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Bulk Quantity

1/12/2015

I uttered a mild expletive and Rachel (the ShopRite of Kingston Dietitian) asked, “Is this the most you’ve weighed?” Yes. Yes it is.

Or, it was until December 11, 2014. I had never been to a dietitian before. The Universe landed me at ShopRite of Kingston during the previous month when synchronistically there was a blood sugar screening happening and I participated. You may have read about that adventure in the last blog.

I have heard it said that there is a difference between awareness and consciousness. I can humbly say that I feel like I have been aware of my overeating habits for some time but not actually conscious of them, to the point that I did something concrete about them… well, not so much, until now.

And thus begins my adventure with calorie counting.

I want to say here that everyone’s relationship with food is different. There are different approaches for each individual. If my experience resonates with you, awesome. If not, take the best and leave the rest.

I oscillate between the mirrors of the Greeks’, “Know thyself” and Shakespeare’s, “To thine own self be true”. In this adventure of knowing myself and being accountable to myself, I know that one of the things I do is to eat healthfully and in bulk quantity. In such bulk quantity that I have been adding on approximately seven pounds a year over the past seven years.

I think of that children’s song Danny Kaye sang called “Inchworm”.The music and lyrics are by Frank Loesser. I learned how to multiply because of these gentlemen.

Inchworm

Two and two are four
Four and four are eight
Eight and eight are sixteen
Sixteen and sixteen are thirty-two

Inchworm, inchworm
Measuring the marigolds
You and your arithmetic
You’ll probably go far

(Repeat Chorus)

Inchworm, inchworm
Measuring the marigolds
Seems to me you’d stop and see
How beautiful they are

So, this is another version of the song, “seven and seven and seven and seven and seven and seven and seven are forty-nine… la, la, la, la… inches, inches, on my waist and everywhere…”

I informed Rachel that I am interested in calorie counting. And as the lucky (?) owner of a Smart Phone I have access to myfitnesspal.com. Initially, I was hesitant about calorie counting on an app (I felt like a Luddite) but… I tried it. This thing is awesome! It told me how many calories I can eat a day to lose a half a pound a week!

I am a motivated participant. I have been measuring my food quantities. I am measuring things like olive oil for individual servings by the teaspoonful. Not by the “just pour it” aka unknown liquid OUNCES. I am learning that an eight ounce serving of sparkling apple cider has 117 calories! And that I am not willing to invest my calories in little high fructose corn syrup chocolate treats of the Halloween variety… 50 calories each! Multiply that by 6!

In a year there are 52.177457 weeks. A half a pound per week weight-loss translates to 26.0887285 pounds in one year! In two years, that’s 52.177457 pounds which is around where I want to be. I’ll take it! Sold! I may utter some mild expletives then: Shazam! Bam! Whoohoo!

Here's a recipe for this week: a warm, fulfilling dish of…
Eclectic Cheesy Lima Beans with a side of Mango Pickle in Oil

For one serving, which may just be hearty enough as a main dish, you will need:

Half a cup of frozen or fresh or cooked-from-dry lima beans, 100 calories
1 ounce of grated cheddar cheeses, 114 calories
1.5 teaspoons of mango pickle in oil, 50 calories
(You can find mango pickle in Indian and Pakistani stores)

Put a cup of frozen lima beans (or fresh lima beans in season) into a cast iron pan with about a quarter of a cup of water. Cook over a low to medium heat for eight minutes or until tender and water has been absorbed. Turn off heat. Add grated cheddar cheese. Serve with a tablespoon of Mango Pickle in oil on the side. Simply succulent! Plus, lima beans have huge amounts of molybdenum an essential trace element I need that I didn’t even know about! Molybdenum reminds me of other great words like pamplemousse (or grapefruit) in Français and preisselbeeren (or cranberry or loganberry) in Deutsch.

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Glucose Levels or My Head in the Sand

1/8/2015

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For Diabetes Awareness Month in November of 2014, ShopRite of Kingston held an informational event with free glucose level screenings. Shoprite's Dietitian Rachel Robinson invited me to attend.

I was there for the Creating Healthy Places to Live, Work and Play project and set up my table at the entrance. I greeted the public, handed out recipe cards for fruit-infused "Waters With A Twist" and Seared Greens. I studiously avoided volunteering to have my finger pricked to test my glucose levels. I am 39 and have never had my blood sugar checked. My grandmother Zimboul was a type 2 diabetic.

I have memories of visiting la abuela Zilda (Zimboul's nickname) in Buenos Aires every two years as a child. I have a vivid memory of her opening up a very 1970s Brazilian tulipwood cabinet, furtively going into a drawer and extracting and handing my sister and myself garotos de amor (to this day one of my favorite bonbon confections). "Don't tell them I gave you this."

Only recently have I started to piece together a diabetes story around this grandmother. She was always napping. Or, rather, sleeping long hours in the middle of the day. She wore stylish wigs. A ritual before visiting Argentina was to go wig shopping in NYC for her. As an adult, putting two and two together, I now know that hair loss is often associated with diabetes. I also know that diabetes can cause fatigue. I begin to understand my Mother's fears around sugar and weight. I begin to understand the un-mourned, unnamed legacies of grief which exist around illness.

I associate my not testing my own blood sugar with my initial, usually ostrich-like response to fear: I stick my head in the sand until I have to come up for air and face reality.

Rachel casually suggested why not test my sugar. So, I did. And, it turns out, I am fine! Actually, I am superlative! My blood sugars were 74 in a fasting state! What a relief. Next stop... more regular blood work!

You never know when personal transformation will strike. It could happen for you too in seemingly unlikely places. Test your blood sugar levels. Whatever the result, you can work with the reality of it. You can name what is going on. It's way more fun than having your head in the sand, dreading the unknown.

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Larry's Twinkling Eyes

11/25/2014

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Larry's twinkling eyes open up a window into his soul for me. Rachel Robinson, my friend and the Dietitian at ShopRite of Kingston kindly introduced me to Larry, the Dairy Manager.

Larry is a humble, eloquent storyteller and a Type-2 Diabetes champion. For the longest time, Larry's blood sugar was out of control. Rachel Robinson's weight loss challenge at ShopRite came up and Larry joined in, not necessarily to lose weight but to get his sugars under control. His levels were swinging between 270 and 160. He could never seem to get them under 160.

Rachel showed Larry and his co-worker Dawn the plate with the food groups, proteins and vegetables. Larry said Dawn suggested going to the gym. “We started going every other day. It made the weight loss challenge fun. We'd go to Pub 99. I’d eye the rack of ribs but go for the cod bruschetta which is under 660 calories." He would really want the French onion soup but just order a small one and ask himself, "Do I really need the extra cheese?" Larry orders blueberry or strawberry salads which are under 700 calories. He started noticing that 10 wings are 1100 calories. "If we go to Roadhouse and it's a big piece of meat, we split it. The biggest kick is doing the exercise, going to the gym and running around here [at ShopRite]. I drink skim milk and put it in a normal size cereal bowl. I tend to stick with the same cereals. The print is small and hard to read." Larry shows me his magnifying glass and tells me his eyes are going. The retina specialist told him that the insides are swollen and holding liquid like a sponge but seem to be coming back under control. He and the specialist will check again, in about three months.

Larry's blood sugars went down and stayed down, in the 80s and 90s. His doctor was ecstatic. "You're doing it! We tell people it's controllable through diet and exercise and you are doing it!" Larry told the Doctor, "I need to be here every month. Not every three or four months. If it's that long, I think I can cheat."

From taking 1000 mg of Metformin per day, Larry went to 500 mg after 30 days. His sugars were monitored all along. After another month, the doctor took him off of the medication entirely and said, "See you in three months." That was seven months ago. Larry takes his blood sugars at the same time every morning where it hovers around 117, but is lower the rest of the day. "One day it was 140, so I jogged down the street. I went from 260 pounds to 203 pounds, from a 48" waist to a 34 or 36" waist. I had to go shopping."

I ask Larry what he is eating. "I eat a lot more salad." He adds pre-shredded carrots and some chopped purple onion. "You pre-slice it and put it in a slider [bag]. And, it's not so expensive. What's a pepper cost? 70 cents? It lasts a week." He adds two sausage patties for protein and jalapeño pepper jack cheese, "because I read that hot sauce gets the metabolism going. Believe it or not, I add hot sauce to my salad. Once in a while I will splurge, have sliced almonds, an apple, raisins or cran-raisins." Sometimes he has popcorn with his salad.

"Instead of a bag of chips at the break, I have a whole wheat bagel with peanut butter." He buys organic peanut butter now because Rachel showed him how the other peanut butters have a long list of other ingredients.

Larry has been a dairy manager for 44 years but had never tasted yogurt until recently. "Someone said it tasted like ice cream so I said, 'I'll stick to ice cream.'" Recently a co-worker convinced him to try some plain Greek yogurt and add walnuts and cinnamon as a snack. He liked it!

Breakfast is usually black coffee, a whole wheat English muffin with organic peanut butter and a half a banana. "A half a banana?" I ask. He put the other half in a baggie and has it later as a snack. He is eating in moderation. One scoop of ice cream instead of the big bowl. "The purpose isn't to deprive yourself. Once in a while, you have a 'cheat day'. For me, it's having pizza. On Halloween, I had six pieces of candy." As a treat for Monday night football, he'll have a diet soda. The rest of the time, it's water.

"I used to eat a lot of pizza. When my wife passed away, it was easier to go to the pizza store instead of cooking. I do cook at home. I'll make chicken with no skin. If I eat sausage patties, I limit it to two. I had tacos last night, in the bowl, with no taco shells. At every meal, I have salad first. I eat only multigrain bread and only whole wheat pasta. I go to my brother's for meals." No one really seems to notice or mind that he is bringing whole grain options. "At night, if I need a snack, I have five dried apricots. If you cut them up, they go further."

"After the gym Rachel said I need a little something" says Larry about reaching for the tootsie roll in the candy dish at the gym. I can see why he needs a snack after the gym. He is on the step machine for an hour. He is also on the elliptical. I ask him how he concentrates when he exercises. "I watch tv. If Dawn or Maryanne's there, we talk. Sue, another co-worker, will go with me once in a while. An exercise buddy helps. You gotta have somebody."

On vacation, he has been known to go to the gym at 11PM. He tells me about the time he worked out twice in one day because his friend called and he didn't have the heart to tell him that he'd already worked out.

In Larry's eyes, burning bright, is a commitment to living fully, to seeing the opportunities put before him and seizing them in a glorious, true carpe diem (seizing of the moment). In Larry's eyes, sparkling and kind, I see an iron will. I see self care: the highest compassion we can bring to ourselves and to others.

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The Deepest Nourishment

8/21/2014

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Here the potatoes rise high, nestled in their hay mulch. The Italianischer lettuce splays out. She wears her oak leaf scarves, her fronds wave in the breeze. Lettuce's other cousins, the Romaines, send their crunchy greetings. The spinach, Swiss chard, Red Russian and Lacinato (aka Dinosaur) kale are laden, their bounty atop their healthy stocks. The fennel bulbs' frilly tops wave to and fro... The sugar snap peas offer themselves for the picking in this not-so-still life scene. Am I describing a Renaissance painting? Am I writing poetry? Am I describing a scene in July at the Kingston YMCA Farm Project? Yes. Yes. And, yes.

This is also the scene unfolding next door at the YMCA Community Garden, at the Clinton Avenue Methodist Church community garden, and at the Thomas Chambers Garden, adjacent to the basketball courts to the Rondout Gardens Municipal Housing site and at countless other sites. This is a modern day renaissance and it is happening right here in Kingston NY. Cornell Cooperative Extension’s (CCEUC) Creating Healthy Places project supports several community gardens, including the Thomas Chambers garden. This garden exists through the generosity of the City of Kingston, which has graciously agreed to allow positioning the garden on City property, and the City of Kingston Parks and Recreation is working with CCEUC to oversee the project. Countless area volunteers also provide assistance, most notably the Master Gardeners and the Bruderhof Community.

These places, composed of carefully tended vegetables, are an environmental change from a public health framework.

There is so much more happening here than a bit of vegetation: positive unseen things.

Much research exists about the transformative power of community gardens, of the human spirit's and psyche's response to green, growing things. As the plants grow up, drug dealing goes down[1]. Of course, this is not necessarily instantaneous but flourishes with time. People become invested in the place where they live, rooted along with their vegetables.

Not mere "wuwu" silliness nor sentimentalism but a subject of serious inquiry, the promotion of wholesome living fits in with the “broken window” theory [1]: fix what is broken and make it better. As quality of life goes up, crime goes down. Community Gardens and Urban Farms seriously improve quality of life and prevent crime.

Our behaviors and responses are integrally interconnected with the places and spaces we inhabit.[2] The beauty of human ingenuity and creativity is our ability to influence these landscapes, externally and internally.

As I pluck a zucchini for Muriel, a neighbor across the street from the YMCA, she tells me that kids have stopped swinging from and breaking the trees. Groups of people no longer congregate at night making a ruckus. Respect is growing here.

The beauty of these sites of urban food production is beyond the aesthetic, it is tangible and concrete: people are receiving cleanly grown food from these sites. All those named here are located in "food desert" areas. It is common for people to rely on the local gas station as their grocery store. Here, we are talking with corner store owners to provide healthier options. We are learning to grow our own food. Our children are experiencing fresh vegetables, from seed to harvest. We socialize in the garden and at the farm stand.

CCEUC’s Creating Healthy Places project partners with the YMCA Farm Project to bring these fresh vegetables to the surrounding neighborhood through the Mobile Farm Stand.

You can purchase vegetables from the Kingston YMCA Farm Project on Tuesdays from the bike-powered mobile market from 3:30 to 3:45pm at the Oncology Support Center at 80 Mary's Ave, from 4 to 5pm at Yosman Tower on Broadway, and from 5:15 until about 6:15 at the Kingston Library. On Thursdays, the Farm Stand is stationary at the YMCA of Kingston and Ulster County at 507 Broadway, from 4 to 7pm, where you will be greeted by the Dig Kids, youth learning farming and entrepreneurial skills. For more information about community gardens please visit: www.creatinghealthyplacesulster.org

[1] Centers for Disease Control and Prevention
http://www.cdc.gov/healthyplaces/healthtopics/healthyfood/community.htm
[2] James Q. Wilson’s "broken window theory" is referred to in Malcolm Gladwell's book, Outliers:The Story of Success (Little, Brown and Company, 2008) in which Gladwell analyzes how environment affects extremely successful people.
[3] Making Healthy Places: Designing and Building for Health, Well-being, and Sustainability
Andrew Dannenberg, Howard Frumkin, Richard Jackson (Island Press, 2011)

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Public Health Policy Through the Ages

7/15/2014

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We are dealing with a new epidemic. Obesity and type 2 diabetes require multi-sector approaches. This is a post-industrial age problem which triggers yet another paradigm shift in public health. This means looking at our environment with fresh eyes. This means examining our urban and rural planning policies. This means creating more accessible bike trails. It means making our playgrounds safe for everyone. It means making our streets walkable so that people do not have to walk on the side of the highway to get to parks and playgrounds and recreation centers. This means PTA's working with school administrators to offer healthier school meals and snacks and beverages. It means developing many more farmers markets to serve the needs of all residents. It means developing food systems councils and lobbying established food policy councils.

Let’s keep the momentum going! Let's examine and reverse the fast food marketing in urban food deserts. We need to partner with corner stores to make lasting changes. We need to reverse the predatory practices of deep-pocketed advertisers that are marketing our vulnerable young children.

Recently, the CHP staff popped in at the offices of CCE colleagues in Rockland County. They are housed in a former sanatorium built in the 1930's; likely built for tuberculosis patients. It has an old-world campus-like feel. It's expansive bathrooms are complete with porcelain tubs, tall sun-drenched casement windows and shower stalls big enough to roll in a hospital bed. In thinking about public health, we can envision buildings like this aging sanatorium of yesteryear.

Then we visited another set of colleagues at the Rockland County Health Department to exchange information about our mutual Healthy Neighborhood Store Project. They are located at a facility built after the advent of public vaccinations. It was interesting to notice the shift in public health policy as reflected in the architecture, which was perfunctory and clinical. One could imagine vaccinations administered by a battalion of nurses in starched white uniforms in the 1950s.

On the drive back to Kingston we discussed how public health policies have changed so dramatically. Who would have imagined that today's public health policy would focus on environmental changes like healthier corner stores, promotion of farmers markets, and complete streets initiatives, that promote a healthy and active lifestyle?

This new shift in public health policy makes for interesting partnerships. It brings diverse people together: school superintendents; young mothers working with urban agriculture committees; community garden members; Mayors; Complete Streets advocates; legislators. We acquire new comfort levels as diverse groups work together to make healthy changes happen.

Yes, we have evolved. In addition to large-scale public health programs based on responding to crisis situations, public health policies are changing to reflect preventive health practices. Be a part of this change! Give of your time, resources and energy. Help us to effect change. We welcome your feedback.

Be in touch with us at [email protected].

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Bulk Quantity

Glucose Levels or My Head in the Sand

Larry's Twinkling Eyes

The Deepest Nourishment

Public Health Policy Through the Ages

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