Measure for measure, a way to cut calories
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/23/_pf.html
By Jennifer LaRue Huget | Thursday, November 26, 2009

The holiday season brings with it an overabundance of advice on how to avoid gaining weight in the face of all those festive meals, cocktail parties and plates of cookies brought in by co-workers. Depending on whose advice you're inclined to heed, you can cut back on carbs, mind the glycemic index of the foods before you, fill up on fat or count every calorie.

Or maybe you could just use smaller plates.

That's the premise of "The 9-Inch 'Diet' " (PowerHouse), a book published last November by a pair of advertising executives that makes a strong visual and verbal argument that much of America's weight problem stems not from eating the wrong foods but from eating too much.

Alex Bogusky, who wrote the book with Chuck Porter, is best known for his work on the "Truth" anti-tobacco ad campaign. He starts the book with a simple tale. Having just bought a lakeside cottage built in the 1940s, he and his wife went out to stock up on dinnerware. But the plates they bought (regular ones from somewhere like Target) didn't fit, no matter which way he tried to jam them in the cupboards. Slowly it dawned on him that those cupboards had been built with much smaller plates in mind. Further research revealed that while most dinner plates today measure 12 inches, in the middle of the past century the standard was nine inches.

And so a "diet" was born. (Bogusky notes that it's not a diet at all -- and thank goodness, as most diets don't work in the long run, he observes.) Bogusky replaced his plates with vintage nine-inchers, and he and his family adjusted their serving sizes accordingly. "Research has proven," Bogusky told me in an e-mail, "the mind is a much bigger trigger for how and when we feel satisfied and full than anybody had formerly realized. More so than the stomach." As a result, he says, he's eating considerably less food at every meal.

And you can, too.

"The 9-Inch 'Diet' " is a fun read, chock-full of images that show how the continual super-sizing of American food-serving vessels has led to our consuming ever-increasing portions. Obviously, the diet is just a way of exercising portion control. But it's an elegant and adaptable way.

People have trouble looking at a portion and knowing whether it's too large or too small, Bogusky says. "If I show you two portions, you can tell me which is bigger, but you won't be able to discern which one is the right size. And today with the size of everything ballooning out of control, there is nothing for us to make a legitimate comparison to. The nine-inch plate is an absolute size reference that we used for a hundred years, and it worked. It can work again."

The beauty of this "diet" is that it doesn't rule out any kind of food. It just gives us a way to gauge how much we should put in our mouths. In fact, several pages of the book are dedicated to color photos showing how meals for various diet plans, from Pritikin and Weight Watchers to Atkins and South Beach, look on a nine-inch plate.

Of course, going nine-inch isn't just a matter of digging Grandma's china out of the attic. First, this approach works only if you commit to it and allow yourself time to get used to using a smaller plate at every meal. The payoff: Once you're in the groove, Bogusky promises, "you won't even have to keep an eye on your portions anymore; your plate will do it for you."

That commitment requires getting rid of your big plates. Bogusky reluctantly suggests that, in a pinch, you can resort to paper plates, whose size is marked right on the package. Bogusky notes that it's not just our plates that have grown larger but also our drinking glasses and flatware; downsizing all of these should, he says, be part of your new campaign.

To make this really work, though, you have to shop for food that will fit on your plate. You may have to ask the butcher to cut a steak into two servings, for instance, or rethink your notion of how big a piece of chicken should be. And, he warns, "don't abuse your nine-inch plate" by filling it to the rim and stacking food high. "Just use common sense," he urges.

That common sense should of course extend to decisions about getting seconds and thirds. Otherwise you might find yourself eating off the equivalent of an 18-inch plate or bigger! And his illustrations imply that your whole meal, no matter how many courses it involves, should fit on your plate. As for dessert, well, Bogusky doesn't offer much guidance, other than to suggest that when you eat out and order dessert, you should split it with someone.

"The 9-Inch 'Diet' " has been around for a year. Why am I writing about it now? Having seen a lot of diet books this year, this one -- written by someone who is neither a doctor nor a dietitian -- makes more sense to me than a lot of the others. It sets the responsibility squarely on our shoulders to pay attention to how much we're putting on our plates and in our mouths.

And then there's this: I know it works, and I knew so even before reading the book. Last Thanksgiving, feeling sentimental, I dug out of my attic my Grandma LaRue's 1950s-era dinnerware, including her nine-inch plates, in a pattern my husband and I have long referred to as "Hideousware." They looked kind of Thanksgiving-y, so we used them at our celebration. The plates were indeed tiny. And we all ate less than usual -- without really noticing.

Have a lovely holiday. And, if you can get your hands on a nine-inch plate, please send me a photo of your own nine-inch meal at checkup@washpost.com.

A chat with Dr.Devi Shetty, Heart Specialist

(Heart Specialist) Bangalore was arranged by WIPRO for its employees . The transcript of the chat is given below. Useful for everyone.

Qn: What are the thumb rules for a layman to take care of his heart?
Ans: 1. Diet - Less of carbohydrate, more of protein, less oil
2. Exercise - Half an hour's walk, at least five days a week; avoid lifts and avoid sitting for a longtime me
3. Quit smoking
4. Control weight
5. Control blood pressure and sugar

Qn: Is eating non-veg food (fish) good for the heart?
Ans: No

Qn: It's still a grave shock to hear that some apparently healthy person gets a cardiac arrest. How do we understand it in perspective?
Ans: This is called silent attack; that is why we recommend everyone past the age of 30 to undergo routine health checkups.

Qn: Are heart diseases hereditary?
Ans: Yes

Qn: What are the ways in which the heart is stressed? What practices do you suggest to de-stress?
Ans: Change your attitude towards life. Do not look for perfection in everything in life.

Qn: Is walking better than jogging or is more intensive exercise required to keep a healthy heart?
Ans: Walking is better than jogging since jogging leads to early fatigue and injury to joints

Qn: You have done so much for the poor and needy. What has inspired you to do so?
Ans: Mother Theresa , who was my patient

Qn: Can people with low blood pressure suffer heart diseases?
Ans: Extremely rare

Qn: Does cholesterol accumulates right from an early age (I'm currently only 22) or do you have to worry about it only after you are above 30 years of age?
Ans: Cholesterol accumulates from childhood.

Qn: How do irregular eating habits affect the heart ?
Ans: You tend to eat junk food when the habits are irregular and your body's enzyme release for digestion gets confused.

Qn: How can I control cholesterol content without using medicines?
Ans: Control diet, walk and eat walnut.

Qn: Can yoga prevent heart ailments?
Ans: Yoga helps.

Qn: Which is the best and worst food for the heart?
Ans: Fruits and vegetables are the best and the worst is oil.

Qn: Which oil is better - groundnut, sunflower, olive?
Ans: All oils are bad .

Qn: What is the routine checkup one should go through? Is there any specific test?
Ans: Routine blood test to ensure sugar, cholesterol is ok.. Check BP, Treadmill test after an echo.

Qn: What are the first aid steps to be taken on a heart attack?
Ans: Help the person into a sleeping position , place an aspirin tablet under the tongue with a sorbitrate tablet if available, and rush him to a coronary care unit since the maximum casualty takes place within the first hour.

Qn: How do you differentiate between pain caused by a heart attack and that caused due to gastric trouble?
Ans: Extremely difficult without ECG.

Qn: What is the main cause of a steep increase in heart problems amongst youngsters? I see people of about 30-40 yrs of age having heart attacks and serious heart problems.
Ans: Increased awareness has increased incidents. Also, sedentary lifestyles, smoking, junk food, lack of exercise in a country where people are genetically three times more vulnerable for heart attacks than Europeans and Americans.

Qn: Is it possible for a person to have BP outside the normal range of 120/80 and yet be perfectly healthy?
Ans: Yes.

Qn: Marriages within close relatives can lead to heart problems for the child. Is it true?
Ans: Yes, co-sanguinity leads to congenital abnormalities and you may not have a software engineer as a child

Qn: Many of us have an irregular daily routine and many a times we have to stay late nights in office. Does this affect our heart ? What precautions would you recommend?
Ans: When you are young, nature protects you against all these irregularities. However, as you grow older, respect the biological clock.

Qn: Will taking anti-hypertensive drugs cause some other complications (short / long term)?
Ans: Yes, most drugs have some side effects. However, modern anti-hypertensive drugs are extremely safe.

Qn: Will consuming more coffee/tea lead to heart attacks?
Ans: No.

Qn: Are asthma patients more prone to heart disease?
Ans: No.

Qn: How would you define junk food?
Ans: Fried food like Kentucky , McDonalds , samosas,Haldirams, Gardens and even masala dosas.

Qn: You mentioned that Indians are three times more vulnerable. What is the reason for this, as Europeans and Americans also eat a lot of junk food?
Ans: Every race is vulnerable to some disease and unfortunately, Indians are vulnerable for the most expensive disease.

Qn: Does consuming bananas help reduce hypertension?
Ans: No.

Qn: Can a person help himself during a heart attack (Because we see a lot of forwarded emails on this)?
Ans: Yes. Lie down comfortably and put an aspirin tablet of any description under the tongue and ask someone to take you to the nearest coronary care unit without any delay and do not wait for the ambulance since most of the time, the ambulance does not turn up.

Qn: Do, in any way, low white blood cells and low hemoglobin count lead to heart problems?
Ans: No. But it is ideal to have normal hemoglobin level to increase your exercise capacity.

Qn: Sometimes, due to the hectic schedule we are not able to exercise. So, does walking while doing daily chores at home or climbing the stairs in the house, work as a substitute for exercise?
Ans: Certainly. Avoid sitting continuously for more than half an hour and even the act of getting out of the chair and going to another chair and sitting helps a lot.

Qn: Is there a relation between heart problems and blood sugar?
Ans: Yes. A strong relationship since diabetics are more vulnerable to heart attacks than non-diabetics.

Qn: What are the things one needs to take care of after a heart operation?
Ans: Diet, exercise, drugs on time , Control cholesterol, BP, weight.

Qn: Are people working on night shifts more vulnerable to heart disease when compared to day shift workers?
Ans: No.

Qn: What are the modern anti-hypertensive drugs?
Ans: There are hundreds of drugs and your doctor will chose the right combination for your problem, but my suggestion is to avoid the drugs and go for natural ways of controlling blood pressure b y walk, diet to reduce weight and changing attitudes towards lifestyles.

Qn: Does dispirin or similar headache pills increase the risk of heart attacks?
Ans: No.

Qn: Why is the rate of heart attacks more in men than in women?
Ans: Nature protects women till the age of 45.

Qn: How can one keep the heart in a good condition?
Ans: Eat a healthy diet, avoid junk food, exercise every day, do not smoke and, go for health checkup s if you are past the age of 30 (once in six months recommended) ....

Give Your Bladder a Hug

Canadians choose to ignore symptoms - hope they'll go away

TORONTO, Nov. 23 /CNW/ - What better time than in November - Incontinence Awareness Month - to give your bladder some well needed attention?

A recent poll conducted by Leger Marketing, on behalf of the Powder Room - a national education program for those with overactive bladder (OAB) - asked 1,500 Canadians about their bladder health. The findings revealed that although people are experiencing OAB symptoms, most are choosing not to seek medical attention - perhaps assuming the frustrating and embarrassing symptoms will go away, or that they will just have to live with them.

The survey was conducted between September 14th and September 17th, 2009. Using a national random sample of 1504 Canadian adults 18 years of age and older (pregnant women were excluded), the method simulates a probability sample which yielded a maximum margin of error of +\-2.5%, 19 times out of 20.

Approximately one-third of respondents reported that they experienced involuntary loss of urine from coughing, sneezing, or laughing; they had to rush to the bathroom for fear of not making it in time; and/or they urinate more than 8 times in a 24-hour period.

Fran Stewart, a nurse continence advisor at Sunnybrook Health Sciences Centre, suggests that people may believe that the constant urge to go to the bathroom, or waking up from sleep several times to use the washroom (known as nocturia), and urinary leakage are all a part of the aging process. "Not so", says Ms. Stewart. "The notion that OAB sufferers just have to live with it is simply not true."

"Lifestyle modification techniques such as drinking bladder-friendly liquids (i.e. caffeine restriction), keeping a bladder diary and Kegel exercises may improve symptoms significantly," explains Stewart. "In other cases, prescription medication can improve overall quality of life. People don't have to limit social activity, worry about locating the nearest bathroom or feel a constant sense of frustration with the condition."

Stewart suggests asking the following questions as a means of evaluating the impact of an overactive bladder on quality of life: "Do I go to the restroom more than eight times a day? Do I have to wear a pad when I go out? Can I sit through a movie without having to use the bathroom? Can I finish a tennis game? Do I avoid situations or activities because of my bladder? Is my overactive bladder causing me embarrassment or problems of intimacy? If you answered yes to any of these questions, you should speak to your doctor."

Overactive bladder is more than meets the eye, suggests the Canadian Continence Foundation, the organization behind Incontinence Awareness Month. Nearly 22 per cent of Canadians 18 or older have bladder problems, costing the Canadian healthcare system $1.5 billion per year in direct costs related to physician and hospital care, drug costs and long-term care(1).

In November, the Canadian Continence Foundation and the Powder Room are encouraging Canadians to pay attention to their bladder and the symptoms of an overactive bladder. The initiative also encourages people to approach their doctor if they have associated pain, sleeplessness or frustration.

ABOUT OVERACTIVE BLADDER

Overactive bladder affects approximately 12 to 18 per cent of Canadians. Having the sudden "urge" to urinate, even when the bladder is not full, is the primary symptom of overactive bladder and not, as some believe, incontinence (urine leakage)(2)(3).

Quality of Life (QoL) - In a person with overactive bladder, the bladder muscle begins to contract while the bladder is filling with urine, rather than when the bladder is full. The individual experiences a sudden urge to use the bathroom, which can be difficult to put off. A recent study of more than 1000 OAB patients, OAB Unveiled, revealed:

• 76% claimed that their day to day life was affected with OAB; 50% said it affected them all, or almost all of the time;

• 51% found it difficult to broach the subject of OAB with their doctor and among those that did, 90% initiated the conversation themselves;

• As many as 25% said that they waited more than four years before discussing OAB with their doctor;

• 87% of individuals suffered negative feelings in coping with OAB; - More than half of the respondents said that as a result of suffering from OAB, they couldn't get a good night's sleep, and, often had to map out bathrooms when out in public;

• 40% of individuals have resorted to wearing diapers or protective pads.

• Side effects top the list among reasons to stop treatment;

• Family physicians play a key role in treatment, and among 69% of respondents, were identified as the key source for OAB information.

Loneliness is like a disease -- and what's worse, it's contagious.
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/30/_pf.html
By Rob Stein | Washington Post Staff Writer | Tuesday, December 1, 2009

Although it may sound counterintuitive, loneliness can spread from one person to another, according to research being released Tuesday that underscores the power of one person's emotions to affect friends, family and neighbors.

The federally funded analysis of data collected from more than 4,000 people over 10 years found that lonely people increase the chances that someone they know will start to feel alone, and that the solitary feeling can spread one more degree of separation, causing a friend of a friend or even the sibling of a friend to feel desolate. "Loneliness can be transmitted," said John T. Cacioppo, a University of Chicago psychologist who led the study being published in the December issue of the Journal of Personality and Social Psychology. "Loneliness is not just the property of an individual. It can be transmitted across people -- even people you don't have direct contact with."

Moreover, people who become lonely eventually move to the periphery of their social networks, becoming increasingly isolated, which can exacerbate their loneliness and affect social connectedness, the researchers found. "No man is an island," said Nicholas A. Christakis, a professor of medicine and medical sociology at Harvard Medical School who helped conduct the research. "Something so personal as a person's emotions can have a collective existence and affect the vast fabric of humanity."

The seemingly paradoxical finding is far more than a psychological curiosity. Loneliness has been linked to a variety of medical problems, including depression, sleep problems and generally poorer physical health. Identifying some of the causes could help reduce the emotion and improve health, experts said. "Loneliness is more than just feeling bad," said Chris Segrin, a professor of communication and health at the University of Arizona, who was not involved in the research. "It really does have consequences."

But some researchers expressed skepticism about the findings, saying the study had the same shortcoming as the earlier work and could not necessarily rule out other explanations for the apparent association. "It is unclear whether their statistical model will 'find' social contagion in every outcome they examine because of the limitations," Jason M. Fletcher of Yale University wrote in an e-mail. He and a colleague conducted a similar analysis using data from a large federal survey to show that acne, headaches and even height could appear to be spread through social networks if not analyzed properly.

Christakis and Cacioppo defended their work, saying their statistical methods accounted for other explanations. And others hailed the work. "I think it's an incredible piece of research," said Mark R. Leary, a professor of psychology and neuroscience at Duke University. "I don't think we anticipated that something like loneliness would cluster like this in a population. It's surprising."

Although the study did not examine how loneliness spreads, Cacioppo said other research has provided clues. People who feel lonely tend to act in negative ways toward those they do have contact with, perpetuating the behavior and the emotion, he said. "Let's say for whatever reason -- the loss of a spouse, a divorce -- you get lonely. You then interact with other people in a more negative fashion. That puts them in a negative mood and makes them more likely to interact with other people in a negative fashion and they minimize their social ties and become lonely," Cacioppo said.

For the study, Cacioppo teamed up with Christakis and James H. Fowler, an associate professor of political science at the University of California at San Diego, who have published a series of papers and the book "Connected," based on data originally collected by the Framingham Heart Study, a long-running government-funded project that has explored a host of health issues.

The researchers used information gathered from the participants over decades, including their friendships, identities of their neighbors, co-workers and family members, and information about their emotional state. Previous studies by Christakis and Fowler concluded that obesity, the likelihood of quitting smoking, and even happiness could spread from one person to another.

Similarly, the new analysis, involving 4,793 people who were interviewed every two years between 1991 and 2001, showed that having a social connection to a lonely person increased the chances of developing feelings of loneliness. A friend of a lonely person was 52 percent more likely to develop feelings of loneliness by the time of the next interview, the analysis showed. A friend of that person was 25 percent more likely, and a friend of a friend of a friend was 15 percent more likely. The effect was most powerful for a friend, followed by a neighbor, and was much weaker on spouses and siblings, the researchers found. Loneliness spread more easily among women than men, perhaps because women were more likely to articulate emotions, Cacioppo said.

The researchers said the effect could not be the result of lonely people being more likely to associate with other lonely people because they showed the effect over time. "It's not a birds-of-a-feather-flock-together effect," Christakis said.

The findings underscore the importance of social networks, several experts said.

"For years, physicians and researchers thought about individuals as isolated creatures," said Stanley Wasserman, who studies social networks at Indiana University. "We now know that the people you surround yourself with can have a tremendous impact on your well-being, whether it's physical or psychological."

The findings suggest that if you help "the people on the margins of the network, you help not only them but help stabilize the whole network ," Christakis said.