On cold winter days I’m among those of you who yearn to be in a warmer climate.  It’s 25 degrees in downtown Baltimore today and icy sidewalks are creating walking barriers in our normally pedestrian-friendly neighborhood.  I’d rather be in Sarasota, Florida right now where it’s 65 degrees.  Although it would be too brisk to be on the beach in a bathing suit, at least walking outside wouldn’t involve donning multiple layers of clothing and clunky water-proof boots.

After watching a few “House Hunters” episodes and seeing the many remote tropical locations people move to, I realize I wouldn't want to trade my neighborhood’s  

"walkability" to live in some temperate climates.  Although I’d enjoy the warm weather and the extra days to walk outdoors, many coastal communities were designed around automobile travel and I would miss the convenience of walking to nearby amenities.

If you’re like me and you daydream on cold days about re-locating either permanently or temporarily to a warmer place, the good news is there’s a tool called Walk Score that rates neighborhoods based on their walkability so you can find a place to "drive less and live more."  Walk Score is a number between 0 and 100 that indicates the walkability of an address.

The vision of Walk Score is to “make it easy for people to evaluate walkability and transportation when choosing where to live.” Walk Score analyzes hundreds of walking routes to nearby amenities from a given location and awards points based on the distance to those conveniences.  When you type an address, neighborhood, or city into the Walk Score search engine it looks for nearby restaurants, coffee shops, grocery stores, schools, parks, etc.  Any amenities that are within a five minute walk or about 1/4 mile of the searched address are given maximum points.  Fewer points are awarded for longer distances and no points are given if the amenity involves a walk that is 30 minutes or longer.

When I was a member of the Maryland Bicycle and Pedestrian Advisory Committee, one colleague expressed her dismay that the 1/4 mile was frequently used as a walkability measure.  She was the mother of cross-country runners and thought that 1/4 mile (i.e., one lap around a high school outdoor track) was a ridiculously short distance to gauge the pedestrian friendliness of a neighborhood.  And yet walkability isn’t related to fitness; it’s a measure of how convenient the amenities are located within a community. Walk Score indirectly gauges how far a person is able to walk without opting to drive to their destination. 

With a Walk Score of 88 out of a possible 100, New York City is ranked the most walkable city in the Walk Score 2014 City and Neighborhood Ranking followed by San Francisco, Boston, and Philadelphia.  Baltimore made the #10 spot with a Walk Score of 66 and yet if you drill down to a specific address such as where we live in Federal Hill, the Walk Score jumps to 97 and it’s described as a “walker’s paradise” where daily errands do not require a car.  Compare New York City’s overall Walk Score of 88 to the Lower East Side Manhattan address where our daughter lives and the Walk Score rises to 98.  Car ownership is not feasible in her New York City neighborhood.  Everyone either walks or uses public transportation, regardless of weather conditions.

Although the automobile-centered designs of many Florida towns result in predictably low Walk Scores, there are some encouraging “new urbanism” changes that “feet-ure” more pedestrian-friendly communities.   For example, Sarasota's Walk Score is a disappointing 49, and yet a relatively new pedestrian-friendly Citrus Square neighborhood (i.e., 453 North Orange Avenue), has an impressive Walk Score of 91. 

The next time you plan a trip or a vacation, try using the Walk Score search engine to help you decide where to stay.  It will allow you to spend less time driving after your arrival and more time walking for purpose or pleasure.

Be Well,
Mary

2.9.14 Update:  Walk Score was used to create a list the following list of cities where the fewest households owned a car in 2012 due largely to their public transportation infrastructure:

1. New York City

2. Washington, DC

3. Boston

4. Philadelphia

5. San Francisco

P.S.  Please ignore the text box below; your comments are always welcome here.

Throughout the year and especially at Thanksgiving and Christmas time, I am thankful for pumpkin puree.  Canned pumpkin is widely available in the U.S. and yet it is not found in many other countries.  When my husband’s relatives visited us from England, I was surprised that they had never seen canned pumpkin before. 

American farmers harvest specific pumpkin varieties that are better for making canned puree than the large pumpkins grown for Halloween Jack-O-Lanterns.  I stuff and bake small decorative pumpkins for dinner and reach for canned pumpkin when it’s time to bake a pumpkin pie or make pumpkin bread. 

This interesting YouTube video demonstrates how Libby's makes pumpkin puree on a grand scale:

Pumpkin pie is a bit healthier than many other pies because it’s made with a vegetable that’s rich in beta-carotene.  Canned pumpkin puree is certainly easier than using fresh pumpkin when making a pie. If you follow the Libby’s pumpkin pie recipe listed on the can, and use low-fat condensed milk, it’s a fairly healthy dessert.  Baked a day ahead of time and refrigerated, it tastes even better than when it’s eaten on the same day it’s prepared.  Baking desserts a day early will allow you more time to focus on cooking the holiday meal. 

Pumpkin bread is another wonderful way to use canned pumpkin puree.  You know a food you've prepared is a winner if your grown children ask for the recipe. Our daughter recently made the following pumpkin bread recipe for her friends and said it turned out well. 

Although this is called “bread,” it should really be considered a dessert because of the high sugar content.  Think of it as pumpkin cake that’s baked in a bread loaf pan.  It redeems itself as a dessert because it's high in vitamin A.  Remember, as with all desserts, eat this in moderation along with a healthy diet:

Pumpkin Bread

Recipe Analysis Summary:
Good points:
Low in sodium
Very high in Vitamin A

Not so good point:
High in sugar (that's why this should be served as a dessert!)

Pumpkin bread makes a healthy holiday gift.  I hope you'll include me on your list this year!

Be Well,
Mary

P.S.  Please ignore the text box below; your comments are always welcome here.

A number of years ago before giving a fitness presentation to a group of public health professionals, I asked a small group of attendees what physical activity barriers they faced.  One woman spoke of how she had been active during the spring, summer, and early fall.  She walked daily after work and biked with her family on the weekends.  “Everything was great until the clocks changed and it was dark by the time I got home from work,” she lamented.  “Now I’m just waiting for more daylight and warm weather so I can start my evening walking routine again.”  I think of her whenever daylight saving time ends as it will this Sunday, November 3... 

If you are intent on being physically active, it's helpful to understand behavior change stages that people normally progress through when becoming more active and maintaining an active lifestyle.  In his book Changing for Good, author and psychologist, James Prochaska, Ph.D. describes specific stages of motivational readiness for change when adopting new lifestyle habits.  The stages include:

1. PRE-CONTEMPLATION

In the pre-contemplation stage becoming more physically active is not a concern of yours. Reading the active living posts on this Be Well blog and referring to additional resources may help increase your awareness of physical activity benefits.

2. CONTEMPLATION

During the contemplation stage you are thinking about increasing your activity level but are not engaging in it. People can get stuck in this stage for years admitting that physical activity would be good for them and yet they are unable to get past the usual barriers…no time, too tired, etc.

In the contemplation stage you need help creating a plan to change current sedentary behaviors. Write down the benefits you hope to gain from physical activity and then list your perceived barriers and various ways to overcome each one.

3.  PREPARATION

Most people are ready to increase physical activity within a month in the preparation stage of behavior change. They think more about the pros of the new behavior than the cons of the old one.

A firm detailed plan for action is helpful during the preparation stage. Set a starting date and make it known to your family and friends. Choose an activity you enjoy that will fit into your schedule.

4.  ACTION

When you are participating in regular physical activity but it's still a new habit you are in the action stage of behavior change. It's easy to let old excuses turn into barriers that cause relapses, eventually leading you back to the contemplation stage.

Social support is helpful at this point in your program. By sharing the activity with a partner, or with physically active family members and friends, you will receive encouragement. Your progress needs to be rewarded. Ask a physical activity professional for help with adjusting your program so you can continue to get the additional results that will keep you motivated.

5.  MAINTENANCE

You will be part of the maintenance stage when you are physically active on a regular basis and it has become a habit.

New information and programs to keep yourself challenged and interested are helpful during this stage. Be proud of your accomplishments. Look for solutions to any new physical activity barriers such as finding indoor activities you enjoy or walking at lunchtime when daylight saving time ends next week. Become committed to regular physical activity and your ability to change your behavior.

Using a stages of change wellness worksheet can help you determine your current motivational readiness for change along with some ideas on how to adopt more healthy lifestyle behaviors. My hope is that physical activity becomes a priority for you so that you can enjoy all of the benefits that result from active living.

Be Well,
Mary

P.S.  Please ignore the text box below; your comments are always welcome here.

On October 24, America will celebrate Food Day 2013, the nationwide movement for healthy, affordable, sustainable food. Food Day aims to:

• Promote safer, healthier diets
• Support sustainable and organic farms
• Reduce hunger
• Reform factory farms to protect the environment and farm animals
• Support fair working conditions for food and farm workers

This Be Well blog supports Food Day throughout the year by promoting healthy eating, safe food handling, and basic cooking skills...

Find out how your diet impacts your health, animal welfare, and the environment by answering 14 questions and discovering if you’re making progress toward a healthy diet and a healthy planet.  After you've rated your diet, share your results and the Food Day Web site (www.foodday.org) with others.

"Eat real" and learn about Food Day 2013 through this video:

If you're feeling inspired, head into your kitchen and try out some new recipes from the Food Day 2013 cookbook:

Be Well,
Mary

P.S.  Please ignore the text box below; your comments are always welcome here.
 

Kayak is my favorite palindrome and time spent kayaking is one of my preferred forms of outdoor physical activity.  Kayaking allows you to view extraordinary natural beauty in remote shallow waters that are inaccessible using other watercraft.  Once you find a good stream, river, or bay “put in” you’ll be able to travel into aquatic areas that many boaters miss, including places with water depths less than one foot.

You’ve probably heard the old joke about the two happiest days in a boater’s life - the day they purchase a boat followed by the day they sell it.  That may be true about owning certain boats and yet, in my opinion, small watercraft including kayaks are an exception...

More than ten years ago my husband and I attended a kayak festival on the Chesapeake Bay and tried out various models until we both chose the Tarpon kayak by Wilderness Systems.  Because we are rather tall, we decided that sit-on-top kayaks were a better option for us instead of trying to fit into a traditional kayak's cockpit.  I began strength training just to be able to help lift the 16 foot, 75 pound boats onto our car roof rack.  Although the Tarpon is a very stable boat with excellent tracking, it’s not the easiest kayak to strap onto the roof of a car.

Last year we sold our sit-on-top kayaks and purchased much shorter, lighter Wilderness System sit-in kayaks through Craigslist.  We’ve found our Pungo kayaks extremely easy to maneuver. They also track well and can be easily lifted onto a rooftop car rack. 

If you’re not interested in owning a kayak and still want to enjoy the sport, it’s easy to find kayak rentals and tours near most large bodies of water.  One locally-owned business, Ultimate Water Sports, has multiple locations on the Gunpowder River in Gunpowder Falls State Park located about 40 minutes from Baltimore City.  They provide kayak rentals, tours and storage.  As the season winds down, they sell some of their used kayak inventory.

Last week during an unusual warm spell, my husband and I kayaked on the bay side of Bethany Beach, Delaware.  Because there were few visitors on Little Assawoman Bay, we were able to kayak in extremely shallow marsh-grass areas and enjoy watching fish and frogs jumping, a pair of eagles, osprey, kingfisher, and  other aquatic treasures amidst a backdrop of early fall color.

Little Assawoman Bay, Fenwick Island State Park, Delaware:

I hope you’ll have an opportunity to kayak in the Delmarva Chesapeake Bay region and enjoy our area’s beautiful unfolding color this fall. 

Be Well,
Mary

P.S.  Please ignore the text box below; your comments are always welcome here.

My father lived until his early 90s and was my wellness role model.  He maintained a healthy weight measured by the fact that the suit he wore on his wedding day fit him throughout his life.  A former high school and college athlete, he continued regular physical activity until his late 80s.  Dad controlled his portions by performing what he claimed was the most important exercise – pushing yourself away from the table. 

I remember that he enjoyed snacking on nuts and yet, because he was mindful of their high caloric content, he would only have a handful saying how much he enjoyed them as long as he didn’t eat too many.  We could all benefit by adopting his healthy approach to nutrition and physical activity…

One of the things I like about nuts aside from the healthful NUTrition they provide is that they’re a very portable, non-perishable source of protein. I have a small bag of unsalted nuts and raisins in my purse for when hunger strikes and healthy food isn’t readily available.  The combination of the nuts (i.e., protein and healthy fats) and raisins (i.e., carbohydrate) makes it a perfect snack. 

I'm fortunate to live in Baltimore where I can buy Jeppi nuts that are freshly roasted in their Lutherville store.  At the Jeppi Nut and Candy Company, it’s best to purchase unsalted varieties of your favorite nuts and go easy on trail mixes because of their added high-calorie, high-fat items such as chocolate coatings and candy.

I buy one pound bags of raw almonds, peanuts, and walnuts for snacking and baking and keep them in the kitchen.  Interestingly, Mindless Eating author Brian Wansink conducted research and found that people who enter their homes through the kitchen door weigh a bit more than those who enter through the front door because they mindlessly graze on foods in the kitchen.  Not surprisingly, one of the high-calorie culprits in the study was nuts. 

To control your portions, keep in mind that a one ounce serving of nuts varies depending on the type and size of each nut:

According to MyPlate, a 1/2 ounce serving of mixed nuts is considered a “one-ounce equivalent" from the protein foods group.  Eating nuts is one of the ways to add variety to your protein sources:

This Greatist infographic beautifully illustrates the case for including nuts in a healthy diet:

Be Well,
Mary

P.S.  Please ignore the text box below; your comments are always welcome here.

When Olympic gold medalist Missy Franklin said she couldn’t recall a time that she didn’t love being in the water, I knew exactly how she felt.  Of all the physical activities that I've participated in, none offer the same level of joy that I feel during and after swimming.  As a child I constantly begged my parents and older siblings to take me to a swimming pool, pond, or lake where I swam until my finger tips resembled prunes.  Although my first teen job was teaching swimming, I never took formal lessons or had the opportunity to swim competitively.  Maybe the lack of competition is why I still enjoy the sport as much as I do today.

Swimming improves physical health and it keeps me balanced emotionally. I've overcome some seemingly insurmountable problems lap swimming.  The rhythmic breathing necessary to swim freestyle evens out any emotional turmoil I’m experiencing.  By the time I’ve finished swimming a mile in the morning, worries tend to roll off of me for the rest of the day like water off a duck’s back...  

In his book Spontaneous Happiness, Andrew Weil, M.D. described how his physical activity choices have changed over time.  He ran in his 30s until it bothered his knees and he then began spending more time hiking and cycling. Later he relied on exercise machines until they became a form of drudgery.  He began swimming regularly around age 60 and reports that his older body likes swimming very much.  He finds that concentrating on his breathing during swimming is both meditative and relaxing and he tries to swim on most days. My hope is that you won’t wait until you’re 60 to discover the joys of smooth swimming (and you don’t attempt any extreme feats such as Diana Nyad's 110 mile swim completion today from Cuba to Florida at age 64!).

During my S.U.N.Y. College at Cortland physical education undergraduate training, we learned swim technique based on “Doc” Counsilman’s book, The Science of Swimming.  Counsilman coached briefly at Cortland State before joining the faculty at Indiana University where he coached numerous 1960s and 70s Olympians such as Gary Hall and Mark Spitz.

Cortland built a new athletic facility before my college coursework began and Counsilman was consulted during the swimming pool design and construction.  My classmates and I benefited from his guidance and swam in a pool with an underwater viewing deck that allowed filming / stroke analysis, as well as underwater speakers that piped in music for the synchronized swim team.  It was one of the best aquatic facilities in the nation at that time and I couldn’t have been happier to swim laps while listening to the underwater music. It’s now called the Harriet Holsten pool and remains as vibrant as ever.

Although Counsilman had an incredible swimming legacy, he advocated an "S-Shaped arm pull" during the freestyle swim stroke (aka, front crawl) that required a palm-out, thumb-first water entry which can lead to shoulder injuries.  I also recall that your fingers were supposed to be slightly spread for greater swim efficiency based on Bernoulli equations and Counsilman's two-dimensional analysis.  Competitive and recreational swimmers have since been taught newer techniques that replace his recommendations.  There is now more body roll during the freestyle, a catch and pull arm stroke, along with several other stroke modifications.  If this catch and pull swim technique is new to you, focus on having your hand enter the water flat, finger tips first, fingers together, and press the water directly behind you.

When I tried this technique it felt awkward at first, especially adding more body roll, although it quickly helped me become zippier in the water.  I now really enjoy how it feels to move through the water using the Swim Smooth technique. This new approach to freestyle swimming helps you identify the strengths and weaknesses of your stroke and provides drills and training tips to make the most of your time in the water.  The Swim Smooth web site (www.swimsmooth.com) contains detailed information on stroke technique including animations you can download and watch before your next swim session.  There is also a Swim Smooth blog called Feel for the Water that posts every Friday.

If you order the Swim Smooth book, I recommend that you get the print edition because the photo descriptions are too small to read on a Kindle. And if swimming technique isn’t something you’re interested in delving into very deeply, a quick read through the contentious issues in swimming will give you an overall appreciation for how your freestyle swim stroke can be modified for smooth swimming. 

The next time you hear someone about my age advocating the “S-shaped arm pull”, help bring them up to date and ask them to explore the Swim Smooth technique.  Until then, I hope to see you lap swimming at the local pool or, if you're lucky like I was last month, maybe you'll have a chance to swim in the crystal clear waters of a New York State Finger Lake before the weather cools:

Be Well,
Mary

P.S.  Please ignore the text box below; your comments are always welcome here.

Once I get started eating sugary foods I crave them more and more. I’ve found that one way to lower my sugar consumption is to wait until late in the day and only eat a few small portions of sweetened foods.  If I skip lunch time desserts and bypass afternoon candy cravings my overall sugar intake is reduced by only having something sweet after dinner. 

There are plenty of reasons to eat less sugar (e.g., it’s addictive; it’s bad for your heart; it increases the risk of certain cancers). After watching the 60 Minutes Sugar Expose featuring Drs. Sanjay Gupta and Robert Lustig and reading more about hidden sugars in the book Salt, Sugar, Fat by Michael Moss, I decided it was time to pay closer attention to added sugars in foods and beverages.  Looking at breakfast cereal choices seemed like a good place to start…

For years my cereal of choice has been Kashi GoLean.  Maybe their early advertising campaign worked its magic on me and created a “health halo” effect over the product because of the soy ingredients, extra protein, and fiber.  When you examine the Kashi GoLean side panel for sugar you’ll note that even though it doesn’t contain the dreaded high fructose corn syrup, it does contain added sweeteners.  Both honey and cane syrup are mentioned twice in the ingredients list and that’s misleading.  It would be more accurate to list them by their total amounts.

In the current National Geographic magazine featuring sugar there is a compelling picture of sugar-coated cereals.  As a child, I ate Cocoa Puffs, Frosted Flakes, and some other sugary cereals that changed the milk in my bowl into unnatural colors.  At one point we had a Cuban refugee living with us who shocked everyone in our family by adding teaspoon after teaspoon of sugar to his already sweetened cereal.  The number of calories in a spoonful of sugar may surprise you especially since the American Heart Association (AHA) recommends that we drastically reduce our daily sugar consumption to these levels:

  Daily Sugar Limits

Men:        150 calories, or 9 teaspoons (36 grams)
Women    100 calories, or 6 teaspoons (24 grams)

The AHA sugar consumption recommendation includes all of the hidden sugars in processed food and any sugar you add to foods and beverages each day.

Since one cup of Kashi Go Lean has 9 grams of sugar, or more than 1/3 the daily limit for women, and I was trying to reduce my sugar intake by only eating sweet foods late in the day, it was time to find a cereal sans sugar. Cooked cereals such as oatmeal and original Cream of Wheat with no added sugar were an option and yet I like eating cold cereal even on cold winter mornings.  After searching through the grocery cereal aisle and concluding that the packaged cold cereals all contained sugar, I decided to make my own.

One of my housemates in college regularly made granola and yet I didn’t want to heat up my kitchen during our hot Baltimore summer by turning on the oven any more than necessary.  Thumbing through cookbooks, I came across a Swiss-Style Muesli recipe (i.e., uncooked granola) in my Food Matters book, and decided to give it a try.  It’s one of those ‘anything goes’ recipes where the main ingredient is oatmeal (5 cups rolled oats) and then you choose what added dried fruits (1 to 1 ½ cups), nuts and seeds (3 cups) you prefer.  If you don’t like the mouth feel of cooked oatmeal, try Muesli instead.  It’s loaded with good-for-you ingredients and after the first day or two, your palate will adjust to the missing sweeteners.  I’ve been eating it every day for months and don’t miss the processed Kashi cereal I was hooked on one bit.

Although it does involve some time to prepare, this is a “dump and stir” recipe that young children can help you assemble.  If no little hands are available to assist, you can put this together fairly quickly once you have the ingredients on hand.  It’s worth the effort, especially if you keep in mind that this recipe provides you with a daily bowl of unsweetened breakfast cereal that will last about two weeks. 

The following recipe is my variation of Mark Bitman’s Swiss-Style Muesli (Food Matters, page 169). Please note that although it is nutrient-dense (i.e., rich in healthy ingredients), it's also high in calories due to the dried fruits, nuts, and seeds.  Enjoy this with yogurt, fresh fruit, nonfat milk, soy, or almond beverage.

             Mary's Muesli

You Will Need:
5 cups rolled oats (not quick-cooking or instant)
1 cup chopped almonds
1 cup chopped walnuts
1 cup raisins
1 cup shredded raw coconut
½ cup chopped dried apricots
½ cup pumpkin seeds (unsalted)
½ cup sunflower seeds (unsalted)
¼ cup flaxseed meal
1 teaspoon cinnamon

What To Do:
Mix ingredients together with a wooden spoon in a very large bowl and store in tightly sealed containers.

Nutrition Information:
Serving size: ¾ cup (this is not a typo! I save room in my cereal bowl to add fresh fruit on top)
Servings per container: 14 (there are about 7 servings in each glass jar shown)
Calories per serving: 309
Total Fat: 16.5 grams (25% Daily Value)
Dietary Fiber: 6.9 grams (27% Daily Value)
Sodium: 6 milligrams (0 % Daily Value)

Good points:  No added sugars or salt.  High in fiber.

Not so good point:   High in calories (due to healthy fats in the nuts and seeds)

Keep in mind that because it’s also high in fiber and more filling, your hunger will be satisfied longer than if you ate a lower calorie / lower fiber cereal with added sugars.

Be Well,
Mary

P.S.  Please ignore the text box below; your comments are always welcome here.

Years ago during an American Council on Exercise conference, I was amused to find many of my colleagues riding escalators and shunning the adjacent set of stairs at the conference venue.  After opening day, an exercise researcher placed a large sign at the base of an escalator that read, “Be A Role Model, Use The Stairs!”  That point-of-decision prompt was all it took to get the majority of conference attendees off the escalator and onto the stairs...

As a species we must have begun thinking about how to walk less sometime soon after evolving from four-legged locomotion to bipedalism.  We’ve become predominantly sedentary within the last several hundred years which is an incredibly short time frame compared to the millions of years that transpired between moving on all fours to walking upright.  In order to thrive, we need to move more and sit less.  Reincorporating the recommended physical activity pattern will be challenging for most of us and I'm just hoping it won't take centuries to accomplish.

In my Take a Stand blog post, I discussed the importance of standing and moving more while sitting less. Research continues to emerge that stresses the importance of getting out of your chair at regular intervals and moving throughout the day.  Among middle-aged and older adult women, sitting for at least 10 hours a day raised the risk of heart attack and stroke compared to those who sat less than 5 hours a day.  In addition to being more physically active, we need prompt ourselves to sit less. Interrupting sedentary behavior every 30 minutes with brief activity breaks (i.e., 1 minute and 30 seconds) may lower the risk of diabetes and heart disease in healthy, normal-weight adults.

It will take a bit of reverse engineering to move away from the labor-saving advances we’ve made during the last century to save ourselves from the deleterious physical consequences of inactivity.  Until then, each morning we can ask ourselves, “How can I be more active today?” and use current sedentary behaviors as cues to move more throughout the day:

Be Well,
Mary

August 14, 2013 Update: Here are some additional studies that support the need to move more and sit less…

British researchers examined the associations of sedentary behavior and physical activity with markers of cardiometabolic health and found that among people with equal levels of exercise or excess weight, those who sat the longest had higher blood sugar levels.

The British researchers also examined the association of sitting time and physical activity with chronic kidney disease and found that middle-aged adults who sat for more than 8 hours a day had a higher risk of kidney disease compared to those who sat less than 3 hours daily.  The study suggests that higher levels of physical activity and lower levels of sitting time are associated with lower chronic kidney disease levels independent of each other and other risk factors.  Results may vary by gender though, with sitting time a more important factor among women and physical activity more the important factor for men. 

Australian researchers found that, independent of physical activity, body mass index, and other variables, sitting time was significantly associated with diabetes and overall chronic disease in a sample of middle-aged men. Those who sat 6-7 hours per day were 15% more likely to have diabetes than those who sat less than 4 hours per day and men who sat 8 or more hours a day were 20% more likely to have diabetes.


P.S.  Please ignore the text box below; your comments are always welcome here.

A few weeks ago my husband and I ate at our favorite Indian restaurant.  Lunch is served buffet-style and that allows customers to sample several different dishes from their wonderful cuisine.  The drawback is that, well it’s a buffet and that means there are many ways food safety can be compromised.  If the lunch service starts at 11:30 for example, I wonder when the restaurant staff put food on the buffet table and whether the food will be held at safe temperatures during the entire lunch period.

Buffet Rule #1: Go early...

It’s a health code violation for restaurant patrons to re-use the same plate and even though the wait staff quickly removed used plates from people’s tables, I watched in horror as one customer returned to the buffet table and refilled his plate.  In doing so, each time he touched his used plate with a buffet serving spoon and put the spoon back in the communal food dish, the entire container became contaminated with his germs.  Care for a helping of hepatitis, anyone? 

Buffet Rule #2:  Be first in line and don’t go back for seconds. 

Safe food handling reduces the risk of foodborne illness.  Sometimes called “food poisoning,” foodborne illness affects just about everyone at some point in their lifetime.  And if you think you've never been affected, those episodes of vomiting or diarrhea, or a “24-hour bug” you experienced in the past may have been the result of eating contaminated food.  One in six Americans get foodborne illness annually.  Some people have mild symptoms while others, especially those with weakened immune systems, have severe illnesses requiring hospitalization.  In the United States there are 3,000 fatalities caused by foodborne illness annually.

Certain subgroups of the population are at greater risk for contracting foodborne illness (e.g., infants; pregnant women; older adults; people taking numerous medications; persons with compromised immune systems).  One way to reduce your risk of being sickened from improperly handled food is to strengthen your immune system through healthy behaviors, such as:

• Being physically active
• Eating well
• Avoiding tobacco
• Getting plenty of rest
• Abstaining from alcohol or drinking only in moderation (i.e., no more than one alcoholic drink per day for women; no more than two drinks per day for men)
• Managing stress
• Washing hands
• Practicing safe food handling

These lifestyle behaviors certainly aren’t typical of college students.  They’ll complain about getting sick from something they ate in the dining hall and yet it’s likely that their immune systems would be better able to handle the cause of their foodborne illness if they practiced healthy behaviors.

Another approach to reducing the risk of foodborne illness involves safe food handling.  Americans have the safest food supply in the world.  Regulations and procedures are in place to keep food safe from our farms to just about everywhere food is served and sold.  Once you purchase food, it becomes your responsibility to handle it safely. 

Pathogens are disease-causing microorganisms that can’t be seen, smelled, or tasted.  Because you can't tell if food is contaminated using your senses, it’s important to understand the many ways food becomes unsafe and learn how to handle food safely.  The acronym F.A.T. T.O.M. is one way to remember the causes of foodborne illness:
                                                                         F.A.T. T.O.M.

FOOD 
Pathogens need an energy source to grow such as moist proteins and carbohydrates.

ACIDITY
Foods that contain little or no acid are the best places for pathogens to grow.  For example, you might assume you were sickened from the mayonnaise in tuna salad and yet mayonnaise is fairly acidic. The tuna (i.e., a moist protein) is the more likely culprit.

TEMPERATURE
Pathogens grow and thrive whenever food is held between the temperatures of 41 – 140 °F.  This range is called the temperature danger zone.

TIME
Pathogens multiply when food is left in the temperature danger zone.  After 2 hours they will have grown to a high enough level to make someone sick.  This occurs after only 1 hour when the air temperature is greater than 90 °F.

OXYGEN
Some pathogens need oxygen to grow and others thrive when oxygen is absent.  Bottled garlic and oil mixtures that were popular gifts years ago are an example of a low oxygen environment. Sorry, if you gave me one of those decorative bottles, I threw it away.

MOISTURE
Pathogens need moisture in food to grow and thrive. Foil-wrapped potatoes (i.e., a moist carbohydrate) can be problematic because  moisture builds up inside the foil.  Crackers on the other hand, are a dry carbohydrate and will not become a source of foodborne illness.

That's F.A.T. T.O.M. in a nutshell.  These foods are often linked to foodborne illness and should be avoided:

Foods to AVOID:

• Raw (unpasteurized) milk or milk products
• Raw or partially cooked eggs and foods containing raw eggs
• Raw and undercooked meat and poultry
• Unpasteurized juices
• Raw sprouts
• Raw seafood

Although public health food safety campaigns simplify consumer messages into four basic steps, please realize that you can do everything correctly and still become sick.  Under the right set of circumstances, anyone can experience foodborne illness. The following steps only reduce your risk because you can never completely eliminate the chance of becoming sickened from contaminated food or water:

If you don't own a food thermometer you can purchase one in most grocery stores, hardware stores, or from large retailers such as Target or Walmart.  Using a food thermometer is the only way to know if food is cooked to a safe minimum internal temperature.

This brochure provides a more detailed description of the four steps to be food safe:

It’s surprising how many people either don’t know or choose not to follow the four food safety steps.  One time I dined at a Thai restaurant with a physician friend who wanted to save her leftovers and take them home to her husband.  The problem was that we were in northern Virginia and about to see a performance, which meant the food would be unrefrigerated for five hours before we returned to Baltimore.  No one likes to waste food and yet when I told her about the 2 hour rule for chilling foods she left the rest of her entree at the restaurant.

Other people think they are following safe food practices at home and are unaware of food safety myths.  Believing it is safe to thaw meat on the kitchen counter is a myth and yet it’s something many well-educated people still do because their parents did so without experiencing any problems.  Many food handling practices of yesteryear are no longer safe due to a number of factors including more resistant bacteria and a greater globalization of our food supply.  By the way, if you think locally-grown food is safer, think again.  Although locally grown food may taste better it isn't necessarily safer than conventionally or organically grown food that has been transported great distances to your grocery store.

You can always check the shelf life of foods and beverages and decide what to keep and what to toss. During extreme weather events that occur fairly frequently in Maryland, it’s important to know how to keep food safe during power outages and other emergencies. 

There’s a virtual assistant called Ask Karen who can address your food safety questions on-line.  If you prefer to speak with a live food safety expert, call this toll free number between 10:00 a.m. and 4:00 p.m. Eastern Time:

1-888-674-6854

There is so much more to know about food safety than most people realize.  Once you become aware of safe food handling, there are times when eating out may seem a bit less desirable.  The next buffet I visit will most likely be one I create at home to entertain friends and family. I'm more confident in my ability to serve up safe buffets and I hope that you are now too.

Be Well,
Mary

P.S.  Please ignore the text box below; your comments are always welcome here.