How do we know if the earth is warming if we don't know what the actual temperature is? It seems simple enough, but if there are only 4 agencies that measure global temperatures and they don't agree with each other, how do we know what the truth is? NASA declares their data isn't really trustworthy according to this article, and that leaves the CRU, which is at the center of the climate-gate scandal. Additionally, according to one site, SurfaceStations.org, 90 percent of the thermometers are less than 100 feet from "biasing influences", like garbage incinerators, asphalt roads, industrial centers, etc. So, again, how are these scientists really certain what the temperature really is?
kiwi mango processor salad
Tonight's "processor" salad included lettuce as a base, topped with broccoli, cauliflower, and cabbage made into slaw using the food processor, topped with sliced kiwi and mango, topped with 2 Tbsp sunflower seeds and spicy pecan vinegar. It was surprisingly good!
quick pressure cooker veggies
I usually eat lunch at home and I need it to be a fairly light meal (no beans, but you can add them!) because I exercise only 3 hours later. Today's meal was very good so I'm posting it. This was a somewhat random selection of veggies from my fridge, but I'd say a good combination is definitely the eggplant, tomatoes, mushrooms and pine nuts. Then just add other veggies from your fridge, like broccoli or greens or cauliflower etc Edamame would be good. It was a bit too much food though so I'm going to list smaller quantities than I used, for next time:
Ingredients:
1/3 eggplant
nappa cabbage or bok choy
shiitake mushrooms
1/2 can tomatoes
1 Tbsp ground pine nuts
Cook everything except the pine nuts in the pressure cooker for 3 minutes; let cool under pressure for a few more minutes. Grind the nuts in a coffee grinder, add to the dish and stir. I thought the combination of flavors was quite yummy. The mushrooms added a meaty taste, the eggplant and pine nuts were good. Here's what it looked like:
Oh, and since housemate doesn't like eggplant or shiitake mushrooms I made her favorite veggies which were potatoes, peas, carrots, tomatoes, and corn. With 1 Tbsp ground pine nuts added in:
Article on junk food addiction
Darryl from the Fuhrman forums pointed us to this fascinating article. Junk food is as addictive as cocaine or heroine. Yikes!
food this week
I might not have much time to blog during the week. I tend to repeat meals a lot and then move on to another set. So I'll probably do that this week. Today I decided to modify my brekky and lunch because having beans at lunch makes me too full during my 4 pm exercise class; and my brekky hasn't been big enough, making me too hungry at lunch. So I think I just need to move my beans to brekky time. Here's my plan for the rest of the week.
brekky: blended salad and 1 cup of beans (more like 1/2 cup of beans in a thick veggie broth). See Sunday's post for a description of this week's beans.
lunch: cooked veggies. My fridge has eggplant, broccoli, cauliflower, shiitaki mushrooms, sweet potato, beats, carrots, rutabaga, bok choy and cabbage. And I've got canned tomatoes. So it will be a different combination every day, maybe with some ground seeds or pine nuts.
Dinner: "processor" salad made from lettuce, spinach, maybe edamame, and veggie slaw (broccoli, cauliflower, etc shredded in the food processor with the grater blade), topped with sweet pea or berry dressing, probably the berry dressing until I get tired of it. Then when I get tired of the veggie slaw, I'll try something else like bell pepper, or just chopped broccoli and cauliflower. I'm really liking raw broccoli and cauliflower on my salads these days. It's a new thing for me. I used to hate raw broccoli and cauliflower!
Berwick to Tame CMS
Don Berwick, soft spoken pediatrician, policy wonk, quality expert, and my friend, has been nominated by President Obama to head CMS. Berwick's global following is a powerful political force that could be harnessed for real reform, and initiate the creation of real value through a fundamental change in the reimbursement structure. Imagine if aspects of his prior writings and research come true---CMS becomes a savvy shopper with global payment, pay for performance, and comparative effectiveness research with teeth. I am giddy with anticipation, but I am also a realist. Can he tame the beast?? Can he manage the internecine politics?? Can he lead us to the Promised Land--very relevant during this holiday week. I am enthusiastic and excited at the prospect. It will be a telling confirmation process. Stand by for action!! What do you think about this nomination?? DAVID NASH
soy milk
If you buy soy milk, be sure to look at the labels. Most have added sugar and chemicals. The only ones that I know of that are organic, and whose ingredients contain only soybeans and water are: Organic Edensoy, Unsweetened; and Westsoy Organic Unsweetened.
GreenGiant from the Fuhrman forums researched these brands and found the following:
Edensoy organic soymilk was the top choice by the Cornucopia Institute. This institute's report on soybeans is eye opening and it rates Edensoy as the only product generally available nationally with a 5 of 5 rating:
"Behind the Bean: The Heroes and Charlatans of the Natural and Organic Soy Foods Industry"
http://www.cornucopia.org/soysurvey/OrganicSoyReport/behindthebean_color_final.pdf
Interesting, WestSoy and many others are rated 0 of 5 because they refused to disclose their source of soybeans.
Last week I bought the WestSoy because it was on sale. Today I bought Edensoy because the WestSoy was all gone. I guess I"ll go with Edensoy in general, assuming it tastes okay.
curbing overeating
From March 18 to March 26 I logged every piece of food I ate in CRON-o-meter. It's very instructive to do that every once in a while. It showed me that I take in about 1500 calories per day, with a protein percentage about 9-13%, fat percentage 20-30%, and the rest in carbohydrates. I get the full range of amino acids and tons of vitamins and micronutrients. The real magic is that logging my food intake really curbs overeating. For one thing, the extra effort to add in the food is just enough obstacle to make you stop when you are full. And it gets you thinking that I'll stop now at lunch because I want this treat at dinner. It's amazing how well it works.
Well, now I want to try going solo and not use this tool and see if I can listen to my stomach to curb overeating. I did notice I got hungry between meals using this tool, so I should get hungry between meals without it. That will be my gauge. That's how it's supposed to be, but I got out of the habit of listening to my body because, well, it's enjoyable to eat. But I was reminded in the last 10 days that it's much more enjoyable to eat when you are hungry. Of course, Dr. Fuhrman says this all the time. This is typical for me to learn from experience that Dr. Fuhrman was right again.
weekend cooking
I've been having fun in the kitchen lately. Well, I think I always have fun in the kitchen. I bought some soy milk last week in order to enjoy a small banana walnut milkshake, so I've been including it (the soy milk) in other recipes too. It does add a nice creaminess. Maybe I'll buy it more often. I made a yummy berry salad dressing on Friday using soy milk, and put that on my "processor" salad. Yesterday I included soy milk in housemate's smoothies. Today I had another banana walnut milkshake. Tomorrow I'll likely make another yummy berry salad dressing for my salad using soy milk.
Then I also had fun with beans. I got my package of heirloom beans. I used the Runner Cannellini beans yesterday. They are so big, nothing like any I've bought at the store before! And of course, very good. On Friday, I was using up some beans from the freezer, and to make them go farther for two big serving topped over veggies, I cooked up a turnip, and blended that in the blender with sesame seeds and lemon juice and water from the veggies; then combined that with the beans. Well, since that's a common lunch for me, I decided to add this stuff to my beans yesterday while preparing, along with some parsnips and leek. So I cooked those up separately (turnip, parsnips & leek), and blended them in the blender with sesame seeds and lemon juice, then combined them with the beans. Recall I cook the beans in a mixture of carrot, kale and celery juice (mostly carrot). Then inspired by a recipe by Hojo on the Fuhrman forums, I added some nutmeg and thyme. Well, I might have combined too many different flavors. Maybe I should have left off the sesame seeds and lemon juice or the nutmeg and thyme. But it actually is still really good. And now I can just pour these over cooked veggies during the week--over veggies, it's good for the beans to have a bit of a bite to them, so I think the sesame seeds and lemon will be a bonus there. I meant to add mushrooms, but I'll just cook those with the veggies so they'll be there. (Note edited a week later: these beans made us fart more than usual. Not that that should stop you from making them).
Yesterday I also made my 7 blended salads for the week (my breakfast).
Today I made sweet pea guacomole and salsa for housemate. I improved on my old version of the sweet pea guacamole by adding a small kiwi. The salsa was new too.
I should be set for quick and easy meals this week.
yummy berry dressing
This is like pouring a milkshake over your salad, which would not be appealing over tomatoes and onions but over lettuce, spinach, broccoli, cauliflower, cabbage, and bok choy, it is yummy.
Ingredients:
1 cup frozen sweet cherries
1 cup frozen blueberries, strawberries, or raspberries, or mixture
1-2 Tbsp hemp seeds or raw cashews
2/3 cup soy milk or hemp or almond milk or water
1-2 Tbsp blueberry vinegar
Blend in a blender until smooth. It if is thicker than you'd like, add some water. I eat the whole thing on my dinner salad.
winter salsa
It's not the season for fresh local cilantro and fresh local tomatoes, so I used some more local ingredients, which were
1 can tomatoes (from the garden or store), drained
1 carrot
one small apple, peeled and cored, or 1/2 regular (I eat the peelings)
part of red bell pepper (1/8 or so)
dried cilantro (or fresh from the store if it looks reasonable--ours was droopy)
tiny bit of onion and garlic so it doesn't overwhelm the other flavors. Add more to taste.
Blend up in a blender. The carrot thickens the sauce.
Thursday, Mar 25, 2010
Last night, work was on my mind so I just ended up working almost all night long! I was kind of panicked about some deadlines and today had a bunch of non-work things to do so I guess I just gave up sleep and worked last night, and did my non-work things today. Weird. Amazingly, I felt fine, occasionally tired but fine today. I probably slept about 2 hours last night. Often I overeat when I'm tired but I did okay today.
Brekky was my usual blended salad. Then I kept snacking while preparing lunch. Lunch was another giant processer salad. "Carrots" from the Fuhrman forums calls them Micro-Processed salads. Mine are a little different because I don't process the lettuce, just the veggies. By processed, I mean run them through the food processor with the grater blade to make a veggie slaw. My salad had lettuce, kale, asparagus, broccoli, yellow bell pepper, and sweet pea dressing. I guess that's almost the same as a few days ago with the addition of kale. I ate some carrots and two tiny apples too. The apples are local, one of the few local items we get this time of year.
I'm glad I snacked because lunch wasn't until 2 pm. The huge salad was good and filling.
Then I wanted a treat at dinner (and I figured I got plenty of veggies already!) so I had a banana milkshake. Yummy! It was small, but just right in satisfaction. I also had a couple of really good very small blood oranges. wow! I hope there's more in the store next time I visit. And I ate a bunch of carrots as I so often do.
Total calories: 1371, protein 51 g (12%), carbs 269 g (72%), fat 25 g (16%).
banana walnut milkshake
This is really simple and really good. It's the same ingredients as banana ice cream but I can't make banana ice cream with a single banana--I need two to blend up and that's usually more than I want (the rational part of my mind that is). This has enough liquid to blend just 1 banana and so it's a milkshake!
Ingredients:
1 frozen banana (wait until it ripens to freeze--yellow with some small brown spots)
3-4 walnut half pieces (about 0.35 oz) (use less if you want fewer calories)
1/3 cup soy milk
touch of vanilla (1/8 tsp)
I freeze the banana as is. Let it thaw a bit (5-10 minutes), chop off the ends, slice longways into two pieces, and then the peels will come off pretty easily. Blend eveything in a blender. Add a little more soy milk if you think you need it.
This is a small milkshake--just a little dessert treat. It has the perfect amount of sweetness for me. If you want more, add a date or date syrup, but I found this just right. Yum!
Total calories: 198; protein 4 g (8 %), carbs 29 g (54%), fat 8 g (38%)
Interesting Articles in the AJCN
I just received an RSS alert for the American Journal of Clinical Nutrition's latest articles. This upcoming issue is full of very interesting material:
1. Dr. Neil D. Barnard reviews food consumption patterns in the US from 1909 to 2007 (1). This is something I've written about a number of times. The most notable change is that industrial seed oil use has increased by more than 3-fold in the last 40 years, and even more in the last 100 although he doesn't provide those numbers. Butter and lard use declined sharply. Meat consumption is up, but the increase comes exclusively from poultry because we're eating the same amount of red meat we always have. Grain consumption is down, although it peaked around 1900 so it may not be a fair comparison with today:
3. Soy protein and isoflavones, which have been proposed to do everything from increase bone mineral density to fight cancer, are slowly falling out of favor. Dr. Z.M. Liu and colleagues show that soy protein and/or isoflavone supplementation has no effect on insulin sensitivity or glucose tolerance in a 6 month trial (3). This follows a recent trial showing that isoflavones have no effect on bone mineral density.
4. Dr. Ines Birlouez-Aragon and colleagues showed that high-heat cooked (fried and sauteed) foods increase risk factors for diabetes and cardiovascular disease (insulin resistance, cholesterol, triglycerides), compared to low-heat cooked foods (steamed, stewed) in a one-month trial (4). The high-heat diet also reduced serum levels of long-chain omega-3 fatty acids and vitamins C and E.
5. Dr. Katharina Nimptsch and colleagues showed that higher menaquinone (vitamin K2) intake is associated with a lower cancer incidence and lower cancer mortality in Europeans (5). Most of their K2 came from cheese.
6. And finally, Dr. Zhaoping Li and colleagues showed that cooking meat with an herb and spice blend reduced the levels of oxidized fat during cooking, and reduced serum and urinary markers of lipid oxidation in people eating the meat (6).
The take-home message? Eat stewed beef with herbs, but don't pre-brown it in vegetable oil. Throw out the tofu and have some artisanal cheese instead.
1. Dr. Neil D. Barnard reviews food consumption patterns in the US from 1909 to 2007 (1). This is something I've written about a number of times. The most notable change is that industrial seed oil use has increased by more than 3-fold in the last 40 years, and even more in the last 100 although he doesn't provide those numbers. Butter and lard use declined sharply. Meat consumption is up, but the increase comes exclusively from poultry because we're eating the same amount of red meat we always have. Grain consumption is down, although it peaked around 1900 so it may not be a fair comparison with today:
In the late 1800s, wheat flours became more popular and available due to the introduction of new [high-gluten] wheat varieties, [low extraction] milling techniques, and transport methods, and during this time new breakfast cereals were introduced by John Harvey Kellogg, CW Post, and the Quaker Oats Company. Thereafter, however, per capita availability of flour and cereal products gradually dropped as increased prosperity, improved mechanization, and transport (eg, refrigerated railway cars) increased competition from other food groups. [Then they partially rebounded in the last 40 years]2. Dr. S.C. Larsson published a paper showing that in Sweden, multivitamin use is associated with a slightly higher risk of breast cancer (2).
3. Soy protein and isoflavones, which have been proposed to do everything from increase bone mineral density to fight cancer, are slowly falling out of favor. Dr. Z.M. Liu and colleagues show that soy protein and/or isoflavone supplementation has no effect on insulin sensitivity or glucose tolerance in a 6 month trial (3). This follows a recent trial showing that isoflavones have no effect on bone mineral density.
4. Dr. Ines Birlouez-Aragon and colleagues showed that high-heat cooked (fried and sauteed) foods increase risk factors for diabetes and cardiovascular disease (insulin resistance, cholesterol, triglycerides), compared to low-heat cooked foods (steamed, stewed) in a one-month trial (4). The high-heat diet also reduced serum levels of long-chain omega-3 fatty acids and vitamins C and E.
5. Dr. Katharina Nimptsch and colleagues showed that higher menaquinone (vitamin K2) intake is associated with a lower cancer incidence and lower cancer mortality in Europeans (5). Most of their K2 came from cheese.
6. And finally, Dr. Zhaoping Li and colleagues showed that cooking meat with an herb and spice blend reduced the levels of oxidized fat during cooking, and reduced serum and urinary markers of lipid oxidation in people eating the meat (6).
The take-home message? Eat stewed beef with herbs, but don't pre-brown it in vegetable oil. Throw out the tofu and have some artisanal cheese instead.
wed march 24 2010
I can't sleep so I may as well blog. wah.
brekky: blended salad
lunch and dinner were eaten out
lunch: cabbage salad and kale with sweet potato sauce. I added a little apple to the sweet potato sauce and it was a winner.
dinner: big ole' salad with edamame and sesame-berry dressing.
My calories were kinda low so I had a little orange (1/2 small) and a carrot when I got home at 9:30 pm. I think I was hungry for it. I know when I'm really hungry, but otherwise I don't really know. So I guess I wasn't really hungry.
I'm running out of food and don't have time to go grocery shopping. I hope I can make it until Saturday morning with what I have. I'm stressed out about work and church stuff I guess, which is why I can't sleep. which of course will only make it worse tomorrow when I'm tired. Stress doesn't seem to have much useful about it. I try to fend it off most of the time but have not been succeeding lately.
Total calories today: 1379; protein 52 g (12%), carbs 224 (59%), fat 45 g (29%).
"processor salad"
I got this idea from "Carrots" on the Fuhrman forums. Carrots puts a whole bunch of raw veggies, fruit, and nuts in a food processor to make a more compact salad. I like chewing my greens, so I chopped my lettuce and spinach with a knife as usual, but I put the veggies through the food processor.
Ingredients:
lettuce and/or spinach, chopped
veggies of your choice (broccoli, cabbage, cauliflower, asparagus, bell peppers, kale, whatever you have around)
delicious dressing of some sort; e.g., sweet pea dressing or yummy berry dressing.
Put the chopped lettuce in a big bowl. Run the veggies through the food processor using the grater blade. Pour these on top of the lettuce. Pour tons of dressing on top. Spend the next 40 minutes eating it! Today, my veggies were broccoli, asparagus, and orange bell pepper. I used both green leaf lettuce and spinach.
Tues., Mar. 23, 2010
Brekky: blended salad, kiwi
Lunch: 2 servings of cabbage salad, plus a carrot and apple peels (from prepping the apples) while preparing. I added boiled peanuts to the cabbage salad and really liked them! Peanuts are actually a legume, so this will count as my beans today.
Dinner: Huge "processor salad" topped with huge portion sweet pea dressing. Boy was that satisfying. It took about 40 minutes to eat. That satisfied my love of eating too.
Total calories: 1500, protein 55 g (11%), carbs 276 g (66%), fat 37 g (22%).
New Review of Controlled Trials Replacing Saturated fat with Industrial Seed Oils
Readers Stanley and JBG just informed me of a new review paper by Dr. Dariush Mozaffarian and colleagues. Dr. Mozaffarian is one of the Harvard epidemiologists responsible for the Nurse's Health study. The authors claim that overall, the controlled trials show that replacing saturated fat with polyunsaturated fat from industrial seed oils, but not carbohydrate or monounsaturated fat (as in olive oil), slightly reduces the risk of having a heart attack:
So basically, even if the authors' conclusion were correct, you overhaul your whole diet and replace natural foods with bland unnatural foods, and...? You reduce your 10-year risk of having a heart attack from 10 percent to 9 percent. Without affecting your overall risk of dying! The paper states that the interventions didn't affect overall mortality at all. That's what they're talking about here. Sign me up!
* Autopsies were not conducted in a blinded manner. Physicians knew which hospital the cadavers came from, because autopsies were done on-site. There is some confusion about this point because the second paper states that physicians interpreted the autopsy reports in a blinded manner. But that doesn't make it blinded, since the autopsies weren't blinded. The patients were also not blinded, so the study overall was highly susceptible to bias.
** They refer to it as "cluster randomized". I don't know if that term accurately applies to the Finnish trial or not. The investigators definitely didn't randomize the individual patients: whichever hospital a person was being treated in, that's the food he/she ate. There were only two hospitals, so "cluster randomization" in this case would just refer to deciding which hospital got the intervention first. Can this accurately be called randomized?
These findings provide evidence that consuming PUFA in place of SFA reduces CHD events in RCTs [how do you like the acronyms?]. This suggests that rather than trying to lower PUFA consumption, a shift toward greater population PUFA consumption in place of SFA would significantly reduce rates of CHD.Looking at the studies they included in their analysis (and at those they excluded), it looks like they did a very nice job cherry picking. For example:
- They included the Finnish Mental Hospital trial, which is a terrible trial for a number of reasons. It wasn't randomized, appropriately controlled or even semi-blinded*. Thus, it doesn't fit the authors' stated inclusion criteria, but they included it in their analysis anyway**. Besides, the magnitude of the result has never been replicated by better trials, not even close.
- They included two trials that changed more than just the proportion of SFA to PUFA. For example, the Oslo Diet-heart trial replaced animal fat with seed oils, but also increased fruit, nut, vegetable and fish intake, while reducing trans fat margarine intake! The STARS trial increased both omega-6 and omega-3, reduced processed food intake, and increased fruit and vegetable intake! These obviously aren't controlled trials isolating the issue of dietary fat substitution. If you subtract the four inappropriate trials from their analysis, which is half the studies they analyzed, the result disappears. Those four just happened to show the largest reduction in heart attack mortality...
- They excluded the Rose et al. corn oil trial and the Sydney Diet-heart trial. Both found a large increase in total mortality from replacing animal fat with seed oils, and the Rose trial found a large increase in heart attack deaths (the Sydney trial didn't report CHD deaths, but Dr. Mozaffarian et al. stated in their paper that they contacted authors to obtain unpublished results. Why didn't they contact the authors of this study?).
So basically, even if the authors' conclusion were correct, you overhaul your whole diet and replace natural foods with bland unnatural foods, and...? You reduce your 10-year risk of having a heart attack from 10 percent to 9 percent. Without affecting your overall risk of dying! The paper states that the interventions didn't affect overall mortality at all. That's what they're talking about here. Sign me up!
* Autopsies were not conducted in a blinded manner. Physicians knew which hospital the cadavers came from, because autopsies were done on-site. There is some confusion about this point because the second paper states that physicians interpreted the autopsy reports in a blinded manner. But that doesn't make it blinded, since the autopsies weren't blinded. The patients were also not blinded, so the study overall was highly susceptible to bias.
** They refer to it as "cluster randomized". I don't know if that term accurately applies to the Finnish trial or not. The investigators definitely didn't randomize the individual patients: whichever hospital a person was being treated in, that's the food he/she ate. There were only two hospitals, so "cluster randomization" in this case would just refer to deciding which hospital got the intervention first. Can this accurately be called randomized?
Mon, March 22, 2010
I'm still trying to adjust my meals to my new schedule. I don't want a big lunch because my exercise class is at 4 pm. Then I end up not eating as many calories for brekky and lunch, and can only eat so much at dinner, so my overall caloric intake has been lower than I expected. Maybe I should eat more at breakfast--or just eat more nuts and seeds. But except for being pretty hungry by lunch and dinner, I haven't notice a problem with it. I'm quite full right now at 8:30 pm and yet, according to CRON-o-meter, I only ate 1352 calories today. I guess I'm pretty sedentary apart from my 2 hour bike ride/exercise class, and I'm almost 50 years old (whoopie!). Here's what I ate.
Brekky: blended salad
Lunch: veggies in turnip sauce. The veggies were brussels sprouts, cabbage, and shitake mushrooms. I cooked everything in the pressure cooker, then blended the turnip with lime juice (didn't have lemon), 1 Tbsp sesame seeds, and 1 Tbsp sunflower seeds, and poured it over the veggies. I made a similar dish for housemate using her more favorite veggies: peas, corn, brussels sprouts and carrots. I snacked on a carrot while preparing, and had a kiwi for dessert.
Dinner: big ole' chopped up salad (11 oz of greens! that's lettuce, romaine, and spinach) topped with bean soup. To the bean soup I added a sliced banana, 1 Tbsp chia seeds, 1 Tbsp shaved coconut, and 1/2 tsp curry powder. I call this my bean curry salad. It's quite good. You could use chopped apple and raisins instead of banana. I snacked on carrots, small apple, and 1/2 red bell pepper while preparing.
Total calories today: 1352, protein 56 g (13%), carbs 258 g (71%), fat 24g (16%).
Food log for Sun, Mar. 21, 2010
Brekky: blended salad.
Lunch: cabbage salad. This was just chopped cabbage, 1 apple, 1/4 cup raisins, 1 Tbsp sunflower seeds, and 1 Tbsp orange vinegar. I ate a big carrot while preparing. Cabbage and carrots are now the only local produce I get at my co-op.
This wasn't enough food to hold me until dinner, but that's all I wanted at the moment.
So then I was out and about and really hungry by dinner time. I was at a fancy reception and the food was not healthy-friendly. I find that the fancier the event, the harder it is to find scraps I can eat. At the lower-scale events, I can usually find some raw veggies or fruit that aren't stuffed or topped with some animal/oil/salt product. Then I went grocery shopping and finally got home to prepare my dinner salad.
Dinner was a yummy big salad of romaine, green leaf lettuce, and spinach, raw cauliflower, edamame, and blueberry-sesame dressing (a full batch!). In the dressing I replaced some of the orange juice with a kiwi. I ate a giant carrot while preparing the salad. I should have taken a picture before adding the dressing so you could see the ingredients better:
Then I added up my food totals and it was only 1100 calories! that's way too little. I thought, I feel full enough. But I don't want to wake up at 5 am hungry. So I made a little banana-cherry freeze dessert to split with housemate (1 frozen banana, 1 bag frozen sweet cherries, 1/4 cup grape juice). That was yummy but then I felt a little too full. Then I realized I forgot to add a bag of blueberries to the food log. Fortunately my total calorie intake was still reasonable. Normally I eat more but I didn't exercise much today. A lesson learned is to listen to my stomach more. I was satisfied after my dinner. However, I do dislike waking up at 5 am hungry.
Total calories: 1406, protein 42 g (9%), carbs 278 g (72%), fat 29 g (19%).
Beans!
I just ordered every type of bean from Rancho Gordo. They sell heirloom beans which are really good and creamy and don't take long to cook because they are fresh. I ordered 24 packages of beans at about $5 a piece. Now that is more than bulk beans at the local grocery store. But, the total cost including shipping is $127, and this will feed me for 6 months. Beans provide about 20% of my calories. So spending $127 for 20% of my calories for 6 months? Good deal!!!!!
Edited a week later, here's the shipment, minus the cannelloni beans that went to the kitchen for soaking:
Practice makes Perfect
Here is a post I made today on the Fuhrman forums expressing my view on learning, practicing and putting your stumbles into perspective:
Learning to be a nutritarian is like learning to play a music instrument or a sport--I mean really learning, not dabbling. When you are really learning a musical instrument, you practice every day. Practice consists of repeating exercises and songs over and over until to get it right. Making mistakes is expected---practicing over and over until you get it right is the solution. You don't apply moral judgments to yourself when you get the song wrong---rather, you expect to get it wrong until you practice enough to get it right. Now, the mistakes can be frustrating in both cases, but that's different from applying moral judgments to yourself. Anyway, my point is, as long as you are practicing daily and working to get it right, you are making progress! Each mistake should be thought of as a learning opportunity: how do I manage a similar situation next time? What you don't want to do is drop out for 3 months and go on an unhealthy food binge. In that case, just like if you don't practice your instrument for 3 months, not only do you not learn, you unlearn and have to relearn when you start up again. So if you blew it yesterday, you just need to keep practicing, like the rest of us. We're all practicing every day!
Gabriel's Oboe by Ennio Morricone
This is my muse for my sermon tomorrow. "...This grace was given, to preach to the Gentiles the unsearchable riches of Christ, and to bring to light for everyone what is the plan of the mystery hidden for ages in God who created all things, so that through the church the manifold wisdom of God might now be made known..." Eph 3:8,9.
Here's an extended trailer for the movie this soundtrack was written for, which also has a sampling of the music - profoundly stirring. If you haven't seen the movie, it's well worth renting/owning.
Here's an extended trailer for the movie this soundtrack was written for, which also has a sampling of the music - profoundly stirring. If you haven't seen the movie, it's well worth renting/owning.
Mar 20, 2010 food
Today was a Saturday and that means smoothie time, where I make a week's worth of smoothies for both me and housemate (that was 15 total today)! First I went to a yoga class, then stopped at the grocery store, where I also scored a 25-lb bag of juicing carrots in addition to all the smoothie ingredients. I just realized I go through about 10 lbs of carrots every week! 5 lbs goes to juice used in my bean soup, and I eat the other 5 lbs! My shopping cart looks pretty strange with all the bagged lettuce, oranges, and berries (and the 25-lb bag of carrots). Anyway, the good news about today is that I didn't overeat as much as I usually do while making these smoothies. I made a meal out of my snacking but I monitored it and even though I got pretty full, I didn't overeat, on calories anyway.
Brekky was a blended salad before yoga. This is low-calorie (there were no seeds in it) and I was hungry afterwards so I got a small handful of brazil nuts at the grocery store and ate them.
Lunch was snacking on smoothies and their ingredients (grapes and orange slices). I ate about 1/2 of a housemate smoothie and 1 of mine--from the leftovers. Next time I will use fewer oranges in mine so I have fewer leftovers. I also had 1/4 cup sweet peas.
Dinner was raw veggies (carrots, red bell pepper, broccoli, cauliflower, and celery) and sweet potato-kiwi dip.
Total calories: 1466, protein 37 g (8%), carbs 291 g (73%), fat 31 g (19%).
I didn't eat beans today (I usually have some every day), but it was still a healthy and enjoyable eating day.
sweet potato kiwi dip (with raw veggies)
I'm almost embarrassed to call this a recipe. This is just what you do with the few ingredients you happen to have on hand and you feel like a quick easy meal. But it was good!
Ingredients:
1 medium or 1/2 large sweet potato, baked (1 hour, 350 F), let cool
1 kiwi
1 Tbsp hemp or sunflower seeds, or 1/2 oz walnuts or other nut (or 1/4 cup boiled peanuts)
1 Tbsp lemon or lime juice, or flavored vinegar
1/4-1/2 cup water
Peel the sweet potato and kiwi (I eat the skins of both and like them!). Blend everything in a blender to desired dipping consistency. If you want more of a sauce to pour over steamed veggies or greens, add more water and maybe some pomegranate juice. Today I didn't use any nuts or seeds because I had plenty earlier in the day--it was still great. I ate this with raw carrots, red bell pepper, broccoli, cauliflower, and celery:
I'm curious to try a sweet potato banana dip sometime. You never know 'til you try it if it will be awful or great.
tracking my food intake, again..
A few days ago I started tracking my food again in the CRON-o-meter program. I'm trying to curb my overeating and the extra effort of measuring and logging my food seems to work. It also makes you realize when you are not overeating on calories but are just eating too much volume, so you need more high calorie food. And today it helped me gauge what to have for dinner after eating more than usual for lunch. I'd rather not have to do this, as it seems obsessive. But eating differently from everyone else in society has psychological effects and is I think the root cause of my overeating (e.g., wanting to have my own treats when I see other people eating their treats), so I need a tool to balance it.
Anyway, since I'm monitoring my food intake, I might start blogging it daily again like I used to, if I have time. I always thought this was the unique and possibly useful thing about my blog, to demonstrate by example what a "nutritarian" eats on a daily basis. Is it? Can you let me know? If so, I'll make an effort. Thanks!
Floppy Ears
I was reading an interesting article regarding some recent scientific studies that challenge what the mainstream believes about evolution. The article is interesting enough, but my take-away was this line:"...not every trait a creature possesses is necessarily adaptive. Some just come along for the ride: for example, genes that express as tameness in domesticated foxes and dogs also seem to express as floppy ears, for no evident reason."Probably the most adorable trait of my basset hound, and the one that has intrigued me the most is just that - his floppy ears. If size is an indicator of degree, basset hounds must be the most tame dogs out there. He is very playful and I have not seen any indicators of aggression, except towards a ball or rope.
But the other issue with his ears that has been floating through my mind is all the uses his ears seem to serve. Just to name a few:
- Sponges - no matter what he drinks, his ears seem to soak up at least half as much.
- Pillows - his ears are really soft and if I had two silky-soft bags hanging from each side of my head, I'd be napping just as much as he does.
- Eye covers - you know those mask-like things some people wear at night or on airplanes. Well, if he has laid his head on one ear, the other drapes over his eyes like one of those masks - very useful.
- Rakes - as he walks along and follows a scent with his nose, his ears seem to be raking up all the debris along side his head. Maybe that's the way he "kicks up" stuff to find what he's looking for.
Guest Commentary: Reforming health care, by any means necessary
Lane Slabaugh, PharmD, MBA
Pharmacoeconomics and Outcomes Research Fellow
Jefferson School of Population Health
The “Slaughter Strategy” being proposed by the Democratic leaders in the House as an alternative route for passing health care reform, (or in the words of House Speaker Pelosi, "kick it through the door”), is balancing on the fringe of illegitimacy. It reminds me of a bossy kid changing the rules in the middle of a game of tag because he is not winning. But the rules of a game of tag are always set on the fly; the rules written in our Constitution were set over 200 years ago. Article 1, Section 7 of the Constitution clearly outlines, in no uncertain terms, the steps that must be taken to pass a bill into law.
The “Slaughter Strategy”, otherwise known as the “deem-and-pass” rule, will effectively pass the Senate’s health care reform bill through the House without a true vote ever taking place. For a detailed explanation of this complicated process, follow this link.
President Obama is taking as safe a stance on this issue as is possible. In an interview on Wednesday, Mr. Obama was repeatedly asked to either defend or denounce the use of the Slaughter Strategy to pass health care reform. The President’s answer never drifted far from gray. “What I can tell you is that the vote that's taken in the House will be a vote for health care reform. And if people vote yes, whatever form that takes, that is going to be a vote for health care reform.”
Kicking this bill through could lead to an unpredictable loss of ownership down the road. Health care reform will reshape our country and it requires that there be sufficient supporters to help ensure that it is successful. Simply passing a bill will not make health care reform work. If Pelosi et al shove this bill through congress using this unconventional process, then when it comes time for its champions to put the rubber to the road we may be left with a car with only one tire.
Pharmacoeconomics and Outcomes Research Fellow
Jefferson School of Population Health
The “Slaughter Strategy” being proposed by the Democratic leaders in the House as an alternative route for passing health care reform, (or in the words of House Speaker Pelosi, "kick it through the door”), is balancing on the fringe of illegitimacy. It reminds me of a bossy kid changing the rules in the middle of a game of tag because he is not winning. But the rules of a game of tag are always set on the fly; the rules written in our Constitution were set over 200 years ago. Article 1, Section 7 of the Constitution clearly outlines, in no uncertain terms, the steps that must be taken to pass a bill into law.
The “Slaughter Strategy”, otherwise known as the “deem-and-pass” rule, will effectively pass the Senate’s health care reform bill through the House without a true vote ever taking place. For a detailed explanation of this complicated process, follow this link.
President Obama is taking as safe a stance on this issue as is possible. In an interview on Wednesday, Mr. Obama was repeatedly asked to either defend or denounce the use of the Slaughter Strategy to pass health care reform. The President’s answer never drifted far from gray. “What I can tell you is that the vote that's taken in the House will be a vote for health care reform. And if people vote yes, whatever form that takes, that is going to be a vote for health care reform.”
Kicking this bill through could lead to an unpredictable loss of ownership down the road. Health care reform will reshape our country and it requires that there be sufficient supporters to help ensure that it is successful. Simply passing a bill will not make health care reform work. If Pelosi et al shove this bill through congress using this unconventional process, then when it comes time for its champions to put the rubber to the road we may be left with a car with only one tire.
Theology Matters
I had the privilege of speaking at the Chi Alpha group on the campus of USM last week. I chose the topic of Doctrine and the importance of Loving the Lord your God with all... your mind - what Jesus said was the greatest commandment. I think it went well.
But today I came across this video trailer for a book call Dug Down Deep. It makes the case that we all should be theologians and I'm intrigued to read it. It fits well with the point of my presentation to Chi Alpha, and my thoughts in general on the subject.
But today I came across this video trailer for a book call Dug Down Deep. It makes the case that we all should be theologians and I'm intrigued to read it. It fits well with the point of my presentation to Chi Alpha, and my thoughts in general on the subject.
DugDownDeep_Carnahan.mov from Covenant Life Church on Vimeo.
Deep Conversations Make Us Happy
I have found this to be true in my own life, but now there's a study to support my own experience. I always have felt recharged after a long, personal conversation with a close friend. I guess I always just thought it was "just me", but it seems there's more to it than that. I think this is also why people still feel so isolated and lonely even with the increased, but shallow connectivity with today's technology. Real relationship doesn't happen over FB, Myspace, or Twitter. It happens over the phone, in a letter, or over coffee. According to the study:
"But, he proposed, substantive conversation seemed to hold the key to happiness for two main reasons: both because human beings are driven to find and create meaning in their lives, and because we are social animals who want and need to connect with other people."So this might actually imply you should sacrifice updating your FB status and pick up the phone instead, if you want to be happier.
Breakthrough Needle
For all you crafty people out there, this is a must-have. It's a brilliant modification to an age-old tool - the needle. 
Check out the link on Bits and Pieces.
Check out the link on Bits and Pieces.
this week's meals; curried salad recipe
Boy I have been busy since I got back from vacation. I changed my schedule around again so I can get more work done. It's working and so I haven't had much time to post. Now I work more in the morning and moved my exercise to the afternoon. So that affects my meal plans. I'm eating lighter brekky and lunches, and heavier dinner---more like the way most people eat. typical meals are:
Brekky: blended salad
lunch: cooked veggies (any kinds including tomatoes); or raw veggies and dip. I've been into my peanut-banana dip this week. today I had asparagus, cabbage, and tomatoes; and various seasonings (italian type). I need to add pine nuts to my grocery list. Ground pine nuts is good in this kind of dish. Tomorrow it will probably be raw veggies and peanut-banana dip for the second time. Friday I'm thinking collards with sweet potato sauce or sweet potato/peanut sauce (on the collards). I guess I'm into peanuts (limited amounts of course) this week.
dinner: big salad with beans or edamame, seeds (usually ground), and fruit, and a little flavored vinegar. basically kitchen sink salad. Tonight's was really good which is why I'm posting. It turned into a curry dish. I took my usual beans, which already have great flavor from the carrot juice and veggies blended in (this week was eggplant and onions); added 1 tsp curry powder, 2 Tbsp ground seeds (take your pick--today was sunflower and sesame), a chopped banana, and chopped grapes! This was really good. Curry is good with sweet fruit. I had this over a chopped head of lettuce. yummy!
These are all fast meals to prepare because I made the blended salads on the weekend and froze them; made the beans on the weekend and froze them into individual servings; and use the pressure cooker at lunch time to cook the veggies.
Book Review: The Primal Blueprint
Mark Sisson has been a central figure in the evolutionary health community since he began his weblog Mark's Daily Apple in 2006. He and his staff have been posting daily on his blog ever since. He has also written several other books, edited the Optimum Health newsletter, competed as a high-level endurance athlete, and served on the International Triathlon Union as the anti-doping chairman, all of which you can read about on his biography page. Mark is a practice-what-you-preach kind of guy, and if physical appearance means anything, he's on to something.
In 2009, Mark published his long-awaited book The Primal Blueprint. He self-published the book, which has advantages and disadvantages. The big advantage is that you aren't subject to the sometimes onerous demands of publishers, who attempt to maximize sales at Barnes and Noble. The front cover sports a simple picture of Mark, rather than a sunbaked swimsuit model, and the back cover offers no ridiculous claims of instant beauty and fat loss.
The drawback of self-publishing is it's more difficult to break into a wider market. That's why Mark has asked me to publish my review of his book today. He's trying to push it up in the Amazon.com rankings so that it gets a broader exposure. If you've been thinking about buying Mark's book, now is a good time to do it. If you order it from Amazon.com on March 17th, Mark is offering to sweeten the deal with some freebies on his site Mark's Daily Apple. Full disclosure: I'm not getting anything out of this, I'm simply mentioning it because I was reviewing Mark's book anyway and I thought some readers might enjoy it.
The Primal Blueprint is not a weight loss or diet book, it's a lifestyle program with an evolutionary slant. Mark uses the example of historical and contemporary hunter-gatherers as a model, and attempts to apply those lessons to life in the 21st century. He does it in a way that's empowering accessible to nearly everyone. To illustrate his points, he uses the example of an archetypal hunter-gatherer called Grok, and his 21st century mirror image, the Korg family.
The diet section will be familiar to anyone who has read about "paleolithic"-type diets. He advocates eating meats including organs, seafood, eggs, nuts, abundant vegetables, and fruit. He also suggests avoiding grains, legumes, dairy (although he's not very militant about this one), processed food in general, and reducing carbohydrate to less than 150 grams per day. I like his diet suggestions because they focus on real food. Mark is not a drill sergeant. He tries to create a plan that will be sustainable in the long run, by staying positive and allowing for cheats.
We part ways on the issue of carbohydrate. He suggests that eating more than 150 grams of carbohydrate per day leads to fat gain and disease, whereas I feel that position is untenable in light of what we know of non-industrial cultures (including some relatively high-carbohydrate hunter-gatherers). Although carbohydrate restriction (or at least wheat and sugar restriction) does have its place in treating obesity and metabolic dysfunction in modern populations, ultimately I don't think it's necessary for the prevention of those same problems, and it can even be counterproductive in some cases. Mark does acknowledge that refined carbohydrates are the main culprits.
The book's diet section also recommends nutritional supplements, including a multivitamin/mineral, antioxidant supplement, probiotics, protein powder and fish oil. I'm not a big proponent of supplementation. I'm also a bit of a hypocrite because I do take small doses of fish oil (when I haven't had seafood recently), and vitamin D in wintertime. But I can't get behind protein powders and antioxidant supplements.
Mark's suggestions for exercise, sun exposure, sleep and stress management make good sense to me. In a nutshell: do all three, but keep the exercise varied and don't overdo it. As a former high-level endurance athlete, he has a lot of credibility here. He puts everything in a format that's practical, accessible and empowering.
I think The Primal Blueprint is a useful book for a person who wants to maintain or improve her health. Although we disagree on the issue of carbohydrate, the diet and lifestyle advice is solid and will definitely be a vast improvement over what the average person is doing. The Primal Blueprint is not an academic book, nor does it attempt to be. It doesn't contain many references (although it does contain some), and it won't satisfy someone looking for an in-depth discussion of the scientific literature. However, it's perfect for someone who's getting started and needs guidance, or who simply wants a more comprehensive source than reading blog snippets. It would make a great gift for that family member or friend who's been asking how you stay in such good shape.
In 2009, Mark published his long-awaited book The Primal Blueprint. He self-published the book, which has advantages and disadvantages. The big advantage is that you aren't subject to the sometimes onerous demands of publishers, who attempt to maximize sales at Barnes and Noble. The front cover sports a simple picture of Mark, rather than a sunbaked swimsuit model, and the back cover offers no ridiculous claims of instant beauty and fat loss.
The drawback of self-publishing is it's more difficult to break into a wider market. That's why Mark has asked me to publish my review of his book today. He's trying to push it up in the Amazon.com rankings so that it gets a broader exposure. If you've been thinking about buying Mark's book, now is a good time to do it. If you order it from Amazon.com on March 17th, Mark is offering to sweeten the deal with some freebies on his site Mark's Daily Apple. Full disclosure: I'm not getting anything out of this, I'm simply mentioning it because I was reviewing Mark's book anyway and I thought some readers might enjoy it.
The Primal Blueprint is not a weight loss or diet book, it's a lifestyle program with an evolutionary slant. Mark uses the example of historical and contemporary hunter-gatherers as a model, and attempts to apply those lessons to life in the 21st century. He does it in a way that's empowering accessible to nearly everyone. To illustrate his points, he uses the example of an archetypal hunter-gatherer called Grok, and his 21st century mirror image, the Korg family.
The diet section will be familiar to anyone who has read about "paleolithic"-type diets. He advocates eating meats including organs, seafood, eggs, nuts, abundant vegetables, and fruit. He also suggests avoiding grains, legumes, dairy (although he's not very militant about this one), processed food in general, and reducing carbohydrate to less than 150 grams per day. I like his diet suggestions because they focus on real food. Mark is not a drill sergeant. He tries to create a plan that will be sustainable in the long run, by staying positive and allowing for cheats.
We part ways on the issue of carbohydrate. He suggests that eating more than 150 grams of carbohydrate per day leads to fat gain and disease, whereas I feel that position is untenable in light of what we know of non-industrial cultures (including some relatively high-carbohydrate hunter-gatherers). Although carbohydrate restriction (or at least wheat and sugar restriction) does have its place in treating obesity and metabolic dysfunction in modern populations, ultimately I don't think it's necessary for the prevention of those same problems, and it can even be counterproductive in some cases. Mark does acknowledge that refined carbohydrates are the main culprits.
The book's diet section also recommends nutritional supplements, including a multivitamin/mineral, antioxidant supplement, probiotics, protein powder and fish oil. I'm not a big proponent of supplementation. I'm also a bit of a hypocrite because I do take small doses of fish oil (when I haven't had seafood recently), and vitamin D in wintertime. But I can't get behind protein powders and antioxidant supplements.
Mark's suggestions for exercise, sun exposure, sleep and stress management make good sense to me. In a nutshell: do all three, but keep the exercise varied and don't overdo it. As a former high-level endurance athlete, he has a lot of credibility here. He puts everything in a format that's practical, accessible and empowering.
I think The Primal Blueprint is a useful book for a person who wants to maintain or improve her health. Although we disagree on the issue of carbohydrate, the diet and lifestyle advice is solid and will definitely be a vast improvement over what the average person is doing. The Primal Blueprint is not an academic book, nor does it attempt to be. It doesn't contain many references (although it does contain some), and it won't satisfy someone looking for an in-depth discussion of the scientific literature. However, it's perfect for someone who's getting started and needs guidance, or who simply wants a more comprehensive source than reading blog snippets. It would make a great gift for that family member or friend who's been asking how you stay in such good shape.
tropical fruits
For the last several days of our Florida trip, we stayed in Florida City and visited the Everglades. A highlight of this stay was our daily visit to the Robert is Here produce stand. Here's Robert serving up some customers:
They grow some exotic (to me anyway) tropical fruits that I tried out. My favorite was the Sapodilla:
You have to let it ripen (it gets soft) before eating it. Then it tastes really good! It was described to me as like a pear with brown sugar. That's a pretty good description. I ate one before it was ripe and it was awful, so you definitely have to let it ripen!
Next on the list was Canistel:
This you also have to let get really soft. It's described as like "sweet egg custard." The first time I tried it, it seemed weird. But the second time I really liked it. It doesn't take long for my taste buds to adapt to exotic tropical fruit!
Then there was the Carambola:
aka, star fruit, and you can see why. This is not so exotic, as I've seen it in my co-op. But it was much better here. I see now I'll have to let my co-op version ripen before eating it. It's described as tasting like a cross between an apple and an orange. I suppose. It's more tart. It's good.
The Asian guava was interesting:
You eat is kind of like an apple, with or without the skin. But once you get to the seeds, you stop. It's good hard or soft--a little sweeter soft. It's like a tart but sweet apple.
Then there was the ugli fruit:
peeled:
It's like a cross between an orange, grapefruit, lemon, and lime. Tart, but good and juicy. It's very ugly on the outside and that makes it fun.
And of course, there were the delicious tree-ripened oranges:
My favorites were the temple oranges.
And the grapefruit--I didn't take a picture of those.
And I also tried some passion fruit. It's extremely tart and strong, like very strong orange juice. It was good as a dip for raw sweet potato sticks.
I also tried some tamarind. It's very tart and sweet. I wasn't in the mood for it on its own, but it would be good in a dressing or dip.
Follow up on the Pennsylvania Budget
The Jefferson School of Population Health was very privileged to hear from key experts this past week during our monthly Health Policy Forum. The most recent posting on this blog by Kenneth Baithwaite,Senior Vice President of the Hospital And Healthsystem Association of Pennsylvania,summarizes the crisis we are facing. As our national leaders prepare to possibly pass some form of health reform, even this coming week, our state is facing a crisis all of its own. How will we pay for the care of the underinsured in the face of a mounting state deficit??One way out of the crisis, in my view, is to ensure that providers practice based on the evidence and that we pay them for good outcomes. If Medical Assistance in PA could turn into a savvy shopper for healthcare, this would save money and improve health care outcomes,at least in the short term. It would take some political courage but the Governor has an opportunity here to make a key policy decision to reduce waste, save money, and improve the health of the population. Bring Pay for Performance to Medical Assistance---that is in part the answer to the riddle. Stay tuned for more about the national scene just as soon as I see what is truly going to happen. What is your view about P4P for MA in PA??? DAVID NASH
Interview on Bizymoms
I recently did a written interview for the website Bizymoms.com. It was the first time I had been invited to do an interview, so I figured what the heck. They bravely posted the interview, despite the fact that my responses could be seen as controversial. You can find it here.
Sizing Up Sperm
OK, admittedly this is a little odd/iffy, but it's being done by National Geographic, so hopefully we can trust it won't be merely gratuitous. It airs Sunday March 14th. Here's the preview.
Guest Commentary: A Balancing Act - PA’s state budget and the health care safety net
Kenneth J. Braithwaite, II
Regional Executive, Delaware Valley Healthcare Council of HAP
Senior Vice President, The Hospital & Healthsystem Association of Pennsylvania
Lawmakers must reconcile the need to balance next year’s state budget with the growing demands being placed on Pennsylvania’s health care safety net. The long recession and slow, jobless recovery present legislators with a challenging conundrum. At the very time when more Pennsylvanians need more safety net services, the state has less revenue available to fund them.
The number of southeastern Pennsylvanians eligible for Medical Assistance, Pennsylvania’s Medicaid health insurance for low-income adults and families, has grown quickly – up 18 percent in the last two years to nearly 700,000 in 2009.
Another 76,000 in the region relied on state-subsidized adultBasic (for adults with incomes below 200 percent of the federal poverty level) and CHIP (Children’s Health Insurance Program) in 2009. An additional 67,000 were stuck on the adultBasic waiting list.
All told, the number of southeastern Pennsylvanians with safety net health insurance or no insurance now accounts for more than a quarter of the region’s population. This is a major problem statewide as well. In 14 counties, 20 percent or more of residents are covered by Medical Assistance.
Medical Assistance is chronically underfunded in the best of times, reimbursing hospitals on average just 82 percent of the cost of the care provided to beneficiaries.
In response to last year’s economic crisis, supplemental hospital Medical Assistance payments were cut 11 percent in the 2009-2010 state budget, even though the number of beneficiaries increased. These cuts came despite the fact that the federal government temporarily increased its share of funding for state Medicaid programs.
Governor Rendell’s proposed budget for 2010-2011 again cuts hospital Medical Assistance payments. In addition, the budget relies on more than $1.5 billion that may or may not materialize, pending government action such as the extension of enhanced federal funding for Medicaid and approval for proposed tolling on I-80.
Also of concern is the projected $525 million to $1 billion shortfall in this year’s budget, the result of lower-than-expected revenues from taxes and other fees.
This year, we must prevent funding gaps in the state budget from becoming new holes in Pennsylvania’s health care safety net. Although un- and under-insured patients and their health care providers bear the brunt of these cuts, we all pay the price. Providers must cover losses from safety net services with income from investments and payments from commercial insurers.
As a result of combined underfunding by Medical Assistance and Medicare, commercial insurers in Pennsylvania subsidize over $1 billion in hospital care*, increasing costs for everyone.
To follow the development of the state budget and its impact on health care, I invite you to go to www.careforpa.org and sign up to receive updates. You can also use the site to check on pending health care-related legislation and to contact state representatives on behalf of patients and providers.
I urge you, as health care professionals, consumers, and concerned citizens, to learn more about Pennsylvania's state budget and other issues shaping the delivery of health care services in this era of reform.
* Analysis of The American Hospital Association (AHA) Annual Survey data
Regional Executive, Delaware Valley Healthcare Council of HAP
Senior Vice President, The Hospital & Healthsystem Association of Pennsylvania
Lawmakers must reconcile the need to balance next year’s state budget with the growing demands being placed on Pennsylvania’s health care safety net. The long recession and slow, jobless recovery present legislators with a challenging conundrum. At the very time when more Pennsylvanians need more safety net services, the state has less revenue available to fund them.
The number of southeastern Pennsylvanians eligible for Medical Assistance, Pennsylvania’s Medicaid health insurance for low-income adults and families, has grown quickly – up 18 percent in the last two years to nearly 700,000 in 2009.
Another 76,000 in the region relied on state-subsidized adultBasic (for adults with incomes below 200 percent of the federal poverty level) and CHIP (Children’s Health Insurance Program) in 2009. An additional 67,000 were stuck on the adultBasic waiting list.
All told, the number of southeastern Pennsylvanians with safety net health insurance or no insurance now accounts for more than a quarter of the region’s population. This is a major problem statewide as well. In 14 counties, 20 percent or more of residents are covered by Medical Assistance.
Medical Assistance is chronically underfunded in the best of times, reimbursing hospitals on average just 82 percent of the cost of the care provided to beneficiaries.
In response to last year’s economic crisis, supplemental hospital Medical Assistance payments were cut 11 percent in the 2009-2010 state budget, even though the number of beneficiaries increased. These cuts came despite the fact that the federal government temporarily increased its share of funding for state Medicaid programs.
Governor Rendell’s proposed budget for 2010-2011 again cuts hospital Medical Assistance payments. In addition, the budget relies on more than $1.5 billion that may or may not materialize, pending government action such as the extension of enhanced federal funding for Medicaid and approval for proposed tolling on I-80.
Also of concern is the projected $525 million to $1 billion shortfall in this year’s budget, the result of lower-than-expected revenues from taxes and other fees.
This year, we must prevent funding gaps in the state budget from becoming new holes in Pennsylvania’s health care safety net. Although un- and under-insured patients and their health care providers bear the brunt of these cuts, we all pay the price. Providers must cover losses from safety net services with income from investments and payments from commercial insurers.
As a result of combined underfunding by Medical Assistance and Medicare, commercial insurers in Pennsylvania subsidize over $1 billion in hospital care*, increasing costs for everyone.
To follow the development of the state budget and its impact on health care, I invite you to go to www.careforpa.org and sign up to receive updates. You can also use the site to check on pending health care-related legislation and to contact state representatives on behalf of patients and providers.
I urge you, as health care professionals, consumers, and concerned citizens, to learn more about Pennsylvania's state budget and other issues shaping the delivery of health care services in this era of reform.
* Analysis of The American Hospital Association (AHA) Annual Survey data
NASA Temps No Good
Here is another bit-o-info regarding global warming data that supports how "concensus" was found - merely copying by NASA from CRU. It really is sad, truly sad, that this is the state of our best and brightest institutions which the rest of us are counting on to understand the planet's temperatures.
"There are only four climate datasets available. All global warming study, such as the reports from the UN Intergovernmental Panel on Climate Change (IPCC), must be based on these four.
They are: the NASA GISS dataset, the NCDC GHCN dataset, the CRU dataset, and the Japan Meteorological Agency dataset.
Following Climategate, when it became known that raw temperature data for CRU’s “HADCRU3″ climate dataset had been destroyed, Phil Jones, CRU’s former director, said the data loss was not important — because there were other independent climate datasets available.
But the emails reveal that at least three of the four datasets were not independent, that NASA GISS was not considered to be accurate, and that these quality issues were known to both top climate scientists and to the mainstream press."
A False Dichotomy
In the discussion section of the last post, the eternal argument about non-industrial people arose: were their lives (a) "nasty, brutish and short" (Hobbes), or were they (b) "noble savages" (Shaftesbury) living in Eden? The former argument states that they had awful lives, and we should be glad we're living int he 21st century. The latter argument implies that we should emulate them as much as possible. Each side is bursting with anecdotes to support their position.
Any time the discussion reaches this point, it stops providing us anything useful. The argument is a false dichotomy, one in which neither answer is correct. The correct answer is (c): none of the above. Some aspects of hunter-gatherer life are preferable to ours, and some aspects of our lives are preferable to theirs. Understanding that we spent a lot of evolutionary time as hunter-gatherers, as well as a few thousand years in small, tightly knit agricultural communities, may be useful in understanding how to work constructively with our own bodies and minds in the modern world.
So please, let's leave behind the false dichotomy and foster a more nuanced understanding of hunter-gatherer life.
Any time the discussion reaches this point, it stops providing us anything useful. The argument is a false dichotomy, one in which neither answer is correct. The correct answer is (c): none of the above. Some aspects of hunter-gatherer life are preferable to ours, and some aspects of our lives are preferable to theirs. Understanding that we spent a lot of evolutionary time as hunter-gatherers, as well as a few thousand years in small, tightly knit agricultural communities, may be useful in understanding how to work constructively with our own bodies and minds in the modern world.
So please, let's leave behind the false dichotomy and foster a more nuanced understanding of hunter-gatherer life.
10 Questions to Ask a Pastor - R.C. Sproul Jr.
Here is a great post that is worth thinking about. Just reading the title, I thought it might be for finding a church and what lay persons would ask of their potential pastor. But it is more for search committees to interview pastors. Regardless, if you ever did have a chance just to ask any pastor these questions you might learn a lot about his values/priorities in ministry. Sproul does actually offer an answer to these questions, which is also encouraging to read.
Racial Sensitivity for Walmart?
It's not what you think. Admittedly, I am white and may not be able to truly understand the issue from a minority perspective, but this is really taking things too far for me. This is retail - it's business. This really has nothing to do with race! But this is about as silly to me as telling teachers they will psychologically harm children by using red ink to grade papers. A few excerpts:
"The implication of the lowering of the price is that's devaluing the black doll," said Thelma Dye, the executive director of the Northside Center for Child Development, a Harlem, N.Y. organization founded by pioneering psychologists and segregation researchers Kenneth B. Clark and Marnie Phipps Clark.... Walmart could have decided "that it's really important that we as a company don't send a message that we value blackness less than whiteness," said Lisa Wade, an assistant sociology professor at Occidental College in Los Angeles and the founder of the blog Sociological Images.
The End of ... Barack Obama
Here is a scathing article about the situation of America under B.O., mostly filled with statistics. The conclusion:
The slickness of campaigning that comes from a combination of heavy funding and public relations expertise does not inevitably translate into an ability to govern. There is no point a nation's having the audacity of hope unless it also has the sophistication and the will to turn it into action. As things stand, Barack Obama and America under his leadership do not.
The Paleolithic Mind
I went to a meditation retreat this week with the Red Cedar Zen community in Bellingham. It was a good experience. Staring at a wall from 6 am to 9 pm for a few days gives you the opportunity to learn a few things about your mind. Some of these are things you already know on some level, but you just need to have them reinforced. For example, the weight of psychological stress that we carry in modern societies like the US. It's only when it goes away for a while that you can see how heavy it was.
I'm totally ignorant of the scientific literature on this, but the way I see it, there are at least two main sources of psychological stress in the modern world for which we aren't well equipped as human beings:
The author says this about their possessions:
Unfortunately, we have more than just possessions on our minds. To live in the modern world is to be pricked to death by a thousand small responsibilities. Remember to make your lunch. Remember to make a doctor's appointment, shop for groceries, tie your shoes, get your oil changed, send that e-mail, make dinner, go for a jog, vacuum the floor, take a shower, pick up the kids-- the list is endless. Are our memories as defective as we think they are, or are we simply not designed to keep track of so many details?
In hunter-gatherer times, we had stress. Homicide, accidents, infectious disease and predation were always stalking us. But it was a totally different kind of stress-- it was occasional, powerful and brief rather than a constant flow of obligations clogging the paths of our minds. Most days were leisurely, with plenty of time for gossiping, staring at the clouds and dozing off.
Those times are gone for us, but perhaps keeping them in mind can help us live more constructively in the modern world. I find that meditation helps keep the thousand pricks of modern life in perspective, perhaps bringing my mind closer to the paleolithic state.
I'm totally ignorant of the scientific literature on this, but the way I see it, there are at least two main sources of psychological stress in the modern world for which we aren't well equipped as human beings:
- Being eternally and inescapably subordinate in a large social structure
- Having too many responsibilities such as possessions and obligations
The Hadza do not engage in warfare [although they do have homicide]. They've never lived densely enough to be seriously threatened by an infectious outbreak. They have no known history of famine; rather, there is evidence of people from a farming group coming to live with them during a time of crop failure. The Hadza diet remains even today more stable and varied than that of most of the world's citizens. They enjoy an extraordinary amount of leisure time. Anthropologists have estimated that they "work"—actively pursue food—four to six hours a day. And over all these thousands of years, they've left hardly more than a footprint on the land.This isn't intended to idealize their lifestyle, but to point out that being a hunter-gatherer has its advantages. One of these is a minimal social structure in which each person is has full authority over himself:
The Hadza recognize no official leaders. Camps are traditionally named after a senior male (hence, Onwas's camp), but this honor does not confer any particular power. Individual autonomy is the hallmark of the Hadza. No Hadza adult has authority over any other. None has more wealth; or, rather, they all have no wealth. There are few social obligations—no birthdays, no religious holidays, no anniversaries.Even "marriage" doesn't carry much obligation. The author describes the Hadza as "serial monogamists". The idea of an eternal bond between two individuals doesn't exist. Women are not subordinate to men:
Gender roles are distinct, but for women there is none of the forced subservience knit into many other cultures. A significant number of Hadza women who marry out of the group soon return, unwilling to accept bullying treatment. Among the Hadza, women are frequently the ones who initiate a breakup—woe to the man who proves himself an incompetent hunter or treats his wife poorly. In Onwas's camp, some of the loudest, brashest members were women.Contrast this with modern civilizations in which everyone has a boss-- whether it's at a job, in a marriage or under your country's legal system. I think this feeling of perpetual subordination is destructive to an animal such as ourselves, that has spent so much of its existence mostly free of these pressures.
The author says this about their possessions:
Traditional Hadza, like Onwas and his camp mates, live almost entirely free of possessions. The things they own—a cooking pot, a water container, an ax—can be wrapped in a blanket and carried over a shoulder.This resembles other African hunter-gatherer groups that have few and simple tools. From the book The !Kung San: Men, Women and Work in a Foraging Society:
!Kung tools are few in number, lightweight, made from locally available materials, and multipurpose.Again, this is in sharp contrast to the modern world, where we have so many belongings it's impossible to keep track of them all. We have giant houses that we "need" to store all these things, and still it doesn't seem like enough. Many of our possessions are indispensable if we want to fit in to society. We need (or feel we need) clothes, cookware, identification, money, transportation, furniture, tools, sports gear, et cetera. Having to be responsible for this extraordinary quantity of possessions (by evolutionary standards) is a heavy weight on our minds.
Unfortunately, we have more than just possessions on our minds. To live in the modern world is to be pricked to death by a thousand small responsibilities. Remember to make your lunch. Remember to make a doctor's appointment, shop for groceries, tie your shoes, get your oil changed, send that e-mail, make dinner, go for a jog, vacuum the floor, take a shower, pick up the kids-- the list is endless. Are our memories as defective as we think they are, or are we simply not designed to keep track of so many details?
In hunter-gatherer times, we had stress. Homicide, accidents, infectious disease and predation were always stalking us. But it was a totally different kind of stress-- it was occasional, powerful and brief rather than a constant flow of obligations clogging the paths of our minds. Most days were leisurely, with plenty of time for gossiping, staring at the clouds and dozing off.
Those times are gone for us, but perhaps keeping them in mind can help us live more constructively in the modern world. I find that meditation helps keep the thousand pricks of modern life in perspective, perhaps bringing my mind closer to the paleolithic state.
Florida salad
I'm visiting the Florida Everglades. There's a great produce/fruit stand near my hotel, called "Robert is Here." They have locally grown vegetables and fruit. So that is supplying me with my meals. Here's today's salads (lunch and dinner):
The bottom layer is romaine lettuce, locally grown spinach, green beans, zucchini, and broccoli. Yum! Then I quartered a couple of fresh tree-ripened oranges, and squeezed the juice on here to marinate the salad and veggies. I age the rest of the oranges after squeezing (it was breakfast time). 
Next I added some beans and my ground seed mixture (sunflower, hemp, chia, flax). I ate some beans and seeds too to add to my breakfast.
Then I added the fruit: ripe banana, mango and local strawberries. yummy yummy. I forgot to take a picture of the final product.
Here I am eating lunch.
I also had a locally grown ugli fruit before dinner. It was really good. And it is extremely ugly. Don't let that deter you.
Wii Fit Parady
Here is a funny video/commercial for a Wii Fit. It's my kind of exercise. I particularly like the "Ikea" comment.
HT B&P
HT B&P
Understanding Culture
Here is an interview with Ken Myers regarding Christianity and culture.
Interview with Ken Myers from Southeastern Seminary on Vimeo.
HT BTWGuest Commentary: Minimizing Risk with REMS – Time to Measure Results
Mike Toscani, PharmD
Project Director
Jefferson School of Population Health
REMS (Risk Evaluation and Mitigation Strategies) is one of the latest initiatives used by the FDA to minimize risks associated with biopharmaceuticals (prescription drugs and biologic products).
Historically, many drug safety issues have led to changes in FDA policy. In 2007, the FDA enacted the REMS and post-marketing study (PMS) requirements that are now in place. This act took the use of RiskMaps to a higher and more enforceable level with sponsors to help ensure drug safety and ongoing pharmacovigilance.
Now, the FDA may require biopharmaceutical sponsors to develop a REMS program prior to marketing approval or may require one based on post-marketing safety information. For select products, a REMS program could include a patient medication guide, a patient package insert, or a targeted communication plan for healthcare providers that could involve educational programs, letters, and other initiatives to encourage the safe use of these medications.
If a more serious risk exists, the sponsor may be required to provide elements to assure safe use (ETASU), which might include: restricting the use of the product via distribution channels, specialized training, a certification program for healthcare providers, pharmacies, facilities, attestations to assure proper patient selection, active patient monitoring, and registry programs. In addition to REMS, the FDA may require the sponsor to conduct PMS trials following approval.
Currently, there are over 80 drugs and biologics with approved REMS programs. Most of these only require a medication guide, but some require a communication plan, while others require an additional ETASU implementation system. In addition to the incremental costs, there is concern that having REMS programs that are too cumbersome to initiate for providers and patients could lead to the use of other less effective products.
Data describing the ability of these programs to directly impact reducing risk has been lagging. There is a strong need to conduct ongoing outcome studies to evaluate the effectiveness of these programs at reducing risk and measuring the potential for under use of these products by healthcare providers for patients who could likely benefit from them.
Project Director
Jefferson School of Population Health
REMS (Risk Evaluation and Mitigation Strategies) is one of the latest initiatives used by the FDA to minimize risks associated with biopharmaceuticals (prescription drugs and biologic products).
Historically, many drug safety issues have led to changes in FDA policy. In 2007, the FDA enacted the REMS and post-marketing study (PMS) requirements that are now in place. This act took the use of RiskMaps to a higher and more enforceable level with sponsors to help ensure drug safety and ongoing pharmacovigilance.
Now, the FDA may require biopharmaceutical sponsors to develop a REMS program prior to marketing approval or may require one based on post-marketing safety information. For select products, a REMS program could include a patient medication guide, a patient package insert, or a targeted communication plan for healthcare providers that could involve educational programs, letters, and other initiatives to encourage the safe use of these medications.
If a more serious risk exists, the sponsor may be required to provide elements to assure safe use (ETASU), which might include: restricting the use of the product via distribution channels, specialized training, a certification program for healthcare providers, pharmacies, facilities, attestations to assure proper patient selection, active patient monitoring, and registry programs. In addition to REMS, the FDA may require the sponsor to conduct PMS trials following approval.
Currently, there are over 80 drugs and biologics with approved REMS programs. Most of these only require a medication guide, but some require a communication plan, while others require an additional ETASU implementation system. In addition to the incremental costs, there is concern that having REMS programs that are too cumbersome to initiate for providers and patients could lead to the use of other less effective products.
Data describing the ability of these programs to directly impact reducing risk has been lagging. There is a strong need to conduct ongoing outcome studies to evaluate the effectiveness of these programs at reducing risk and measuring the potential for under use of these products by healthcare providers for patients who could likely benefit from them.
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