What We Eat Affects Everything

From The Atlantic

What We Eat Affects Everything

How men and women digest differently, diet changes our skin, and gluten remains mysterious: A forward-thinking gastroenterologist on eating one’s way to “gutbliss”

Robynne Chutkan, MD, is an integrative gastroenterologist and founder of the Digestive Center for Women, just outside of Washington, D.C. She trained at Columbia University and is on faculty at Georgetown, but her approach to practicing medicine and understanding disease is more holistic than many specialists with academic backgrounds. She has also appeared on The Dr. Oz Show (of which I’ve been openly skeptical in the past, because of Oz’s tendency to divorce his recommendations from evidence).

Chutkan’s first book comes out today. You might pick out an Oz-ian air to the title: Gutbliss: A 10-Day Plan to Ban Bloat, Flush Toxins, and Dump Your Digestive Baggage. Oz even endorses it on the back of the jacket: “Dr. Chutkan blasts away the bloat as she tastefully explains the guts of our problems.”

Dr. Chutkan helped me reconcile some of this—blast away a little bloat, if you will—on simplifying medicine, subspecialists embracing therapies aimed at overall wellness, why a gastroenterology clinic would be sex-specific, and how to think about the whole gluten-free idea; among other answers to questions I wouldn’t have thought to ask.
The title of your book is catchy and uses this evocative term “gutbliss.” I’d not heard it before. Did you come up with it, and what does it mean?

I did come up with it. The earlier part of my career, my first eight years after my training I was at Georgetown full-time in an academic practice seeing patients in my area of expertise, which is Crohn’s disease and Ulcerative Colitis. I was treating people who had serious medical problems, we were doing complex procedures, and prescribing complicated drugs with a lot of side effects. And then things sort of shifted for me. I began to feel like academic medicine didn’t pay enough attention to the contribution of diet and lifestyle and stress, to digestive health, which felt, to me, like an obvious connection.

So I decided to open an integrative practice where we focus on additional things besides the illness, like the things that created the illness. I switched from being at the top of the pyramid treating people at the end-stage of the disease, to the base of the pyramid counseling more people who were starting to have symptoms, but didn’t necessarily have bad diseases yet. So “gutbliss” for me evokes this idea of how you can create wellness in your digestive tract. And this blissful gastrointestinal tract has a lot to do with how you eat and how you live, since most diseases don’t just fall out of the sky into your lap.

I had started a nonprofit in ’09 called Gutrunners, which was sponsored by one of the large GI societies, and we put on races at our national GI meetings, and the idea was to focus on the contribution of nutrition and exercise in preventing digestive disorders. So, this whole “gut” thing for me was very natural.

People advised against calling the book Gutbliss and said, “Oh, it’s sort of in your face; it makes me think of stool and intestines.” But I think the intestines are beautiful and marvelous, so I wanted to include that. And I wanted to show how something that is, in many ways, closeted, mainly bowel movements and intestinal function, could actually be this wonderful, blissful thing. In fact, there’s a little bit of focus on this in the book. There’s a chapter on “Beauty and the Bloat,” on how what you put into your body, mainly your GI tract, profoundly affects how you look. So that was how I came up with the term “gut bliss.” Sort of combining the intestines, which people think of as not so lovely, with a blissful state of health.

You mentioned some things we could eat that might influence appearance.

Skin disorders like rosacea, which a lot of people confuse with acne is a good example. A lot of people are using harsh things on their skin for this sort of redness on the cheeks and nose. Rosacea’s actually an autoimmune disease and, like most autoimmune diseases, we don’t actually know what causes it, but there’s a very strong association with something called dysbiosis, a bacterial imbalance and overgrowth of the wrong kinds of bacteria in the gut.

When I work with people on their diet, whether it’s cutting back on dairy, or switching them from a starchier, sugary processed diet, to a more plant-based way of eating, their skin often clears up. And I sort of joke with my friends because they’re like, “Aren’t you a butt doctor? Why are you so obsessed with the skin?” And I’m like, “Well, I’m more than a butt doctor.”

But, I find there’s such a fascinating skin-gut connection. One of the things I talk about in the book is the idea that the skin actually represents the outside of our GI tract, and the GI tract represents the inside of our skin.

You probably don’t know this because you probably don’t wear makeup, but when you put makeup on, like foundation and eye makeup and so on in the morning, by the end of the day it’s gone. Literally gone—it looks like you don’t have anything on. Where does it go? It gets absorbed into our body. And the opposite thing can happen when you eat certain foods; you can see the effect coming out on your skin. There’s this incredible connection between the two. And the same way we overuse antibiotics and expose our digestive tract to chemicals that alters this delicate balance between good bacteria and bad bacteria, we do the same thing to our skin. We use harsh soaps that contain chemicals that kill off a lot of the skin bacteria that are really important for healthy skin, and then our skin is dry and unhealthy and peeling. So there are a lot of parallels there. I think most of us have had that experience of seeing a person who has a real inner glow. Maybe if you’re 20 you just have good genes and you can have pizza and beer every day and still glow. But if you’re over 40, often there is a fair amount of kale involved. There could be some cookies and ice cream too, but usually the people who have that glow are doing something right, and it often involves getting sweaty on a regular basis and eating the right food.

The tagline of the book is “A ten-day plan to ban bloat, flush toxins, and dump your digestive baggage.” Can you give us a preview of what that is working towards, or some of the steps?

Sure. Full disclosure, I didn’t love that tagline. This really is not a diet book, and I wanted to be very clear on that. This is a book about how to achieve and maintain digestive wellness. Hippocrates said it first: All disease begins in the gut. The 10-day plan makes the information in the book more accessible to people. It’s very similar to the advice that I give patients in my practice. It’s not about eating a perfect diet every day. But ten days is actually enough time to make some changes and see some results. Maybe get rid of a lot of the sugary stuff, maybe get off the gluten, eat more plants, do some exercises using a light dumbbell on your tummy to get rid of gas. So it gives people some very simple but very effective things that they can do so that they can experience what it feels like to get rid of the bloat, to be regular, to not have digestive upset. And beyond not just having digestive upset, to experience a little of this gut bliss.

So once you do that, what about the rest of your life? It’s really about the 80 percent rule. Most of us are “toxing” 80 percent of the time and detoxing 20 percent of the time. And we should really think about flipping that—we should think about detoxing 80 percent of the time. And I’m not suggesting anything extreme. Today I did some work at home, I made a fruit and veggie smoothie for breakfast, went to spin class, I met some people for lunch, and I had a kale salad with roasted chicken and a big bottle of water. Nothing so profound, but all healthy stuff that made me feel good. And if you’re doing that 80 percent of the time, you can tolerate that 20 percent of debauchery in whatever form that might be, whether you’re drinking a bit too much, or not exercising, eating the wrong food, having too much ice cream. And then we don’t have this need to constantly be detoxing and cleansing all the time.

Try to maintain these healthy habits about 80 percent of the time, and then 20 percent of the time you’ll have something that is not necessarily the best, but that you enjoy. It means you can go out to dinner and not be so rigid or careful about what you eat, but that most of the time you are paying attention. Because there’s this incredible disconnect I find in medicine today (and obviously there’s lots of commerce involved in this), that promotes the notion that disease just falls out of the sky and there’s no connection between how you live and what happens to you from a health point of view.

Of course there are diseases where we don’t know the cause, or they’re environmental, or it’s bad genes or bad luck, but certainly for a lot of the illnesses we see there is this connection. So this book tries to help people, and women, more specifically, make that connection that if you’re bloated—which can be such a large and confusing expression for women of things not being quite right in your GI tract—there are actually things that you can do to try and figure it out. You can be a bit of a medical detective, and you can look at these areas: is it the food you’re eating, is it something you’re drinking, is it lactose intolerance, is it gluten sensitivity, is it hormonal imbalance? Or, is it an anatomical problem? Do you have ovarian cancer, is it bad endometriosis, do you have a voluptuous female colon where your colon’s wrapped around your uterus?

Without giving specific medical advice, the book gives people ideas on what sort of places they can look. Because one of the things I see so often is women who come in and they’re given that pat on the head, and, “Oh, you have irritable bowel syndrome and here’s a Xanax. You’re just stressed out.” Sometimes there’s some truth to that, but when you dig a little deeper and slice up that irritable bowel syndrome pie, there often is something more tangible as well as a solution. There’s an undiagnosed parasite, there’s a food sensitivity, there’s undiscovered hypothyroidism. There’s estrogen dominance. There’s some reason, physiological, functional—or it’s because of something in the medicine cabinet. Some vitamin, prescription pill or supplement that’s not agreeing with you.

To just sort of say your bowel is irritable but we don’t know why, I feel like that’s not a real diagnosis. It’s like saying, “You’re tired,” and that’s your diagnosis: Well, you have tired disease and here’s a pill to take for the rest of your life to pep you up. So, again, why are you tired? And I think that’s what people, not just women, want. They want answers. And I think that’s why there’s so much investigation on the Internet that can lead to all kinds of problems down the road when you’re self-diagnosing pancreatic cancer and you really just have heartburn. The book provides sensible, practical information. It’s a bit of a roadmap and a guide for the woman who is bloated or has digestive problems, not instead of a doctor, but in addition to, to help her figure out where she should be looking.

Do you only see female patients in your practice?

Even though my clinic is called the Digestive Center for Women, I do see male patients. A lot of the patients I see have Crohn’s disease and ulcerative colitis, which affects men and women equally. About 10 percent of the patients I see are male.

What are some differences in the way you approach female patients as opposed to men? In my mind, at least, the digestive tract isn’t something commonly thought of as a gendered part of the body.

I’m glad you asked that. There actually are some profound differences between the female and male digestive tracts. To start with, the female colon is longer than the male colon, on average, about 10 centimeters longer. We don’t know why, but we think part of that is to allow for more absorption of water or fluid during childbearing. Because you have to keep the amniotic fluid replete, and the circulation and blood volume increases during pregnancy.. And what that extra length in the colon does is create this redundancy, these sort of extra twists and turns, and that’s why women are so much more bloated and constipated than their male counterparts. So there’s that difference in length as well as redundancy. Think of the male colon as kind of a gentle horseshoe, and the female colon as being a tangled-up Slinky.

Not only is that due to the difference in length, but think of the pelvis. Women have this rounded, gynecoid pelvis so that when the uterus expands there’s room for a baby. Men have a narrow, android pelvis. What happens in women is that more of the colon drops down deep into the pelvis. In women, the colon is really right there mixed up with the uterus, and the ovaries, and the Fallopian tubes, and the bladder. In men, the only hardware you have is this little bitty prostate gland, and the bladder, and that’s it. So in men, most of the colon is up in the abdomen where there’s tons of room and not fighting for space with the reproductive organs, like in women. So that’s anatomical difference number two.

The third thing is that because of differences in hormonal levels with men having more testosterone on board, you guys have a well-developed abdominal wall. So even a man who’s overweight and has a big beer belly still has a tighter, more robust abdominal wall just because of the testosterone. Men will complain that they’re fat, but will rarely complain that they’re bloated because that tighter, more defined abdominal wall, the rectus abdominis sheath, which is, to some degree dependent on testosterone, that holds the bowel in place. It’s sort of a Spanx-type thing that muscular wall. In women, our abdominal wall is much less rigid and tight and doesn’t hold things in place as much, because of the difference in hormonal levels, so our bowels bulge out more, and we bloat more. And of course many women have had children, and their abdominal wall is stretched, and they may have something called a diastasis recti where there’s a split in the abdominal wall muscles because of the pressure from pregnancy. So the abdominal wall is the other big reason why men complain of being fat, and women complain of being bloated. Estrogen and progesterone can have really profound effects on the GI tract, whether you retain water or not, and how things move through your intestines. So, these are just some of the factors, not even getting into brain differences, but just from a hormonal and anatomical point-of-view.

Pelvic floor disorders in women are another big difference in the male and female GI tract. The pelvic floor is sort of like a hammock that all of the organs that are down in that area sit on—the bladder rests on it, the uterus rests on it, the bowels rest on it, and it often becomes stretched out after childbirth, or just with age, and things can start to descend. The uterus can change position and it can press on the bowels. So when you approach constipation in a woman, you always have to be aware of these pelvic floor issues. Because if you just do the basic things like give them a fiber supplement to help them get stuff out, and the problem is a pelvic floor issue, they’re actually going to feel worse; they’re going to be more bloated. You have to consider whether the sphincter may have been damaged during pregnancy or childbirth, or if the pelvic floor may have dropped. These are not considerations in men.

There are lots of different gender factors. Thyroid disease is much more common in women than in men, so that’s one of the first things that I check in a constipated women. Perimenopause is another factor. And that isn’t just when you stop having your period. It’s really that decade before you stop menstruating, which for most women is going to be 40 to 50, sometimes 35 to 45 — and it can profoundly affect the gut and bowel habits. Men don’t go through that; that’s not a factor with men at all. So there are lots of different things that you have to think about when you’re approaching bowel issues in women.

You mentioned going gluten-free, and I wanted to get your take on that. It seems like a lot of people going in that direction don’t have a diagnosis of celiac disease. What do you tell people who are interested in trying it? Is there evidence that people who tested negative for celiac disease still benefit?

First of all, I think it’s important to distinguish celiac disease from gluten sensitivity, because celiac disease is an autoimmune disease that is associated with a lot of other problematic things, like osteoporosis, iron deficiency anemia, arthritis, diabetes, even cancer. And if you have celiac disease, whether or not you have symptoms, it’s important to come as close as you can to 100 percent avoidance of gluten, because the ongoing exposure to gluten can damage the small intestine and lead to some of these other associated problems. So that’s the first thing I tell patients, is that we have to figure out what’s going on. And some patients say, Well, can’t I just empirically avoid gluten? And I tell them, no, because if you have celiac disease, you have to be 100 percent regardless of whether you have symptoms. If you have gluten sensitivity (but don’t have celiac disease) and you want to eat an almond croissant, go for it. Part of the issue is that the wheat itself is not what it used to be. It’s been hybridized and had different things done to it to increase the crop yield and shorten how long it takes for the wheat to bear. One can make all sorts of scientific and unscientific arguments about what we’re meant to eat, but I don’t think we’re meant to eat animal crackers, for example. I think it’s a stretch to call the refined, processed wheat products a food group, but I also don’t think everyone needs to empirically avoid them all the time.

Certainly if you’re having digestive problems, it’s worth trying. I usually tell people to do a six-week elimination trial; if you don’t notice a difference there’s no reason to avoid it. But my biggest caveat is to tell people there’s no point in doing this and then eating gluten-free bread, and gluten-free pancakes, and gluten-free cookies. It’s sort of like sugar-free. If you’re diabetic, I would say to you, you should think about having fruit for dessert. I would never recommend that someone have sugar-free ice cream or a sugar free drink, because that stuff’s worse than the sugar quite frankly. The same thing applies to gluten. If you think you’re gluten sensitive and you feel poorly when you eat gluten, you should avoid wheat. It just makes sense. If you’re lactose intolerant you should avoid dairy. This is your body giving you feedback saying no, I don’t like this thing. But if you decide once a month, I’m going to have a sandwich using regular bread and I may not feel so great, but I don’t have celiac disease, just a sensitivity, I think that’s okay and I think that is preferable to eating gluten-free garbage every day. Gluten-free processed products can be just as bad for you as the regular stuff that contains gluten. They’re not providing you any nutrients, they’re empty calories. So that’s a big challenge that I face with some of my patients. If you’re just gluten sensitive, have a pancake on the weekend if you really want it, but don’t eat gluten-free cookies every day of the week and think that somehow this is being healthy. Just like I would never eat low-fat or sugar free ice cream. If I’m going to have ice cream I’m going to have the real thing—I’m just not going to eat it every day.

In terms of a mechanism for gluten sensitivity, do you think were going to find antibodies that were going to be able to quantify for people in the future? Or is this akin to an allergy?

I think it’s not going to be something that we can pinpoint easily. Like if you have rheumatoid arthritis and your joints are destroyed and we can see that on a X-ray and you have antibodies that we can measure. I think it belongs in that very grey area of food intolerances, and I think we have to have common sense about it. If you eat something and you feel sick, I don’t think you need a doctor, an antibody test, or an allergist to tell you that maybe you shouldn’t eat that thing. I love the point Michael Pollan makes about nutritionism and trying to make everything so scientific. We’ve just lost our common sense a little bit. If you drink milk and then you have gas and diarrhea and bloating and you feel terrible, I don’t think you need a doctor to tell you [that] you shouldn’t drink milk, or you should drink less of it. So much of food science is driven by food manufacturers and this huge market for products. I cringe when I see the gluten-free section of the supermarket—which is getting bigger and bigger. And it’s mostly a whole bunch of junk. If the package says gluten-free, don’t buy it because guess what, a potato doesn’t say gluten-free. A pineapple doesn’t say gluten-free, and a piece of chicken doesn’t say gluten-free. So if it says gluten-free on it, be wary. There are incredible fortunes being made in the gluten-free world, and I’m not sure they’re doing consumers much of a favor.

I feel inundated by gluten-free product marketing. It’s on labels right next to “sugar-free” and “low fat,” as if it’s becoming understood to be universally a good thing. Knowing that there’s a discrete mechanism behind lactose intolerancewe make less lactase [the enzyme that breaks down lactose] as we get older, some people genetically make less than others; not breaking down lactose leads to gas. The condition is explainable. We still wonder what it is about the insensitivity toward glutenin people who don’t have celiac disease, if it really is gluten that’s making us have these symptoms like mental fogginess, or whatever constellation of things some people associate with it.

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Elbow Pain

Have you ever had pain from Pull-ups, Pressing (bench or standing), and repetative sports like golf or tennis?  I sure have.  Based on the flowing, it seems time really does heal all wounds.  From The New York Times

For Tennis Elbow, No Such Thing as a Quick Fix

CreditIllustration by Mark Matcho

Tennis elbow is not exclusive to tennis players; anyone who frequently twists an arm or carries a heavy briefcase can develop it. But whoever they may be, sufferers of the condition in the past 10 years have generally been offered a cortisone shot as treatment. Recent surveys in the United States and Britain show that injections of the steroid, which rapidly dulls pain and fights inflammation, are the preferred first line of treatment among many orthopedic specialists. But growing evidence suggests that the injections, while effective in the short term, can frequently worsen the condition in the months that follow, raising interesting questions about the risks of quick fixes for pain.

For decades, tennis elbow was thought to be caused by inflammation in the tissues around the joint. Newer science, however, including biopsies of the sore tissues, shows little inflammation, except in the very early stages of the injury. Instead, it is thought to involve degeneration of the tissues: If the joint is used repeatedly and strenuously, the body cannot repair any resulting minor damage before more damage occurs, and the tendons that hold the elbow together begin to fray and buckle. The pain can be debilitating and last for months.

As a treatment, cortisone shots are appealing because they are easy to obtain; any general practitioner can administer them. But the most sophisticated study to date of tennis-elbow treatments finds that cortisone seems to be counterproductive.

In the study, published last summer in BMC Musculoskeletal Disorders, 177 people who had just developed tennis elbow randomly received two cortisone shots three weeks apart or a placebo injection on the same time schedule. Both groups also got elbow massages and began a six-week series of at-home arm stretches and exercises. A third group was not treated at all, to serve as a control.

The volunteers’ elbow function and pain were tested periodically until they were a year out from treatment. At the first check-in at six weeks, the men and women who had received cortisone reported much less pain than those in the placebo and control groups, both of which, on average, reported elbow soreness that was only slightly lower than at the start. But in another six weeks, the cortisone-treated elbows were as sore as those of everyone else. And six months after treatment, those who had received cortisone had significantly more elbow pain than the other groups.

Why cortisone might have worsened people’s tennis elbow remains uncertain, says Dr. Morten Olaussen, a family-medicine physician and researcher at the University of Oslo in Norway who is a co-author of the new study. But it is plausible that the drug could impede structural healing within the joint.

The good news is that after a year, almost everyone’s elbow recovered, whatever their treatment or lack of it. In fact, the control group had the same success rate — close to 80 percent — after a year as all other participants. These results suggest that despite many of our instincts to do something — anything — when we hurt, the cheapest and most efficacious treatment for tennis elbow could turn out to be time.

“Avoid painful activity and just wait and see,” Dr. Olaussen says.

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Everyone Remembers Their First Bike

From The New York Times

Everyone Remembers Their First Bike

CreditGiselle Potter

When I outgrew my tricycle, my mother never replaced my wheels. Enviously I watched as the other kids in my neighborhood mounted their shiny Schwinns, confident cowkids on imaginary mares. They wobbled side to side on training wheels, inserted cards into the spokes as noisemakers, and sailed by with colorful banners flowing from handlebars. I was the one kid on the block with only feet as transportation.

My mother, a first-generation American, never learned childhood pleasures like how to swim or skate. Her widowed Russian immigrant mother, unable to support her, placed her in the Hebrew Home for Orphans in Jersey City when she was 2 until her teens. Sensible shoes took precedence over fun.

Growing up without a mother as a role model, Mom later relied on Dr. Spock for parenting advice, supplemented by rumors and old wives’ tales. When I asked why I couldn’t have a bike, she found it hard to explain. It was more than the sticker price, or a fear that I’d fall and break bones. Finally she said, “It’s just… you could hurt yourself. Permanently.”

I didn’t understand until much later that she somehow believed I’d lose my virginity. She thought she was protecting me, in more ways than one. I bitterly watched my friends ride off, leaving me behind. I was the tortoise in our neighborhood Tour de France.

When Mom wasn’t watching, my friend Lonny let me hop aboard his bike, holding me steady until I learned to steer around my driveway in Sheepshead Bay, Brooklyn.

By the time I graduated from college, my mother’s thinking had evolved. She bought a heavy old used bike, relying on me to teach her to ride. Helmetless to the library and back again, gray hair tousled in the wind, she proved it was never too late to discover the joys of going out for a spin.

When I was married she finally approved of my first two-wheeler. We rode around, side by side. “Isn’t this fun?” she asked, stopping for a red light. Nodding, I didn’t confess that I wished we could have shared these kinds of activities together when I was young. I silently vowed I’d be a different kind of mother.

I bought my daughter, Amy, her first bike when she was a toddler, one of those contraptions with a long handle for a parent to push and steer. Proudly I measured her development by her bicycles. The first one, pink with streamers, sold at the end of the summer to an even smaller girl for $10. Her first “big bike” in neon blue. I sprinted beside her when she cast off her training wheels.

Every summer my family drove to a lakeside utopia to vacation with our three bikes — Papa, Mama and Baby — perched on top of the car. Eventually I let Amy take off on her bike with friends to the playground, or the mythical place under Thunder Bridge where kids mistook raccoons for monsters.

Driving home one August when Amy was 10, we were singing show tunes in the car when we heard an alarming noise. In the rearview mirror, we saw our rooftop bike rack fly onto the highway at 70 miles per hour, landing with a thud, toppling over in the right lane of the highway — luckily deserted.

My husband backed up 100 feet to the carnage. Amy, sitting up on her knees to see through the rear window, sobbed as she saw our family of bicycles, disabled on the road. The bike rack was defective, and its anchor had loosened on top of our car.

I stroked Amy’s arm, unable to hug her from the front seat. Then I echoed my mother’s voice, recalling the time she reassured me that she had minimal injuries after her car tires blew out on the highway: “Things can be replaced. People can’t.”

Amy stared at her bent wheel, the torn seats of all three, my basket crushed flat. “My bike can’t be replaced!” Her bike was a symbol of independence and growing up, the freedom of wheels that I hadn’t had at her age.

Just that morning we’d taken a farewell ride to say good-bye to the lake, feeding ducks leftover bread, a three-generational family ritual started years ago by my mother, and continued after she died.

“We’re lucky we had one last ride together,” Amy said now, watching grimly while my husband, Steve, dragged the bikes and twisted rack off the highway. We dialed 911 and waited for a state trooper to arrive. No one had been hurt, but we had the wreckage to contend with: The rack was ruined and there was no way to fit the bikes in the car.

Amy, freshly freckled from weeks in the sun, stroked her bike’s front tire. This was her first brush with the startling reality that everything can change in an instant.

She scraped the registration sticker from her bike frame, her own personal memory. I knew then, just as my mother eventually realized, that I wouldn’t always be able to protect my daughter from harm. And like my mother, I would never stop trying. But I also learned the value in encouraging my daughter to have adventures I’d been denied, even if they sometimes end with tears.

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No Way!

From Texas A&M

Contrary To An Earlier Study HSC Confirm Exercise Is Good For Your Brain

Morning YogaResearch has found that exercise causes more new neurons to be formed in a critical brain region, and contrary to an earlier study, these new neurons do not cause the individual to forget old memories, according to research by Texas A&M College of Medicine scientists, in the Journal of Neuroscience.

Exercise is well known for its cognitive benefits, thought to occur because it causes neurogenesis, or the creation of new neurons, in the hippocampus, which is a key brain region for learning, memory and mood regulation. Therefore, it was a surprise in 2014 when a research study, published in the journal Science, found that exercise caused mice to forget what they’d already learned.

“It stunned the field of hippocampal neurogenesis,” said Ashok K. Shetty, PhD, a professor in the Texas A&M College of Medicine Department of Molecular and Cellular Medicine, associate director of the Institute for Regenerative Medicine, and research career scientist at the Central Texas Veterans Health Care System. “It was a very well-done study, so it caused some concern that exercise might in some way be detrimental for memory.”

The animal models in the exercise group—in the previous study—showed far more neurogenesis than the control group, but contrary to what one might think, these additional neurons seemed to erase memories that were formed before they started the exercise regimen. To test this, the researchers removed the extra neurons, and the mice suddenly were able to remember again.

“The mice who exercised had a large number of new neurons,” Shetty said, “but somehow that seemed to break down the old connections, making them forget what they knew.”

Shetty and his team decided to replicate this earlier research, using rats instead of mice. Rats are thought to be more like humans physiologically, with more-similar neuronal workings. They found that—luckily for runners everywhere—these animal models showed no such degradation in memories.

“We had completely contradictory findings from the 2014 study,” said Maheedhar Kodali, PhD, a postdoctoral fellow at the Institute for Regenerative Medicine and the first author of this study. “Now we need to study other species to fully understand this phenomenon.”

Shetty and his team trained their animal models to complete a task over the course of four days, followed by several days of memory consolidation by performing the task over and over again. Then, half the trained animal models were put into cages with running wheels for several weeks, while the control group remained sedentary.

The rats who ran further over the course of that time had much greater neurogenesis in their hippocampus, and all rats who had access to a wheel (and therefore ran at least some), had greater neurogenesis than the sedentary group. On an average, they ran about 48 miles in four weeks, and neuron formation doubled in the hippocampus of these animals.

“This is pretty clear evidence that exercise greatly increases neurogenesis in the hippocampus, which has functional implications,” Kodali said. “Neurogenesis is important for maintaining normal mood function, as well as for learning and creating new memories.” This connection may help explain why exercise is an effective antidepressant.

Importantly, despite differing levels of increased neurogenesis, both moderate runners and brisk runners (those who ran further than average) in Shetty’s study showed the same ability as the sedentary runners to recall the task they learned before they began to exercise. This means even a large amount of running (akin to people who perform significant amount of exercise on a daily basis) doesn’t interfere with the recall of memory.

This new research should provide some comfort to those who read the earlier research and worried that their nightly run is causing them to forget things.

“Exercise is not at all harmful,” Shetty said. “It doesn’t cause any memory problems, and there are many studies proving its benefits for making new memories and maintaining good mood. Now, our study showed that exercise does not interfere with memory recall ability. Keep exercising, and don’t worry about losing your old memories.”

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Being a 200-lb. female athlete

From The Indy Star

Being a 200-lb. female athlete: Indiana Olympic throwers talk

They don’t fit the body mold of the elite female athlete. That’s OK. That’s what’s made them a success.

Dense. Thick. Broad. Bulky.

Doesn’t matter the word, these women get it. They don’t look like elite athletes.

In the pool of Olympic competitors — world-class, premier athletes displaying cut, toned, lean bodies —the throwers on the U.S. Olympic track and field team often don’t fit the mold.

The shot put and javelin hoisters, the hammer and discus throwers. These are the bigger women of the Olympics – women who have, admittedly, had to come to terms with the bodies they live in and the scrutiny they face.

More than 200 pounds at 5-7 — that’s what U.S. Olympic hammer thrower Amber Campbell measures. Scales and doctors offices, weight charts and body mass calculations, those all conclude one thing: obese.

Campbell is just fine with her body measurements. She’s healthy, strong and kicking butt at what she loves.

“I’ll never be 135 pounds at 5-foot-7,” said Campbell, 35, a Pike High School graduate who is at her third Olympics, the games in Rio. “If I were 135 pounds, I couldn’t throw a hammer. It’s not about being wispy and thin. To be a good athlete, you have to be strong.”

Earlier this month, Campbell threw her lifetime best — 242 feet, 10 inches — the top throw by an American this year and No. 4 on the all-time U.S. list. It happened as she repeated as U.S. Olympic Trials champ, setting a trials record as well.

It took Campbell some time to mesh a positive self identity with a larger body, especially as a young girl who would eat when she felt down. The acceptance came on the playing field where sports didn’t discriminate by size. If she was a good competitor, that’s what mattered.

“I realized, it’s not about how I looked, but how I felt,” she said. “I was able to look in the mirror and just appreciate what God made me physically. And mentally I started to accept it.”

The positive body image Campbell has achieved isn’t something all female athletes have. Even the 90-pound gymnasts and the 120-pound swimmers. Even the lanky basketball players on the U.S. basketball team.

Many female athletes — more than 25 percent — dangerously restrict their eating, often in hopes that losing weight will increase their sports performance, according to a 2015 study by the NCAA Sport Science Institute, The Female Athlete Body Project.

Female athletes often don’t consume the amount of calories needed for their intensely active lifestyle. They may compare their consumption to what non-athletes are eating, and their bodies to what those women look like, the study found.

Women athletes also may see a super-thin body as one that signals she is more committed to her sport, when in reality she is “severely harming her body,” the researchers said.

Even the most lean of athletes can grapple with body image, Lewis said.

“Professional bodybuilders, it’s not horribly uncommon that body image is still a struggle for them,” she said. “A lot of this has to do with how we frame things up in our minds. The way we think about things, if it’s skewed.”

Lewis gives the example of the tiny smart car. If that’s considered the perfect size for a car?

“Then a bigger car, even if it’s a great luxury vehicle, it looks horrible,” she said, “because it’s not the right size.”

Kara Winger, a Purdue University grad in Rio for the javelin throw, remembers the ex-boyfriend in college who told her — after she started lifting weights — it was a good thing they had broken up.

“Because he wasn’t into girls who were bigger like me,” said Winger, 30, who is 6 feet tall and 185 pounds. She immediately developed thicker skin about the topic and came to realize her body is perfect for her.

“I used to spend time wishing my limbs were skinnier or I had a firmer behind,” said Winger, the American record holder in javelin. “But in the past few years, I’ve really honed in on how good my body feels when I’m in great competition shape.”

Winger has felt the expectations that a female athlete should be “lean and mean, with defined muscles all over.”

“Those things are not predetermined in my genes, so when I force myself there, disaster strikes,” she said. “I’m gifted with height, long arms, powerful legs and a midsection that is wide and strong enough to transfer tons of energy during a throw. I have to give this body muscle and a little bit of cushion so that it will continue performing the extreme task I ask of it.”

Felisha Johnson, 280 pounds and 6-1, never had any dreams that she would look like the models on the New York City runways.

Lawrence North and Indiana State graduate Felisha Johnson talks about competing in basketball and shot put. (David Woods / IndyStar)

“I knew I was never going to look like that,” said Johnson, a Lawrence North grad who is in Rio as an Olympic shot putter. “My family is on the bigger side.”

When asked to describe her body image, Johnson reveals confidence.

“Athletic, a normal body image for women,” she said. “Muscular and bigger.”

Johnson, 27, attributes her acceptance and positive body image to her parents, who always said, “Your body is your body.”

“They never said, ‘Hey, you need to lose weight,’ ” she said. “If you want to be an athlete, your body is going to be totally different.”

Johnson said in the circles she hangs with, she’s average.

“But people in the outside world, they will say, ‘You’re huge. How much do you bench?’ ” she said.

Comments like that irk Herb Sampson, owner of Titan Fit in Indianapolis, a Cross Fit affiliate that specializes in strength training.

“It’s still hard because the vast majority of people 30 and older will still say to women, ‘Oh you should lose 10 pounds,’ ” he said.  “For what? So I’m more appealing to you? I want to win a gold medal. I want to be strong.”

At the end of the day, no matter what the sport or the challenge, the person who is stronger will always win, Sampson said.

“You can’t be too strong,” he said. “I always tell my clients when you get too strong, I’ll give you your money back.”

Sampson does think that societal norm has shifted somewhat with stronger women — not skinny women — more accepted as the standard of beauty. But there is a ways to go.

Amanda Bingson, the American record holder in the hammer throw, has been outspoken about body shaming and fat bashing. She posed partially nude for ESPN The Magazine’s body issue in 2015. She confidently reveals that her weight hovers around 210 pounds.

“Dense would be the right word for me,” she told ESPN. “Generally, when you look at athletes, you see their muscles and all that stuff; I don’t have any of that. My arm is just my arm — it’s not cut, it’s not sculpted. I don’t have traps bulging out to my ears; I have a neck. I don’t have a six-pack. My legs are a little toned, but they aren’t bulging out. I’m just dense. I think it’s important to show that athletes come in all shapes and sizes.”

Campbell thinks that’s important, too, but even better? Don’t worry about what anyone else thinks.

“I don’t think it’s super healthy to be so focused on what somebody else’s perception of you is,” she said. “Whether that’s skinny, strong, or anything else. Just focus on being healthy.”

Follow IndyStar reporter Dana Benbow on Twitter: @DanaBenbow.

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Hour of Exercise a Day May Offset Sitting’s Toll on Health

Let’s hope!

From Health Day

Hour of Exercise a Day May Offset Sitting’s Toll on Health

Study found risk of early death dropped when physical activity levels went up


By Steven Reinberg
HealthDay Reporter

WEDNESDAY, July 27, 2016 (HealthDay News) — Just one hour of physical activity a day — something as simple as a brisk walk or a bicycle ride — may undo the increased risk of early death that comes with sitting eight hours or more on a daily basis, a new study suggests.

“These results provide further evidence on the benefits of physical activity, particularly in societies where increasing numbers of people have to sit for long hours for work or commuting,” said lead researcher Ulf Ekelund. He is a professor in physical activity and health at the Norwegian School of Sport Sciences in Oslo, Norway.

“Unfortunately, only 25 percent of our sample exercised an hour a day or more,” he said.

The study also found that watching TV for three hours or more a day was linked with an increased risk of early death, regardless of physical activity — except among those who were the most physically active.

However, even among those who exercised the most, the risk of premature death was significantly increased if they watched five hours of TV a day or more, the researchers added.

It’s not TV, per se, that is associated with an increased risk of dying early; rather, TV is a marker for sitting and not being active, Ekelund said.

In their review of 16 previously published studies that included more than one million people, the researchers divided the participants into four groups: those who got about 5 minutes of moderate-intensity exercise a day; 25 to 35 minutes a day; 50 to 65 minutes day; and 60 to 75 minutes a day.

The increased risk of early death ranged from 12 percent to 59 percent, depending on how much exercise the participants got, the findings showed.

“Indeed, those belonging to the most active group, and who are active about 60 to 75 minutes per day, seem to have no increased risk of mortality, even if they sit for more than eight hours a day,” Ekelund said.

“Sit less, move more, and the more you move the better,” he suggested.

The report, which did not prove that inactivity caused early death, was published online July 27 in The Lancet.

According to Dr. David Katz, president of the American College of Lifestyle Medicine, “This important analysis fortifies the increasingly clear verdict from a large and growing body of evidence addressing physical activity and health: all movement is good movement.”

Evidence is clear that moderately vigorous exercise has an array of health benefits, Katz said.

“If you don’t exercise but can stand often, do. If you can’t stand often but can exercise, do,” he added. “Better still, do both. It’s clear: all movement is good movement.”

Not only does physical inactivity increase the risk of early death, it’s expensive, according to another study published in the same journal issue.

In that study, researchers estimated the cost of being physically inactive based on the increased risk for type 2 diabetes, heart disease, stroke, and breast and colon cancer. In 2013 dollars, the study authors estimated that inactivity costs the United States about $28 billion annually.

“The current economic cost of physical inactivity is borne mainly by high-income countries. However, as low- and middle-income countries develop, and if the current trajectory of inactivity continues, so too will the economic burden in low- and middle-income countries who are currently poorly equipped to deal with chronic diseases linked to physical inactivity,” study author Dr. Melody Ding, of the University of Sydney in Australia, said in a statement.

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Three minutes, forty-three seconds, and thirteen hundredths of a second is the fastest that a human has ever run a mile, as far as we know. Hicham El Guerrouj, a Moroccan middle-distance runner who was then twenty-four years old, accomplished the feat in 1999, averaging slightly more than sixteen miles per hour as he sped around Rome’s Olympic Stadium track. A determined wisp of a man, El Guerrouj weighed a hundred and twenty-eight pounds at the time and stood five feet nine inches tall in his running socks. Those few who’ve come close to running a mile as fast as El Guerrouj have been roughly the same size, and that’s not a coincidence: if you wish to run middle or long distances quickly, it helps to travel light.

The Jamaican sprinter Usain Bolt, on the other hand, has “one of mankind’s most sculpted bodies,” as GQ put it a few years ago: he is eight inches taller than El Guerrouj and weighs more than two hundred pounds. When the six-time Olympic gold medalist set his hundred-metre world record of 9.58 seconds, in Berlin, in 2009, at the age of twenty-two, he averaged more than twenty-three miles per hour, peaking at more than twenty-seven. He couldn’t sustain that pace over a continuous mile, of course; his best two-hundred-metre (19.19) and four-hundred-metre times (45.28) make that clear. So how much would Bolt slow down while running a full mile? Could he run that distance in less than, say, five minutes?

This hypothetical has been debated by running geeks for years. On the popular Web site, for instance, one commenter began a discussion of the topic five years ago; the most recent reply is from this past May. Respondents have suggested times as low as 3:55—fewer than five hundred Americans have ever run an officially recognized four-minute mile—and as high as six minutes, a feat well within the grasp of a half-decent teen-age miler. (More than twenty-three thousand high-school runners clock a five-minute mile in the United States each year.) The prevailing wisdom on the thread was summed up best by a visitor using the handle “idiots,” who commented last July, “Are you guys insane??? One of the world’s best junior 400m runners and possibly the greatest 100m/200m runner ever and you think his mile is the same as any random high school kid running track? You really think because he sprints he has no aerobic fitness at all?”

The co-founder of, Robert Johnson, who is a former college cross-country coach, has a different view. “The question is a good one,” he said recently. “But those people on the site are all distance runners who have no idea what they are talking about.” Johnson is “very confident” that Bolt would not be able to break five minutes. “If that was the over/under, I’d mortgage my nonexistent house to try to bet up to six figures he was over that,” Johnson said. “He’s a total fast-twitch-muscle-fibre guy. To expect Bolt to be good at the mile simply because he is the world’s greatest sprinter would be like expecting a great three-hundred-and-twenty-pound N.F.L. offensive lineman to be good at playing running back simply because he’s a great football player. It’s ludicrous.”

Johnson has a twin brother, though, named Weldon, a former Olympic-trials distance runner who co-founded the Web site with him. Weldon respectfully disagrees with his brother. “With training,” he told me, “I would think Bolt could break five minutes.” Other educated observers are willing to go even further. Zebulon Lang, an assistant track and cross-country coach at Cornell University, said, “I’m happy to go on record that I believe Bolt could run a mile in 4:20 right now.” Lang cites the strong fifteen-hundred-metre time (4:14) by the world-record-holding decathlete Ashton Eaton, as well as the impressive eight-hundred-metre début time (1:53) by Jeremy Wariner, a three-time gold medalist in the four hundred metres. Lang’s thinking, essentially, is this: if one of the best quarter-milers ever can become an élite half-miler, and perhaps the best decathlete ever can run what equates to a 4:34 mile, then the best sprinter of all time can at least run a mile as well as a strong high-school athlete.

But what about Bolt’s likely inability to pace himself over longer distances—not to mention his body’s spiking blood-lactate levels and relatively poor capillary density as his body exceeds its trained limits? (Running a mile quickly requires efficient consumption of oxygen and recycling of the body’s accumulating lactate; running a hundred metres quickly does not.) His mostly anaerobic training would hurt him in a mostly aerobic race, right? Probably. “Speed over short distances does not automatically guarantee relative speed over long distances,” Ross Tucker, a professor of exercise physiology at the University of the Free State, in South Africa, told me. “Mainly because the system used to produce energy sent to muscles is quite different. What a one-hundred- or two-hundred-metre sprinter relies on is incapable of meeting his demands over a mile. By definition, the training a short-distance sprinter does is in polar opposition to that of a middle-distance runner. One-hundred-metre speed translates pretty well up to four hundred metres. But after that there is a large change.”

Tucker, too, brought up Ashton Eaton. “If he runs 4:15 to 4:17 [in the fifteen hundred metres] at the end of two days of decathlon competition, I reckon a fresh effort puts him at around 4:20 for a mile,” he said. “Yes, a decathlete’s training is necessarily geared towards more endurance than a one-hundred-metre runner, but I don’t think to the extent that they’re an irrelevant comparison. If Eaton is capable of a 4:20 mile with his training, then Bolt,” with middle-distance training, “won’t be much faster than 4:30, in my opinion.” If Tucker had to guess, he’d put his money on 4:45 to 4:50. “But the incentive for him would have to be large.”

There are relevant precedents one can cite, and they don’t bolster the case for Bolt’s success. The late American sprinter Florence Griffith Joyner, who won three Olympic gold medals and still holds world records in both the hundred (10.49) and two hundred metres (21.34), attempted to become a distance runner after her sprinting career ended. It didn’t work out well. Perhaps the most visually convincing argument against Bolt’s potential prowess in the mile is the footage of the nine-time Olympic gold medalist and sprinting specialist Carl Lewis struggling to run a 2:16 half-mile in his prime, in 1986, on television. It’s clear from his last lap that the man who was then the “fastest human in the world,” as the TV announcer calls Lewis, is spent. He makes the half-mile look hard. “There’s no way Lewis would have finished that mile in under five minutes,” Robert Johnson told me.

Bolt’s agent, Ricky Simms, won’t say whether he believes that his client could run a mile in less than five minutes. But Simms confirmed, over e-mail, that the world’s greatest sprinter has, in fact, never tried running that far: “Usain has never run a mile.”

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Clean Ladder


135 x10, x8, x6, x4, x2

115 x10, x8, x6, x4, x2

95 x10, x8, x6, x4, x2

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How the Government Supports Your Junk Food Habit

From The New York Times

How the Government Supports Your Junk Food Habit

At a time when almost three-quarters of the country is overweight or obese, it comes as no surprise that junk foods are the largest source of calories in the American diet. Topping the list are grain-based desserts like cookies, doughnuts and granola bars. (Yes, granola bars are dessert.)

That’s according to data from the federal government, which says that breads, sugary drinks, pizza, pasta dishes and “dairy desserts” like ice cream are also among Americans’ top 10 sources of calories.

What do these foods have in common? They are largely the products of seven crops and farm foods — corn, soybeans, wheat, rice, sorghum, milk and meat — that are heavily subsidized by the federal government, ensuring that junk foods are cheap and plentiful, experts say.

Between 1995 and 2010, the government doled out $170 billion in agricultural subsidies to finance the production of these foods, the latter two in part through subsidies on feed grains. While many of these foods are not inherently unhealthy, only a small percentage of them are eaten as is. Most are used as feed for livestock, turned into biofuels or converted to cheap products and additives like corn sweeteners, industrial oils, processed meats and refined carbohydrates.

Health advocates have long pointed out this seeming contradiction. While the federal government recommends that people fill half their plates with fruits and vegetables to help prevent obesity, only a small fraction of its subsidies actually support the production of fresh produce. The vast majority of agricultural subsidies go instead to commodity crops that are processed into many of the foods that are linked to the obesity crisis.

“The subsidies damage our country’s health and increase the medical costs that will ultimately need to be paid to treat the effects of the obesity epidemic,” a 2012 report from the U.S. Public Interest Research Group, a nonprofit consumer advocacy organization, concluded. “Taxpayers are paying for the privilege of making our country sick.”

Now federal health researchers have examined the relationship between metabolic disease and the consumption of federally subsidized foods.

The study, led by a team at the Centers for Disease Control and Prevention and published this month in JAMA Internal Medicine, looked at over 10,000 adults and the foods they reported eating in a typical day. Then the researchers split the subjects into groups according to the proportion of foods they ate that were derived from the seven major subsidized commodities.

After adjusting for age, sex, socioeconomic factors and other variables, the researchers found that those who had the highest consumption of federally subsidized foods had a 37 percent greater risk of being obese. They were also significantly more likely to have belly fat, abnormal cholesterol, and high levels of blood sugar and CRP, a marker of inflammation.

While the study does not prove cause and effect, its authors say that this strong association is consistent with other research showing that diets that are higher in subsidized foods tend to be poorer quality and more harmful to health.

“This tells us that the factors that influence the prices of our foods are an additional factor,” said Ed Gregg, chief of the epidemiology and statistics branch in the C.D.C.’s Division of Diabetes Translation. “We’re hoping that this information reaches policy makers and the people who influence how subsidies work.”

The subsidies program was started decades ago in part to support struggling farmers and to secure America’s food supply. Since 1995, the government has provided farmers with close to $300 billion in agricultural subsidies overall, which are included in the federal farm bill, along with money for nutrition initiatives like the federal food stamps program, known as SNAP. The farm bill is renewed by Congress every five years; the version approved in 2014 called for $956 billion in spending.

But critics say the subsidies program no longer serves its original purpose. Instead of supporting small farmers who grow fruits, nuts and vegetables – which the government calls “specialty crops” — the program now primarily subsidizes large producers that churn out a handful of “commodity” crops that include grains, corn, sorghum and oilseeds like soybeans.

According to the Government Accountability Office, small “specialty” farms represent three-quarters of the country’s cropland but receive just 14 percent of government subsidies. Large agribusinesses that specialize in growing the major commodity crops represent 7 percent of the cropland and receive about half of all subsidies.

Previous versions of the farm bill even stipulated that farmers who took subsidies for commodity crops could not grow fruits and vegetables. If they did, they were penalized, said Caroline Franck, the co-author of a 2012 report in the Archives of Internal Medicinethat explored the role of agricultural subsidies in obesity.

Ms. Franck, a research assistant at the Lady Davis Institute for Medical Research of the Jewish General Hospital, McGill University, said many factors influence what people choose to eat. While it’s difficult to argue that subsidies are a direct cause of obesity, they clearly play a role.

“I think it’s safe to say that what happens at the top of the food chain has an impact on what happens at the bottom,” she said. “Agricultural policies are just not aligned with public health goals.”

In part because of public pressure, the last farm bill, which was passed in 2014, allowed farmers who grow commodity crops to use 15 percent of their acreage to grow fruits, vegetables and other specialty crops. It provided support to organic farmers, including $100 million for research to improve organic production. And it funded a “healthy incentives” program that encourages food stamp recipients to consume more fruits and vegetables by increasing the value of food stamps that are used to buy fresh produce at retail stores or farmers’ markets.

Ms. Franck said that early results suggest that the program is increasing the amount of fresh produce people consume. But others are not so sanguine. Raj Patel, a research professor at the Lyndon B. Johnson School of Public Affairs at the University of Texas at Austin, said that the funding for fruits and vegetables in the most recent farm bill was “crumbs” compared to the billions in subsidies for commodity crops.

Dr. Patel said it was time for the federal government to adopt a “national food policy” like one that has been proposed by the Union of Concerned Scientists, a nonprofit advocacy group. Among other things, a national food policy would ensure that farm workers receive fair wages, that all Americans have access to healthy foods, and that the government’s nutrition recommendations and agricultural policies are aligned, he said.

“It would transition us away from the unhealthy consequences of the current industrial food policy,” he said. “I think there’s something very broken about the subsidy system.”

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What foods are healthy

Is popcorn good for you? What about pizza, orange juice or sushi? Or frozen yogurt, pork chops or quinoa?

Which foods are healthy? In principle, it’s a simple enough question, and a person who wishes to eat more healthily should reasonably expect to know which foods to choose at the supermarket and which to avoid.

Unfortunately, the answer is anything but simple.

The Food and Drug Administration recently agreed to review its standards for what foods can be called “healthy,” a move that highlights how much of our nutritional knowledge has changed in recent years – and how much remains unknown.

With the Morning Consult, a media and polling firm, we surveyed hundreds of nutritionists – members of the American Society for Nutrition – asking them whether they thought certain food items (about 50) were healthy. The Morning Consult also surveyed a representative sample of the American electorate, asking the same thing.

The results suggest a surprising diversity of opinion, even among experts. Yes, some foods, like kale, apples and oatmeal, are considered “healthy” by nearly everyone. And some, like soda, french fries and chocolate chip cookies, are not. But in between, some foods appear to benefit from a positive public perception, while others befuddle the public and experts alike. (We’re looking at you, butter.)

“Twenty years ago, I think we knew about 10 percent of what we need to know” about nutrition, said Dariush Mozaffarian, the dean of the Tufts Friedman School of Nutrition Science and Policy. “And now we know about 40 or 50 percent.”

Here’s what we found.

Foods considered healthier by the public than by experts
Percent describing a food as “healthy” Nutritionists Public Difference
Granola bar 28% 71%
Coconut oil 37% 72%
Frozen yogurt 32% 66%
Granola 47% 80%
SlimFast shake 21% 47%
Orange juice 62% 78%
American cheese 24% 39%

Of the 52 common foods that we asked experts and the public to rate, none had a wider gap than granola bars. More than 70 percent of ordinary Americans we surveyed described it as healthy, but less than a third of nutritional experts did. A similar gap existed for granola, which less than half of nutritionists we surveyed described as healthy.

Several of the foods considered more healthful by everyday Americans than by experts, including frozen yogurt, a SlimFast shake andgranola bars, have something in common: They can contain a lot of added sugar. In May, the Food and Drug Administration announced a new template for nutrition labels, and one priority was to clearly distinguish between sugars that naturally occur in food and sugars that are added later to heighten flavors. (You’d be surprised how many foods contain added sugar.) It’s possible nutritionists know this, but the public still does not.

Foods considered healthier by experts than by the public
Percent describing a food as “healthy” Nutritionists Public Difference
Quinoa 89% 58%
Tofu 85% 57%
Sushi 75% 49%
Hummus 90% 66%
Wine 70% 52%
Shrimp 85% 69%

On the other end of the spectrum, several foods received a seal of approval from our expert panel but left nonexperts uncertain. Most surprising to us was the reaction to quinoa, a “superfood” grain so often praised as healthful that it has become the subject of satire. (At the moment, The New York Times cooking site offers 167 recipes for quinoa, roughly a third of which are explicitly tagged “healthy.”)

In addition, tofu, sushi, hummus, wine and shrimp were all rated as significantly more healthful by nutritionists than by the public. Why?

One reason may be that many of them are new foods in the mainstream American diet. Our colleague Neil Irwin measured mentions of trendy foods in Times coverage over the years, and found that quinoa had only recently picked up steam. Others may reflect mixed messages in press coverage of the healthfulness of foods. Shrimp was long maligned for its high rate of dietary cholesterol, though recent guidelines have changed. And public messages about the healthfulness of alcohol are conflicting: While moderate drinking appears to have some health benefits, more consumption can obviously have real health costs.

We weren’t surprised to find areas in which both ordinary Americans and experts disagreed.

We expect researchers to be better informed about current research, and everyday consumers to be more susceptible to the health claims of food marketers, even if the claims are somewhat dubious.

But some of the foods in our survey split both the public and our panel of experts.

Foods that both experts and the public have mixed feelings about
Percent describing a food as “healthy” Nutritionists Public Difference
Popcorn 61% 52%
Pork chops 59% 52%
Whole milk 63% 59%
Steak 60% 63%
Cheddar cheese 57% 56%

Four of the foods listed above – steak, cheddar cheese, whole milkand pork chops – tend to have a lot of fat. And fat is a topic few experts can agree on. Years ago, the nutritional consensus was that fat, and particularly the saturated fat found in dairy and red meat, was bad for your heart. Newer studies are less clear, and many of the fights among nutritionists tend to be about the right amount of protein and fat in a healthy diet.

The uncertainty about these foods, as expressed both by experts and ordinary Americans, reflects the haziness of the nutritional evidence about them. (If you’re a steak lover and you find this news discouraging, our colleague Aaron Carroll has written that red meat is probably fine in moderation.)

It’s clear that many shoppers do want to eat healthful foods but are unsure what to choose. To gain some perspective on this, we asked Google which foods were most commonly part of a simple search: “Is [blank] healthy?” We used these results to generate some of our survey questions. The food people were likeliest to ask about was also one nutritionists generally approve of: sushi.

Is _________ healthy? What American internet users searched for most often

4.peanut butter
11.brown rice
15.cottage cheese
18.rye bread
23.white rice
26.dark chocolate
27.coconut milk
29.canned tuna
30.feta cheese
32.frozen yogurt
33.beef jerky
36.chinese food
38.greek yogurt
39.brown sugar
41.sparkling water
42.turkey bacon
45.sourdough bread
46.smoked salmon
47.dried fruit
48.miso soup
49.Indian food
50.Basmati rice

There are some areas of nutritional consensus. Nearly everyone agreed that oranges, apples, oatmeal and chicken could safely be described as healthy, and also agreed that chocolate chip cookies,bacon, white bread and soda could not.

Foods that both groups think are unhealthy
Percent describing a food as “healthy” Nutritionists Public Difference
Hamburgers 28% 29%
Beef jerky 23% 27%
Diet soda 18% 16%
White bread 15% 18%
Chocolate chip cookies 6% 10%
Foods that both groups think are healthy
Percent describing a food as “healthy” Nutritionists Public Difference
Apples 99% 96%
Oranges 99% 96%
Oatmeal 97% 92%
Chicken 91% 91%
Turkey 91% 90%
Peanut butter 81% 79%
Baked potatoes 72% 71%

Where does this leave a well-meaning but occasionally confused shopper? Reassured, perhaps: Nutrition science is sometimes murky even to experts.

Your overall diet probably matters a lot more than whether you follow rigid rules or eat just one “good” or “bad” food. Our colleague Aaron Carroll has published a list of common-sense rules for healthful eating, which represents a good start.

We also asked our experts whether they considered their own diet healthful, and how they described it. Ninety-nine percent of nutritionists said their diet was very or somewhat healthy. The most popular special diet type was “Mediteranean”; 25 percent of our nutritionists picked it. But the most common answer, even for experts, was “no special rules or restrictions.”