Saturday, November 3, 2012

Magic to Do in the Magic City


Beth Kitchin and Ben Vereen
                Ben Vereen worked magic in the Magic City Thursday night. Mr. Vereen, as you probably know, is an awarding winning actor, dancer, singer of stage and screen. He also has diabetes. He was here Thursday to speak at the kickoff event for Cities for Life - a grassroots diabetes awareness and management program designed to fight diabetes in our community. In a country where diabetes is running rampant, Alabama has one of the highest rates.  That’s one of the reasons  Birmingham was chosen out of more than 50 cities by the American Academy of Family Physicians Foundation for this pilot program.  But the other reason Birmingham was chosen is that our city has tremendous resources. Not only are we home to the University of Alabama at Birmingham – one of the best medical research and teaching  universities in the country –  we are also a community with tremendous unity and commitment among our citizens.  They don’t call us “the Magic City” for nothing! 
                At the kickoff Thursday night, there were doctors, researchers, community organizers and activists, directors of non-profits, and many, many others all with one thing in common: we care about our community.  And when Ben Vereen spoke, he ignited the room with his passion for fighting diabetes. He ended his call to action with a beautiful rendition of The Impossible Dream that brought us to our feet. 
                So as Mr. Vereen sang  in Pippin: “Join us, leave your fields to flower, join us, leave your cheese to sour . . . We’ve got magic to do, just for you. We’ve got miracle plays to play”. 
So join us at www.aafpfoundation.org/cities for life  because we’ve got magic to do. 
Beth Kitchin, PhD, RD
Assistant Professor
UAB Department of Nutrition Sciences

Monday, October 1, 2012

My Day in Athens, Grease

It all started when UAB media rep Bob Shepard (“Shep” to those who know him well) emailed me with a request to talk to a reporter from Alabama Public Radio about fat.  But this was no typical media request on the rising obesity rate.  This was a story on the inaugural Athens Grease Festival in Athens, Alabama on Saturday September 29.  The festival has much going for it: a clever geographic play on words, a charming Mayberry-like downtown square with plenty of municipal buildings sporting Greek columns in ode to its ancient Mediterranean namesake, Alabama “Athenians” dressed in togas, and of course, lots of fried foods.  Who could resist?

The reporter, Maggie Martin of Alabama Public Radio, brought up the obvious conundrum: should we be celebrating fried foods in a state that is one of the fattest in the fattest nation in the world? “Sure” I said as I headed toward the fried green tomato booth.  The fried green tomatoes were crisp on the outside, juicy on the inside. This was going well.  As we moved on to the fried candy corn booth, I elaborated on my position:
Fried Candy Corn: A delectable
combination of Bisquick, Corn
Flacks, buttermilk, and
chopped up candy corn. 
  •  I am not a killjoy. It is not my job to play food and fat cop. I have no interest in calling people out with a wag of the finger and a disapproving glare for eating funnel cake. And really, how motivating is that anyway? Paternalistic proclamations demanding that you drop the funnel cake and back away immediately only serve to turn people off and ignore you.
  •  I would be a hypocrite to criticize others when I did not drive up to the festival to window shop. I went with every intention of chowing down on some of the best fried food in the country.
  • Fried foods are part of our Southern Food Culture.  I was born and raised in the south. But growing up the child of an Italian-American mother and German-English father both from the northeast, my food culture was northern. When I moved from Virginia to the deep south, I had never even heard of fried pickles (I pictured a whole dill pickle deep fat fried on a stick) or fried green tomatoes (this was before the wonderful book by Fannie Flagg).   And while I still can’t stand sweet tea, it was love at first taste when it came to fried foods.
  • You can be healthy and have your fried foods too.  I actually catch a lot of flak from people when they see me eating a burger, fries or chocolate. But being a healthy eater does not mean that every single thing you eat must be wholegrain, organic, or free of preservatives, trans fats, sugars, and red dye.  I eat fried foods and red meat three or four times a month – not a day.  I recommend the “80/20 rule”: if you eat healthy stuff 80% of the time and not-so-healthy stuff 20% of the time, you’re probably doing pretty well. But portion control is a constant key to having your favorite foods and being healthy too.  Leaving some on the plate is a good idea.
  • Food is social and emotional. We don’t eat for sustenance alone. Food satisfies something emotional and psychological in us. This is only unhealthy if we turn to food as a way to cope and it keeps us from reaching our health goals. As Rhoda Morgenstern once said to Mary Richards on my favorite show of all time The Mary Tyler Moore Show:  “. . . cottage cheese solves nothing; chocolate can do it all!”
Fried Ribs
So, that’s why in my interview with public radio about the Athens Grease Festival I defended the celebrations of fried foods.  And as the festival website states: "Organizers are not worried about encouraging others to indulge as long as everyone eats responsibly the other 364 days of the year". 

Grilled swordfish, asparagus,
potatoes, and squash. 

     

 I finished off my afternoon at the festival with a basket of fried fish, fries and hushpuppies. Well, one hushpuppy – I left the other behind along with most of the fries. I was definitely hitting my limit. When I got back to Birmingham, I went for a run and that evening my boyfriend cooked me a delicious meal of grilled asparagus, potatoes, squash and swordfish.  Hey, it’s all about balance.

Now to prepare for next weekend when I serve my yearly duty as a judge (third straight year!) at the Cahaba River Fry Down. So, if you see me eating fried catfish, please don’t judge me.  It’s all in a day’s work. 

Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham 

Saturday, August 25, 2012

Severe Weather Food Safety



      Alabamians are no strangers to severe weather and the power outages that often come with it. Hurricanes, tropical storms, straight line winds and tornadoes often leave you without electricity. With Tropical Storm /Hurricane Isaac heading our way later this week, let’s review a few key food safety tips to prepare for the storm. We’ll also talk about what to throw out and keep after a long power outage. Here are some tips from the folks at FoodSafety.Gov! 

Before the Power Outage:
·         Appliance Thermometers. You should have one in your freezer and your fridge. Not only will it help you keep the temps at the right level during fair weather, you can tell after a power outage to tell if the food is still safe.
·         Fill Your Freezer. A full freezer will keep food safe longer. Group your foods close together and fill plastic container with water and freeze them if your freezer is not full.
·         Keep a Supply of Bottled Water Stored in a Safe, Dry Place.

During and After the Power Outage:
·         Keep Fridge/Freezer Doors Shut: Food in the fridge will be safe for 4 hours if you keep the door shut.  A closed, full freezer will keep food safe for 48 hours if you don’t open it. That time span drops to 24 for a half-full freezer.

·         Check the Temps: If the freezer temp is 40 degrees or lower, it is safe to refreeze the foods; if the fridge temps are above 40 here are the rules:

Throw Out:        
·         Raw or cooked eggs, meat, poultry, fish
·         Casseroles, soups, stews
·         Soft cheeses like cream cheese, cottage cheese, brie, mozzarella
·         Shredded cheeses
·         Pizza
·         Milk
·         Cut fresh fruit
·         Cream Pies
·         Cooked Pasta, Rice or Potatoes
·         Creamy Salad Dressing and Mayonnaise  

               Keep:
·         Jelly, mustard, ketchup, pickles, olives
·         Hard cheeses (cheddar, Swiss, parmesan - whole or grated)
·         Fresh whole and opened canned fruits
·         Raw vegetables
·         Fruit Juices
·         Fruit Pies
·         Vinegar Based Sauces and Salad Dressings

For more information in much greater detail go to www.foodsafety.gov

Beth Kitchin, PhD, RD
Assistant Professor Nutrition Sciences
University of Alabama at Birmingham 

Saturday, May 12, 2012

Eating for IBS

As a registered dietitian, I have been counseling patients with a variety of medical needs for years. The condition that has always left me empty handed when it comes to patient advice is irritable bowel syndrome (IBS). Most of our nutrition texts simply state “the patient has to figure out for themselves what foods they can and cannot tolerate”. Big help huh? Well, after a little searching, I found a little-known diet based on a little-know hypothesis that may help with IBS.
            First, a little background on IBS:
IBS is one of the most common disorders that doctors diagnose.
Ø  As many as 20% of Americans have IBS.
Ø  The good thing about IBS is that it is not a dangerous disease. There is no damage to the intestines with IBS and no risk of any long-term complications. Other intestinal diseases like celiac disease or Crohn’s disease where the intestine is actually physically damaged.
Ø  The bad thing is that IBS can wreck your life. People who have it experience bloating, abdominal discomfort, and can alternate between diarrhea and constipation. And there really isn’t a cure for it.
Ø  But the good news is that some people may respond well to a diet called the “Low FODMAP” diet.


           The idea behind it is that foods from 5 different groups tend to ferment in the intestine and contribute to the symptoms of people with IBS. The idea was developed and studied by an Australian nutritionist. While more research is needed to find out if it really works, it can’t hurt to try it. The foods are abbreviated by the acronym FODMAPS: Fermentable Oligo-, Di-, Mono-saccharides and Polyols. High FODMAP foods tend to ferment in your intestines and cause the symptoms of IBS. High FODMAP foods include prunes, apples, milk, watermelon, asparagus, avocado, corn, and wheat. But there are many more.
          
  You don’t have to completely eliminate all of the foods on the list – you may be able to handle some in small amounts. You may be more sensitive to some than others. So, if you are struggling with IBS, I recommend that you eliminate the FODMAP foods for several days to a week. If you find that your symptoms subside, then you can add back individual foods (one at a time) from the list to see which are more problematic for you. Obviously, keeping a detailed food record will be very important for sleuthing out the foods you need to ditch from your diet.
            
     There is a terrific, easy-to-use list you can print at this website: http://ibs.about.com/od/ibsfood/a/The-FODMAP-Diet.htm    Go to the very end of the article and you will see “For a printable chart of low FODMAPs food, click here” and it will take you to the list!  I do recommend that you work with a registered dietitian to help you develop your own healthy, low FODMAP diet!

Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham 

Friday, April 20, 2012

Could Dr. Oz be Wrong?

I saw a Dr. Oz video today on yahoo about diet foods that make you gain weight.  I was disappointed to find diet sodas in his commentary. Why? Because the study he quotes on the video does not show that diet sodas cause people to gain weight at all. This one study has been so badly misinterpreted that just about everyone thinks that it is a fact that diet sodas will make you gain weight.
Here’s the problem: the study that is constantly quoted as “proving” that diet sodas cause weight gain can’t show cause and effect at all. It is an observational study. The researchers used people’s self-reported intake of diet sodas over a nine-year period and then looked at what happened to their weight during that same time. Just because the people who drank more diet soda were also the people who gained more weight does not mean that one caused the other. This doesn’t make it a bad study. The problem is that media headlines and reports – including Dr. Oz’s video – do not accurately report what this study showed – or did not show.

If you read the actual study, at the end, the researchers themselves say that there may be no causal relationship at all between diet sodas and weight gain. They also discuss other studies – intervention studies that can show cause and effect – that mostly show that artificial sweeteners don’t cause an increase in hunger and weight gain.  Add that to what we know about the inaccuracies in self-reported food intake and you can see that this study, while interesting, does not show that diet sodas cause weight gain.

So why does the media continually misreport these studies? My suspicion is that, perhaps, they like hyped up, simplified headlines. They may not take the time to read the actual study on which they’re reporting relying, instead, on the study press release. They also don’t seem to be reporting about what the body of scientific literature is showing on a particular topic – rather, showcasing one study that is unlikely the definitive work on the subject.

In the interest of self-disclosure, I must tell you that I don’t regularly drink diet sodas myself – maybe two or three week. Nor do I think that they are good for you. But I also don’t think they are particularly bad for you. Future intervention studies could possibly show that they somehow impede weight loss – but as of now, the studies don’t show this.

Bottom line? The jury is still out on this one. If there is an effect, it will likely be different for different people. To state that diet sodas cause hunger and weight gain as though it is a fact is a misinterpretation of the scientific data available at this time.

If you’re interested in learning more about media reporting on scientific studies, check out this website: www.healthnewsreview.org

Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham 

Monday, February 6, 2012

Don't Be Afraid of the Cheese: PCRM's Anti-Cheese Scare Tactics

Last week, the Physicians Committee for Responsible Medicine (PCRM) were at it again with in-your-face ads blaming a much loved food for America’s poor health.  These are the same folks who told baseball fans not to eat hotdogs because eating a hotdog is like smoking a cigarette (see the hotdogs in the cigarette pack here: http://www.pcrm.org/search/?cid=1686).  This time, cheese was on the receiving end of PCRM’s wagging finger of shame.
The new anti-cheese ads show big bellies and fat thigh thighs accompanied by: “Your Abs on Cheese” and “Your Thighs on Cheese”. You can see the controversial and annoying ads here:  http://www.pcrm.org/media/news/fat-focused-billboards-warn-albany-cheese   I have several problems with these kinds of ad campaigns:
1.    They don’t work. Do groups like PCRM honestly think that cheese-loving Americans are going to give up their cheddar because of obnoxious billboards like these? If anything, contrarian Americans will eat more cheese just to show ‘em that they can’t tell us what not to eat. I count myself among cheese-loving contrarian Americans and am eating a piece of cheese as I write this.
2.    They are biased.  Neal Barnard, MD, the leader of PCRM, has his own version of the four food groups that has no animal foods at all. Trying to turn all of America into vegan vegetarians, while a healthy proposition, is futile. We love our meat and dairy in America. Dr. Barnard says that cheese increases the risk of heart disease and causes obesity. If you eat too much cheese and it contributes to weight gain, then that is true. But that is true of anything that has calories. If you eat cheese within the context of an overall healthy diet that is low enough in calories to keep your weight healthy, then cheese is not bad for you. In fact, it’s high in protein and calcium – two important nutrients.  Dr. Barnard often commits the cardinal sin of claiming that data from observational studies shows cause and effect relationships – something observational studies cannot do. In fact, cause and effect type studies showing that cheese does not increase bad cholesterol levels are starting to rack up.
3.     It makes the rest of us look bad. Who wants to listen to a big bunch of patriarchal buzz kills who don’t want you to eat anything that they deem unhealthy? When nutrition experts are constantly telling you all the things you like are bad for you, of course you’ll start tuning them out. 
In Dr. Barnard’s defense, he is mounting this campaign because America’s cheese intake has increased dramatically over the decades. Cheese is high in fat – and not the healthy kind. The folks at PCRM are not bad people – they promote ethical treatment of research animals and do truly care about the health of the American public.  For those who are vegan vegetarians – it’s a great and healthy choice. But meat eaters can be healthy too. Vilifying a single beloved food is not the way to help Americans eat healthier and fix the obesity problem.  We need to focus on being more active and eating patterns as a whole rather than taking one food to the woodshed.
Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham 

Monday, January 23, 2012

Dawn of the Diet Soda Drinking Zombies

Apparently, it is a well-known fact that aspartame (the artificial sweetener better known as Nutra-Sweet) eats your brain. Essentially, it makes holes in your gray matter. At least that’s what someone informed me last week as I opened a can of diet coke at lunch. Having just watched the brilliant, tongue-in-flesh-eaten-cheek movie Zombieland  that weekend, my mind naturally wandered to the living dead, their brains mercilessly eroded by diet coke.
But in Zombieland, it’s not diet soda that eats your brain – it’s red meat. In the movie, the U.S. population is decimated after someone eats a mad cow infected burger and becomes a zombie. Well, you know how it goes. He bit someone, then he bit someone, and so on and so on. In two months’ time, the whole country is walking dead, save for a few resourceful survivors. By the way, Bill Murray makes a delightful cameo appearance.   
Being told that my diet coke was going to eat holes in my brain coupled with my fear of future zombiehood, I googled “aspartame eats brain”. I found unsubstantiated scare tactics, alarmist emails, urban legends, and “studies” not published in any credible scientific journal. I then did a scholarly search on aspartame and found that credible studies show that, no, aspartame is unlikely to eat your brain.
Now, don’t get me wrong: artificial sweeteners are not a health food. Could we find out down the road that certain artificial sweeteners are not safe? Possibly. But the scientific data that is out there – and there’s lots of it - supports that they’re safe.
The bottom line is that the FDA does a good job of evaluating artificial sweeteners for safety. I know we are living in an era of great governmental distrust. But after the saccharin debacle of the 1970’s when the potential ban of that sweet stuff resulted in great public outcry and criticisms over faulty interpretations of the rat safety studies, the FDA became more stringent in its oversight of the research. The FDA’s approval of aspartame is based on over 100 toxicological and clinical studies.   
I have absolutely no expectation that I will convince the aspartame safety doubters that aspartame is not dangerous. And that’s just fine. There’s no reason you should use it. All I’m asking is this: the next time you see me with a diet coke, please don’t tell me that it’s going to eat my brain and let me enjoy my lunch in peace. 
Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Dawn of the Diet Soda Drinking Zombies

Apparently, it is a well-known fact that aspartame (the artificial sweetener better known as Nutra-Sweet) eats your brain. Essentially, it makes holes in your gray matter. At least that’s what someone informed me last week as I opened a can of diet coke at lunch. Having just watched the brilliant, tongue-in-flesh-eaten-cheek movie Zombieland  that weekend, my mind naturally wandered to the living dead, their brains mercilessly eroded by diet coke.
But in Zombieland, it’s not diet soda that eats your brain – it’s red meat. In the movie, the U.S. population is decimated after someone eats a mad cow infected burger and becomes a zombie. Well, you know how it goes. He bit someone, then he bit someone, and so on and so on. In two months’ time, the whole country is walking dead, save for a few resourceful survivors. By the way, Bill Murray makes a delightful cameo appearance.   
Being told that my diet coke was going to eat holes in my brain coupled with my fear of future zombiehood, I googled “aspartame eats brain”. I found unsubstantiated scare tactics, alarmist emails, urban legends, and “studies” not published in any credible scientific journal. I then did a scholarly search on aspartame and found that credible studies show that, no, aspartame is unlikely to eat your brain.
Now, don’t get me wrong: artificial sweeteners are not a health food. Could we find out down the road that certain artificial sweeteners are not safe? Possibly. But the scientific data that is out there – and there’s lots of it - supports that they’re safe.
The bottom line is that the FDA does a good job of evaluating artificial sweeteners for safety. I know we are living in an era of great governmental distrust. But after the saccharin debacle of the 1970’s when the potential ban of that sweet stuff resulted in great public outcry and criticisms over faulty interpretations of the rat safety studies, the FDA became more stringent in its oversight of the research. The FDA’s approval of aspartame is based on over 100 toxicological and clinical studies.   
I have absolutely no expectation that I will convince the aspartame safety doubters that aspartame is not dangerous. And that’s just fine. There’s no reason you should use it. All I’m asking is this: the next time you see me with a diet coke, please don’t tell me that it’s going to eat my brain and let me enjoy my lunch in peace. 
Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Tuesday, January 17, 2012

Breaking Nutrition News: Paula Deen Has Diabetes

Paula Deen has diabetes and the media goes wild. Forgive me for the headline, but this is  about as close as we get to breaking news in the field of nutrition. The last time this happened Mary Kate Olsen went public with her eating disorder. Or was it Ashley? But these are serious diseases and celebrity diagnoses can often help others. 
As a frequent media “expert” on local news, I am having to form an opinion about this and will be heading up to the local TV station at 9:30 this evening to comment on it live. I have already Facebooked it to get my friends’ responses and, just like my friends, their comments are all over the place:
  •   "Keep your hands off my butter!”
  •  “If she wants to make money off her cooking she should be a role model or give up the spotlight.”
  • "I make my own personal choices on what I eat . . . regardless of her recipes . . . I think she is entertaining but would never make her recipes for my own consumption.”
  • "She needs to be totally honest with herself and her fans. She needs to let people know that for most people diabetes is preventable and her diet caused this."
  • "She is an entertainer, not a role model.”
And those are just the highlights. I had more comments on the Paula Deen question than any other post in my history on Facebook (61 comments and they’re still coming in). But what do I say about it? What do I even think about it? People love Paula and chastising her for her past gluttony would only make me sound like the typical buzz kill health professional who’s always telling you what you should and shouldn’t do. And I’m no angel. I never pass up French fries, chocolate, or cheese when offered.
On the other hand, diabetes is a serious disease that comes with serious consequences: blindness, kidney disease, amputations, and early death from heart disease. This hot topic is no laughing matter. The south has some of the highest rates of stroke, high blood pressure, diabetes, heart disease, and obesity. Southern cooking, as delicious as it is, hasn’t helped.
So will she or won’t she be a role model for the masses or will she merely use this to make more millions? The latter may be the case as she signed on with Novo Nordisk almost simultaneously with her announcement (which came 3 years after her diagnosis).  And here’s where I do have an opinion: celebrities hawking drugs.  Paula Deen is influential – and she could influence many American to want the “Paula Deen diabetes drug” even if it’s not the right drug for them. She could give people the impression that you can just eat her way and take a drug for your diabetes and all will be fine.  People may say she has no responsibility to be a role model but by endorsing a drug, she is making herself a role model.
Type 2 diabetes is a disease that can sometimes be treated through diet and exercise alone. Sometimes diabetes patients do need medicines to control their disease – but why take a drug that has potential side effects when exercise and eating healthier may do the trick?
So here’s my hope for Paula Deen: I hope she’ll ditch her drug company endorsement  and promote portion control with her yummy high calorie southern delectable dishes. I hope she’ll add some healthier dishes to her standard dishes to promote balance and enjoyable eating. I hope she’ll go out there and show people how to be more physically active and reduce their risk for diabetes and other chronic diseases. She has tremendous influence with her fans and this is an opportunity for her to do real good rather than hawk a diabetes drug. She can still make a tremendous amount of money in her new role as the new and healthier Paula. She may even save some lives. Does she owe it to society? No – it’s totally her business. But it sure would be nice for the Queen of Southern Cuisine to be the Queen of Diabetes Prevention. Okay that has no ring to it at all – but you know what I mean. 

Beth Kitchin, PhD, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham