2,780-Calorie French Toast: Cheesecake Factory Tops The (Calorie) Charts

(atobest/Flickr via Compfight)

Veronica Thomas
CommonHealth Intern

The Cheesecake Factory doesn’t just have the biggest menu. It also has the biggest calorie bang for your buck, according to this year’s Xtreme Eating awards from the Center for Science in the Public Interest.

Consider their Bruléed French Toast, described in the menu as: “Extra thick slices of rustic French bread baked and grilled golden brown. Topped with powdered sugar and served with maple-butter syrup with bacon or grilled ham.”

French toast seems innocent enough, and it’s even “bruléed.” If the French do it, it must be healthy. After all, French women don’t get fat, right? But at a whopping 2,780 calories, this breakfast treat is enough to satisfy an average person’s energy needs for the entire day—and half of tomorrow. To burn off that toast, you’d have to run a marathon. Yes, you read that right. A marathon.

This custard-stuffed toast, along with the Farfalle with Chicken and Roasted Garlic and the Reese’s Peanut Butter Chocolate Cake Cheesecake (yes, that’s double the “cake”), placed The Cheesecake Factory as the clear winner of this year’s Xtreme Eating awards.

Ranked by the Center for Science in the Public Interest each year, these nine awards go out to the meals highest in calories, sugar and salt sold at chain restaurants around the country. The center is making a point: It’s pushing for the federal government to require calorie counts on chain-restaurant menus – and the numbers certainly do pack a punch.

So, who are the other six offenders—or should I say, winners?

  • Red Robin’s A.1 Peppercorn Burger, a serving of Bottomless Steak Fries, and a Monster Salted Caramel Milkshake (3,540 calories and four days’ worth of sodium)
  • Famous Dave’s “Big Slab” of St. Louis-Style Spare Ribs with a corn muffin, Famous fries, and Wilbur (baked) beans (1.5 pounds of meat and 2,770 calories)
  • BJ’s Signature Deep Dish Chicken Bacon Ranch Pizza (2,160 caloriesor what you burn while swimming for four hours straight)
  • Chevys Fresh Mex’s Super Cinco Combo (1,920 calories, not including the bottomless basket of greasy tortilla chips)
  • Joe’s Crab Shack’s Big “Hook” Up Platter (3,280 calories and three days’ worth of fried saturated fat)
  • Maggiano’s Prime New York Steak Contadina Style (2,420 calorieshalf of which come from the sausage-and-potato garnish alone)

I must admit, I got a little hungry writing this post. But if I ever do get one of these meals, I think I’m going to have to take the long way to the restaurant — as in walk to the location in the next state over.

Food Stamps For Heirloom Tomatoes? Diet Effects Of Farmers Market Vouchers Studied

(Lindsay_NYC/Flickr via Compfight)

Veronica Thomas
CommonHealth Intern

Heirloom tomatoes for three dollars a pound. A four-dollar bunch of purple and yellow carrots. Well-heeled women stopping for local produce on their way to Whole Foods and the neighborhood juice bar.

That’s what comes to mind when I think of a farmers market. Bargain buys for low-income families? Not so much. But according to a new study, published in the journal Food Policy, vouchers for farmers market produce might improve the diets of low-income families—well, at least for those who go there anyway.

“Farmers market vouchers are a way to place all consumers on the same playing field,” says Carolyn Dimitri, an associate professor of food studies at NYU and the study’s lead author.

Low-income families often receive federal food assistance from two government programs: Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps. While these programs help ensure access to food, they do not guarantee its nutritional quality. In fact, most food assistance funds can be spent on anything, from potato chips to ice cream.

In general, low-income families don’t eat a lot of fruits and vegetables, often because they live in “food deserts” where options are limited. Some local governments and non-profits are aiming to increase these families’ access to fresh produce by offering vouchers—which are basically coupons—to use at farmers markets.

This year’s landmark Farm Bill created the first federal program to provide nutritional incentives in farmers markets and maybe even grocery stores. Before the program is implemented, this study’s investigators were interested in seeing if the incentives actually work.

The New York University researchers recruited 281 women from five farmers markets in New York, San Diego and Boston—one market in Lynn and the other at Copley. The women, who were already receiving federal food assistance, were offered up to $10 in produce vouchers every time they shopped at the market. Continue reading

As Mass. Lawmakers Take Up Addiction Bill, What’s Most Effective Treatment?

Hydrocodone pills, also known as Vicodin. (Toby Talbot/AP)

Hydrocodone pills, also known as Vicodin. (Toby Talbot/AP)

As Massachusetts lawmakers work on differences in the $20 million bill designed to address the state’s opioid crisis, questions remain about which treatments are best.

Several business and insurance leaders have written to Gov. Deval Patrick saying that some parts of the bill may not encourage the most effective addiction treatment. Essentially, they say, more beds may not be the answer, but more medication and longer outpatient care might be better.

The House bill requires insurers to pay for at least 10 inpatient days of addiction treatment if that’s determined to be medically necessary; the Senate bill requires up to 21 days of inpatient coverage.

“We just believe patients should have a choice.”
– Leominster Sen. Jennifer Flanagan

But the American Society of Addiction Medicine estimates that 95 percent of opioid-dependent patients do not need inpatient care, and might be better off with medication maintenance and several months of outpatient therapy. Lawmakers maintain that they do not want to mandate any form of treatment.

“If we have this epidemic that continues to grow, we’re essentially in uncharted territory, and current treatment options aren’t working,” said Leominster Sen. Jennifer Flanagan, one of the bill’s co-sponsors. “If people want inpatient treatment or medication maintenance, they should be able to decide that with their doctors.”

At the same time, a new report contains some surprising findings about medication maintenance addiction treatment. It says that methadone, long used to treat heroin addiction, may be the most effective and cheapest treatment.

The report, from The New England Comparative Effectiveness Public Advisory Council, found that when comparing methadone with suboxone (Buprenorphine) or naltrexone (Vivitrol), more patients stayed in treatment longer if they were taking methadone. Continue reading

Legal Experts Call For More Regulation Of Mobile Health Apps

smartphone (Stephan Geyer/Flickr)

(Stephan Geyer/Flickr)

Veronica Thomas
CommonHealth Intern

Want to hypnotize yourself thin? There’s an app for that. Want to monitor your heart rate without buying another gadget? There’s an app for that too. With the emergence of countless mobile health applications, smartphones are quickly transforming health care at our fingertips.

Mobile health—“mHealth”—apps have the potential to help promote healthy behaviors, expand health care access, and manage costs. But in order to protect the safety of consumers, health law experts say there needs to be more regulation by the Food and Drug Administration.

According to the new report, just published in the New England Journal of Medicine, only about 100 out of 100,000 mHealth apps available on the market have been FDA-approved.

Many mobile health developers, however, worry that FDA oversight will hinder creativity and growth. The FDA approval process can cost tens of thousands of dollars and take months or even years to complete. Before committing time and money to FDA endorsement, many developers first look to consumers for a stamp of approval.

From the study’s press release:

“Consumers will be spending a lot of money on these products, and venture capital is flying into the industry,” says the article’s lead author, SMU Dedman School of Law Associate Dean of Research Nathan Cortez, adding that by 2017 mHealth apps are expected earn $26 billion— up from $2.4 billion in 2013.

The FDA needs “additional funding and in-house technical expertise to oversee the ongoing flood of mHealth products,” the authors note. An under-regulated mobile health industry could create “a Wild West” market, says Cortez, who has conducted extensive research into FDA regulation of mobile health technologies.

While consumers might trust that iTunes and Android would only sell legitimate health apps cleared by the FDA, that just typically isn’t the case, Cortez says. Continue reading

When Hand, Foot And Mouth Disease Sweeps Through: What To Know

(Bob Reck via Compfight)

Veronica Thomas
CommonHealth Intern

Summer is not only the season for watermelon and zucchini. It’s also the time for Hand, Foot and Mouth Disease. Typically found in younger kids, it’s a contagious viral illness marked by a fever and rash — either skin or mouth blisters.

Hand, Foot and Mouth swept through several WBUR employees’ families recently, so we checked in with an expert: Dr. Clement Bottino, a pediatrician at Boston Children’s Hospital in the Division of General Pediatrics who sees a lot of the illness in the Primary Care Center. “Nothing unusual,” he says, “just the summertime viruses.

“Viruses are kind of like vegetables,” he explains. “There are winter and summer varieties. The winter ones cause illnesses like the common cold, while those in the summer cause fever-plus-rash-type illnesses, like Hand, Foot and Mouth.”

Hand, Foot and Mouth typically affects children under the age of 5, but older children and even adults can catch it as well. Symptoms can vary. Some children may only have a fever and mouth blisters, while others have the characteristic rash without other symptoms. The rash may present with classic red bumps on a child’s hands and feet, or a more diffuse rash that includes the diaper area.

Some people, particularly adults, may show no symptoms at all, but they can still spread the illness to others. Hand, Foot and Mouth is transmitted through direct contact with saliva, mucus or feces. Daycare is notorious as a hotbed of activities for spreading infection: hugging, sharing cups, coughing and sneezing, and touching infected objects. While patients are most contagious during their first week of illness, they can spread the virus for weeks after the symptoms fade.

According to Dr. Bottino, the most important thing for parents to know is that the virus is mild and “self-limited,” meaning it usually goes away on its own, causing no scars or lasting problems. Most patients feel better in seven to 10 days without any treatment at all. I asked Dr. Bottino what else parents should know about Hand, Foot and Mouth Disease. Our conversation, edited: Continue reading

Project Louise: Exercise Every Single Day? Says Who?

(Bjørn Giesenbauer via Compfight)

(Bjørn Giesenbauer via Compfight)

This is getting interesting. One week into the challenge laid down by Editor Carey and Coach Allison — to exercise every single day before 7 p.m., and to post a comment reporting that I did so before 11 p.m. — I have made several discoveries.

  1. Carey was right. Exercising every day makes you feel better.
  2. The sweatier the exercise is, the better you feel.
  3. I hate being told what to do.

Let’s focus for now on No. 3, because we all know that Nos. 1 and 2 are true. Right? We do know that, yes? We just don’t do it because … well, because of No. 3.

At least that’s what I’m concluding about myself. Even though I signed up for Project Louise of my own free will, and even though I did it because I really, truly want to change my habits for good and live a longer and healthier life, and even though I know that Carey Goldberg, Allison Rimm and all the other wonderful people who are helping me on this journey are truly here to help, not to push me around, a huge part of my brain reacts to all this support and encouragement and expert advice with a simple, all-too-familiar refrain:

You’re not the boss of me.

Yes, this is the week when I’ve been getting in touch with my inner child. Or, more precisely, my inner brat.

As soon as I wrote that, I realized that I have heard that phrase before — from a wonderful woman named Pam Young, who has written a lot about this idea that we all have an inner “brat” whom we need to learn to love. Because it’s that little bratty voice that keeps us from doing all the good, mature, responsible things we all know we should do. And as long as you keep fighting the brat, you’re going to lose — as any mother of a 2-year-old can tell you.

Likewise, as that same mother can tell you, the secret to success is to persuade the 2-year-old that what you’re telling her to do is actually fun — to make her want to do it, and even to make her think that it’s her own idea. Continue reading

My Right Breast: One Man’s Tale Of Lump And Mammogram

Journalist B.D. Colen chronicles  his own mammogram experience both in prose and in photos he took during the procedure. ((c) B. D. Colen, 2014)

Journalist B.D. Colen photographed his own mammogram during the procedure. ((c) B. D. Colen, 2014)

By B. D. Colen

It began with an itch I just had to scratch. Doesn’t every adventure begin that way?

I was lying in bed reading on a Saturday evening, and without even looking I idly scratched a spot on the right side of my chest –- at that point I had a chest, not breasts. As I did, my fingers rode over a small something, a little like a speed bump about an inch below and two inches to the left of my right nipple.

I stopped reading and started poking. And prodding. And pushing. And feeling. And manipulating. And panicking.

“That’s a lump!” I thought, and suddenly I had a right breast. With a lump in it.

I spent Sunday attending to the usual chores and pleasures, with a good deal of poking and prodding added in. There was absolutely no question that something was dwelling there, beneath my AAAA right breast. But what was it? And what was I worried about? After all, I’m a man, and men don’t…Well, yes, men do get breast cancer. In fact about one in every thousand men will develop breast cancer during their lifetimes. Granted, that’s barely worth mentioning compared to a woman’s one-in-nine chances, but it still means that the possibility was indeed real that something ugly and malignant was barely hiding beneath my skin.

The following day, I already had an appointment with my primary care physician about something else, and when we were finished I said, “So, Sam, I seem to have this lump in my right breast.”

(Photo c. B.D. Colen, 2014)

(Photo (c.) B.D. Colen, 2014)

Suddenly, my normally garrulous physician grew serious. “Let’s take a look,” he said, asking me to lie down on the examining table. He had me show him where I thought the lump was and I instantly isolated it – I’d already felt the damned thing enough times to be able to go right to it.

He felt it, felt around it, poked and prodded, and in less than a minute said, “You’re right, there’s something there.” Then, without further kidding – which I’d expect from him – and without any “Well, it’s probably nothing, but let’s be sure,” he sat down at the computer and started typing. “I’m putting in an order for a ultrasound and a mammogram,” he said. “For tomorrow.”

Mammowhat?! Mammogram? Me? But I’m a man! And at 67? Is this some really, really weird dream I’m about to wake up from? How in God’s name were they going to do a mammogram when there’s practically no mam on my chest?

But into the rabbit hole, through the door marked “Women (almost) Only” I went. Though not before Googling “male breast cancer” and convincing myself that I was going to die: Family history? Check. Average age of 68? Check. Sometimes Google is not your friend.

The nice woman down in radiology scheduled me for 10 the next morning, and told me that I shouldn’t worry. “It’s probably nothing,” she assured me. I thought, “That’s probably what you tell all the guys.”

I don’t need to tell any of you who are women what a painful, essentially degrading experience having a mammogram is. I’ve since read the jokes advising women to prepare for the procedure by placing a breast on the edge of their freezer and slamming the door on it – and that is pretty close to the reality. Continue reading

In Public Comments, Partners-Coakley Deal Brings Praise And Protest

partners

Quite an “only in Massachusetts” moment.

Patriots owner Robert Kraft and leaders of Raytheon, Suffolk Construction and Putnam Investments have all filed letters in support of an anti-trust agreement that would not normally see the light of day before a judge approves the deal. The opposition includes public health professors, a group of top economists and politicians battling Attorney General Martha Coakley in the governor’s race.

This show of force is weighing in on a deal Coakley negotiated with Partners HealthCare. It would let the state’s largest hospital network expand its market power, but with constraints, some of which would last for 10 years.

Here, in the medical mecca that is Boston, health care is big business, an issue in the governor’s race and a top concern for consumers and employers who struggle to pay for it.

So the agreement is setting a new precedent for public scrutiny. Insurers, physicians and patients are poring through the document, line by line, to understand what it might mean for them and the future of health care in Massachusetts. AG Coakley is collecting public comments through September 15th. She’ll have a week to respond and then Suffolk Superior Court Judge Janet Sanders has scheduled a hearing on the agreement September 29th.

In the first batch of comments out today, most of the supporters focus on Partners’ leadership in the medical community and don’t dive into the details of its alleged anti-trust practices and the proposed remedies. Opponents, on the other hand, plunge right in. Here are a some highlights:

The South Shore Hospital community has submitted at least a dozen letters in support of the agreement, which would clear the way for the hospital to join Partners. Weymouth Mayor Susan Kay applauds the AG’s “significant and even historic benefits for the acute care market place.” And Norfolk County Central Labor Council Secretary James Howard says “enough is enough.”  Please, Howard urges Coakley, “stop letting self interested parties hinder this process.”

I imagine Howard refers to the coalition of Partners’ competitors who say the deal will raise costs, but maybe he means Coakley’s rivals in the race for governor.  Democrat Steve Grossman calls the deal a failure that could “take us down the wrong path for many years to come.” And Don Berwick, who also faces Coakley in the Democratic primary, has submitted a petition with 456 signatures called “Block the Partners deal.” Continue reading

Brain Scientists Learn To Alter And Even Erase Memories

This optogenetic device uses light to activate specific brain cells. (Courtesy McGovern Institute for Brain Research at MIT)

This optogenetic device uses light to activate specific brain cells. (Courtesy McGovern Institute for Brain Research at MIT)

For 32 years, Leslie Ridlon worked in the military. For most of her career she was in army intelligence. Her job was to watch live video of fatal attacks to make sure the missions were successful.

“I had to memorize the details, and I have not got it out of my head, it stays there, the things I saw,” she says. “The beheading — I saw someone who got their head cut off — I can still see that.”

Leslie Ridlon retired from the military eight years ago, but she finds she cannot work because she suffers from severe PTSD. (Courtesy)

Leslie Ridlon retired from the military last year, but she finds she cannot work because she suffers from severe PTSD. (Courtesy)

Ridlon is now 49 and retired from the military last year, but she finds she cannot work because she suffers from severe post traumatic stress disorder. She has tried conventional therapy for PTSD, in which a patient is exposed repeatedly to a traumatic memory in a safe environment. The goal is to modify the disturbing memory. But she says that type of therapy doesn’t work for her.

“They tried to get me to remember things,” she says. “I had a soldier who died, got blown up by a mortar — he was torn into pieces. So they wanted me to bring that back. I needed to stop that. It was destroying me.”

She has concluded that some memories will never leave her. “Everything I could get rid of as far as memory I think I’ve already done it,” she says. “I think the deep ones that you suffer from, I don’t think anyone can take them away. I don’t believe anyone can. I think the ones I have now, they’re going to just stay there. I’m just going to have to manage them.”

But what if these traumatic memories could be altered or even erased permanently? Researchers say they are beginning to be able to do that — not just in animals, but in people as well.

Not long ago, scientists thought of memory as something inflexible, akin to a videotape of an event that could be recalled by hitting rewind and then play. But in recent decades, new technology has helped change the way we understand how memory works — and what we can do with it. Scientists can now manipulate memory in ways they hope will eventually lead to treatments for disorders ranging from depression to post-traumatic stress to Alzheimer’s disease.

“We now understand there are points in time when we can change memory, where we can create windows of opportunity that allows us to alter memories, and even erase specific memories,” says Marijn Kroes, a neuroscientist at New York University.
Continue reading

Project Louise: On Exercise, Sex, Free Stuff And The Secret Of Life

(Edson Fong via Compfight)

(Edson Fong via Compfight)

 

Dear Louise,

Let me be blunt: I’m afraid you’ve been having sex without orgasms.

When it comes to exercise, that is.

To extend this ham-handed metaphor a bit farther: I know some people say there’s no such thing as bad sex unless it hurts you. And of course there’s no such thing as bad exercise unless it hurts you. Any bit of activity, any rise from the couch, any flight of stairs, is good.

But I worry that halfway through your Project Louise year, while you’ve made truly laudable progress on healthier eating and emotional self-care, you clearly have yet to catch the exercise bug. Oh, you’ve tried, heroically, from bike rides to hot yoga to personal training. But it somehow hasn’t stuck.

So that’s the purpose of this letter: To try to jump-start your fitness, to remind you that in your original goals you listed “Create and follow a regular, sustainable exercise plan”; and most importantly, to try to persuade you that exercise — daily exercise, moderate to vigorous — is the magical secret of life.

(Readers, won’t you help? As in, let’s all pile on Louise! I end this letter with a few of my own quirky personal tips for making exercise a daily habit. Please add a few of your own in the comments section, or whatever arguments you think might most help Louise get going.

And we can also all help with accountability. Louise has agreed that beginning tomorrow, she’ll get some form of activity or exercise every day by 7 p.m. and report in on it by 11 p.m. in the comments section below.)

True, we’re aiming for sustainable change and reporting to an online audience every day does not seem like a lifelong practice. But this is just for the month, just to try to establish the habit.

Some say it takes just 21 days to establish a new habit; it’s surely more complex than that – some research suggests the average is more like two months — but here’s how you know you’re there: It’s harder not to do it than to do it.

Louise, I do believe that’s the key. You’ve said that you don’t make time for exercise the way you do for reading because it’s not as pleasurable. I’d so love you to reach the point I’ve reached: I do enjoy the exercise in and of itself, but what most motivates me is the desire not to feel like crap on a given day. It’s harder to face the torpor and irritability of not doing it than the brief sweaty effort of doing it. Continue reading