Mercury puts Arctic kids at risk

There is a long standing debate about the benefits of eating fish particularly for pregnant women and unborn children because of high levels of mercury in fish.

A recently published study shows how high intake of mercury is damaging brain development in Inuit children in the Arctic Quebec, Canada. Children’s IQ level was found to be linked to the intake of  marine animals with high mercury levels e.g. beluga whale, seal, walrus as well as fish.

Pregnant women in the Arctic have been urged to eat more Arctic Char as it is currently considered to be less contaminated.

The high exposure of mercury not only affects children’s IQ it can also effect attention, motor skills, heart rate and lead to respiratory problem and ear infections.

Jacobson JL, Muckle G, Ayotte P, Dewailly É, Jacobson SW. Relation of Prenatal Methylmercury Exposure from Environmental Sources to Childhood IQ. Environ Health Perspect; http://dx.doi.org/10.1289/ehp.1408554. Advance Publication: 10 March 2015

Background:

Although prenatal methylmercury exposure has been linked to poorer intellectual function in several studies, data from two major prospective, longitudinal studies yielded contradictory results. Associations with cognitive deficits were reported in a Faroe Islands cohort, but few were found in a study in the Seychelles Islands. It has been suggested that co-exposure to another contaminant, polychlorinated biphenyls (PCBs), may be responsible for the positive findings in the former study and that co-exposure to nutrients in methylmercury-contaminated fish may have obscured and/or protected against adverse effects in the latter.

Objectives:

To determine the degree to which co-exposure to PCBs may account for the adverse effects of methylmercury and the degree to which co-exposure to docosahexaenoic acid (DHA) may obscure these effects in a sample of Inuit children in Arctic Québec.

Methods:

IQ was estimated in 282 school-age children from whom umbilical cord blood samples had been obtained and analyzed for mercury and other environmental exposures.

Results:

Prenatal mercury was related to poorer estimated IQ after adjustment for potential confounding variables. The entry of DHA into the model significantly strengthened the association with mercury, supporting the hypothesis that beneficial effects from DHA intake can obscure adverse effects of mercury exposure. Children with cord mercury ≥ 7.5 μg/L were four times as likely to have an IQ score below 80, the clinical cut-off for borderline intellectual disability. Co-exposure to PCBs did not alter the association of mercury with IQ.

Conclusions:

To our knowledge, this is the first study to document an association of prenatal mercury exposure with poorer performance on a school-age assessment of IQ, a measure whose relevance for occupational success in adulthood is well established. This association was seen at levels in the range within which many U.S. children of Asian American background are exposed.

Full Article:  click here

Via: National Geographic

EAT LIKE A BABY TO LOSE WEIGHT AND GET HEALTHY

Babies use food for body building fuel and nourishment to develop a healthy growing body.  They have a built in alarm clock every two to  three hours that cries out to be fed, and they also will pull away from food when they are full, eliminating the need to count calories.  As adults, we can learn much from our precious infants.  Also, their nutrients are usually always quality coming straight from Mom’s milk, or formulas containing everything a growing body needs to be healthy.  If we grab onto this philosophy and implement that strategy into our own daily nutrition, we would be on our way to adopting a healthy lifestyle.

Eating is no longer about growing a strong healthy body with quality nutrients and everything about filling our precious system with crap that does nothing but take us further from being healthy people.  We no longer pay attention to our full barometer, intake too large of portions, and fill our stomachs with foods that lack in nutritional value that cause inflammation in our blood streams, the root cause of most disease of the human body.  Food is not only our fuel, but our medicine, and can truly keep our body top notch and healthy, with minimal visits to the doctor if we consistently intake quality healthy “real” foods.  We have come full circle into a fight against healthy food and are so caught up in being mad about what we eat and why we should not eat it when it comes to healthy food.  The reason for this unfortunate issue comes straight from what sits on our grocery shelves and the marketing ploys that we all face each day through sources of media and advertisement.  Studies have shown and there are plenty of documentaries to support that the major food producers are making us fat.  But it does take team work because we can choose to say no to processed, GMO (genetically modified organisms) products, and non-organic pseudo foods that do nothing but provide a momentary good flavor and add fat stores to our bodies.  Consider that anything in a box, bag, or wrapper with ingredients unable to be understood and further stating low fat, low-sugar, and low-calorie are nothing but chemical shit storms in a package. There will be some food items packaged and part of the organic and Non-GMO certified programs and I will applaud those food producers that do understand the importance of supplying that information to consumers.  Off that soap box and getting back to eating like a baby.

Back to the basics, simplicity, and stress free healthy eating just like when we were babies is the key to mastering our daily nutrition.  It is time to stop over-thinking, over-complicating, and to start making the focus about eating healthy.  Forget about the chemical shit storms and reach for the real foods: lean organic proteins, fresh vegetables and fruits, raw nuts and nut butters, organic eggs, plain Greek yogurts, healthy fats in olive oil and avocado are just a sampling of the many healthy foods just waiting for our purchase and consumption.  Change out the sodas for water and start getting excited about the vast amount of selections of healthy food.  Personally, my hunger alarm clock goes off just the same as a baby close to the three hour mark, and I grab something healthy and satisfy that natural feeling.  I do not count calories or even worry about that because what is important is the healthy food that I feed my body and eating just until I feel satisfied, never to the point of overfull.  My body knows how much it needs because I listen to when I should stop eating.  I will say that no one ever got fat eating Kale, so even if I did eat two pounds of greens, I still would not worry about that, but would most likely not enjoy my frequent bathroom visits as a result.   Life was simpler when we were babies and the decisions made for us as we naturally cried out when we felt hungry and satisfied within 20 minutes with a boob or bottle full of nutrients, but as adults we can create a similar life by having healthy foods in our homes and eating when we feel hungry, not because we are bored or trying to squash some emotional feelings through unhealthy processed stuff.  It is a simple perspective but gives us something to think about in regards to our “mental game” surrounding nutrition. 

Thanks for stopping by my Blog, hope you enjoy the content, and if you have not become a follower yet, I would love to see your face on my friend's list, or if you want to receive my free updates, use the button below to select your feed preference. I look forward to responding to your comments and appreciate your shares.

Stay Healthy ~ Darla 

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Is Meat Unhealthy? Consolidated links

Several people have asked for a consolidated list of links to my series on meat and health.  Here it is!  This should make it easier to share.  

Is Meat Unhealthy?  Part I.  Introduction and ethical/environmental considerations.

Is Meat Unhealthy?  Part II.  Our evolutionary history with meat.

Is Meat Unhealthy?  Part III.  Meat and cardiovascular disease.

Is Meat Unhealthy?  Part IV.  Meat and obesity risk.

Is Meat Unhealthy?  Part V.  Meat and type 2 diabetes risk.

Is Meat Unhealthy?  Part VI.  Meat and cancer risk.

Is Meat Unhealthy?  Part VII.  Meat and total mortality.

Is Meat Unhealthy?  Part VIII.  Health vs. the absence of disease.

Is Meat Unhealthy?  Part IX.  Summary.

Health Policy Insights from the Medical Home Summit: Wellness, ACOs

The Opening Ceremony of
The Medical Home Summit

The Population Health Blog is back home after attending the intellectually rewarding Population Health Colloquium and Medical Home Summit.  It was great to reconnect with old colleagues and make new friends.

In no particular order, here are some PHB take-aways:

One representative from household-name health insurer spoke in a lofty plenary session on the merits of keeping patients healthy. While the PHB was inspired by the videos of device-wearing joggers, it all seemed eerily reminiscent of the wacky pharmaceutical company value-propositions from years ago. That's when these companies said that they weren't selling "pills" but "cures."  It remains to be seen if Humana's transition from pooling risk to promoting fitness will lead to a similarly unprofitable ending.

More than one smart policymaker expressed skepticism on-stage about the ability of Accountable Care Organizations to reduce costs or increase quality. Wow. The PHB suspects more ACO shoes are getting ready to drop inside the beltway. If that's correct, it seems the expert-class is not only reducing their exposure to the coming stinkbombs, but is retooling to get in on The Next Big Idea gravy train.

One compelling speaker suggested that truly "patient-centric" primary care medical homes should offer timely access, the ability to talk to the doctor by phone at any time and attentiveness to the social dimensions of their patients' needs while richly rewarding docs to provide high-value care to fewer patients.  When the PHB mused out loud that may be what precisely what Concierge/Direct Primary Care practices are doing, the reaction of the audience prompted momentary concern that it might get lynched. 

The looming repeal of the SGR was mentioned only in passing, suggesting that few believe that this latest legislative fix portends a renewed commitment to health care reform.  As the PHB understands it, the current proposal commits Medicare to a .5% increase in physician fees per year over the next five years. This reminds the PHB of a compromise it made when the Spouse countered that a loaded SUV was a better option than a loaded sedan.  We got the loaded SUV.

And the EHR wasn't mentioned at all, which kept the PHB from offering its novel twist on Ms. Clinton's Emailgate tempest. It's clear that the Secretary reasonably concluded that her State Department's email system was unable to meet her personal workflow electronic communication and documentation needs. Our nation's EHR-using physicians feel her pain and salute her for her approach to finding a workable solution. After the American Medical Association gives her a suitable award, they should ask her if they can expect that same commitment to innovative health information technology solutions when she wins the White House.

Image from Wikipedia
         

Salted Caramel Oatmeal

Salted. Caramel. Oats. You like the sound of that? Oh yes you do. Having dessert(ish) foods for breakfast is what life is all about. Seriously, if you haven't tried the Creamy Chocolate Oatmeal that I posted some time ago, get on it, NOW! So next up is this sinfully indulgent beast of a breakfast that'll leave you fully satisfied and ready to take on a new day.

This recipe owes its sweetness to date paste, or date caramel as I prefer to call it (see below). I make mine by mashing a few soft dates with a fork but this may not be so easy if you don't have the right kind of dates. The ones I'm talking about here can be seen above; soft, un-pitted ones that are super easy to peel and have a melt-in-your-mouth consistency. If you can't find these where you live, soaking a few of the drier, pre-pitted dates overnight would probably work as well.

Date Caramel

The wonderful, caramel-y flavour comes from the amazing Organic Burst Maca Powder that I've been putting in everything lately. If you don't have any maca at hand then I suggest you sub it for a spoonful of mesquite powder or simply leave it out and let the dates work their caramel magic all on their own.

Salted Caramel Oatmeal

Ingredients:

- 1/2 cup rolled oats

- 1 cup unsweetened almond milk

- 3-4 soft dates with the pits still in them or 3-4 pre-pitted dates soaked overnight (30 g)

- 1/2 tbsp Organic Burst Maca Powder (could sub for mesquite or omit completely)

- Salt to taste

How to:

1. Bring oats, salt and almond milk to the boil (in a small saucepan) then lower the heat to a simmer.
2. Peel (optional) the dates and mash them to a gooey mess using a fork and a spoonful of water.
3. Add the date paste to the saucepan and stir well until the paste has dissolved in the oatmeal.
4. Stir frequently as you wait for the oats to get to the desired consistency. Add in the maca powder right at the end to preserve its nutrients as much as possible.
5. Add toppings such as banana coins and/or peanut butter and serve immediately.

FITNESS IS ABOUT TRUTH OR CONSEQUENCES

How many of us stand in the truth of our life or live in denial and non-acceptance of the actions that clearly rebel against a healthy lifestyle?  I wish I could see a show of hands and have a world-wide workshop to discuss this issue.  Standing in our truth has everything to do with being able to become a healthy person, and can be applied to all areas of our life: relationships, careers, fitness, and overall health which represent a moderate list that encompasses our existence as a human being.

Being honest with our self is the first step to being able to change those things that are weighing us down physically and emotionally.  If we are unable to be honest with ourselves, then being honest with others will not happen.  When lying to ourselves is at the forefront of or life, behaviors are usually exhibited through bitterness, anger, blame of others, argumentative reasoning, defensiveness, unhappiness, and a clear nonacceptance of responsibility. On the other side of that come acceptance of our truth and realizing that we can be healthier, happier people if changes are implemented each day to begin the process of adopting a healthy lifestyle.

Our responsibility is to stand in our truth and make the choice to go one way or the other.  Do we want to be healthy or not, do we want to continue in self-destructive behaviors or not, do we want to be happy or not, do we want to be an honest person or not?  Standing in our truth opens the door to trust of self and that can eventually be shared with others as we become examples of how to live a healthy life.  We can only live in the path of not standing in our truth for so long before serious consequences begin happening in the form of illness, depression, broken relationships, loss of friends, and even disengagement of family members.  A healthy person exhibits a happy outlook on life and is willing to share their experiences freely and with an open heart to sincerely help others because they know first- hand the work it took to stand in their truth.  The person that remains in denial continues to show a negative view of life, self, and people around them, and generally repel any meaningful relationships. 

The consequences to not standing in our truth to adopt a healthy lifestyle are harsh.  Lying to self and others remain on the top of the ugly list when it comes to life in general.  Living a healthy life will take the action of standing in our truth, acceptance of that truth and the follow-through with daily choices and actions to move our bodies and minds in a healthy direction. 

Thanks for stopping by my Blog, hope you enjoy the content, and if you have not become a follower yet, I would love to see your face on my friend's list, or if you want to receive my free updates, use the button below to select your feed preference. I look forward to responding to your comments and appreciate your shares. 

Stay Healthy ~ Darla

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Stay Healthy from my family to yours

Raspberry and Cherry Crumble Pi(e) for one

Happy pi(e) day! I always love to celebrate otherwise insignificant days that have somehow come to revolve around food. There is National Cinnamon Roll Day (which is kind of a Swedish thing), Mardi Gras, several pancake days and so on. This day in particular kind is so geeky and amazing at the same time that you just can't help but loving it. 

I pondered long on which pie to make. There was an idea of making it a banoffee-thingy lurking somewhere inside my mind, and vegan key lime pie had a certain appeal to it as well. As I was brainstorming, I kind of ran out of time. So what better way to save the day than to whip up an extraordinarily simple crumble pie! All you need is frozen or fresh berries and a couple of pantry staples and you're all set and ready to go!

Before going in the oven

Now, I usually make sure to test my recipes more than once before posting them on here but as there is so little that could possibly go wrong with this, I'll share this recipe before pi(e) day has passed. Let me know if you give it a try!

Raspberry and Cherry Crumble Pi(e) for one

Filling:

- 1 cup (roughly) frozen or fresh berries, I opted for frozen sweet cherries and frozen raspberries

- 1 tbsp cornstarch (potato starch/tapioca flour works as well)

- 1/2-1 tbsp sweetener of choice, such as coconut sugar or erythritol

Crumble:

- 4 tbsp rolled oats

- 1 tbsp coconut flour

- 2-3 dates (24g)

- 1/2 tbsp unsweetened apple sauce

- 1/2 tbsp melted coconut oil

- Pinch of pure vanilla powder

How to:

1. Preheat the oven to 350F/175C
2. Place berries in a bowl and toss in cornstarch until everything is coated.
3. Transfer to a small pie dish and add your sweetener to the berries by sprinkling/pouring it on top. (If you've gone for all sweet berries such as sweet cherries and strawberries, you may want to omit the sweetener.)
4. In another bowl, combine all the ingredients for the crumble -except for 1 tbsp oats- by blending them with a hand blender until a sticky dough forms.
5. Mix the remaining oats into the dough. It should crumble easily and if not, add a bit more liquid/flour until you've reached the right consistency.
6. Sprinkle the crumble evenly on top of the berries and bake in the oven for about 15 minutes or until it starts to brown.
7. Let cool for a few minutes and serve with a few spoonfuls of coconut cream (preferably whipped - mine wasn't) and even more fresh berries if you wish.

Food Reward Friday

This week's lucky "winner"... a bacon hot dog donut, by Krispy Kreme!

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The Latest Health Wonk Review Is Up

The latest Health Wonk Review is being hosted by Brad Wright and the cleverly named Wright On Health Blog.  This is a review of some of the better health policy blogs from about the web.  You Won't Go Rong by checking it out.

Enjoy!

FIX YOUR FITNESS

We do not need anyone to tell us that we are unhealthy or that we need to fix our fitness, right?  If you are unhappy with yourself, feeling like crap, have been told by the doctor to change your lifestyle, or have had your friends and family kindly give you hints, then guess what, you already know that you need to fix your fitness. Fitness goes beyond the physical and includes emotional and spiritual well-being as well.  Don’t think we can walk around in physically pretty bodies and be all messed up emotionally, stressed out, overwhelmed and feeling like life is too big to handle.  Fixing our fitness requires looking at our complete picture and making the choice to clean up our act. 

It is not rocket science and requires nothing magic to fix our fitness, just our will, determination and follow-through to become healthy.  The media would like us to believe that we need a bunch of expensive things, products, pills, and potions to obtain the body that we are looking for, but the truth of the matter is that we all possess the ability to create our fitness.  The first step is admitting the areas we are unhealthy and putting forth a plan of action to get the process of adopting a fit lifestyle started.  If being overweight and struggling with painful joints, lack of energy, low self-esteem, and frequent illness is the issue, a great start would be to look at daily nutritional intake and exercise. If emotional problems such as anger, high stress on the daily, inability to relax, and tension that sends your shoulders to the ears is a constant, a great start would be to look into what is causing these feelings through possibly a counselor or clergy member. 

The important thing is to get on board with fixing your fitness.  Procrastinating on this very important subject does nothing but waste what could be a healthier happier life.  Being in denial about being unhealthy is also a thief of health and fitness.  Changing our mental game and looking at ourselves with rose colored glasses off to expose all the unhealthy parts is what it will take to implement the changes needed to fix our fitness.  It is a brave step in the right direction and today is always the right day to get to work.  

Darla Leal, Fit at 50

Thanks for stopping by my Blog, hope you enjoy the content, and if you have not become a follower yet, I would love to see your face on my friend's list, or if you want to receive my free updates, use the button below to select your feed preference. I look forward to responding to your comments and appreciate your shares.

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A Health Care Clerisy?

We're here and we've figured it out

The Population Health Blog is reading Joel Kotkin's "The New Class Conflict." While it hasn't gotten through all of it, the central premise is a refreshingly alternative explanation for our
national malaise. 

It's less a matter of conservative vs. liberal ideologies that are leveraging class warfare. Rather, it's us vs. an unholy alliance of the new internet-media Oligarchs and their fawning expert clerisy.

"The New Class Conflict" doesn't dive into the implications for health reform. That naturally prompted the PHB to apply Mr. Kokin's lens to our healthcare expert class. 

Let the readers decide if this shoe fits. It may be paranoid, but it sure is fun to think about.

A quick word on the Oligarchs: these are the fabulously wealthy who dominate Silicon Valley.  They truly believe their template for success can change society for the better. They are very willing to deploy their new-found billions to promote their progressive, technological and green mindset.  The fact that their solutions are enormously self-serving makes them no different than the industrial barons of the 1930s.
   
Enter their health reform "clerisy" allies. They are made up of a growing academic, media, not-for-profit and government-worker technocratic class.  Armed with their science-based insights, they are advocating, lobbying, funding and regulating away an old health care order previously dominated by church, lay-business and volunteer organizations. Markets and ownership are being replaced by the priestly wisdom of an unelected elite presiding over a regulated utility. And they are being cheered on by their liberal-progressive and highly creative allies who dominate the old and new social media.

Opposing views are not only unwelcome but drowned out by a self-reinforcing echo chamber of this clerisy's group-think. Unapproved thoughts on, for example, the old-fashioned ability of health insurers to pool risks, the virtues of fee for service to incent access and the merits of small physician-owned private practices are tut-tutted as sadly misinformed. The few who rise above the noise are labeled as in the pockets of fat cats or being right-wing ideologues. 
   
And who should be surprised that the oligarch's interest in information technology dominates their health care agenda? Electronic records will save health care from itself, decision support will usher in a new clinical wisdom and big data today will lead to miracles tomorrow.  And by the way, if that leads to additional billions flowing to the oligarchs, all the better.  All that remains is figuring out which city they should buy an estate in so that they can run for elected office and legislate a single payer system modeled after Microsoft and powered by Google.

Their hardest job?  Persuading consumers as well as front-line health care workers to "work against their material interests or traditional beliefs." Think about paying more for energy, giving up control of education  and letting the NSA troll Facebook's data for bad behavior. In the healthcare space, patients must agree to consume less health care with health insurance they don't want while letting more of their personal data be used. Front line providers have to do more with less income, less control and less prestige.
. 
Oh, and the clerisy and their oligarchs remain personally insulated against the very policies that they promote for everyone else. If they need health insurance, it won't be a Bronze plan from an Exchange any more than they'll give up their big cars, private schools and internet privacy.

It's the 1% alright, but they're hiding in plain sight.

Frightening thoughts.

Food Reward Friday

This week's lucky "winner"... donuts!!

Krispy Kreme donuts being made.  Hopefully this image isn't appetizing enough to make you want donuts.

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The Iron Triangle of mHealth Apps Due Diligence: What CEOs and Boards Need to Know

As the Population Health Blog's medSolis CMO expertise in mHealth expands, it can't help but admire the infectious "can-do" optimism of its "app" programmer-developer colleagues and competitors. Even if healthcare is a morass of dreary economics, regulatory meddling and dysfunctional politics, these entrepreneurs really do believe that "there is an app for that!"

And neither are leaders in hospitals, clinics, provider systems, insurance companies, medical device manufacturing and population health immune from the developers' enthusiasm. "Apps" are being built or bought with the belief that they'll lower costs, create profits, increase quality, promote satisfaction, build brand, secure customer loyalty and generate invitations to White House conferences.

The PHB agrees. Apps can certainly achieve many of these outcomes, and it is looking forward to seeing the Roosevelt Room for itself in the not-too-distant future.

But that doesn't mean that CEOs, Boards and investors shouldn't be wary of how the healthcare "Iron Triangle" should factor into their "app" due diligence.

Old fashioned management experts will recognize the concept. They know that any project involves trade-offs between cost, quality and access. Improve any single dimension and the other two will suffer.  Improving two means having to compromise on the third. 

In other words, there are inevitable trade-offs.

Population health service providers are well acquainted with this. For example, launching a diabetes initiative means balancing the costs of the program, the intensity with which the enrollees will be managed (quality) and outreach with a span of services as well as associated risks that will be addressed (access). Accepting a lower fee per patient may lead to compromises in quality. Insisting on a greater span of managed risks could lead to higher costs or cut-backs in the level of patient counseling.

Which brings the PHB to mHealth. To the PHB, the three iron sides to configuring an app are the same:

Cost: This is not only a function of the nuts and bolts of programming, hosting and updating the app, but includes the additional economic burden of maintaining up-to-date security for the users' personal health information. There's also the added cost of updates.

Quality: This includes dimensions such as symptom control, condition management, promoting patient safety, reducing identifiable risks and measuring outcomes for quality improvement as well as research.

Access: The interface has to be speedy and intuitive, meeting consumerist expectations for ease-of use. That includes connectivity, screen loading, minimal manual inputting and efficient asynchronous communication.

How should CEOs and Boards think about apps? 

They should think about cost, quality and access and understand the inevitable trade offs that underlie the sweet spot of a successful app.

Costs will never go away. But smart app developers are using off-the-shelf, open-source as well as modular programming with (secure and encrypted) web-based hosting. Shortchanging IT support or security risks not only crashes and hacking, but could limit the end-users' ability to manage the continuum of health risks (quality) in a user-friendly and speedy manner (access).

Quality is important but judgment is necessary in understanding the secret sauce that links quality, behavior change and risk. It's possible to "overdo" condition management with a glut of care options, unnecessary attention to every risk, over-engineered branching logic and over dependence on human inputs. 

Access will be what the end-user cares the most about, including ease of use in a pleasing interface. Streamlining this too much, however, could lead to shortcuts that compromise optimum condition management or require additional costly information technology.

Bottom line?

If a company's senior leadership or Board of Directors is grappling with an app-based product launch, they need to understand the inevitable cost-quality-access trade-offs that were made in the course of its design.  If the cost is low compared to benchmarks, ask about the compromises in quality or access that were made.  If the developers claim that the condition management is the highest quality, scrutinize development costs and how access could suffer. 

Accordingly, the best apps on the market will be those that strike the right balance between cost, quality and access.

Trading away Health: Reflections on an HIA of a trade agreement”

Guest post by Fiona Haigh:

The HIA team at CHETREhas been working with a group of Australian academics and non-government organisations to carry out a health impact assessment (HIA) on the Trans Pacific Partnership Agreement (TPP) negotiations. The report has attracted a lot of attention and in general has been a different experience from the typical HIAs that we are involved in. We thought it would be interesting to share with the HIA community a few reflections on our experience.

We weren’t commissioned to do this HIA- a small group of us thought it would be a good and interesting thing to do and we somehow managed with some support from CHETRE and the Public Health Association of Australia keep it going. The support from CHETRE enabled us to bring in Katie Hirono to do a lot of the work on it and we were supported by a group of experts and advocacy groups who contributed their expertise and advice. There were some technical challenges to do with trying to do an HIA on something that is being kept secret. We had to base our assessment on leaked documents on wikileaks and advice from academics working in the area and policy experts. We also faced the challenge of trying to predict likely future public health policies that could be impacted on by the trade agreement (since it won’t affect current policies). We approached this by working with policy experts to identify likely future public health policies in our scoped areas of focus that would be impacted on by the TPP.

We also walked the talk of taking a participatory approach, which meant sharing power with the technical advisory group and the advocacy groups that we worked with throughout the process. We feel that this has worked really well- it meant that we focused on issues they identified as important and we have produced a report that they have been able to immediately use for their advocacy. Without them I’m pretty sure this report would not be having the impact it has had so far. The report is being talked about on the front pages of major newspapers, there have been multiple radio interviews, a social media campaign led by CHOICE (the main consumer advocacy group in Australia), lots of tweets and perhaps most satisfying of all we’ve been labeled scaremongers in a press release from the minister for trade and investment - we must be doing something right!

NO ONE BUT YOU CAN MAKE HEALTH HAPPEN

In this world of comparison and getting pissed off at her or him for seeming to accomplish everything, and then spewing “what’s your excuse” in our faces, it’s no wonder women and men alike are throwing up their arms in frustration and happily giving a bird salute attitude at achieving fitness goals.  

Put on the brakes here and look at what has happened.  Letting others control what is best for our health and fitness is out right wrong, and does nothing for us.  That being said, why are we allowing people or media so much control over our decision making to create a healthy, happy life when they have little to no concern or care for us?  Why so pissed about it?  What it comes down to is that no one but you can make health happen.  You know that saying that goes, “whether you do or you do not, you are right.”  Well, that is true and the choice to get healthy lies squarely on your shoulders.  There is no amount of jealousy, blaming others, or putting up defensive posture because others are doing what you are not willing, that will get you closer to your health and fitness goals. 

It does not matter how busy you are, I am, he or she is, because we all can say that we are too busy to carve out that very important exercise hour, and plan and prep healthy food time.  The “what’s your excuse” phrase does hit hard and can ruffle the feathers, especially when it comes from family and friends.  When it comes from the media, it is easier to be judgmental and hide behind our computers commenting on how cushy her or his life is and how they have the time to get it done.  I say bullshit to that and start accepting responsibility for our actions, stop comparing to others, and who gives a crap what anybody’s excuse is.  What is important are the excuses that we are making and why.  It is time to tune into self and let go of insignificant negative drama that weighs down our positive minds.  No one but you can make the choices to move past the excuses and the feelings that keep you from getting healthy. 

Darla Leal, Fit at 50

Thanks for stopping by my Blog, hope you enjoy the content, and if you have not become a follower yet, I would love to see your face on my friend's list, or if you want to receive my free updates, use the button below to select your feed preference. I look forward to responding to your comments and appreciate your shares.

Stay Healthy!

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Build Your Own Yogurt Maker, Sous-vide Cooker, and All-purpose Fermenter for $40

I make a half gallon of yogurt, twice a month.  I like making my own yogurt for many reasons, but it's a bit of a pain.  Since I make large batches, I can't use a standard yogurt maker.  I often get distracted and over-heat the milk, and the method I use to incubate the yogurt is wildly inefficient (my beloved Excalibur dehydrator).  I also need a constant warm temperature for various other fermentation projects, and that's often difficult to achieve with the tools I have.

I finally found a better solution: a temperature controller that accurately regulates the temperature of a slow cooker by turning an outlet on or off.  I simply set the temperature of the controller, place the temperature probe into the slow cooker, and plug the slow cooker into the temperature controller outlet.  The slow cooker then stays at whatever temperature I want.  Here's what the temperature controller looks like:

Once built, the temperature controller with or without the slow cooker can be used for a variety of other tasks (including regulating cooling devices).  Here are some ideas that come to mind:

• Sous-vide cooker
• High-capacity yogurt maker
• Bread dough riser
• All-purpose thermophilic fermenter (e.g., for tempeh, natto, koji)
• Beer/cider/wine fermentation temperature controller
• Kegerator controller
• Freezer-to-fridge conversion
• Egg incubator
• Soil temperature controller for seed starting

Don't worry, I'm not turning into a food blogger.  But this sous-vide-cooked
chicken I made with my DIY temperature controller was pretty tasty.
I used this recipe from NomNom Paleo.

You can build the whole thing for about $40, including the slow cooker.

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Health Impact Assessment of the Proposed Trans-Pacific Partnership Agreement

An HIA of the Trans-Pacific Partnership Agreement (TPP) has just been released, authored by Katie Hirono, Fiona Haigh, Deborah Gleeson, Patrick Harris and Anne Marie Thow.

From the media release:

Report finds medicine affordability, public health policies at risk in Trans Pacific Partnership

A report released today by a large team of academics and non-government health organisations reveals that the Trans-Pacific Partnership Agreement (TPP) poses risks to the health of Australians in areas such as provision of affordable medicines, tobacco and alcohol policies and nutrition labelling. Many public health organisations have been tracking the progress of the TPP negotiations over the past several years and have expressed concerns about the potential impacts and lack of transparency. 

“The TPP includes provisions that don’t just affect trade. They affect the way the Government regulates public health,” said Michael Moore, Chief Executive Officer (CEO) of the Public Health Association of Australia (PHAA). “In many areas – such as nutrition labelling - it’s already a struggle to implement effective policies that promote health. If certain provisions are adopted in the TPP, this will be another hurdle for organisations seeking positive public health outcomes.”

The report also argues that: “The TPP risks increasing the cost of the Pharmaceutical Benefits Scheme (PBS), which is likely to flow on to the Australian public in terms of increased co-payments (out-of-pocket expenses) for medicines”. An increase in co-payments risks declining public health and increasing hospitalisations, particularly for people who are already disadvantaged.

A team of researchers from UNSW Australia, Sydney University and La Trobe University conducted the health impact assessment based on leaked documents from the trade negotiations.

“In the absence of publicly available current drafts of the trade agreement, it is difficult to predict what the impacts of the TPP will be,” said Dr Deborah Gleeson, one of the report’s authors. “In the study, we traced the potential impacts based on proposals that have been - or are being - discussed in the negotiations. But the only way to properly assess the risks is to allow a comprehensive health impact assessment to be conducted on the final agreement before it gets signed by Cabinet.”

The report offers a set of recommendations to the Department of Foreign Affairs and Trade to reduce the likelihood that the TPP will negatively impact health in Australia. Such recommendations include excluding an investor-state dispute settlement (ISDS) mechanism, and including strong wording to ensure that public health takes priority where there is a conflict with trade concerns. The report also recommends that Government change its approach to conducting trade agreements, for example by publishing draft texts and negotiating positions on issues of public interest.

Trade negotiators are meeting next week in Hawaii. The Minister for Trade and Investment, Andrew Robb, has said he anticipates the negotiations will wrap up within the next few months.

“It’s vitally important that health is given high priority in the final stages of the negotiations,” said Lynn Kemp, Director, Centre for Health Equity Training, Research and Evaluation. “We urge the Australian Government to consider these issues seriously.”

The HIA report can be accessed here.