January 2010

For those who cast a hungry eye at the fruit samples at farmer’s market, I offer a cautionary tale.

I’m not sure why, but customers expect samples at produce markets. That may even be one reason they go.

Rarely do you see samples set out at supermarkets in the produce department, although I’ve seen people grab a grape or a cherry out of the bin – or even out of a plastic bag – even when there’s no free sample sign.

I was recently at an outdoor farmer’s market where they were selling cantaloupe for a buck. Not a bad deal, but customers wanted a taste. So the owners came out with a cantaloupe cut in half with a serrated knife, so that there were little ridges in the fruit to break off.

A woman said to the outdoor crowd, like we were her accomplices in a Stephen King movie: “Anybody got a knife?”

Nobody said a word. Her husband tried to break a chunk off, but didn’t come up with much. Then I saw her pick up the entire half, look around to see if anyone was watching, and bite a piece off with her teeth.

Then she set it back on the display case.

Yes, this is an extreme case and yes, the owners should have properly prepared the fruit before setting it out – or maybe they were in the process of doing that but hadn’t finished the job yet.

But it doesn’t matter to me, because I wouldn’t eat a sample piece of market fruit on a bet, no matter how carefully it was served up.

Is this an attitude backed up by scientific research? Not necessarily, but it would seem to be common sense.

Last May, SmartMoney, an online Wall Street Journal publication, published a book called, 1,001 Things They Won’t Tell You. In it was a section called, 10 Things Your Farmer’s Market Won’t Tell You.

Number 9: “Our samples are about as sanitary as a bowl of bar nuts.”

The writer contends that, “with so many shoppers fondling bowls of orange sections, these freebies can be a breeding ground for bacteria.

“To cut down on food-borne illnesses such as salmonella and E. coli, farmer’s markets have rules about dispensing samples. Some states regulate this area, too. California, for example, requires farmers to wash knives with bleach and set out toothpicks to pluck berries from trays.”

Enforcement of those rules is another matter, though. How many states employ food police to actively check this stuff out?

So a lot of people, including myself, assume that public food samples are risky. But stories about studies showing these products crawling with bacteria may be more myth than fact.

In 2005, actor Johnny Depp appeared on The Tonight Show with Jay Leno and talked about his germaphobia. He told a squeamish audience: “There was a study done where they tested an ordinary bowl of peanuts in a bar. Twenty-seven different kinds of urine.”

In contrast, check out, Top 10 Fascinating Facts That Are Wrong, published last February.

A top “false fact” cited by the writer is that a scientific study on peanuts in bars revealed 100 different contaminants. Apparently, no such study exists.

“However, there was a study on ice cubes in UK bars in 2003 which discovered that 44% of ice cubes tested contained coliform bacteria.”

I knew there was a reason I stick with beer.

Photo: http://www.flickr.com/photos/kubina/3735263827/

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With people scrambling for a buck, there’s a whole alternative economy afoot in the United States. I wouldn’t call it an underground economy, because it’s all perfectly legal and above board.

But Americans are figuring out creative ways to generate cash. Mystery shopping, for one. The dream job: evaluating movie trailers.

And then of course there’s volunteering as a medical research subject.

You can look at being a research guinea pig a couple of different ways. From a broader perspective, you might say it’s a civic duty to help advance the cause of medicine.

On the other hand, you may be hard up for cash, and even the pittance offered by some research facilities may sound attractive.

I was perusing our local alternative weekly newspaper recently and came across several research organizations looking for candidates with the right mix of medical misfortune. A university’s psychology department, for example, is seeking people with schizophrenia or schizoaffective disorder.

“During the study, you will take part in an interview (regarding symptoms, how you cope with the illness, and cultural information) and, if interested you may also be eligible for free family therapy for schizophrenia/ schizoaffective disorder.”

The payoff: $25. In other words, enough to take the whole family to Taco Bell.

There are also ads for people with psoriasis, Rosacea and Type 2 diabetes. “Reimbursement for time and travel up to $250,” one of the display ads says.

You can find trials in other states by hooking up with BioTrax International. Its Web site has drop-down menus for all 50 states, plus categories for “healthy volunteers” and seniors, along with folks who have medical issues such as diabetes and asthma. Note: You do have to apply for the studies online and file a lot of personal information.

The Center for Information & Study on Clinical Research Participation (CISRP), based in Boston, is another outlet for finding out about research projects. The company actually acts as a public relations conduit, promoting the idea through TV, ad and print campaigns. One of them is the “Medical Heroes” public service message, which you can watch here.

How much can you make being a research subject? Not that much. A couple of hundred, from what I can see. But a little research of my own revealed that there has been, and there remains, a big shortage of volunteers.

Of course, there are those who say that it’s our “moral duty” to volunteer for research projects. This recent Science News article makes that point.

And it’s certainly a legitimate view. But here’s mine. Pharmaceutical companies, and other major corporations engaged in health care delivery, make billions off the top-heavy, convoluted American medical system.

Why shouldn’t the little guy get a decent cut?

Photo: http://www.flickr.com/photos/sarahb-photography/2891830008/

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How long does it take to get back into running shape after an illness? That’s what I’ve been in the process of finding out over the last several weeks.

Right after Christmas, I set my sights on completing a half-marathon in Naples, Fla., an event held on Jan. 17. I realize, not a big deal for many runners, but I’ve always been very slow at building up distance.

I only ran three miles, three times a week for five to seven years before deciding to bump it up. And even then I did it quite gradually.

Last fall, I did six miles for a while, then jumped it up to eight. With the end of the year in sight, I completed a 10-miler with no trouble. So I figured, what’s the next step? Right. I hopped on the Web and signed up for the half, figuring it would be a lot of fun.

Naples is a great town.

But a couple of days later – the virus must have been laying low and waiting for me to punch in my credit card number – I started getting a sore throat. By the time New Year’s Day dawned, it was painful to swallow. Next two days, the most exercise I got was moving from the bed to the couch.

I took some walks after I started to recover, but didn’t run for a good 10 days. And then I was lucky to finish two miles.

The race was last weekend but needless to say, I wasn’t up to a 13-mile jog. Three weeks since the illness, and now I’m back up to five miles. I don’t see six or eight on the horizon for at least another week.

And the 10-mile test? Maybe a month … but who knows? It’s surprising to me how long it takes to rebuild endurance.

It was a setback but I’ve got my eyes peeled for another shot. But I guarantee there will be a bottle of hand sanitizer prominently positioned to ward off the next round of viral interference.

Photo: The long road back via Flickr.com

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Internet gambling has become one of the best ways to squeeze money out of the population. Not that long ago, people who craved the thrill of poker, blackjack or slot machines had to plan a trip to Las Vegas, Atlantic City, or the Bahamas.

Now, given a computer with any kind of reasonable Internet access speed, you can turn your own home into a casino. (And if that’s not risky enough, you can always try shuffling the money around in your 401-K.)

A 2006 study by Merrill Lynch estimated that online gambling profits, $12 billion at the time, would double to $24 billion in 2010, and then shoot for the moon over the next five years, pulling in $528 billion by 2015.

Those who enjoy the rush of gambling understand the attraction of the online games, which are becoming more visually sophisticated with lots of bells and whistles to enhance the experience.

But a new study shows that because of the psychology involved with online gambling, their play becomes a reinforced habit even though they may be losing money.

The reason, in a nutshell: A lot of small wins make a bigger impression on players than one big loss.

This is the conclusion of Kyle Siler, a Cornell doctoral student in sociology who analyzed 27 million online poker hands. Back-to-back wins are actually likely when you’re playing for small stakes, but the more you play, the bigger the chance you’ll get hit with a big loss.

The study was published online in the December Journal of Gambling Studies.

Another interesting finding: Small pairs were actually more valuable to small-stakes players than medium pairs – a fact players often fail to absorb.

Simply put, says Siler, “The biggest opponent for many players is themselves, given the challenges of optimizing one’s mindset and strategies, both in the card game and the meta-games of psychology, rationality and socio-economic arbitrage which hover beneath it.”

Of course, people embrace gambling despite what everyone calls “the house edge.” Vegasclick.com has broken down the house advantage mathematically, for each game.

How will you do on any given day? Here’s the formula: Wager X House Edge X Number of Hands = Expected Loss. Still convinced you can beat the odds over the long haul?

Photo: http://www.flickr.com/photos/johnseb/2312539092/

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Watching TV is the great American pastime, at all hours of the day and night. Viewers are just as likely to tune in for morning shows as they are for afternoon soaps, evening news shows or old sitcoms in the wee hours.

And surely they understand that this is not a health-boosting activity. But neither do most people believe that watching the tube hour after hour is actually deducting years from their life.

That is, however, the conclusion of a newly-released study by Australian researchers. Writing in the Jan. 11 issue of Circulation: The Journal of the American Heart Association, they managed to quantify the hazards of TV viewing at a time when it’s at an all-time high, at least in the U.S.

The researchers assessed lifestyle habits of 8,800 adults in Australia, and compared these habits to the risk of death from cardiovascular disease and cancer. Although Australians were the targets of the study, the authors contend that results are applicable to the U.S. and Britain as well.

They found that for every hour of TV viewing over the seven-day period of the study, there was an 11 percent increased risk of death from all causes, and an 18 percent increased risk of death from cardiovascular issues. There was a 9 percent increased risk of cancer death.

“What has happened is that a lot of the normal activities of daily living that involved standing up and moving the muscles in the body have been converted to sitting,” said lead author David Dunstan, of the Baker IDI Heart and Diabetes Institute in Victoria, Australia.

“Technological, social, and economic changes mean that people don’t move their muscles as much as they used to – consequently the levels of energy expenditure as people go about their lives continue to shrink.

“For many people, on a daily basis they simply shift from one chair to another – from the chair in the car to the chair in the office to the chair in front of the television.”

What I find most interesting is that Americans seem utterly unconcerned about their viewing habits. The latest Nielsen survey, released last May, showed that the average American watched 153 hours of TV per month, a 1.2 percent increase from the previous year.

That, by the way, is roughly 5.1 hours of screen time per day.

That sounds like a lot, but couch potatoes have sort of a loveable image in the United States. They’re rascals for not going down to the gym to work out, and sprawling out in front of the tube instead. Americans really know how to hang loose, the thinking goes, and it’s kind of humorous and endearing.

For example, an Illinois businessman recently won his third Ultimate Couch Potato title at the “ESPN Zone.” He stared down the screen for three straight days, breaking the Guinness World Record for steady TV viewing, according to The Chicago Tribune.

He won $1,000 for a new TV, a recliner, a year of cable, and a trophy in the shape of a potato. He could only take three bathroom breaks per day and get out of the chair for occasional stretching.

These kinds of contests are known as “Competitive Sitting” events, and they have been attracting quite a bit of attention.

I’ve cut my television viewing drastically over the last two years, but not over any perceived health issue. I simply can’t find very many gems in the garbage pile that makes up the average daily TV schedule.

But even if you live for new episodes of Dancing with the Stars, American Idol or any of the popular reality shows, it sounds like punching the TV off button once in a while may be just what the doctor ordered.

Photo: http://www.flickr.com/photos/f-r-a-n-k/237317726/

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Most of us know people who get migraine headaches, or we suffer with them ourselves. When one strikes, there’s usually nothing to do but wait it out, often hiding in a darkened room.

Often, it’s a long wait, but any light can make it worse.

Now, researchers have identified a pathway that light travels to induce sensitivity. It could lead to new and better treatments for patients who get migraines and also suffer from a condition called photophobia.

Eighty-five percent of people who get migraine headaches – which affect about 30 million Americans – also suffer from photophobia.

The research was conducted at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, and published in the online journal, Nature Neuroscience.

“Clinically, this research sets the stage for identifying ways to block the pathway so that migraine patients can endure light without pain,” said Rami Burstein, a professor of anesthesia and critical care medicine at Beth Israel Deaconess Medical Center and Harvard Medical School.

Scientists compared light sensitivity among people who are legally blind and could see some images and those who could see nothing. Those in the second group, who couldn’t sense light, did not have a worsening of symptoms, but those in the first group who could sense light did.

“This suggested to us that the mechanism of photophobia must involve the optic nerve, because in totally blind individuals, the optic nerve does not carry light signals to the brain,” Burstein said.

They followed the light signals back into the brains of rats and found a group of cells that are stimulated by the signals. They theorized that if the signals can be blocked the light sensitivity can be eliminated, and the headache pain eased.

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I had a piece about the Taco Bell Drive-Thru Diet recently. Now, a new study of 10 chain restaurants shows you can’t believe their posted calorie counts anyway. Some of the items have up to 200 percent more than advertised.

Even some of the frozen meals, like Lean Cuisine and Weight Watchers, had 8 percent more calories than the labels listed, according to January issue of the Journal of the American Dietetic Association.

The study was conducted at Tufts University in Boston.

Researchers believed the variation could be attributed to human error rather than deception – difference in preparation, for example, or slightly increased volumes of ingredients. There’s also some variation in testing methods, they noted.

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The U.S. Senate ended the decade with a vote trumpeted to extend health care to everybody. But the new decade began with efforts to restrict care more than ever.

The first announcement came from Mayo Clinic, a standard bearer in the medical industry. It said it would no longer accept Medicare patients at its Arizona facility and hinted at expansion of this policy.

Arizona, of course, is thick with retirees who rely on the government program for health care services. But now those services are in jeopardy.

If Mayo sticks its neck out and find that its bottom line is enhanced by not treating Medicare recipients, it will be a warning shot fired across the bow of health care reform. Mayo is calling this a two-year “pilot program,” which may lead to Medicare shutdowns at facilities in Jacksonville, Fla. and Rochester, Minn.

Will other clinics, hospitals and physicians follow?

Mayo isn’t the only large health care provider to start pulling back services from the non-traditionally insured. Jackson Memorial Hospital – with a longstanding reputation for providing services to the poor in Miami and South Florida – said it will no longer offer dialysis services to those uninsured who can’t pay cold cash upfront.

The new policy affects 175 patients currently getting treatment.

A Miami kidney specialist and medical ethicist, Raul de Velasco, told the Miami Herald that the hospital’s decision was “almost cruel,” and added that the patients “will not die quickly or suddenly – but they will die, a slow death.”

These are two powerhouses of health care in the United States. To have them pull back services at what many consider to be a turning point in U.S. health care history is not to be shrugged off.

In a health care system based on profit and loss, the impact is likely to spread – even if Congress gets a bill to President Obama’s desk this year. I know of nothing in the current health care bills that would prevent these two pull-backs in care from taking place.

Just because the government mandates coverage, and insurers are required to accept new policies, doesn’t mean that the providers can’t opt out of the system.

The danger is that we will develop a three-tiered health care system. At the top, people with solid-gold benefits, or those able to pay cash, will receive Cadillac care. In the middle there will be patients who can access care, but only by a dwindling number of providers who are willing to provide deeply discounted services.

And at the bottom, there will still be some people who fall between the cracks and have no coverage at all.

Congress should address this issue, but I’m not holding my breath.

Photo: http://www.flickr.com/photos/newslighter/523392/

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Fast food joints aren’t noted for their lean cuisine. But there’s a sense out there that people need to take control of their own health issues.

The question is, how to do that without giving up the tasty fare we’ve all come to relish for that quick fix? Answers are being cooked up in corporate board rooms.

All across the culture, plans are emerging that allow people to maintain their old habits, but with a fresh twist of responsibility. For example, there are credit card companies that deposit a nominal amount of money into a “savings account” for every purchase you make on the card.

This allows you to become a “saver,” like the folks on CNBC suggest, while you’re still spending like there’s no tomorrow.

Which brings us to the Taco Bell Drive-Thru Diet. I was watching the Sugar Bowl over the weekend and the Drive-Thru Diet was one of the main sponsors. Which means there was an instant replay of the ad after every change of possession.

So I got to see a lot of a woman named Christine, who lost 54 pounds over two years on The Drive-Thru Diet. The details are fuzzy. She says she dropped the weight by eating selections from the restaurant’s “Fresco” menu while “making other sensible choices.”

On the Web site, Christine’s Story, the first thing she says, to clear up any confusion, is this: “As you know, the Drive-Thru Diet Menu is not a weight-loss program.”

She goes on to explain: “I reduced my daily calorie and fat intake by 500 calories to 1,250 calories a day, and, after two years, I ended up losing 54 pounds! These results aren’t typical, but for me they were fantastic!”

So, it’s hard to know if Christine cruised to the drive-thru daily, or bi-weekly, or whatever, and maybe ate poached salmon, steamed cauliflower and salads the rest of the time.

On the Media Gallery video page, she says she replaced “a typical fast-food lunch or dinner” with a Fresco selection – but how often?

This is great marketing, although it does push the envelope, doesn’t it? Naturally, when people see “The Drive-Thru Diet,” they figure it’s … well, a diet. No problem, load the site up with disclaimers.

A gold star for the ad staff. When is a diet not a diet? When you’re thinking outside the bun, of course.

Photo: http://www.flickr.com/photos/jgclarke/141468240/

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Predicting the future in any one subject area is part educated guess, part science fiction writing. But we columnists take a stab at it anyway, so we have something to dig up next Christmas and assess our forecasting skills.

Let’s get right into it:

1. Swine flu spikes again this spring and there’s a new round of concern, and vaccinations. But the virus’ spread levels off in April and virtually disappears by May. There will be very few new cases over the summer non-flu season, unlike 2009.

2. An even more watered-down version of the health care reform bill passes, but the Democratic victory dance is short lived. Most of the provisions don’t go into effect for years, and the subject virtually vanishes from the news. There’s almost no impact on mid-term elections.

3. A major breakthrough in cancer research is announced in July. It involves the concept of using the body’s own immune system to kill off cancer cells. This approach has been a focus of research for years, but it is finally honed to the point where it is widely applicable to many different variants of the disease.

4. Medical video conferencing begins to score big as insurers realize that they can service more customers faster through online “virtual visits.” This proves to work well for routine matters, along with self-reported patient data for things like blood pressure and blood sugar.

5. Software for virtual mental health counseling becomes a big hit when a program is designed that allows verbal interaction. The effectiveness of this “Doc-in-a-Box” is slammed by the American Psychological Association.

6. A shocking new study finds that coffee is a medical miracle beverage that helps prevent, and treat, a wide range of health issues. Coffee houses across the country begin offering some simple clinical services by physician assistants along with a steaming cup of joe.

7. Animal researchers discover that dogs can be trained to sense blood sugar problems and digestive disorders and they can predict strokes up to a week in advance. They find out that chihuahuas are particularly skilled in this area, leading to a surge in the number of chihuahuas for sale. Prices skyrocket.

8. Researchers discover that bean sprouts aren’t really healthy at all. A new kind of breakfast cereal that incorporates sprouts doesn’t sell well, and is finally pulled from the shelves.

9. Sleeping under a pyramid becomes a new health craze. Bed, Bath & Beyond comes up with a unit you can hang from your ceiling over your bed, and it becomes the hottest new gift for Christmas 2010.

10. A new type of toothpaste supposedly allows you to brush just once a week. But dentists are outraged and make appearances on TV shows to oppose the product, from Oprah to Jerry Springer.

Photo: http://www.flickr.com/photos/jon_a_ross/3652491576/

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