Posts for: December, 2013
By: Douglas Anderson, DC, DACBSP, CCN
Recently, a national online news magazinecame out with what may be developing into an annual event. For the third straight year, the magazine asked experts to rate diets. In this case, 19 panelists ranked 29 diets for a number of categories including weight loss. Since every diet has supporters and only one can have the highest ranking, this exercise can start as many arguments as ranking the 29 cutest breeds of puppies. After I read what they had to say, rather than getting pulled into a food fight (pun intended), my thoughts centered on why we need so many diets as decided it was time for an obesity update.
Even though the American Medical Association reclassified obesity as a disease during its 2013 annual meeting (more on that next month), America's obesity explosion appears to have leveled off. In fact, the U.S. is no longer the fattest nation on Earth, having just been passed by Mexico. The bad news is that almost seven out of 10 adults in America need to lose weight. The reason is simple - too many calories ingested, too few calories expended.
Body mass index (BMI) is a popular way for epidemologists to classify the weight of large groups of people. BMI is calculated in the following ways: body weight in kilograms divided by the height in meters squared; or body weight in pounds divided by the height in inches, squared and multipled by 705.
The BMI is fairly accurate for normal people. It is not as accurate for extremely short people or athletic people (heavy exercisers) of normal size, and completely inaccurate for those who are heavily muscled. BMI accuracy improves when used to compare large sample sizes.
Americans went on a 25-year bender from 1975 to 2000. Although I elected to list data at five-year intervals, from 2000 to 2007, America hit a seven-year calorie plateau. From 2008 to 2010, there were slight declines for three straight years - something not seen since 1972 to 1975.
If you compare 1975 with 2010, you will see an increase of approximately 484 calories per day, 92 percent of which (about 446 calories) is from grains, added fats and added sugars. The approximate breakdown in terms of calories from fats and approximately 209 calories from carbohydrates.
While the anti-fat and anti-carb crowds continue to blame each other for America's weight problem, the data shows that seven out of 10 Americans didn't become overweight from a single macronutrient. The best chancefor success is to tailor a program to fit a person's specific needs. This conflicts with the current model of having people conform to a program.
Insufficient activity is the other major factor in the fattening of America. In 2008, the U.S. Department of Health and Human Services published new exercise guidelines.
1. "Diet Plans That Work: U.S. News Best Diets." U.S. News and World Report, January 2013.
2. National Center for Health Statistics: Health, United States, 2012: With Special Feature on Emergency Care. Hyattsville, MD, 2013;
3. Schiller JS, Lucas JW, Ward BW,Peregoy JA. Summary of health statistics for U.S. adults: National Health Interview Survey, 2010. National Center for Health Stastics. Vital Health Stat, 2012; 10 (252): 100.
4. National Center for Health Statistics, Op Cit; Table 67, p. 215.
Two-time Olympic ice hockey player Caitlin Cahow this month wrote about the darkness following her concussions and thanked all of those who helped her return to the sunshine.
"One year ago today: I couldn't read, remember, think clearly, go outside without dark glasses, or stand for 5 minutes without debilitating headaches, dizziness and crippling fatigue. The joy had been stripped from my life. No future was imaginable," she posted on her Facebook account. "Today: two semesters shy of graduating law school, after a full day of work at my law firm, I came home to run a personal best 13 mile time into the sunset along the Charles River, symptomfree and irrepressibly happy. Do you believe in miracles? Because I am one."
Cahow, 28, won't be with the U.S. team when it gathers today to begin preparations for the Sochi Olympics- she retired this year- but she hopes her story helps others who have suffered traumatic brain injuries.
In terms of concussions, women's ice hockey is the most dangerous NCAA sport, according to a study using NCAA data from 1988 to 2004. In an Ivy League review of concussions in women's hockey released in May, the report cited that statistic among various other sobering numbers.
Theories abound on the reasons-from neck strength to officiating to the rules of the women's game. Body checking is not allowed, but it's still very physical. "Sometimes you're more likely to get a concussion in the women's game because we don't grow up hitting," Cahow said. "You're not trained to take hits."
Cahow was playing for her pro team, the Boston Blades, on Jan. 28, 2012, fighting for a puck along the wall when the hit came. She was diagnosed with a concussion and cleared to play a month later, only to be injured again when she was blindsided by a crushing hit. In the days that followed, she couldn't get out of bed. Each day was worse.
She had graduated from Harvard and was in law school at Boston College, and now she couldn't formulate sentences. For a stretch of two weeks, she didn't get out of bed. She doesn't remember even eating. She lost 25 pounds. The headaches persisted from the moment she woke up to the moment she tried to sleep and haunted her in nightmares in between.
"It was like having a zombie for a friend," said Blades and Harvard teammate Kate Buesser, who is with the national team this week.
The heavy haze of depression, that often-unspoken-of side of brain injuries, took over. Cahow says she understands now when she hears about a former NFL or NHL player who takes his life after struggling with a brain injury.
During a particularly dark stretch in the spring of 2012, she thought about the pain drugs that filled her medicine cabinet, the accumulated prescriptions from a life on the ice. She never liked taking any medications, not even Advil, but that was before she became someone else.
"I remember a day thinking, 'I have like five bottles of that stuff in my bathroom that could be an easy fix.' I thought about it, and I just thought about my mom," she said, her voice breaking, "I'm lucky. I thought of her and thought of my most cherished people, and I got myself up and went to the bathroom and threw everything away. I remember walking outside and throwing it in the dumpster, thinking I can't even have that near me."
Moving from Boston to her parents' house in the island town of Vinalhaven off the coast of Maine helped Cahow find her way back. She turned down an internship at a prestigious law firm, took the year off from law school, worked on a lobster boat and finallywent to see Ted Carrick, a chiropractic neurologist in Georgia who is best knownfor helping NHL star Sidney Crosby return to the ice. Carrick's practice seeks to improve brain function through eye exercises, practical therapy with tests on the ice in Cahow's case, and nutrition. By October, Cahow was also back in pads, playing for the Blades.
"I never thought I would play again. Walking was overwhelming. I couldn't imagine being on skates," she said.
In her first game back, Cahow scored about the ugliest goal ever recorded. No matter. Both teams clapped. Skating fast with the wind in her face never felt better. She finished the year as one of the top three defensemen in the Canadian Women's Hockey League, and the Blades won the league championship.
When Cahow was left off the roster for the U.S. team that won the world championships in April, she was crushed. She was invited to try out for the Olympic team but decided to retire, a decision that surprised many teammates.
"A lot of people don't know what it's like to go through something like that. There's not many people who lost as much as she has in terms of her job and her schooling. They've lost playing time but haven't lost parts of their lives they were working for," Buisser said. "She wanted to leave on her own terms."
"I felt the most remarkable sense of relief," Cahow said of her decision. "The thing that hurts the hardest has been my bruised ego. When you've been the best at something, you want it all the time; it's an addiction. One of the great things that this concussion taught me is that I have a lot of things I enjoy about my life and I found a lot of gratitude in meager things, just a beautiful day."
At that end of that beautiful day along the banks of the Charles River at sunset, Cahow wanted to thank all of those who carried her through those dark days. Her doctors, Carrick and Lynn Carlson; her friends and teammates; the lobster crew that nursed her back to health. And her mom, Barbara Kinder, "for smiling even when it hurt, and for holding me, when there was nothing else left to do," she wrote.
"I am stronger for the struggle, and more eager for the days to come. I don't want to waste one second of this second chance I have been given. Thank you to all who held my hand and guided me along the way. I am truly blessed."
Whiteside, Kelly. Out of Concussion Darkness: Ice hockey player Cahow recovers after brutal ordeal. USA TODAY. August 27, 2013