What Can and Should be Done about Police Shootings, Whether By or Of?

Welcome back to The County Fare!  It’s been awhile – this year has been incredibly busy and in addition to parenting and forging my way through life, volunteer commitments have consumed my available time and so I’ve had very limited time to pursue matters blogospherical.  Furthermore, I’m going to do a little road construction here on the site and put in a few extra lanes.  Thus far, The County Fare has been a nutrition and nutrition-policy conversation.  However, there’s more to life than plant-based eating (I know!! It’s shocking!), and so after extensive discussions with the CEO of the website (who looks a lot like I do), we concluded that other topics might be of interest to the readers, and are definitely of interest to our writing staff (which also looks a lot like I do).  Hence, today’s topic.

What in the World Can and Should be Done about the Recent Police Shootings, Whether By or Of?

These stories are omnipresent right now.  Two horrifically chilling instances of police officers killing citizens have occurred in just the last few days, and have contributed to what surely must be a retaliatory attack on police at a rally in Dallas.  All of these events resulted in a tragic loss of life.  All of them are very sad.  All are, at the very least, frustrating and disappointing for thoughtful citizens, and all are horrifically world-altering for those with connections to the victims.

And all are verbal hand-grenades waiting to explode.  Tension is extremely high – if you’re ever on social media, and everybody’s always on social media anymore unless you’re a curmudgeon like I, you can’t help but see inflammatory and unproductive language everywhere you turn.  People are furious.  People are defensive.  People have some good points.  People routinely fail to see the holes in their own arguments.

And so I’m going to view this through a prism which, I think, is applicable to a vast range of political and social topics, namely that most everyone here is partly right, and that’s the good news.  But the bad news is that few are willing to honestly acknowledge sound points which challenge favored narratives.  And that’s a big problem when the stakes are life and death.

Which they are.

Black lives matter.  Blue lives matter.  All lives matter.  Guess what?  It all matters.  Guess what else?  All these labels are facile, stupid, divisive and ultimately unhelpful, because they minimize very valid feelings of those under intense pressure.

Let’s consider at the facts surrounding the shooting of Alton Sterling, and let’s keep in mind that while there’s all sorts of evidence being bandied about in the media, I don’t pretend to have any special insight over the “true” facts.  All I’m working with is what’s available to me, which is news reports (which I generally try to avoid anymore, because the whole world has gone mad).  So for those of you who are feeling litigious, please assume “allegedly” or “hypothetically” precedes every sentence.

This situation looks like flat-out murder to me.  We have a clear video of a subdued man being shot by police.  Perhaps he wasn’t perfectly compliant while lying on the ground with two shouting officers directly overhead and pointing their guns at him – one would think that might be understandable.  By all accounts, these two officers have had prior disciplinary actions brought against them regarding inappropriate use of force.  Both officers had body cameras, both of which “fell off” and provided no usable footage.  The storeowner, outside whose establishment this tragedy occurred, was detained by police so that the store’s surveillance footage could be confiscated.  Of course that footage was later determined, by police, to contain no relevant footage.  Community activists waited to see if the city of Baton Rouge would provide transparency into what occurred, and subsequently determined that opacity was to rule the day, and so they released the cell-phone footage on social media.  This is pretty damning material – it doesn’t look good for the Baton Rouge Police Department.

There are competing claims – some are reporting that Mr. Sterling, who was selling CD’s outside of the store, was menacing other citizens and that he may have had a gun, which he did not by most reports.  Was this claim fabricated?  Who knows.

What caused this killing?  Was it vigilante “justice” handed out by racist cops?  Was it a dangerous and explosive situation that spun out of control?  Was it inadequate training of the Baton Rouge Police Department?  Was the victim at fault?

Judging from the footage, we can rule out the last question above.  Whether he had previously been aggressive on the sidewalk, the man was clearly subdued.  But the other rationales?  Which was the catalyst?

Here’s the problem with the analysis that I’ve seen thusfar – it assumes that there WAS a primary cause, when chances are it was a little of each – systemic racism, stressful situation and inadequate training.  And so we have talking heads in the media who are shouting at each other on the basis of whichever rationale best matches their pre-existing narratives.  We have human offense-taking machines who make careers out of faux-outrage on TV, and the result of this “un-thought” is an obfuscation of both the situation on the ground and also any steps that might help going forward.

There ARE solutions out there.  But they’re all-hands-on-deck solutions.  We live in a complex world where simplistic answers don’t tend to get you very far.  Cannot body cameras be affixed in such a way that they don’t fall off?  Can they be integrated into a shoulder strap so that they’re secure?  Cannot we increase salaries of police officers so as to ensure that we’re hiring people who are going to do a good job?  Can we use incentives to alter police demographics so that the officers better understand the communities in which they work?  Can we improve police training?  Can we build community to allow law enforcement and citizens to know each other outside of these intense and tragic circumstances?

And can we please acknowledge that race absolutely plays a factor in this type of event?  Notice I’m not saying that this officer or that is a closet klansman who’s out to settle scores.  But racism, just like sexism, creedism or anti-this-or-that-ism, is a pervasive force that subtly affects one’s thinking.  And that should be acknowledged and addressed in not only police training but also in our communities.  In schools, places of assembly, politics, business – anywhere racism occurs.  Which is pretty much everywhere.

Clearly, retaliatory killings OF police officers in Dallas are not the answer.  Violence tends to induce a never-ending vicious cycle like that (exhibit A – any history book).  So what’s the answer?  The answer is the kitchen approach – honest dialog, sensible modifications to police equipment, smarter police-hiring practices, better training, better interfacing with the community.  If I were a white police captain in Baton Rouge, I’d be filling up my schedule with PTA meetings at majority-black schools, meetings in black churches, block parties in black neighborhoods – anywhere to plant seeds for positive momentum.

If I were a black resident of Baton Rouge, I’d try my best to channel my outrage in a direction that could produce desirable results.  This does not include starting fights on facebook and demanding immediate assistance with the oppression of my particular demographic group, while conveniently ignoring the plight of other groups which also suffer.  Where was the black outrage in the assault on the gay-nightclub in Orlando a couple weeks back where at least 49 people were killed?  Where’s the black outrage for the death toll from the war in Syria, where something like 490,000 citizens had been killed as of February?

The world is an interconnected and complex place.  All of these group have legitimate grievances, but it’s rare to hear sufficient acknowledgement of grievances beyond one’s individual experience.  But that all-hands-on-deck approach?  It requires thoughtful inclusion of other causes.  Yes, police shootings of black civilians in America are a travesty, and I don’t think any reasonable person can deny that there’s a racial influence at work.  So let’s acknowledge it.  Let’s discuss it with one another.  Let’s do a better job teaching young people the right way to live in a world where not everyone looks the same.  Let’s make common-sense, practical improvements to hiring practices, technology and training.

Let’s acknowledge that there are a lot of ways to acknowledge, respect and mitigate this problem.  And until things are better, let’s implement them all.

And “right now” would be a great time to start.

-dw 7/8/16

The World Needs Saving — Antibiotic Resistance Is a Big Deal

Hello faithful readers!

It’s been awhile since my last post — the blog is a labor of love, but I seem to be suffering from a chronic case of only-24-hours-in-a-day-itis, so the strategic time reserves have been overtaxed over the last few weeks.  Nevertheless, I sally forth tonight.

The topic?  Antibiotic-resistant bacteria.  And the news (and there is news), is grim.  But this discussion raises an even larger issue, and that’s this — how hard can I push on a subject before claims of alarmist writing overwhelm the utility of the underlying message?

It’s like plant-based eating.  I can pile on evidence of its being an optimal diet both in terms of nutrient-acquisition and disease-avoidance, and that’s great.  Or I could go combative-vegan, as opposed to garden-variety-vegan (couldn’t resist), and show you a bunch of hideous pictures of what takes place in commercial abattoirs, and while that makes a memorable point, it’s coming across a little strong for most readers out there who are reading this post at the end of a long workday.

My point is that there’s a balance to be had, and it tends to be a non-stationary target.  So I’m writing this article not to scare you, but this is scary stuff and I guess I’d rather err on the side of alarmism than failure to inform my audience.

So let’s get on with the show and discuss antibiotic-resistant bacteria.  For those of you unfamiliar with the term, let me catch you up with some broad brushstrokes.

If you’re both alive and reading this article, then you’re the beneficiary of a “golden age” of medicine — the antibiotic era.  Most of you know that chronic diseases, such as cardiovascular disease and cancer, are our leading causes of death worldwide.  According to the World Health Organization, cardiovascular diseases killed 17.5 million people in 2012 alone (1) (2).  But this hasn’t always been the case.  Humans have been around for somewhere between 100,000 and 200,000 years, depending a bit on your definitions.  And for the vast majority of that time, Rite-Aid has not had whatever-sporin ointment on sale for $3.99 per half-ounce.

It’s hard to fully appreciate what this means since we’ve nearly lost living memory, at least in the western world, of life before antibiotics.  But before antibiotics, and for the vast majority of humanity’s existence, infection has been a prolific killer, and heavily contributed to a very short average lifespan.

How many scrapes and cuts have you had over the course of your life?  How many of those have become infected?  For how many of those have you used some sort of antibiotic?  Am I saying that without antibiotics, your next scratch is going to kill you?  No, but the risk is there.  If we lose antibiotic protection, simple infections can and will kill again.

David, that’s alarmist!  My response?  Fine — but only if, by alarmist, you mean pointing out uncomfortable truths.  And what’s more?  According to Maryn McKenna in her 2015 TED Talk, a loss of antibiotics also means a loss of protection for people with weakened immune systems, such as cancer patients, AIDS patients, transplant recipients and premature babies (3) (4).  Further, let’s go ahead and cross off treatments which install “things” in the body — stents, pumps, pacemakers and joint-replacements (3).  McKenna estimates that without antibiotics, 1 in 6 patients undergoing joint-replacements would die from infection.

If you’ve never had a joint-replacement then I can almost guarantee that you know at least several people who have.  Would you be willing to undergo a knee-replacement operation if you had a 17% chance of dying?  Or would you just live with the pain (which can be agonizing)?

Oh and we’re not done yet, because the next thing to consider is other surgeries, even routine ones, which today are nearly all preceded by antibiotics.  Again, it’s not a death sentence, but there’s a very real risk attached.

What about pneumonia and strep?  Humanity has suffered greatly from pneumonia, in particular.  McKenna claims that we’ve seen times where pneumonia killed 30% of children (3), but I think that’s a striking overstatement.  I’ve looked around a bit and found a 30% number, but that covers unidentified fevers, including pneumonia, scarlet fever, dysentery, etc (5).

But McKenna does raise an interesting point in that antibiotics allow us a certain confidence with which we approach our lives.  There’s little reason to think that a simple infection is fatal.  But if that assumption changes, what would that mean for the overall quality of our lives?  What “safe” behavior suddenly becomes a serious risk due to the possibility of injury and resultant infection?

It’s a grim picture, and I don’t particularly enjoy being so fatalistic, but I think it’s important to share some of the background on this issue.

But what, then, is antibiotic resistance?  And what does that have to do with anything?  Antibiotic resistance is essentially all the inevitability of evolution sped up to a timeframe that we can see within our own lives.  Bacteria, like all other life forms, grow, develop, thrive or die based on environmental factors and their genetic code.  As bacteria reproduce (think approximately 20 minutes to produce a new generation(3)), that code is replicated and transferred, but sometimes what is essentially a copying error occurs.

That copying error is the random mutation of Darwin’s theory.  Then comes the natural selection part — if the mutation prevents death at the hands of certain environmental stimuli, then the mutated bacteria will out-compete its peers when the stimuli are present.  If you’re one of the last bacteria standing, then future generations will tend to have something very close to your genetic code, thus reinforcing that particular resistance.

So for our purposes, the mutation is a resistance to a certain antibiotic.  It kills neighboring bacteria, but the resistant versions survive and reproduce, thus creating geometrically-expanding populations of resistant bacteria.

But David, this is all theoretical, right?  Nope.  Consider this — penicillin began widespread distribution around 1943.  Resistance was detected around 1945.  Vancomycin?  Widespread distribution in 1972.  Resistance in 1988.  Imipenem?  1985 and 1998.  Daptomycin?  2003 and 2004 (3).

Okay David, so we just keep making new antibiotics and we’re fine.  Don’t worry about it!  Well, no.  Pharmaceutical companies are hesitant to drop big bucks into antibiotic R&D for the exact reason that resistance can develop so quickly.  There’s too much uncertainty with respect to ultimate profitability.

But David, don’t we still have antibiotics that work?  Well, yes and no.  According to McKenna, 50,000 Americans die every year from infections that no drugs can help.  Worldwide, that number is closer to 700,000 (3).  We still have antibiotics that work, but we’re increasingly resorting to more dangerous varities — the ones which come with the scary and life-threatening side-effects.  Liver failure, anyone?

And yet, that may be on the verge of changing.  The bit of news that got me thinking about the topic of antibiotic resistance is the discovery, in 2013, of a colistin-resistant gene (called MCR-1) in e-coli bacteria in animals (pigs) in China, which has since become far more prevalent in that country and has been detected on other continents as well.  What’s colistin, you ask?  Good question.  It’s one of those last-line antibiotics with the awful side effects.  You don’t want to take this stuff if your life doesn’t absolutely depend on it.  But even colistin may be falling as a last-line treatment as a recent Lancet Infectious Diseases study found MCR-1 in alarming numbers of samples in pork, chicken and even in human hospital patients (the percentage is low, but that it’s present at all is alarming) (6) (7).

Even more alarmingly, the Lancet study found that this resistance can spread horizontally in addition to vertically — that is to say that it doesn’t rely entirely on traditional evolutionary models — it can actually jump from bacteria to bacteria, spreading extremely quickly.  The precise mechanism for these horizontal jumps is probably a layer of complexity beyond what most of my readers want, but if enough people ask, I can give it a shot.

There is no getting around the issue of antibiotic resistance — it’s an inevitable consequence of evolution in addition to its being facilitated by other mechanisms.  The time that resistance requires for development is unpredictable — it often does rely on a random mutation, after all.  But there ARE steps we can take to slow the process.  What are they?

First, we have got to stop squandering our antibiotics.  Penicillin, for instance, was sold over the counter until the 1950s (3).  In many parts of the world, antibiotics are still sold that way.  You can pick your numbers here — McKenna argues that in the USA, 50% of antibiotics used in humans are unnecessary, and that 45% of prescriptions in doctors’ offices are provided to relieve conditions which antibiotics can’t improve (such as viral infections) (3).

Think of it this way — everytime we use an antibiotic, we’re providing an opportunity for resistance to spread.  If the bacteria in your particular infection happen to have developed a random mutation making them resistant to your antibiotic, then use of that antibiotic kills the other bacteria, leaving the resistant ones free to reproduce.  If they then spread beyond your body, then congratulations — you win.  Or, more accurately, we all lose.

In addition, 80% of antibiotics used go to support food production.  Think livestock.  Because of the unthinkable conditions of factory-farmed meat production (back to the balance I discussed at the beginning — it’s horrible, and in fact it’s so bad that once you learn about it, it haunts you), antibiotics are required to allow these animals to survive in sufficient quantities.  Not only that, but also the antibiotics allow the animals to grow faster, making the food production business more efficient, more profitable, and a hell of a lot less humane.

But the ridiculous quantities of antibiotics used allow for a tremendous breeding ground, if you will, for resistance.  This risk can be minimized by smarter food-production methods, methods that are both sustainable and more ethical.

So, dear readers, please consider the issue of antibiotic resistance.  Tell your friends.  Refer them to this article.  What we need is something on the scale of the switch from incandescent to CFL and now LED light bulbs.  We can slow the development of resistance by reducing the chances for resistance to develop.  Don’t pressure your doctor for antibiotics unless there’s sufficient need (a lot of factors go into this calculation — use your judgment).  But more importantly, know where your food comes from.  Reduce consumption of factory-farmed meat (and, I would argue, reduce or eliminate meat-consumption altogether).  If you must eat animal products, find better producers.  If you live in the Virginia area, I’d highly recommend food raised by my friend, Joel Salatin, at Polyface Farms.

And don’t lose hope.  Where McKenna goes wrong is in the doom and gloom — if you raise, too vocally, the spectre of inevitability and implosion, too many people will throw up their hands and ignore the issue (exhibit A — climate change).  There are new drugs in the pipeline, but they’re very expensive and time-consuming to bring to market (think $10 years and a billion dollars each).  So what’s needed is an all-hands approach — reduction in unnecessary use (both in humans and especially in food-production), better awareness, more emphasis on antibiotic R&D and, and I’m not generally a huge fan of pharma corporations, but I wonder if we should better incentivize the development of antibiotics through extended patent protection, tax incentives or the like.

We do not want to run out of useful antibiotics, and with the fall of colistin, we may have just run out.

 

Notes:

1.  http://www.who.int/mediacentre/factsheets/fs310/en/index2.html
2. On the balance issue, I find it interesting that we lose our collective minds about the risk of terrorism — it’s very scary, after all — and we take all sorts of steps to minimize the risk, yet reducing our bacon intake is just way too extreme to seriously consider.  Ugh.
3. https://youtube.com/watch?v=o3oDpCb7Vql
4. One of the best parts of blogging is that I can make up my own citation rules as I go.  Welcome to common-sense citations instead of pointlessly complicated and pretentious grandfathered systems.
5. http://chnm.gmu.edu/cyh/primary-sources/166
6. http://phenomena.nationalgeographic.com/2015/11/21/mcr-gene-colistin/
7. http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00424-7/abstract

 

Red and Processed Meats, Their Implications for Carcinogenesis, and America’s Collective “Whatever, Dude.”

You folks read the news last week, right?  You saw that the World Health Organization declared that processed meats do cause cancer? (1)  Well, that was the headline, at least.  And then, to the shock of absolutely no one, the news was lampooned and ridiculed by… pretty much everyone. (2)  Here’s what I don’t get — What’s so damned funny?

I let this sit for a week because I wanted to get a sense for the tone of responses to this message before I opine.  After having done so, I think it’s fairly safe to group the critics into several different schools of thought:

You’ll pry the bacon out of my cold, dead hands.  Yuk yuk.

One needs but to do a google search for “bacon meme” to witness this bizarre cultural phenomenon where a widely-known contributor to adverse health outcomes is praised in such a way that the health outcomes themselves are mocked.

Bacon tastes good.  I get it.  I grew up eating it, I remember getting excited on those mornings when the smell of bacon permeated the house, and while I’ve been on a fairly-strict plant-based diet for several years now, bacon and I may have crossed paths on a few occasions.  Maybe there was a time in my life when I, too, would have blithely ignored or even mocked the health consequences (and not just the carcinogenicity — also the saturated fats, the cholesterol, the crowding out of healthier foods and their useful micronutrients).

After all, I was a teenager once, and I was a twenty-something once.  I remember feeling invincible and know that I would have cast aside warnings from a bunch of “old folks” or “worrywarts” who were trying to come between me and a preferred food.  Diet?  Who cares?  I’m 20-whatever years old, I can bench press a mountain, and I’m going to eat whatever I want, thank you very much.

But now, at 41, my views have changed.  At 41, I’ve seen too many beloved relatives suffer and die from diseases which were highly predictable based on environmental and lifestyle factors (read:  diet).  That’s not unique to one’s 40’s, but here’s what’s even more troubling in some ways — the same thing is happening to my similarly-aged peers.  Few things have shaken me quite like the loss of one of my high-school tennis partners earlier this year.  I have other friends who are struggling with severe health issues and treatments — our collective willingness to say “whatever” at the need for highly-invasive surgery never ceases to astound me.  Issues of health and mortality are resonating with increasing intensity.  And I’d be remiss to omit my own health transformation here.

My peers and I are in an insanely busy phase of life, where parenting obligations and career obligations merge in a tsunami of “why does my calendar look like an army of pens exploded on it?”  Add in ever-increasing concerns for parents who themselves will need more care (google “sandwich generation” if you’re interested), and it’s easy to understand why many folks throw up their hands with respect to the consequences and find comfort in the ice cream, or the bacon or whatever provides a quiet moment of pleasure when the kids are finally asleep.

But does this make sense?  Somehow heart surgery in our 30’s and 40’s is no big deal, but a change of diet?  No way!  That’s way too drastic.  Watching our relatives suffer severe consequences of diabetes or heart disease — that’s unfortunate, but you can’t expect us to eat a little better.  And rather than confront the truth that everyone knows — diet DOES play an important role in your health — we just mock it with memes about bacon.  I don’t understand this thinking.

I’m going to just sit here and pick apart the science, because I read something once.

Here’s another other big school of thought for critics of nutritional guidance.  Let’s pick apart scientific results that we don’t like by citing confounding variables or disagreement among scientists.  Oh!  Or we can talk about absolute versus relative risk and make the percentages sound less scary!  Sow enough doubt in an unwelcome result and all the cards will fall down.

As someone who tries to think critically, I understand the motivation for skepticism, and quite often, that’s a very healthy thing.  Notice what I did there with the word “healthy.”  Because that’s exactly what many of the scientific detractors are doing when they criticize scientific results.  For instance, “theory” has multiple meanings — there’s the scientific definition, whereby a hypothesis is tested so thoroughly and for so long that it’s as good as fact (gravity, climate change, etc), but then there’s the conversational definition whereby it’s closer to a “working assumption.”  It’s much easier to criticize evolution if you go with the second definition of “theory.”

Scientific detractors often play games with semantics in order to bolster otherwise-weak positions.  Or they’ll commit ad hominem fallacies — “this information came from the World Health Organization?  Well what do they know?”  Guys, the WHO didn’t run the actual experiments.  They’re simply opining on the the review of over 800 epidemiological studies which looked at associations between red and processed meats and cancer.  These studies were done across many countries and continents, giving additional weight to prospective cohort studies and also utilizing high-quality population-based case-control studies for extra evidentiary oomph.  (3)

This is not some secret cabal of James Bond villains trying to mess with your breakfast.  This is a working group within a highly-respected international organization, evaluating results from 800 highly-respected scientific studies, with such results appearing in highly-respected and peer-reviewed medical journals, such as The Lancet. (3)  It’s the real deal, and your cable-news outlet of choice doesn’t change the results one bit, no matter how strongly you wish it would.

What was that about absolute versus relative risk?  Take a look at this article, where the author criticizes the study on which this current conversation is based.  He decries the mention of the “statistically significant dose-response relationship, with a 17% increased risk… per 100 g per day of red meat and an 18% increase… per 50 g per day of processed meat” of colorectal cancer. (3)  The author of the “no big deal” piece correctly states that the 17% or the 18% refers to the relative, and not actual risk.  That is, if you eat a certain amount of processed meat, you’re not necessarily increasing your likelihood of contracting colorectal cancer by 18%.  Instead, you’re increasing it by 18% of the actual risk in the first place.  So, he posits, if your baseline risk of colorectal cancer was 10%, then 18% on top of that would leave you with an 11.8% chance of developing that cancer (2).

That’s a reasonable point, and displays a problem in the reporting on all sides of the issue.  Although in a country with epidemic levels of “too long, didn’t read,” I’m not sure how we can best address it.  How many folks who started reading this post made it through the paragraph immediately above?  I’m guessing many, because I have the best readers on the internet, but not all authors are so lucky.  But think about this — multiply that increase in relative risk by our total population.  Now multiply it by the financial cost of treatment.  Now you no longer have to wonder why our country spends so much on health care.  It’s a big deal.

Confounding variables are an issue in one specific study.  They’re much less of an issue when you’re doing meta-analysis of hundreds of studies.  Actual versus relative risk are important concepts to understand, but anything that increases the risk of life-ending disease is a big deal.  And keep the politics out of it — you may not like the WHO, but this is bigger than your petty political gripes.  Critical thinking means more than just ticking off the same few boxes in every article, demonstrating that you know a few definitions, and collecting a paycheck.  This is journalism with an agenda.  In fact, it’s the opposite of science.

This is too confusing.  One day a food is good for you.  The next day it’s bad.  Even the scientists don’t know what we should eat, so why should I bother?

Here’s the last category of responses.  And here’s the tough-love part.  Yeah, the reporting is often pretty terrible.  You have 18-year-old kids writing opinion pieces on concepts they barely understand, if even that.  And yeah, if you’re not accustomed to reading scientific studies, they can seem pretty opaque (because while the authors tend to better know what they’re talking about, the writing itself is offensively bad — almost universally).  And yeah, we’re all busy.  I get it.  But if we choose to ignore health for the sake of a few minutes of peace and quiet at the end of the day, or if we diminish its role as a priority in our day to day lives, we do pay a price for it.

Red and processed meat are bad for you.  Please limit their consumption.

Sources:

1.  http://www.bbc.com/news/health-34615621
2. http://mashable.com/2015/10/31/processed-meat-cancer-risk/?utm_campaign=Mash-Prod-RSS-Feedburner-All-Partial&utm_cid=Mash-Prod-RSS-Feedburner-All-Partial
3. http://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045%2815%2900444-1.pdf

Men, When it Comes to Nutrition at Home, Either Help Out or Shut Up

I know a few people whose lives have more or less gone according to plan.  If your dad owns a business, and you’re groomed, from a very young age, to take over someday, then maybe you’re one of these people.  Or if you’re a sports prodigy at age three and you go pro after spending 15 years training at some remote tennis camp in Florida, maybe you’re in the club also.

I’m not.  I’m a member of what I suspect is a vast majority of people who make it up as they go along — making plans here and there, working hard towards certain goals, rolling with the inevitable changes in course.  And on my particular journey, I find myself writing (mostly) about nutrition policy which, let’s face it, is not exactly a hot topic among business lunches in the old boys’ club.

I wish nutrition was a bigger deal for guys — many men could stand to benefit tremendously from a little nutritional knowledge.  Need supporting evidence?  Check out the latest stats on cardiovascular disease, or strokes, or obesity.  Or, easier still, look at your plate the next time you sit down to a restaurant meal.  What’s that plate of food doing for your overall health, your energy level or your lifespan?

But there’s an upside to my path’s taking this particular shape.  And that is the ability for me to gather nutritional information and report back to the “guy team.”  It’s almost as if I’m a double agent here, only without the Aston Martins and the casinos in Monte Carlo.

So here’s my bit of advice for all the men out there who happen across this blog:  Help out or shut up.

“David!  You traitor!  I thought you were one of the guys, but you sold us out!”  Not at all.  I’m doing you a favor.  “How?”  I’m glad you asked.

If you’re like most families in that your wife is the primary force behind the home menu, you have a some options:

1. Shut up (whether or not you’re happy with what’s made),
2. Complain, or
3. Complain but offer to help.

#2 isn’t a good choice.  And yet it’s the choice being made over and over by far too many guys.  Anecdotal?  Sure.  The sample size is small and the experimental controls are approximately nil.  But does anyone really want to dispute that this is happening?

Look, I get it.  I’ve done it myself, as a matter of fact.  But then I smartened up.  Regardless of whether both spouses work, every piece of evidence I’ve seen on the subject indicates that women still do the preponderance of housework (including food preparation) despite, in many cases, their working outside the home too.

That means women are making the preponderance of nutritional decisions out there.  They’re investing time and energy into this (when they’re already tired), and this time & energy are magnified when kids come into the picture, and ESPECIALLY if those kids have specific health conditions which require extra attention to nutritional matters.

How would you like it if your wife repeatedly criticized your driving on very long trips but never offered to take a turn?  It’s that, only every day.  And often in front of the kids — guys, if this pattern sounds familiar, I urge you to stop immediately because this type of hole is hard to escape.

The exact nutritional philosophy doesn’t matter for purposes of this article (it only matters for your health, your long-term wallet and the environment, so go whole-foods-plant-based and thank me later).  If you don’t like what’s for dinner, offer to cook the next one.  Offer to go shopping.  Search the web for some recipes you’d like to try.  Do something besides sit there and complain.

And definitely do not EVER undermine a mom’s nutritional practices in front of a child.  That’s marriage 101, guys, and too many of us are messing it up repeatedly.  If you think she’s wrong, that’s cool.  But have the conversation privately and be ready to follow it up with some helpful action steps.

I encourage everyone to become educated on the topic of nutrition.  In no way am I suggesting that men should remain silent on the matter.  Get involved as much as your schedule allows (and then clear some of the schedule so you can get even more involved).  But just make sure you’re pairing offers of help with the complaints.

Look, part of marriage is being in trouble about stuff from time to time.  And sometimes the trouble is absolutely worth it (I hope Mrs. The County Fare doesn’t read this one)!  The trick is picking your spots — don’t waste your in troubles on a recurring and 0ften-mundane thing like your wife’s food choices.  Save it for the big stuff — hiding out on Saturdays so you can watch the game when she thought you were going to watch the kids.

Be smart, have your opinions, but if you want to express them, you’d be wise to back them up with an offer of help.

Healthier Food Options Aren’t as Expensive as You Think.

Do you ever stop to consider how frequently we find ourselves blocked by self-imposed narratives?  “I can’t possibly do X, because… Y!”  Maybe it’s a self-preservation instinct — I can’t jump off this mountain because I’m not wearing a parachute and because those rocks way down there look pointy and kind of far away.”

If your narratives are sound, then by all means, carry on.  But what if your narratives are factually incorrect?  “Bodybuilders need eleventy-billion grams of protein in a day.”  “Vegetarians are frail and unhealthy.”  “I can’t make healthy food choices because the cost is prohibitively high.”  Hogwash.  Poppycock.  Balderdash.  Tommyrot.  Bunkum (that’s all I have off the top of my head).

image via dollarphotoclub

Everybody knows by now that I’m all about the whole foods, plant-based diet, but that’s not the focus of tonight’s musings.  Instead, I want to drill down on that third narrative — the one asserting that healthy food choices are unworkably expensive.

From where does that narrative arise?  We’ve all heard it said that Whole Foods ought to be renamed “Whole Paycheck.”  And while there may be some truth to that, it turns out that Whole Foods has very competitive pricing on its bulk bins items and some of the store-brand organic brands.  You don’t have to buy absolutely everything from the same grocery store, and if you shop around, you can learn what’s cheaper where and when — it’s not hard to do.

But you know what?  I think the “Whole Paycheck” narrative is just a thinly-veiled political epithet from the same people who think that salad is “rabbit food” best left to rabbits, or who like to say “eye-ran” instead of “Iran,” just for the sake of annoying thinking people.

Instead, I think the real basis for the narrative is the search for any excuse to justify continuing unhealthy habits.  Why force ourselves to make a change when we can identify a scapegoat and throw it under the bus?

So what can we do about this problem?  Well, a good first step would be the dispelling of the narrative.  Let’s look at a recent meta-analysis (a study of various studies) published in BMJ Open by Mayuree Rao, a medical student at Brown University.  In comparing a number of studies, Rao concludes that a “healthier” diet costs something like $1.50 per day over the price of a less healthy alternative (1).

Whoa.  Wait a minute.  What about confounding variables?  What constitutes a healthy diet?  What constitutes “unhealthy?”  Are we talking organic, free-range, fair-trade, GMO-free, all-natural yoga-practicing tomatoes?  Or are we just talking about “eat your vegetables, you lunkhead?”  And why are we reading a study done by a medical student instead of a professor somewhere, and what is this BMJ Open journal?

Well, first of all, I’ll let you in on a little secret.  A lot of studies, even if a professor has her name at the front, were actually undertaken by students.  I wouldn’t suggest spinning wheels with that claim as the axle — your tires will probably just fall off before you know it.  And fine, if you don’t like the journal, that’s okay.  And if you want to contest the definitions of “healthy” and “unhealthy,” you may find that the number winds up being $1.23 a day or $1.71 a day or $1.57.

Who cares?  The point is that the cost of healthier eating patterns aren’t all that expensive.  Compare that $1.50 to the price of your coffee from Starbuck’s this morning.  Or better yet, compare it to the cost of living with diabetes or CVD or all of the above.  Before you worry too much about the price of eating your vegetables, worry about the cost, both in lifespan and dollars, of your current eating pattern.

Interestingly, the cost of meats and proteins were among the most striking price differences, giving us yet another reason to eschew animal products (1).  Yes, meat substitutes can be expensive too, so get your protein from vegetables, legumes and whole grains instead.  And guess what, you don’t need as much protein as you think you do — that’s another faulty narrative.

If you live in a “food desert” where healthy shopping options aren’t available, then this isn’t going to do you a lot of good.  If you’re scraping by as is, and can’t find that extra $1.50 per day (would be north of $500 a year), then so be it (although I think you can find a number of healthy and inexpensive options too — tip #1 is bulk  bins)!  But if the narrative of “healthy = expensive” resonates with you, and if you have the means and geography to do something about it, I’d suggest you reconsider this narrative!

-dw 9.28.15

1.  http://bmjopen.bmj.com/content/3/12/e004277.full#aff-1

Click for a Great Cause

Could I ask a favor of everyone?  I’m involved with an organization called “Real Food for Kids,” which works extremely hard to advocate for healthy eating options for children in Northern Virginia.  If you have a moment, I’d appreciate it if you’d click through and vote to help us receive this charitable donation from WTOP, one of our local media outlets.

Here’s the link

Thanks, guys!

The County Fare is Off this Week!

The County Fare is also the PTA president so attention is required elsewhere for the first week of school.  Back soon!

Banana Bread!!

Some people walking around out there in the world will claim to dislike banana bread.  While I’m happy to give people the benefit of the doubt wherever possible, my objective, scientific conclusion is that banana-bread antipathy is a sure sign of terrible person-hood.

Ok maybe not, and I should be careful here because Mrs. The County Fare both dislikes banana bread and reads this blog (hopefully it’s not the other way around?!?), but honestly, what’s not to like about this recipe?  Get with it, people!

It’s easy, it’s decently healthy (moderation is important, especially for any diabetics out there) and it tastes great.  Without further ado, let’s get to the recipe!

The County Fare Banana Bread!

Ingredients:

1/2 cup applesauce

2 tbsp water

2.5 very ripe bananas

2 tsp lemon juice

1/4 cup almond milk

1.5 cups whole wheat flour

1/2 cup sugar

1 tsp baking powder

Instructions:

1. Mix together the wet ingredients (this does not include the bananas)
2. Mash bananas very well and add to the wet
3. Mix the dry ingredients and add the wet to the dry
4. Bake at 350 degrees F.  If you’re using a loaf pan, go for 75 minutes.  If you’re doing muffins, try 45 to 50 minutes.
5. In either case, it’s done when you can stick in a toothpick and it comes out clean.

-dw 9/7/15

Asian Bulgur Salad!

This recipe has been adapted from “The China Study Cookbook”

Lettuce wraps are amazing in restaurants but there are two problems.  First, just about every restaurant ever loads them so full of sodium that.. well, what’s the point?  Second, they’re impossible to make at home if you’re a busy person or if you’re a male.  The lettuce never peels off in nice neat pieces and after the first few torn leaves I just say the heck with it and make a big salad.

Real food for real people, and that’s real talk.

So let’s go with a healthy dish with a bit of asian flair.  The bulgur gives you the benefits of a delicious whole grain — satiety, moderated glycemic index, iron, tons of micronutrient goodness.  This dish is easy, tastes amazing and is a very healthy meal.

Without further ado, here it is!

The County Fare Asian Bulgur Salad!

Ingredients:

The Salad Part:

1/2 cup veg broth

6 cloves garlic, minced (or not — i hate peeling garlic)

2 tbsp diced fresh ginger

1 onion, diced

2 carrots, finely diced

1 can water chestnuts, rinced and finely diced

1 bell pepper, diced

1/2 cucumber, diced

1/4 cup sesame seeds

1/2 cup lo-sodium soy sauce

4 cups cooked bulgur (2 cups dry bulgur and 4 cups water — cook it like you would rice)

lettuce or dark leafy green of your choice — 1 head

The Dressing Part:

1/2 cup almond butter (or peanut butter or whatever you like)

2 tbsp lo-sodium soy sauce

1 tsp finely diced fresh ginger

1/2 cup Thai red curry paste

1/2 cup coconut milk (the cans in the asian aisle at the store are higher in fat but yield a thicker dressing than do the ones in boxes in the veg milk aisle — i usually go with the lower fat ones)

Instructions:

1.  In a skillet, cook broth, garlic, onion, carrot and water chestnuts for 5 minutes.

2.  Add sesame seeds, soy sauce & bulgur.  Cook for 3 minutes, stirring frequently.  Remove from heat and let it cool.

3.  In a separate bowl, mix the sauce ingredients until well-blended.

4.  Once bulgur mixture is cool, mix in the bell pepper and cucumber.

5.  Pile it on top of some lettuce, add a hit of the dressing and rock the world.  It’s good cold, too.  Just keep the dressing separate until just before eating.

It’s Time to Re-think Homeowners’ Associations. The Question Should Be Return on Investment and not Preservation of Value.

I really dislike homeowners’ associatons (HOAs).

HOA Apocalypse.  Image via dollarphotoclub.

I’m not talking about associations where the residents pitch in to maintain a swimming pool, or a communal lawn service or some other shared and “essential” feature.  Instead I’m talking about those useless amalgamations of bored people who band together to dictate property rights with an eye toward “maintenance of property value.”

The whole concept feels very Stepford to me, and I think HOAs have a markedly deleterious effect on community.  By “community,” I’m not referring to a place with a bunch of houses — I mean “community” in the less tangible form, that tacit social contract and sense of shared concerns, hopes and desires.

HOAs discourage meaningful human interaction.  Instead of getting to know your neighbor and expressing concerns and finding collaborative solutions, you just complain to the HOA board, which then sends out nastygrams dictating that neighbors comply with certain rules or else risk fines or even liens on property.  The level of absurdity to which these roving teams of zombies stoop will differ from neighborhood to neighborhood, but at the end of the day, they’re just differing flavors of zombies, and they are a source of never-ending frustration to those yet to be afflicted with the brain-eating zombie-plague.

I think most people realize this.  A few try to defend HOAs as doing “something useful for the community,” but those defenses are generally half-hearted and whispered as if not even the defenders of HOAs believe what they’re saying.  But the defense that I find the most irritating is the ubiquitous claim that “HOAs preserve home values.”

I’d like to use a scientific term here to express my conclusion regarding that claim, and that term is “horse-puckey.”

The mantra of value preservation is always bandied about, but interestingly there’s no tangible evidence to support it.  Sure, you can go out on google and find anecdotal claims made by housing developers or real estate agents or even HOAs themselves, but it’s important that we remember that “anecdote + anecdote does not equal persuasive.” And if we’re having a battle of the anecdotes, I could point to plenty which assert that HOAs may actually lower property values.

Preferences change over time — buyers today are more concerned with issues like solar panels and chemical runoff than they were 20 years ago.  Native vegetation with lower watering demands is becoming more desirable.  HOAs locked into decades-old covenants (because nobody can remember the last time a quorum was seen) are inflexible and may find themselves out of favor with younger buyers.

What about the science?  Are there any studies which demonstrate a causal relationship between HOAs and increased home values?  I’m not aware of any.  But here’s the thing — it doesn’t matter, because that’s not the right question to ask.

Why is this question wrong?  Well, let’s assume that the statement, “HOAs increase property values,” is correct.  Assume that neighborhoods A and B are similarly located with similar houses of similar ages with children attending similar schools and similar commuting requirements for the adults.  Neighborhood A has a HOA and its houses are worth 3% more than those of neighborhood B.  Fine.  I don’t think this is the case, but let’s assume that it is.

Are you getting a better value by buying in neighborhood A?  No, you’re not, because you’re paying a higher purchase price to begin with.  Your house may be worth more, but you’ve already paid that much more for the house.  Further, you now have HOA fees (which vary wildly), you have compliance costs (better hire a lawn service if you don’t have endless weekend time), you have environmental costs (spray toxic death to preserve non-native grasses and who cares about the watershed or the health of neighborhood kids and dogs), you have a loss of enjoyment of your home (sorry, you can’t paint your door that color),  you have frustration costs (nastygrams about the yard), your property can be subject to fines and liens by capricious board members, and the list could go on and on.

Yeah, your house may be worth an extra $X when you go to sell, but how much of $X have you already paid in HOA fees and compliance costs?  And remember, the longer you live there, the more these fees and costs add up.  If you’re a long-time resident, chances are you’re WAY in the red without even realizing it.

Think about it this way — if I buy $10k of a stock valued at $30 per share, and $10k of a stock valued at $25 per share, and they both go up by 5%, which one gives me the better return?  Neither.  It’s a tie.

The better question is that of return on investment.  Do houses in HOA neighborhoods provide a better return on your housing investment?  I see absolutely no evidence of this being the case.  There is absolutely no reason to believe that the value of HOA houses increases faster than that of unbound houses.  And the rate of value increase is a completely separate question from overall value.

This defense of value preservation is the reddest of red herrings.

At the end of the day, HOAs provide values to HOA management companies, developers who think they can charge higher prices per unit and to the neighborhood busybodies who like to feel important.  And that’s about it.

Now I’ll repeat that I’m not talking about communities that maintain or preserve an important asset like a swimming pool or other recreational facility.  And I’m not saying that all HOA board members are mindless zombies (just most of them).  But the reasons we give in support of HOAs are garbage — we believe them simply because we’ve heard them for so long.  They fall like dominoes when the slightest scrutiny is pointed their way.

So David, I take it you live in an HOA neighborhood and wish you didn’t.  You shouldn’t have moved there in the first place.  Well, that’s generally a fair point, but one ought remember that in many parts of the country, there aren’t a whole lot of options.  Developers like HOAs.  Management companies like HOAs.  They’re becoming more and more common and where I live, you pretty much either live in an HOA neighborhood or you don’t buy a house.

And regardless of my happiness or unhappiness with my HOA, I’m concerned that the covenants are so inflexible.  Sure, they can be changed, but it’s extremely difficult because nobody ascribes the HOAs enough importance or validity to warrant attending the meetings to vote on anything.  Why not work to get out the vote?  Well, because most everyone else feels the same way also, especially the younger homeowners.

Be careful with HOAs — I have a strong suspicion that in addition to their logical indefensibility, they’re going to wind up hurting our ROI as well due to the rigidity.

-dw 8/24/15