forgiving body scored in the normal range, and I (and my insurer) avoided thousands of dollars in medical expenses.

Until that point, I failed to connect the dots. I failed to see the connection between my lifestyle and the very real complications that would eventually play out as life-threatening medical problems requiring expensive medical treatment. I also failed to see the connection between my food choices and their impact on the environment. My ignorance could have cost me my life, hence my passion for encouraging others to take stock before it is too late.

Measuring your fitness footprint is the first step in achieving a healthy body on a healthy planet. Here are three areas to assess:

• Health Risks: How does your lifestyle influence your blood pressure, body mass index, body fat and risk of a heart attack, a stroke or diabetes? Are you increasing your risk of life-threatening medical problems by indulging in a sedentary lifestyle or too many burgers and fries? Are your medical bills contributing to the estimated $168 billion Americans will spend on weight-related medical care? To calculate your risk for cancer, diabetes, heart disease, osteoporosis and stroke, go here.
• Longevity: How does your lifestyle influence the length of your life? Do you eat fresh fruits and vegetables daily? Are you connected in a meaningful way to others? Do you exercise on a regular basis? How much alcohol do you drink? Do you smoke? To calculate your physiological age and how long you can expect to live given your current lifestyle, go here.
• Food Choices: How does your choice of food impact the environment? What we choose to eat is critical because the production and consumption of food may account for one-third of the total global carbon emissions. According to ecological measures, we need all the farms we have now plus many more on nearby planets if we are to sustain our current habits.

It’s not difficult to lighten your fitness footprint. You can begin by making a few simple, ecologically friendly food and lifestyle choices part of your daily routine.

Follow the seasons when choosing foods and, when possible, purchase produce from local growers. Make creative use of leftovers so food is not wasted. Pick one day a week to enjoy a meatless meal. Stop eating when you are no longer hungry rather than when you are full.

Integrate movement into your day, whether that means pacing the floor when you talk on the phone or taking the stairs instead of an elevator. Support community groups that are working to create foot-friendly communities through the construction of trails, parks and bicycle paths. Recycle your tennis shoes and carry a reusable water bottle. When possible, go outdoors and exercise with a positive friend. Stay socially connected and laugh a lot.

It’s been 99 years since the Titanic sunk. Fortunately for us, we don’t have to wait for the perfect medical insurance system before we begin our own healthcare reform. While there’s still time, we need to lighten our fitness footprint so we are nimble enough to scramble into a lifeboat.

Photo courtesy of John Nyberg

Four Ways to Help Your Child Stay Fit

One out of every five toddlers is overweight. What are the implications? Infant car seats must be redesigned to safely accommodate heavier infants and toddlers. School uniforms and student desks have to be supersized to accommodate heavier youngsters. A number of clothing retailers have introduced lines for oversized teen girls.

Pediatricians are being trained to recognize the symptoms of adult-onset diabetes and stroke in their young patients. As part of this education, participants at the American Stroke Association's International Stroke Conference 2011 learned that “a marked increase in the rate of stroke was noted in children ages five to 14.”

Leaders promoting the Let’s Move campaign initiated by First Lady Michelle Obama are working in partnership with local communities to address the expanding problem of childhood obesity. To be effective, however, their efforts need to be reinforced by day-to-day actions in our homes. What positive steps can families take? Psychologist Howard Rankin, author of weight-loss and wellness books, says, "Especially for children, exercise is the key. Ensuring that your child gets up and moves around for five or ten minutes when playing video games or while playing on the computer is important."

Here are four more suggestions from researchers:

Every Day Tasks Can Become Fun Family Fitness Activities: Participating in fitness activities with the entire family promotes healthy habits and provides quality together time. Today’s families frequently struggle to find time for physical exercise. Yet setting aside time for fitness may not be as hard as parents think, especially if parents turn everyday activities into family fitness fun. Chores such as shoveling snow, washing cars or raking leaves can double as fitness activities.

Healthy Eating Habits Are Formed Early: According to the Feeding Infants and Toddlers Study, children’s eating habits are formed between birth and 24 months, with many permanent eating habits formed by age three. These findings underscore parents’ responsibility to find fun and creative ways to encourage kids to eat healthfully. Parents can set a good example by eating nutritiously themselves, as well as by providing a variety of healthy food choices for kids. In addition, asking kids to help with food preparation and cooking makes them feel involved and fosters a healthy relationship with food.

Kids Who Dine with Their Families Are Less Likely to Be Overweight: Researchers report that kids who enjoy regular family dinners are less likely to be overweight than kids who rarely eat with their families. When families eat together, they tend to eat healthier foods, such as vegetables and fruits. Kids who eat regular meals with their families also perform better in school and are less likely to drink alcohol or take drugs than other kids are.

Kids and Parents Can Both Enjoy Healthy Meals: For delicious, kid-tested recipes, check out The National Heart, Lung, and Blood Institute’s new cookbook, Keep the Beat Recipes: Deliciously Healthy Family Meals. This innovative, inexpensive cookbook includes 40 healthy, family-friendly and easy-to-prepare recipes that your kids—and you—will love. And for families on a tight budget, the recipes are also leftover friendly.

Obesity places a terrible burden on kids. Besides being at risk for adult obesity and facing a lifetime of weight-related health problems, overweight kids face painful social discrimination. Maintaining self-esteem in the face of an ongoing stream of negative feedback about a child’s appearance is very difficult.

Parents do not have an easy job, given the 24/7, easy accessibility and attractiveness of high-calorie, low-nutrition food. Nonetheless, they have the primary responsibility for protecting their offspring’s health, and the best way to help youngsters stay trim is to become a positive role model. Teacher and counselor John Weyenberg underscores this concept when he says, “Parents owe it to their children to set the best example possible in all areas of life . . . Preventing obesity in children and teens begins with parents and the example they set.”

Photo courtesy of Horton Group

Ready for a Retail Workout? Shape Up While Shopping

For optimum health, the Surgeon General recommends 30 minutes of daily exercise. Yet a recent study suggests that twice this amount—1 hour—is required if women want to avoid gaining weight with age.

Carving an hour out of each day for exercise is tough, given the spread of our responsibilities. For those who work full-time, parent and maintain a home, multitasking is a way of life. If we can’t find a solid hour to exercise, we’ll need to find exercise opportunities throughout our busy days.

Retail workouts may be the solution since on average, women shop about an hour daily. If we combined shopping and exercise, perhaps we could find some of those precious 60 minutes. A typical trip to the mall, for instance, involves walking nearly three miles. And for serious shoppers―the shopaholics who spend two or three times that much time and forgo meal breaks—the distance can double or triple. In fact, some of these shoppers (my girlfriend is one) easily qualify for the pro shopping circuit.

If you’re shopping at the mall, go equipped with a pedometer, a good companion and these tips:

• Park at the outer perimeter of the parking lot and walk briskly through the mall. Set a goal for the number of steps you want to log and keep walking until you’ve reached your goal. (Window shopping is allowed as long as it doesn’t slow your pace.) Walking improves almost all aspects of fitness: strength, coordination, endurance and balance. It also is easy on joints, increases energy and burns calories. Some malls even have stroller fitness walks for new moms.
• Take the stairs and avoid the elevator. Not only will your legs be strengthened, but they will be more shapely. You’ll also strengthen your cardiovascular system.
• While waiting to pay for your purchase, pull your belly button toward your back. Hold for 10 seconds and repeat. This will strengthen your gluteal (rear) muscles.

If you’re grocery shopping, try these moves:

• Park at the perimeter of the lot so you’ll be forced to walk extra steps.
• If you are purchasing only a few items, carry a basket as you shop. After your groceries are bagged, carry them back to the car. A gallon of milk weighs 12 pounds. Lifting weights strengthens your arms, upper torso and back.
• When reaching for an item on a lower shelf, squat. Repeat two or three times. This move strengthens calves, thighs, gluts and abs.
• Reach for items high on shelves; hold for 10 seconds. Then repeat 5 times. (If you feel self-conscious, pretend you can’t decide whether to buy the product.) Stretching on your toes with arms above your head strengthens your legs, back and arms. It also improves balance.
• Grasp the grocery cart handle tightly on both sides and try to pull your hands apart. Hold for 10 seconds. Repeat. This strengthens your shoulders and the back of your arms.
• Grasp the middle of the cart handle with one hand and push right and left for 5 turns. Alternate hands. This strengthens arms, shoulders and abs.
• Spread your legs to the width of your shoulders. Try to squeeze the floor together between your feet. Hold for 10 seconds. Then push your feet apart and hold for 10 seconds. Repeat. These two exercises firm up inner and outer thighs.
• While your groceries are being checked, stand on one leg, straighten your body and bend one knee backward. Hold for 90 seconds. Repeat with the other leg. Your lower legs and ankles will be strengthened and you’ll improve your balance.

Whether you head to the mall or the grocery store, don’t begin hungry. Before leaving home, eat a nourishing meal and pack a healthful snack in your purse along with a supply of water. Wear comfortable walking shoes. Throughout your retail workout, engage your senses—especially smell, sight and touch. Stop for a sample of soothing lotion or try out a relaxing massage chair. (You’ll be less inclined to eat from stress or engage in recreational eating.) And pick your indulgences. For example, choose a single piece of dark chocolate (60 calories) rather than an oversized cupcake (600 calories).

Opening your purse, removing your credit card, replacing your credit card and closing your purse will never rise to the level of cardio-intensive exercise, but if you are willing to squat, reach, lift and walk while shopping, over time you can burn hundreds of calories. And think of all the shopping opportunities you have: the mall, grocery store, superstore, warehouse club and department store.

To guarantee success, however, incorporate this one last no-matter-what exercise: carry your fitness goals wherever you go.

Eating Done Right: Asparagus—This Week's Featured Food

My earliest recollections of eating asparagus date back to my childhood. Each spring, our family (who farmed near Rowley, Iowa) would drive to Waterloo, a trip of about 40 miles each way, to get asparagus. During the ride, I remember my parents discussing how the sandy soil around Waterloo produced the wonderful asparagus that they were eager to eat. (I was six years old, so their enthusiasm was lost on me.) Now that I look back, I marvel at parents who would make a two-hour car trip with kids for the simple pleasure of eating a vegetable they loved. 

Perhaps part of the joy was in the ritual of spring that asparagus represented. Now that asparagus is in season, how can I resist making it the vegetable of the week? After all, asparagus complements most dinners as a side dish, and cream of asparagus soup is delicious. Leftover asparagus can be chopped and tossed in mixed-green salads or added to omelets.

My favorite recipe for asparagus is a simple one. I break the stalks by hand and then rinse them. After spreading the stalks on a foil-lined cookie sheet, I sprinkle olive oil and seasonings on top. (I use a sprinkling of lemon-pepper and garlic salt.) I cover lightly with foil and bake at 400 degrees for 15 minutes. I remove the upper foil sheet and leave the oven on warm until I am ready to serve dinner. What could be easier? And what could be more delicious?

Bon appétit.

Photo courtesy of Anna H-G

Get Your Kids Moving!

The single most important way parents can engage their kids in physical activity is to be a role model. Both parents and children need to incorporate movement into their daily lives. Playing outdoors, weather and safety permitting, should be part of your daily routine. Community sports programs are also an excellent way to promote exercise. If your kids aren’t competitive, consider enrolling them in dance, swim, martial arts or gymnastic classes. You could also mount a basketball hoop over your garage door or plan vacations around exercise opportunities, such as camping by a lake.

Parents can find many inexpensive activities to help kids stay fit:

• Play hide-and-seek, dodge ball or other games outdoors.
• Go on a treasure hunt.
• Ride a bike.
• Play hopscotch.
• Jump rope.
• Swim at a local pool.
• Play with a Hula-Hoop.
• Go to a public playground.

For more ideas, go here.

Having fun together should be the focus of family activities. Exercise is simply the natural by-product of playful family times. Packing a picnic lunch and taking a hike provides the opportunity to exercise and reinforces family bonds. Families can also bike, skate or visit playgrounds in nearby parks. A visit to the zoo will get kids walking. At home, turn off the television and go outdoors for games of hopscotch, jump rope, kickball or tag. Invite the neighborhood kids to join your family’s games.

Movement is a normal part of everyday life for all of us, whatever our age. Infants and toddlers are constantly learning new motor skills, and structured exercise is not needed. An ample amount of unstructured playtime should be incorporated into preschool children’s routines. By the time children reach elementary school, 15-minute segments of organized physical activities are appropriate. The goal should be a minimum of one hour of exercise daily by the time your child reaches elementary school and thereafter.

Many of our children will face a lifetime of medical problems if we don’t help them stay trim and fit. Whether we’re parents, grandparents or family friends, we need to encourage each other to get moving with our kids.

Photo courtesy of Neil Gould