The Food Issue

I cannot remember an issue of the New Yorker than I enjoyed as much as the recent food issue (November 21, 2011). Unfortunately, the articles are behind a pay wall, and there is no way I can do the authors' marvelous writing justice by paraphrasing it, so if you're not a subscriber to the magazine or missed the issue at the newsstand, you'll just have to take my word for it. It was superlative.

But here are some teasers: There is an article by the indefatigable Calvin Trillin - truly a national treasure - explaining his signature dishes in his signature way. An article on apples  helped me understand the science (large cells!) of why the tasty HoneyCrisp apples and next generation SweeTango are juicier than other varieties. There is an article on coffee and one on foraging, that art of finding food in the great outdoors. I initially thought a New Yorker-length article on foraging would be boring and, honestly, I trudged into reading it with an "it will be good for me" attitude. Thank goodness I persevered, because the author approached the topic from a delicious blended perspective of travel writing, botanical science, and foodie insight that transported me far away from my urban kitchen table to a place where anything growing is potential food. After chewing on that piece for awhile, I realized why I was so enamoured with the entire issue of the magazine: it broadened my thinking about food. In fact, I raised my head from the page and looked out my window at my shady and sloping front yard and dreamt of raised beds strategically placed to catch the spotty sun and wondered how much it would cost to terrace the back yard.

Mark Bittman wrote recently in the New York Times that the United States, bestowed with some of the world's most perfect soil and climate to grow plants, imports more fruits and vegetables than it grows. Isn't that weird? Years of farm economics have pushed America's breadbasket, that great swath of Midwestern black soil, to become America's corn basket, at the expense of filling those baskets with the very foods we should be eating. If you've been following HealthTwisty, you know I was raised on a farm that created hybrid corn and beans for farmers to grow But when I was a kid, we did not focus solely on those two crops. We also raised wheat and oats, alfalfa and hay, with periodic forays into sorghum and sunflowers. When my grandparents were still active, the farm was still a sustenance place, where the people living there grew gardens, tended stands of fruit and nut trees, managed tracts of timber, and raised animals in addition to the row crops. I don't think my grandparents bought much at grocery stores other than paper products and baking and canning supplies, and, as they grew older and didn't want the responsibility of keeping a milk cow, dairy products.

I'm not idealizing that lifestyle because I know how much work it is. Well, maybe I am idealizing it a bit. But really, I just mention it in a roundabout way to exemplify the changes that have happened in just two generations of farming.

Which brings me to my point. Over those two generations, our food supply has become tragically narrow and it is to the detriment of our health, and our planet's health. Currently, there is a farm bill winding its way through Congress. The Environmental Working Group has posted a leaked copy of the bill here, but I don't know if it represents the most recent version. Even though the farm bill was originally initiated to help US farmers, it has evolved to the point where author Michael Pollan notes

"It isn't really a bill just for farmers. It really should be called the food bill because it is the rules for the food system we all eat by."

So we should all care what the farm bill says. The draft of the farm bill posted by EWG does have language about expanding support for fruit and vegetable growers, at least with federal crop insurance. And there is wording about limiting some subsidies and allowing others to expire with the current bill in 2012. Those are positive steps towards refocusing our nutritional attention on fruits, vegetables, and lean proteins. The 600-pound gorilla in the room, though, is the immediate concern of economically feeding the growing population of this country and the world. There are worries that the new farm bill will reduce the Supplemental Nutrition Assistance Program, aka food stamps, and few discussions about increasing access to fruits and vegetables. Farm economics are complicated and contentious, interwoven with politics and laden with big money influence. I don't have the answers, but I support those who are trying to come up with the win/win situations that will allow farmers to continue to practice their livelihoods and grow nutritious food that can be turned into reasonably priced products - including those used for energy - for consumers.

Since the debt committee has thrown up its hands, the farm bill will continue to be negotiated. In the interim, I urge you to find a copy of The New Yorker's food issue. The writing is delectable, to be sure, and the contents take you so far away from standard supermarket fare that you feel like you've been on a field trip to the bright side. Broadening our thinking about food allows us to dream, which then allows us to "begin with the end in mind," as Steven Covey famously laid out as an important step in intentionally starting on a new path. And that is my wish for Congress - please begin with the end in mind in creating a farm bill that can make good use of the farming resources this country offers in order to feed us all in a healthy way. That's all.

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Turkey!

By far, Thanksgiving is my favorite holiday. I love that the only thing you're pressured to buy is food, and the only thing you're supposed to do is be thankful (well, other than cook). No gifting, no stuffing candy in plastic eggs, no singing, no pine needles in the carpet. Just the F's: food, family, and friends.

But now we can add some additional letters to the holiday: M-R-S-A, as in methicillin-resistant Staphylococcus aureus. And MRSA is bad stuff. Because not only is the problematic bacteria that causes staph infections resistant to the antibiotic methicillin, it is becoming resistant to other antibiotics and it is showing up in more and more places. It left the realm of hospitals long ago, and now is common in locker rooms and sporting fields, and unfortunately, it is all over our food.

Ick.

I've written about this issue before, but not since last year. By all accounts, the situation is becoming more grim, with more types of supermarket meat containing drug-resistant Staph. Originally limited to pork products, these superbugs have been found also in beef, chicken, and, just in time for Thanksgiving,  turkey. Other strains of Staph aureus on meat have shown resistance to other antibiotics, including tetracycline (TRSA?). Maryn McKenna, over at Wired.com, follows this issue closely and keeps us updated on the decided lack of progress in addressing it. Here is her most recent report on the topic.

What can you do to reduce your risk of being exposed or infected by MRSA or other superbugs from your meats? Well, I think a reasonable approach is to treat your kitchen like it is a laboratory.

When you work in a lab, there are standard practices to avoid contamination and keep your samples sterile. While most home cooks will not keep a squirt bottle of ethanol handy to wipe down their stainless steel surfaces or work under a negative-flow ventilation hood, there are consumer-friendly practices to maintain a clean work environment in your kitchen and not spread bacteria that may be on your pre-cooked food to your work surfaces where it can then contaminate other foods.

As always, the first line of defense is prevention. Try not to bring MRSA-tainted meat into your home in the first place. That means buying meat derived from animals that were raised organically. They will not have have been fed antibiotics without reason and have a far lesser chance of harboring antibiotic-resistant bacteria.

Even mass-produced meats can be handled safely with a few extra precautions. For example, purchase a non-porous (that means no wood) cutting board specifically for meat. This board comes out only for meat and is put in the dishwasher immediately after meat is prepared on it. If you don't have a dishwasher, boil water and use that along with dishwashing soap to clean the board after use. The water has to be super hot in order to sterilize the surface. Same with the utensils you used to prep the meat.

Before you begin working with the meat, you may want to consider how to turn on your water with your elbow, or turn it on before you start working with the meat so you will not have to touch the handles (visualize surgeons scrubbing down and going into the operating room with their hands parallel to their bodies and pushing open doors with their bodies, etc). Handles are petri dishes for germs.

After you work with the meat and put the cutting board away, wipe down your counters with hot soapy water or a disinfectant, using a sponge dedicated for this purpose or disposable paper towels or wipes. Microwave the sponge, or put it in the dishwasher, after you have used it.

Then, wash you hands with soap and hot water. If you have cuts on your hands or fingers, or if your hands are dry enough to have cracked skin, consider wearing gloves when you handle meat. Bacteria living on the surface of your skin may not be a problem (except for spreading it around), but bacteria entering your body through a cut can be a whole different story.

Cooking foods properly will kill MRSA and other bacteria, so make sure the big holiday turkey is completely done before you take it out of the oven. And, I'd think twice about cooking stuffing inside the bird. There have always been concerns that the moist stuffing inside the bird is a breeding ground for bacteria, but now that bacteria is so much more dangerous, I just wouldn't go there.

What I've just outlined is merely an amping up of common-sense kitchen rules. But because of our overall lack of education in food preparation, I rarely see people practice them. If you do them diligently, they'll go a long way toward lowering your risk of contaminating your food with all sorts of  food-borne bacteria, not just MRSA.

So Happy Thanksgiving! Be safe and enjoy this meaningful US holiday.

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Counting Sheep

Today's New York Times carried an article on a topic that HealthTwisty intern Chelsea Leonard and I have been discussing: sleep deprivation. Even though Chelsea, a college sophomore, and I, a middle-age working mom, are at different stages in our lives, we share the same problems that interfere with sleep: high expectations for work (and schoolwork, in Chelsea's case), personal interactions, and volunteer time. And we both suffer from a love/hate relationship with the electronic devices that allow us to manage our ever-increasing to-do lists while simultaneously keeping us tethered to our obligations when we should be focusing on winding down for the day.

And it's not just Chelsea and me who have problems with sleep. The article in today's Times notes that over 15 million women aged 40 to 59 in the US had a prescription for the generic form of the sleep drug Ambien last year. That's a phenomenal number when you consider there are only about 43 million women in those age groups in the United States, which means over one quarter of them (us!) have a prescription for one specific drug. The problem is much, more worse when you realize that 15 million does not include prescriptions for Ambien itself, or for anti-anxiety or anti-depression meds that are used off-label to encourage sleep, or the over-the-counter meds, like Tylenol PM, or even the medicinal glass of wine that is commonly used to fall, and stay, asleep.

I'd say this is an epidemic. And it seems to be starting young.

Chelsea writes from the perspective of a college student:

"It seems like no one I know gets the amount of sleep they want or need. People are always preoccupied with one thing or another, and then end up spending the next day in a sort of lethargic blur. Sleep hygiene, a combination of regular sleep and good bedtime habits, feels like an impossible task sometimes. My doctor tells me to associate my bed with sleep only (and to watch TV, eat, and do work elsewhere). But I’m a little skeptical about this strategy. I spend so much time testing out new energy drinks, but have never tested ways to just get a good night’s sleep."

And because she is a neuroscience major, Chelsea is interested why we have problems sleeping and the results of sleep deprivation:

"There’s a pretty strong connection between the rise in Internet accessibility and decline in sleep. The problem is that sleep needs are biologically determined. The “sleep clock” is located in the brain’s hypothalamus region, and (unfortunately) hasn’t evolved along with technology. When this system is tampered with consistently, it actually leads to some serious physiological effects. The most obvious of these are memory and attention level. The biggest shock to me, though, was that a seventeen-hour day could have the same results on performance as a blood-alcohol level of 0.05%.  Some states impose penalties on drivers at this level. Lack of sleep probably isn’t considered a huge concern, with drunk or high drivers on the roads, but nearly one in every ten 25-35 year olds reports falling asleep at the wheel in the last month alone. That’s a big deal. Lack of sleep is not only a health concern for the individual, but is becoming a safety concern for people around them."

So how much sleep do we need? Chelsea's research turned up this information:

"Of course, a good night’s sleep is based on what you need at your age. The National Sleep Foundation notes that newborn babies need around 18 hours of sleep a night, whereas adolescents can function perfectly well on only 9-10 hours. For adults, the general consensus is about 7-9 hours. The amount of sleep a person needs depends on two components: their basal sleep need (the hours of sleep needed for optimal performance) and sleep debt (loss of sleep due to restfulness, etc). An easy way to tell if you’re getting the sleep your body needs is how long it takes to fall asleep at night. If it takes you less than five minutes to fall asleep at night, your body needs more rest! If you’re the type of person, like me, who shifts around for a while, consider what’s keeping you up. Often, it’s too much screen time before bed or preoccupation with the day’s worries."

The National Sleep Foundation offers these tips for falling, and staying, asleep:

• Establish a regular bed and wake time
• Avoid nicotine altogether and avoid caffeine close to bedtime
• Avoid alcohol
• Exercise regularly (but complete the workout at least 3 hours before bedtime)
• Establish a consistent relaxing “wind-down” bedtime routine
• Create a sleep-conducive environment that is dark, quiet and comfortable
• Discuss the appropriate way to take any sleep aid with a healthcare professional.

However, Chelsea notes,

"A lot of commonly recommended sleep tips aren’t practical for me in my schedule. I can’t block out all noise, because I have night-owl roommates, and I don’t like herbal tea or warm milk. But there are definitely some reasonable strategies for better sleep. No one needs a can of Coke before bed, or a three-hour nap around dinnertime."

As for me, I've found the most effective way to get a good night's sleep is to vigilantly guard my time. This means saying no to too many volunteer tasks; to ensuring that all members of my family share in the details of our lives, such as making sure everyone has haircuts, or good food to eat, or is ready for the day ahead; and to ensuring that I have at least an hour of down time before going to bed at a regular time. By decreasing my mental clutter, I have found it easier to stay asleep without waking to fret over the myriad details of work and family life.

And a final word from Chelsea:

"If everyone consciously tried to get a good, consistent night’s sleep most days of the week I’m sure it would reduce most of the stresses that kept them up at night in the first place."

I think she's right about the Catch-22 of sleep - we often wake up to worry, then worry about worrying. A good night's sleep can help put it all in perspective.

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