New Under the Sun:
Volume 4, Issue 2
This year began in a most stressful manner with the South Asian Tsunami. Although we may believe otherwise, events that occur across the globe can have an almost immediate impact on our lives. The best way to handle stressful events, whether happy or otherwise, is to maintain optimal health. The healthier we are, the more easily we will be able to handle the challenges of this new year.
Walking to Buy Produce: Researchers used data from 963 participants in the 1996-97 National Food Stamp Program Survey to determine the participants’ intake of fruits and vegetables and possible environmental factors affecting that intake. Some of the variables they considered involved location and ease of access to grocery stores. Based on the analysis, the researchers concluded that the further the grocery store was from their home, the lower the participants’ intake of produce. They further concluded that unless access was taken into account, attempts to increase fruit and vegetable intake among low-income populations were likely to fail. Donald Rose & Rickelle Richards. Food store access and household fruit and vegetable use among participants in the US Food Stamp Program. Public Health Nutrition. 2004: 7: 1081 – 1088.
A different group of researchers who focused on obesity found that those who were overweight were more likely to sit for long periods of time while those who were slim tended to be constantly moving around: standing, walking, or just fidgeting. How did they determine this? By requiring the 20 study participants (10 obese, 10 lean) to wear specially designed underwear 24 hours/day for 10 days. [They did get new underwear each day!] High tech devices embedded in the underwear monitored every movement the study participants made. Participants were also required to eat all their meals at the clinic and could not eat anything else during the study. The data on diet and movement provided the researchers with all the information they needed to accurately assess metabolic differences between the two groups. They concluded that regardless of caloric intake, lean individuals move more and obese individuals sit more. Since the movement required to lose weight does not involve a strenuous new exercise program at the gym, the researchers feel that if they can just encourage those who are naturally inclined to sit more to get up and move around during the day, that weight reduction will follow. James A. Levine, Lorraine M. Lanningham-Foster, Shelly K. McCrady, Alisa C. Krizan, Leslie R. Olson, Paul H. Kane, Michael D. Jensen, and Matthew M. Clark. Interindividual Variation in Posture Allocation: Possible Role in Human Obesity. Science 28 January 2005: 584-586.
Comment: Although these two studies might appear to be unrelated, together they may explain why certain European populations tend to stay slim despite diets which include foods associated with weight gain in the United States such as lots of cheese and rich desserts. Traditionally in most European cities and towns, food was available at small neighborhood stores or outdoor markets. Each day, individuals would visit the markets to select food items for that day’s meals. During season, fresh fruits and vegetables were readily available a short walk from home. In many places, this is still the case, although supermarkets are also common. If easy access to stores is one of the main determinants of fruit and vegetable intake, then it would not be surprising to find that individuals who shop for food on an almost daily basis would eat more of them. If the shops or markets are also located near where one lives, it would make sense that one would walk to and from the shops thereby increasing exercise regardless of one’s metabolic proclivities.
It would not be surprising, then, to find that obesity is more common in suburbia and outlying areas where walking to the store each day is not feasible. For low-income urban dwellers another factor comes into play: safety. Shops may be within walking distance, but may not be realistically accessible if one must walk through a crime-prone area to get to them.
Prescription for staying/getting slim: 1] move to a safe neighborhood where good shops are within easy walking distance; 2] walk to the shops for food, including fruits and vegetables, almost every day; 3] and if that is not possible, make sure you don’t get too comfortable in that chair!
Fertility and Age: You can’t fool Mother Nature, even if your desire is to be a mother yourself. Most women (and men) have an urge to reproduce. We can deny it or delay it, but there comes a point when a child of one’s own is desperately desired. Despite the occasional news story of an older woman having a successful delivery, for most women too long a delay can lead to disappointment. Biologically, a woman’s period of greatest fertility and best reproductive outcome is between 18 and 25. It decreases slightly from 26 – 30. There are further decreases to age 35, at which point the failure rate begins to steeply increase. Analysis by researchers at the Centers for Disease Control (CDC) has found that the same fertility and age correlation also holds true for Assisted Reproductive Technology (ART) attempts.
On average, there are successful outcomes using ART for about 1/3 of reproductive attempts. However, the vast majority of successful outcomes are among women in their 20s and early 30s. For this group, about 37% of attempts lead to successful births. After age 35, the success rates slowly and then rapidly plummets with increasing age: 31% success for women 35 – 37; 21% for women 38 – 40. For women 41 – 42, the success rate is halved to 11%, while for those over 42, the best they can achieve is a 4% success rate. If a woman uses donor eggs from a young woman, her chances of success are about 50% regardless of age.
This analysis was based on data obtained during 2002 from 115,392 ART cycles recorded by 391 fertility clinics across the United States. There is a delay in analysis and reporting due to the fact that each pregnancy must be followed to term and somewhat beyond to determine if the outcome was successful. Based on the data, ART resulted in 45,751 babies from 33,141 deliveries in 2002. Although new controls have been instituted, ART tends to result in multiple births more frequently than is true for unassisted pregnancies due to the implantation of multiple embryos.
An important conclusion to be reached from this study is that women, regardless of fertility status, cannot afford to delay attempts at reproduction much beyond their early 30s if they desire the best chance of achieving pregnancy and having a successful delivery. Mother Nature, our biology, won’t be fooled. Staff, Centers of Disease Control. 2002 Assisted Reproductive Technology Success Rate. 2004. US Department of Health and Human Services.
Book Review: This month we are reviewing When Germs Travel by Howard Markel. The subtitle of the book is Six Major Epidemics That Have Invaded America Since 1900 and the Fears They Have Unleashed. One would expect that the Spanish Flu epidemic would be one of the epidemics that Markel discusses since it occurred in 1918 and killed thousands of Americans, many of them in the military, and 20 to 40 million people worldwide. However, it gets no mention. This seems odd until one realizes that the real thesis of the book is that many in the United States fear and, thereby, discriminate against immigrants. Infectious diseases are used as the reason for discriminatory practices, but, as Markel shows, generally without sufficient cause. Laying the cause for an epidemic on some other group has a long history. While in many cases there is support for that decision, as when the Spanish brought small pox to the Americas, in other cases blaming some other group serves to obscure practices of one’s own group that may have contributed to the epidemic.
The six diseases Markel discusses are: tuberculosis, bubonic plague, trachoma, typhus, AIDS, and cholera. In addition to giving the history of a particular epidemic, Markel personalizes the story of each epidemic by focusing on specific individuals affected by it. This serves to make each topic more accessible to the reader and also guides the reader towards the author’s thesis that we would improve healthcare for all by being less discriminatory. Yes, the health of the general population needs to be protected, but such protection may be aided by a more open immigration policy that limits the number of illegal immigrants who tend to fear obtaining healthcare until it is too late, for them and for others. The health of the US population would be further improved by making sure that the world’s other populations also receive adequate healthcare. With the speed of air travel, viruses and bacteria can quickly and easily spread thousands of miles in a few hours. As Markel states, “Regardless of the contagious threat,…the human race is simply too interconnected to rely on walls or borders as public health safeguards…In the twenty-first century we live in a world where water supplies, food chains, social customs and practices, housing, and living conditions all impact everyone, eventually, whether we acknowledge it or not.” (pp. 209-210)
If we really wish to improve public health and limit or eliminate epidemics, we need to understand that the “public” is the entire population of the world.
AnthroHealth Tip of the Month: In accordance with the information presented in this month’s newsletter, this month’s tip is to keep plenty of fruits and vegetables available to snack on during the day. But don’t keep them too available. Put them somewhere that requires you to get up and walk to them. In that way you not only have a better chance of getting the recommended 8 – 10 servings/day of fruits and vegetables, but you are also “fidgeting” your way to a higher activity level: weight loss and health gain in just a few, easy steps.
© 2001-2009 Kathleen E. Fuller, PhD. All rights reserved.