Category for health

Low fat, saturated fat, and sugar: the confusion continues

This month two reputable doctors, horrified by the rise in bariatric surgeries to reduce the harms associated with diabetes, published an op-ed on the front page of the Sunday Review of the NYTimes sharply suggesting that we’re doing it all wrong with it comes to medical measures recommended for diabetics.

Most doctors — and the diabetes associations — portray diabetes as an incurable disease, presaging a steady decline that may include kidney failure, amputations and blindness, as well as life-threatening heart attacks and stroke. Yet the literature on low-carbohydrate intervention for diabetes tells another story. For instance, a two-week study of 10 obese patients with Type 2 diabetes found that their glucose levels normalized and insulin sensitivity was improved by 75 percent after they went on a low-carb diet.

At our obesity clinics, we’ve seen hundreds of patients who, after cutting down on carbohydrates, lose weight and get off their medications. One patient in his 50s was a brick worker so impaired by diabetes that he had retired from his job. He came to see one of us last winter, 100 pounds overweight and panicking. He’d been taking insulin prescribed by a doctor who said he would need to take it for the rest of his life. Yet even with insurance coverage, his drugs cost hundreds of dollars a month, which he knew he couldn’t afford, any more than he could bariatric surgery.

Instead, we advised him to stop eating most of his meals out of boxes packed with processed flour and grains, replacing them with meat, eggs, nuts and even butter. Within five months, his blood-sugar levels had normalized, and he was back to working part-time. Today, he no longer needs to take insulin.

The paper ran a follow-up story by one of its best medical reporters, Gina Kolata, that cast some doubt on the simplicity of this recommendation.

But there are no large and rigorous studies showing that low-carbohydrate diets offer an advantage, and, in fact, there is not even a consensus on the definition of a low-carbohydrate diet — it can vary from doctor to doctor.

“There have been debates for literally the whole history of diabetes about which kind of diet is best,” said Dr. C. Ronald Kahn, chief academic officer at Joslin, and no relation to Dr. Richard Kahn. But, he said, “the answer isn’t so straightforward.”

The diet question arose again in the public discourse with the revelation last week that the sugar industry (the Sugar Foundation) backed a study way back in the 1960’s that shifted blame for heart disease from sugar — which is where the evidence was pointing at the time – to saturated fat.

The sugar industry paid scientists in the 1960s to play down the link between sugar and heart disease and promote saturated fat as the culprit instead, newly released historical documents show.

The internal sugar industry documents, recently discovered by a researcher at the University of California, San Francisco, and published Monday in JAMA Internal Medicine, suggest that five decades of research into the role of nutrition and heart disease, including many of today’s dietary recommendations, may have been largely shaped by the sugar industry.

“They were able to derail the discussion about sugar for decades,” said Stanton Glantz, a professor of medicine at U.C.S.F. and an author of the JAMA Internal Medicine paper.

It’s now the medical consensus that processed foods — which typically include unnecessarily added sugar — worsen heart disease. But it’s easy to overlook the fact that — then and now — researchers also suspect that saturated fat worsens heart disease. Saturated fat vs fat overall was an issue I wrote about a couple of years ago: although unsaturated fats, such as the olive oil that is at the heart of the Mediterranean diet, are considered healthy, the saturated fats found in butter, meat, and cheese do not get off so easily.

As NPR said, discussing the sugar study from the l960’s:

The review minimized the significance of research that suggested sugar could play a role in coronary heart disease. In some cases the scientists alleged investigator incompetence or flawed methodology.

“It is always appropriate to question the validity of individual studies,” [JAMA author] Kearns told Bloomberg via email. But, she says, “the authors applied a different standard” to different studies — looking very critically at research that implicated sugar, and ignoring problems with studies that found dangers in fat.

Exactly. As Dr. David Katz, editor of Childhood Obesity, and a professor at Yale, put it in a Forbes column:

Almost everyone who ultimately winds up considering bariatric surgery has tried every diet under the sun. When you recall that some of the most popular diets of recent years, from Atkins to South Beach, have been “low-carb,” the notion that this is the road too seldom taken can only be proffered by those lost in the woods.

A low-carb diet has certainly been among the attempts made by almost every patient I have ever referred for bariatric surgery, helped to find an alternative to it or treated after. Low-carb diets work in the short term like almost every other diet, and generally fail over time like every other diet for just about everybody.

Katz writes unusually sharply for a doctor:

As I noted recently, there is a booming cottage industry now, amplified at every turn by those directly interested in selling beef and perhaps butter, in peddling the notion that saturated fat has not only been exonerated of all ills (it has not), but is actually good for us now (but for biochemical nuance, this is plain baloney).

The problem with “the sugar did it!” is that we tend to process such revelations as an endless sequence of either/or choices: it was either sugar or saturated fat. That’s perilously silly.

Leaving aside the truly devastating environmental implications of encouraging moremeat intake by nearly 8 billion Homo sapiens at a time of climate change, desiccating aquifers, deforestation and biodiversity itself on the endangered list–there is the simple fact that dietary patterns reliably associated with good health outcomes across study methods, global populations and decades are high neither in sugar nor in saturated fat. They are, instead, high in wholesome foods, mostly plants–every time.

Or, as HL Mencken put it:

There is always a well-known solution for every problem — neat, plausible, and wrong. 

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Be grateful, but stay away from the Permagrin

In the NYTimes, the estimable Arthur Brooks — the rare research-oriented conservative writer — makes a case for expressing gratitude this season, even if we do not feel it.

This Thanksgiving, don’t express gratitude only when you feel it. Give thanks especially when you don’t feel it. Rebel against the emotional “authenticity” that holds you back from your bliss. As for me, I am taking my own advice and updating my gratitude list. It includes my family, faith, friends and work. But also the dappled complexion of my bread-packed bird. And it includes you, for reading this column.

That’s the conclusion of the column. Does that mean that inauthenticity is central to the conservative movement, if the President and thought leader of the American Enterprise Institute is calling for more of it?

Weird thought. Sorry. Anyhow.

Here’s another angle on a similar question. According to a wonderful story in Marketplace called Don’t Worry Be Happy or Else You’re Fired, the forced cheer one sees in retail sales has an emotional cost.

Cara O’Regan’s former job will probably sound pretty familiar to a lot of people. “We were encouraged to be positive and put a positive spin on things whenever possible,” she said.  O’Regan worked in retail sales. [edit] She faked a positive attitude to do her job. More accurately, faking it was her job. “You know, always with a smile on your face — a lot of clapping involved,” she said. “Clapping for the customers, clapping for our co-workers — any excuse to applaud anyone.”

There’s a term for this kind of faking it: emotional labor.

“Emotional labor,” according to Alicia Grandey, professor of industrial organizational psychology at Penn State University, “is a type of work where instead of physical labor where you’re using your muscles to perform the work, you’re using your emotions to perform the work.”

What’s the difference between these two states of inauthenticity? In one case the inauthenticity is bought and paid for, in the other it’s chosen.

Yet the first is said to make for bliss, and the second for disease.

Grandey has done research suggesting faking happiness all day long is emotionally taxing. Faking it, she argues, creates a sense of dissonance between internal and external states over long periods of time “and that’s been shown to create physical tension which can build up and create health issues, and over time result in job burnout.”

Brooks quotes neuroscience, which is a much weaker evidence than it might appear, while Grandey’s research looks at bodily questions through a social science lens.

Neither story uses the wonderful word I have often heard attached to “emotional labor” — the Permagrin (TM). Maybe it’s time for scientists to look at the question through that lens.


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The John Muir Way — now in Scotland too

Mark Grossi, a California reporter of long standing, recently retired, and his paper republished some of his best work, notably this recounting of a stretch on the John Muir Trail, walked in memory of Gross’s late father.

Speaking of John Muir, recently a wonderful story in the Wall Street Journal described a new trail through Scotland in honor of this great immigrant American hero.

Here in his homeland, however, Mr. Muir remains surprisingly little-known. Until recently there was not much to mark his memory apart from this statue and the small, white, pebble-dashed house across the road, where he was born in 1838 and which today houses the John Muir’s Birthplace museum.

Last year, Scotland inaugurated the John Muir Way, a new walking route that traverses the country west-to-east for 134 miles between the Firth of Forth and the Firth of Clyde. It was conceived both to resurrect Mr. Muir in the Scottish consciousness and, as environmentalist Keith Geddes, one of the Way’s architects, explained, to “help today’s young Scots develop a relationship with the countryside around them.”

The trail takes a few days, and has industrial and architectural parts as well as wild parts. But walking on past Loch Lomond, the first and most famous of Scottish national parks, Henry Wismayer finds a certain peace.

Throughout the afternoon we rarely saw another walker. And if we looked in the right direction at the right moment even here, 30 miles from Glasgow, we could glimpse the pre-human innocence Mr. Muir coveted, away from what he called the “tyranny of man.”

Perhaps, I thought, as we rolled down toward the Way’s end in coastal Helensburgh, the intrepid nature-lover, who described himself as “hopelessly and forever a mountaineer,” might have selected a trickier route through these hills.

But accessibility is what the Way is all about: coaxing people to dust off their boots, pack a bag and set out to explore the many colors of Scotland’s coastline and countryside. And that is no doubt a mission that Mr. Muir would have commended.

From the story, here’s a new statue of Muir stood up in his hometown, ancient Dunbar.


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Did avoiding fats make our obesity problem worse?

Could the misunderstanding about fat have made the American problem with obesity worse?

That’s the understated implication — or an implication — of the latest version of the medical consensus on fats in the bloodstream, as defined by Frank Hu, head of Harvard’s School of Public Health, in a story by Jane Brody in the NYTimes with a clunky headline.

To quote::

Experts now realize that efforts to correct past dietary sins that made heart disease and stroke runaway killers have caused the pendulum to swing too far in the wrong direction.

“The mistake made in earlier dietary guidelines was an emphasis on low-fat without emphasizing the quality of carbohydrates, creating the impression that all fats are bad and all carbs are good,” Dr. [Frank] Hu, a professor of nutrition and epidemiology [at Harvard’s School of Public Health], said. “It’s really important to distinguish between healthy fats and bad fats, healthy carbs and bad carbs.”

But half-buried in this thoughtful framing of a complex question remains a fundamental truth. Saturated fat — butter, meat, and cheese — is dangerous to your health. .

To quote Hu — who has led huge studies of this issue — again:

He explained that saturated fat, found in fatty animal foods like meats and dairy products, raises blood levels of cholesterol and is not healthy,

What follows is a discussion of alternatives, and the alternatives are worthy and great in fact, but having written a contrarian story about another misunderstanding of medical research into fats a year ago , may I say I feel vindicated in listening to and focusing on the work of researchers such as Hu and David Katz, of Yale and the journal Childhood Obesity, who continue to warn that saturated fat is not your friend.

Butter curl

Butter curl


No matter how pretty.

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Ventura County: Highest pesticide use in California

Spectacular story for The Food and Environment Network, published in The Nation, by Liza Gross.

For Ventura County and Oxnard, here's the nut of it: 

Use of many of these sixty-six pesticides has fallen statewide since 2007. But a handful of communities saw a dramatic increase. By 2012, the most recent year for which data is available, more than 29 million pounds of these chemicals—more than half the total used in the state—were applied in just 5 percent of California’s 1,769 census ZIP codes, according to an independent investigation by this reporter. In two ZIP codes that Zuñiga knows well—areas that include the Oxnard High neighborhood where she trained and south Oxnard, where she lives—applications of these especially toxic pesticides, which were already among the highest in the state, rose between 61 percent and 84 percent from 2007 t0 2012, records at the California Department of Pesticide Regulation show. Both are among the ten ZIP codes with the most intensive use of these pesticides in California. And both have sizable Latino populations—around 70 percent—thanks, in part, to the large number of farm jobs in the area. The great majority of the people who work in the strawberry fields in Oxnard, which hosts the largest population of farmworkers in Ventura County, come from Mexico.


Read the whole thing. It's not that long. Really, give it a chance.

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GOP: Party of Big Pizza — and obesity?

Last year at this time I started working on a story about childhood obesity in a couple of small towns in Ventura County, and how different the picture looked in an upscale, mostly white town such as Ojai, where childhood obesity runs behind the national average of about 35%, and how it looks in the poorer, mostly Latino town of Santa Paula, where childhood obesity prevalence is among the highest in the state, at about 48%.

Interviewing the director of food services for Ojai's schools, I learned that she does not allow frozen pizza at all for her students eating school lunches, and did what she could to discourage parents from bringing pizza to after-school events. By contrast, I heard from a student at Santa Paula High, most students went for the frozen pizza at the high school every day.

Naturally I wondered if there was a connection to the high rates of obesity, but my adviser at USC/Annenberg's Health Reporting fellowship, discouraged me pointing the finger of blame at a single food for Santa Paula's obesity problem. 

So my ears perked up when today I came across a characteristically strong but unusually wide-ranging column from Paul Krugman at the NYTimes, who argues that based on contributions, it's fair to say that Republicans are "the party of Big Energy and Big Food…and in particular, the party of Big Pizza."

Could caloric frozen pizza explain the obesity problem among kids eating free and reduced lunches?

Krugman pointed to a great story in Bloomberg Business, with some potent graphics, which show that big pizza companies — both retail and school food companies — give crazy amounts of money to the GOP, and almost nothing to the Democrats. To wit: 


It's startling. And it made me wonder again about the contribution of pizza towards obesity, especially after discovering that frozen pizza was trying to get credit as a vegetable for its tomato sauce, which seemed (to put it politely) a stretch (and not just to me):

Under the existing rules, tomato paste is given extra credit toward a vegetable serving because it's made of concentrated tomatoes. So 2 tablespoons of tomato paste — roughly the amount on a slice of pizza — is counted as a half a cup, or the equivalent of one vegetable serving. For school lunch purposes, a slice of pizza was considered a serving of vegetables, a point first made by [nutrition advocate] Wootan in 2011 that became a late-night punchline. The Department of Agriculture’s new rules, though, would have stopped giving tomato paste extra credit: From now on, 2 tablespoons would count as 2 tablespoons. Kraig Naasz, CEO of the American Frozen Food Institute, a trade group that lobbies for frozen pizza, says the tomato paste rule was simply a crafty way to get pizza out of schools: “None of our members wanted the federal government to say, ‘Pizza is bad for you.’ You would have been telling an entire generation that pizza is a food you shouldn’t consume.”

Back at his desk, Krugman wondered about an association between GOP dominated states and obesity, and finds, according to a CDC plot, that the answer is yes — even if you look only at obesity among non-Hispanic white people, the "diabetes belt" of the nation tends to be Southern and conservative politically.


But my advisor Martha Shirk in turn argued that pizza in the schools has changed in recent years, and I didn't have the "smoking gun" kind of evidence to make that accusation. The validity of her point can be seen in a letter from a second-grader in Louisiana this past week, very much in the "diabetes belt," who complained to the First Lady, who famously led the charge for better foods and more activity in schools.

Trip Kilbert complained in his letter that the new pizza, made of whole grains, was "terrible." First Lady Michelle Obama wrote back and sent consolation and some pictures, but wouldn't change the menu.

Leaping to a conclusion: if a second-grader doesn't like the whole grain frozen pizza, maybe it's not as obesogenic as it used to be, as Martha said, and can't be held responsible for a generation's obesity problem. 

Darn it. Would have been so simple!

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Not getting enough sleep? Take a nap, research says

Washington, DC–A short nap can help relieve stress and bolster the immune systems of men who slept only two hours the previous night, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

A news release on napping from The Endocrine Society:

Washington, DC–A short nap can help relieve stress and bolster the immune systems of men who slept only two hours the previous night, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Lack of sleep is recognized as a public health problem. Insufficient sleep can contribute to reduced productivity as well as vehicle and industrial accidents, according to the U.S. Centers for Disease Control and Prevention. In addition, people who sleep too little are more likely to develop chronic diseases such as obesity, diabetes, high blood pressure and depression.

Nearly three in 10 adults reported they slept an average of six hours or less a night, according to the National Health Interview Survey.

"Our data suggests a 30-minute nap can reverse the hormonal impact of a night of poor sleep," said one of the JCEM study's authors, Brice Faraut, PhD, of the Université Paris Descartes-Sorbonne Paris Cité in Paris, France. "This is the first study that found napping could restore biomarkers of neuroendocrine and immune health to normal levels."

The researchers used a cross-over, randomized study design to examine the relationship between hormones and sleep in a group of 11 healthy men between the ages of 25 and 32. The men underwent two sessions of sleep testing in a laboratory, where meals and lighting were strictly controlled.

During one session, the men were limited to two hours of sleep for one night. For the other session, subjects were able to take two, 30-minute naps the day after their sleep was restricted to two hours. Each of the three-day sessions began with a night where subjects spent eight hours in bed and concluded with a recovery night of unlimited sleep.

Researchers analyzed the participants' urine and saliva to determine how restricted sleep and napping altered hormone levels. After a night of limited sleep, the men had a 2.5-fold increase in levels of norepinephrine, a hormone and neurotransmitter involved in the body's fight-or-flight response to stress. Norepinephrine increases the body's heart rate, blood pressure and blood sugar. Researchers found no change in norepinephrine levels when the men had napped following a night of limited sleep.

Lack of sleep also affected the levels of interleukin-6, a protein with antiviral properties, found in the subjects' saliva. The levels dropped after a night of restricted sleep, but remained normal when the subjects were allowed to nap. The changes suggest naps can be beneficial for the immune system.

"Napping may offer a way to counter the damaging effects of sleep restriction by helping the immune and neuroendocrine systems to recover," Faraut said. "The findings support the development of practical strategies for addressing chronically sleep-deprived populations, such as night and shift workers."

Other authors of the study include: Samir Nakib, Catherine Drogou, Maxime Elbaz, Fabien Sauvet, Jean-Pascal De Bandt and Damien Léger of the Université Paris Descartes-Sorbonne Paris Cité.

The study, "Napping Reverses the Salivary Interleukin-6 and Urinary Norepinephrine Changes Induced by Sleep Restriction," was published online, ahead of print.

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Wild: What if I was never redeemed?

If Wild, the book, the movie, the world-wide phenomena, had no other virtue, the story would deserve praise for the sheer volume of reaction and thought that it has inspired.

If Wild, the book, the movie, the world-wide phenomena, had no other virtue, the story would deserve praise for the sheer volume of reaction and thought that it has inspired. Not just on hiking, but on feminism, on wilderness, on relationships: previously unknown author Cheryl Strayed hit a chord nearly everybody recognized but nobody had ever heard sounded quite that way before  

The influential review of the book, by Dwight Garner in the NYTImes, from just two years ago, is at once respectful, but also a confession, in that the reviewer makes clear that he has been, as Shakespeare would say, overthrown. Wild broke his heart, as we say in our time, and tears came to his eyes, and what can a reviewer say after that? 

But not because Strayed put her life at risk, or had an insanely dangerous time outdoors.  

The author was not chewed on by bears, plucked dangling from the edge of a pit, buried by an avalanche or made witness to the rapture. No dingo ate anyone’s baby. Yet everything happened. The clarity of Ms. Strayed’s prose, and thus of her person, makes her story, in its quiet way, nearly as riveting an adventure narrative as Jon Krakauer’s two “Into” books: those matey fraternal twins, “Into the Wild” and “Into Thin Air.”

Screenwriter Nick Hornby read this review, ordered the book, and set out to adapt it — even before getting the assignment, though he knew as little about hiking as Strayed did when she set out. 

I felt I understood the book. It wasn't about hiking, not to me. It was about grief, families, ambition, rage, disappointment and hope, and it was written with an urban liberal-arts sensibility that succeeded in placing anyone with the same set of values right there on the trail with Cheryl, screwed up, unprepared, determined to succeed in her ambition simply because there are no viable alternatives anywhere else.

But why was Strayed's story so riveting? After all, thousands of people have hiked the Pacific Crest Trail. Nearly everybody a person meets thru-hiking the trail is on a quest, as occasional trail companion Chris Nottoli likes to say. 

What's so special about Strayed? 

Surely the best overall — and longest! — attempt to answer this question comes from Kathryn Schulz for New York magazine. Interestingly, she frames the question much as Garner does — at first:

People love to read about outdoor extremis and debacle, à la Into Thin Air, but books about nature in which nothing goes terribly wrong do not normally attract millions of fans. Moreover, there is a kernel of genuine radicalism in Wild — and radicalism, by definition, does not appeal to the mainstream. Outside of slave narratives and horror fiction, adult American literature contains very few accounts of a woman alone in the woods. YetWild is the story of a woman who voluntarily takes leave of society and sustains herself outdoors, without the protection of a man, or, for that matter, of mankind. It is the story of a woman who does something physically demanding day after day, of her own free will, and succeeds at it. It is the story of a working-class woman and her mind — of what Strayed thought about in the three months she spent almost entirely alone. And it is a story that ends happily in the near-total absence of that conventional prerequisite for happy endings, romantic love.

That phrase "near-total" stuck in my craw a bit, because the movie does conclude with a mention — if not the in-person sight — of a romantic love. To make sure Schulz was right about this interpretation I looked up the conclusion in the book, and what do you know, it's just about word for word. Strayed does mention returning to the Bridge of the Gods, where she concluded her trip, to marry a new man. 

But Schulz's point — that this was a woman's story that has to do with self-discovery, and not about being discovered — remains central to the story. As she says:

In a ­culture with profoundly ambivalent feelings about independent women, it is not always clear what kind of adventures we will be lauded for undertaking, nor what kind of tales we will be lauded for telling. So why did so many people fall in love with Strayed and her story?

I asked Strayed myself a similar question, when she spoke at UC Santa Barbara a couple of years ago, hoping privately that she would say something about how her story arrived at a moment when as a people we were falling back in love with the wild and the trail. Or were at least open to stories about that, as we as a culture had not been in either of the boom times of the 80's or 90's. Sez me. 

Strayed did not. In a polite but firm way she spoke of the writing itself, and of the publishing team that gave the book the best possible launch. Which wasn't what I wanted to hear, but statistics cited in a recent LA Times op-ed appear to bear our her point: 

Visits to the 58 crown jewels of the National Park System — nature-based parks such as Acadia, the Grand Canyon and Yosemite — peaked in 1997, and, per capita, had declined 19% by 2010. Some who work in state and national parks have expressed deep concern to me about how school kids show up on field trips not so much eager to play, or excited to learn, but unsettled by whatever ferocious creatures might be lurking in the bushes. As stated in a news release last summer by the U.S. Fish and Wildlife Service, “Getting [today's] visitors to reweigh perceived threats is an art.”

(It's been four years since those stats were published, and I like to think that the tide has turned towards respect for wilderness. Certainly I see people on mountain trails — particularly women, many not young — that I didn't see when I was hiking Sierra trails twenty years ago.)

But Schulz would agree with Strayed. She points out that Strayed's story — in which she has to lose everything, and start over — has a myth's power. 

Strayed sets out on her journey after the loss of her mother (and husband, stepfather, father, and childhood home)… It is as if only the total destruction of the domestic sphere could justify a woman’s presence on such adventures. Or rather — since Strayed’s story is not fabricated — it is as if that destruction were necessary in order to secure the audience’s sympathy for a woman doing something risky and alone.

As a literary device, the destruction of the home front silences these concerns. But it has another advantage: It is universally familiar — not from stories about independent women but from stories about independent children. In real life, the death of a parent is an agonizing loss. But in fiction, that death, while nominally tragic, often marks the beginning of an adventure; it gives the hero the freedom, and sometimes the motive, to go explore an unfamiliar land. Mowgli in the jungle, Bambi in the forest, Huck on his raft, Dorothy in Oz: For any of these adventures to transpire, the parents must first be made to vanish. 

Further, as Schulz says, and Reese Witherspoon, who became the heroine of the tale in the movie seconds, this is a classic American story, in that it is about a woman who had nothing, no money, and sitll and found something, in this world and in herself. Witherspoon told the LA Times:

And it was really important that it wasn't about, like, white-girl problems, you know? I told her that so many people in this world have nothing, and that's what I really responded to, that you get to the end of this movie and this woman has nothing. She has no man and no money and no parents and no job, and it's a happy ending. And that's extraordinary in this life because so many people don't know where to turn or what resources are going to lift them up out of their grief or their despair, and she did this for herself with nothing. And I felt like it could be inspirational to other people.

Which it clearly was. Thank you Reese Witherspoon, and thank you Cheryl Strayed. Especially for these concluding words:

What if I forgave myself? I thought. What if I forgave myself even though I'd done something I shouldn't have? What if I was a liar and a cheat and there was no excuse for what I'd done other than becuase it was what I wanted and needed to do? What if I was sorry, but if I could go back in time I wouldn't do anything differently than I had done? … What if what made me do all those things everyone thought I shouldn't have done was what I wanted and needed to do? What if I was sorry, but if I could go back in time I wouldn't do anything differently than I had done? … What if what made me do all those things everyone thought I shouldn't have done was what also had got me here? What if I was never redeemed? What if I already was? 



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Students vs. obesity in Santa Paula CA

Let me belatedly post the main story I have been at work on for the last six months or so, as part of a Reporting on Health fellowship, about obesity — and those battling it — in Santa Paula. 

Turns out, appropriately, it's students and young adults who have taken up the fight. Not to mention of course doctors, educators, health care agencies, and countless others I didn't have a chance to quote. 

I confess to liking my lede, for rhetorical reasons:

Americans today are an exceptional people: We are the heaviest in the world. Now the federal government’s Centers for Disease Control and Prevention warns that as we supersize ourselves we are skyrocketing our risk of developing diabetes.

Especially at risk are children in Ventura County.


For more, please see Mission Healthy.

People — including the funders, who want it numerically — ask for some measure of impact. Wonder if I've heard much of a reaction. Well, a number of friends have told me that they thought it was good, they liked it, even that it actually had something of a happy ending, but that's all I've heard.

Well, that's enough. "Respect of my peers," as they say in sports. 

Note: a smart and faithful reader writes in to remind me that my math skills have gone to hell in the last forty years. So I'm going to keep my "metric" simple: compliments must outweigh reasonable complaints about errors re: any given story by 10-to-1 for it to be any good. This means — practically speaking — a story can't be good unless it is essentially error-less. 

That's a high standard, and that's why editors and time are required for good journalism. 

(Er, not that anybody asked…) 

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How to confuse the media and public: Butter ’em up

A few months ago the rapturous reporting of a new study on saturated fat caught my eye. Sounded too good to be true, and, well, long story short, that's exactly what it turned out to be.

Here's the opening, from the USC Annenberg/California Endowment's Reporting on Health site:

Time to jump on the bandwagon of saturated fat? 

Read the headlines about diet this year and you could easily think, "Why not?"

"Butter is back" said the New York Times in a headline on Mark Bittman's March 28 column. In his opening, Bittman sounded joyful, almost giddy, at the prospect of eating unlimited amounts of saturated animal fats: 

Julia Child, goddess of fat, is beaming somewhere. Butter is back, and when you’re looking for a few chunks of pork for a stew, you can resume searching for the best pieces — the ones with the most fat. Eventually, your friends will stop glaring at you as if you’re trying to kill them.

"Eat Butter," read the cover of Time, headlining a lengthy cover story in June by science writer Bryan Walsh.  

"Butter is bad — a myth," declared Joanna Blythman, of The Guardian. 

This surprising development in dietary medicine made headlines around the world. Almost unnoticed in the aftermath was the strong pushback from the international research community. 

Perhaps the pushback didn't make headlines because it wasn't what lovers of cheese, meat and butter wanted to hear. 

The interesting thnig about reporting this piece is how surprisingly willing leading experts were to actually talk. I queried one leading researcher in Cambridge, expecting if lucky he might respond to an email, but he asked to talk on the phone. For which I remain grateful.

Perhaps health issues bring out the good in people. Even if sometimes misreported.


Note: I think it's fair to point out that this story on the Reporting on Health site turned out to be unexpectedly popular — seems to have hit a nerve. Always great to hear people are listening. 



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