Tell the FDA how you want the bad news delivered on your fave restaurant food

It's been just over three months since the landmark healthcare reform bill was signed into law, and the federal government is now drafting the regulations that will bring some of the law's key anti-obesity initiatives to a restaurant or fast-food counter near you.

Specifically, the bill made it the law of the land that restaurants that are part of a chain of more than 20 stores must post for consumers the calorie content of their offerings. Consumers must be able to get, in writing and on the spot, a lot of additional details about the nutritional content of the food served, including its total fat, saturated fat, sodium, fiber, total carbohydrates, complex carbohydrates, sugars, dietary fiber and total protein.

Now, several states and local jurisdictions beat the federal government to the punch on this. But the federal law will impose greater consistency on what is a patchwork of nutritional-posting requirements. 

For patients with diabetes, those who tote their points with Weight Watchers, or watch their carbs on one of the many low-carb diets, for consumers concerned about sodium's impact on their blood pressure or seeking to banish saturated fat from their plate, the way in which of all this information is presented can make it easier or harder to follow an eating plan. So here's your chance to tell the FDA how you would have restaurants, delicatessens, fast-food-joints, shops brewing coffee or scooping ice cream -- even movie theaters -- organize and provide nutritional information for consumers like you.

Here's the link to give the FDA a piece of your mind. (After choosing "submit a comment," you'll need to supply the following "Docket number": FDA-2010-N-0298 and hit "search.")

The site for comments opened midday Thursday and will stay open for 60 days.

Still wondering how healthcare reform will affect you? Here's the government's comprehensive site.

--Melissa Healy

Book Reviews: 'The No Om Zone,' 'The Yoga Body Diet' and 'Healing Yoga for Neck & Shoulder Pain'

Some people use yoga to strengthen, stretch and relax muscles; others delve into its lifestyle and spiritual aspects. Here are three new books with varying approaches to the 5,000-year-old practice.

“The No Om Zone” bills itself as a “no-chanting, no-granola, no-Sanskrit practical guide to yoga.” This book by Kimberly Fowler, founder of the L.A.-based YAS Fitness Centers, is geared to athletes and others who want to improve muscle tone and flexibility, take away aches, alleviate pain and calm the mind. Fowler promises you won’t have to go sit on a mountaintop and chant to achieve these results.

The former triathlete started doing yoga in 1983 to rehabilitate after an injury and became a fan after seeing the benefits to her body and athletic performance. She was turned off, however, by "elitist" classes targeted to the few who could do pretzel poses and handstands. Today, the motto in her yoga classes is “safe, fun and effective.”

Her book offers short workouts for 13 parts of the body, including the neck, arms, core/abs, lower back, hips and knees. Each body part gets its own chapter describing and showing the anatomy of the area, common injuries, recommended yoga poses for it and a workout routine typically lasting about 10 minutes. Poses are accompanied by photos, step-by-step guides, difficulty ratings, descriptions of benefits, tips and modifications to make them easier.

Fowler does manage to slip some mind-body material into the book. The first body part addressed is the head, for example, and here she talks about the benefits and practice of meditation and describes how to do yoga breathing.

This is a good book for those who want yoga workouts targeted to individual body areas as opposed to a one-size-fits-all workout. Fowler also offers a "No Om Zone" DVD containing three 15-minute workouts.

“The Yoga Body Diet,” by Kristen Schultz Dollard and John Douillard, is everything “The No Om Zone” is not. Not only is it not a no-granola book, it even includes recipes for granola.

Dollard, digital director at Self magazine, is a yoga teacher and former editor of iyogalife.com. Douillard directs LifeSpa, an ayurvedic retreat center in Boulder, Colo., and has written and produced numerous health and fitness books, CDs and DVDs.

Their pretty book – generously illustrated with colorful pen-and-ink drawings – says it can help you get a “yoga body” in four weeks through eating, exercising and de-stressing according to the principles of yoga and ayurveda.

The book describes ayurveda as yoga’s sister science, one of the world’s oldest medical systems practiced by 80% of India’s population today. Dollard and Douillard say their mission is to present “ayurveda’s greatest hits” and teach you how to use it for weight loss.

“Yoga Body” kicks off with a quiz to determine what ayurvedic “type” you are: vata (airy), pitta (fiery) or kapha (earthy). Each type is told what kinds of foods to eat and avoid, yoga moves to do and lifestyle changes to make. Recipes for chai tea, pad Thai, roti pizza and other dishes include variations for each ayurvedic type.

The book’s illustrated yoga pose guide is easy to follow, with about 75 positions that range from the simple corpse pose to the more challenging revolved half-moon.

The book at times has the feel of an overly simplified greatest hits compilation as it offers its take on ayurvedic practices. Some of the recommendations – such as to stop snacking and eat only three meals a day – may not work for some or even have proven benefits. But those interested in the ayurvedic philosophy may find the book an approachable starting point to determine whether they want to go further into the practice.

“Healing Yoga for Neck & Shoulder Pain” zeroes in on the area of the body where many people feel the effects of stress. Author Carol Krucoff, a yoga therapist at Duke Integrative Medicine in Durham, N.C., writes that neck and shoulder tension, tightness and discomfort are the top complaints of her students. Krucoff says she’s been successful in helping people find lasting relief with yoga, though it doesn’t happen overnight.

Krucoff, a former Washington Post journalist, looks at the practice of yoga through this lens, exploring the science of neck pain and yoga; the anatomy of the spine, shoulders, neck, face and jaw; the role of stress and emotions in neck and shoulder pain; and the best postures for sitting and standing.

She explains how, where and when to do yoga; how to breathe properly; and how to do 38 poses to help the neck and shoulders. Simple line drawings illustrate the mostly gentle exercises. Some of the stretches can be done in an office chair. 

“Healing Yoga” is a good introduction for those who want to focus on this part of the body, or ease into yoga for physical reasons or lack of familiarity with the practice. The book’s production values are basic, but the writing is clear, informative and inspiring.

Krucoff writes that the best healing comes when people bring the lessons of yoga into their daily lives.

“Rather than muscle your way into a yoga pose, you learn to relax into it -- using the tools of gravity, patience, and the breath -- to allow the pose to deepen and unfold,” she says. “Over time, with regular practice, the lessons learned on the yoga mat begin to influence how you live in the world.”

-- Anne Colby

Photos, from top: "The No Om Zone: A No-Chanting, No-Granola, No-Sanskrit Practical Guide to Yoga," Kimberly Fowler, Rodale Books, $19.99; "The Yoga Body Diet: Slim and Sexy in 4 Weeks (Without the Stress), Kristen Schultz Dollard and John Douillard, Rodale Books, $21.99; "Healing Yoga for Neck & Shoulder Pain: Easy, Effective Practices for Releasing Tension & Relieving Pain," Carol Krucoff, New Harbinger Publications, $17.95

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Book Review: 'Gold Medal Fitness' by Dara Torres

Dara Torres was 41 when she won three silver medals at the 2008 Beijing Olympics, beating women years her junior and becoming the oldest swimming medalist in the history of the Games. Her wins were a victory for older athletes everywhere. 

In "Gold Medal Fitness," written with Billie Fitzpatrick, Torres answers the question many have asked her since: How did she do it?

Her new book -- a follow-up to her memoir, "Age Is Just a Number"  -- outlines the fitness program that she says remade her body and helped her win races long past the age at which most competitive swimmers hang up their goggles.

"Gold Medal Fitness" shows readers how to replicate her type of workouts and perhaps experience greater success in their own athletic endeavors. It describes the swimmer's approaches to goal-setting, diet and exercise; offers 35 days of simple menu plans; features pictures and descriptions of the kinds of exercises and stretches that are a mainstay of her workout; and gives tips on cardio and recovery.

Torres says she has become stronger, leaner and more efficient through a type of strength training she learned from Andy O'Brien that works on three planes of movement to strengthen core muscles. She says most exercise equipment is designed to strengthen one or two muscle groups at a time on a singular plane, whereas most life activities and sports work on multiple planes: up and down, forward and back, side to side and rotating top and bottom.

Though she says the "deceptively simple" exercises shown in her book can be done by people at any level of fitness, they do require equipment and a commitment to learning the proper form. Access to a gym -- as well as a workout partner or trainer -- is probably a given, since exercises call for a BOSU trainer, a Swiss ball, a medicine ball, dumbbells, a cable machine and an incline bench. 

Torres has attained her flexibility, she says, from a resistance stretching program called Ki-Hara that she learned from Steve Sierra and Anne Tierney. Ki-Hara incorporates eccentric training, which contracts and lengthens muscles at the same time. Torres says this type of training builds more muscle power, helps create fast-twitch muscles and speeds recovery. She says Ki-Hara has "literally changed" her body so that she's become faster in the pool and more in balance. These exercises don't require equipment, though a yoga mat, towel and Swiss ball can be used.

Book Review: 'Diet Myths That Keep Us Fat' by Nancy L. Snyderman

The Information Age has not been kind to the dieter. The sheer volume of nutritional data available today can be overwhelming. And dietary advice seems to change with the season -- eat more carbs, don't eat carbs, count calories, don't count calories, cut back on fats, eat all the fats you want. Who can keep up?

NBC News chief medical editor, physician and author Dr. Nancy L. Snyderman attempts to bring some sanity to the table with her book "Diet Myths That Keep Us Fat," now out in paperback.

In it, she examines the many diet and nutrition beliefs floating around today -- some that she says are true and others that are anything but. She looks at popular weight-loss strategies and describes their origins, how they work, whether they're effective and how they stack up medically and nutritionally. 

Snyderman's perspective is both personal and professional. She writes about gaining the typical "freshman 15" when she started college -- and how she kept gaining until she eventually tipped the scales at 200 pounds. She experimented with fad diets to lose weight and spent years going up and down in weight. She writes, "I've starved myself, and I've pigged out; I've binged, dieted, skipped meals, and lived to tell about it."

She eventually saw a therapist and gained insight into her overeating. "Although I still consider myself a work in progress, I learned to lay the foundation for a healthier life, in much the same way I was laying a foundation for my medical career," she writes. Today she looks at food as fuel, eating foods she likes in moderation and letting herself indulge in treats now and then. She exercises regularly with activities that are convenient for her and that she enjoys. For her, this is an effective and healthy way to keep off the extra pounds.

It's this relaxed approach to eating and exercise that she brings to "Diet Myths." Written in a conversational style, the book is engaging even as it's discussing the glycemic index, the pros and cons of diet drugs and surgeries and how hormones can influence your hunger and weight.

One of Snyderman's major points is that calories do count. (High-protein, low-carb diets, she says, work primarily by restricting calories.) She offers easy ways to think about calories and keep track of them without feeling as if you're doing so. She does the same thing with carbs -- and emphasizes that because our bodies need them to function properly they shouldn't be eliminated from our diets.

Attention to beverage calories grows, but has yet to catch up with waistlines

Calories count, even if they're not chewed. Consumers know this, and yet still they splurge. (Often daily. At every meal. And in between meals.) But, finally, it seems, they're starting to do the math, even as researchers are analyzing the finer effects of what we drink.

The journal Physiology & Behavior recently devoted an entire issue to beverages and health.

Among the featured papers:

-- Patterns of beverage use across the lifecycle. The upshot: Kids are lapping up increasing amounts of  treacly drinks; so are adults. Adults over 60, however, seem to cut back on beverages in general.

From the abstract: "The consumer shift toward increased levels of [sugar-sweetened beverages] and alcohol, limited amounts of reduced fat milk along with a continued consumption of whole milk, and increased juice intake represent issues to address from a public health perspective."

-- Dairy beverages and energy balance. The upshot: Calcium is good for you; don't skimp on it.

From the abstract: "A new line of evidence suggests that an inadequate calcium intake during an energy restricted weight loss program may trigger hunger and impair compliance to the diet."

-- Alcohol, appetite and energy balance: Is alcohol intake a risk factor for obesity? The upshot: Some alcohol seems to be good; more is probably bad.

From the abstract: "Epidemiological data suggests that moderate alcohol intake may protect against obesity, particularly in women. In contrast, higher intakes of alcohol in the absence of alcohol dependence may increase the risk of obesity, as may binge-drinking, however these effects may be secondary to personality and habitual beverage preferences."

And now we have the just-released Drink This, Not That!, both for consumers who prefer the simplicity of being told what to do and for those who enjoy marveling at the shocking number of calories available for a relative pittance. (Perhaps you've perused Eat This, Not That! Same  approach.)

The new offering gives this example, among  others: A Gotta Have It (i.e. large) sized PB&C shake from Cold Stone Creamery: 2,010 calories.

It's unclear just how popular such an offering is -- or whether an almost-500 calorie alternative is truly the best way to go.

But attention to such details is good. And overdue.

Here's CalorieCount's offering of calories in beverages -- many, many beverages to be exact.

And here's some free advice on choosing beverages from the Centers for Disease Control and Prevention. Among the tips: Skip whipped cream at the coffee shop. Ask that smoothies be prepared without added sugar. And then there's this: Drink water with meals.

It's crazy enough, it just might work.

-- Tami Dennis

Photos: Don't kid yourself. Credits: Los Angeles Times

Book Review: 'The Stress-Eating Cure' by Rachael F. Heller and Richard F. Heller

Many dieters will see themselves in the portraits of overeaters presented in “The Stress-Eating Cure,” by Rachael F. Heller and Richard F. Heller, authors of the popular “Carbohydrate Addict” books. 

The Hellers write in their new book about the anxiety-induced stress eater, the task-avoiding stress eater, the person who eats on the sly. They describe people whose overeating is triggered by social situations, those who eat to reward themselves for self-sacrifice and others who eat on the run, barely tasting their food.

The 11 types of stress eaters they identify have something in common, they say: Their overeating, cravings and weight gain are caused not by a lack of discipline and willpower but by a hormonal imbalance.

Unlike those whose bodies produce the right amount of hormones in the face of unpleasant circumstances, stress eaters -- who often are more sensitive to their environments -- respond to stress with “trigger-quick” hormonal reactions, the Hellers say. The hormones at play are ghrelin, serotonin, oxytocin and leptin as well as insulin, cortisol and adrenaline. 

Each type of stress eater is prone to surges and deficiencies in these hormones in different combinations, the authors say. The Hellers offer a diet they say will help bring these hormones back into balance and relieve stress, plus behavioral modification programs that are tailored to each type.

Weight-loss surgery for kids: maybe as a last resort

For the 17% of American kids who are considered obese, prevention -- the strategy everyone agrees is the best way to tackle the nation's health woes -- is no longer an option. What, then, to do to prevent a wave of obesity-related diseases down the line?

A new review article published in the British journal the Lancet acknowledges that despite all the hand-wringing -- and the fact that the breathtaking rise in obesity among kids has begun to stabilize -- we seem to know less than ever about what works best to prevent or reverse obesity in kids. Current recommendations for how much kids should reduce their caloric intake "might be too conservative," given research done in 2006, says a team lead by a researcher from the National Institutes of Health, Dr. Joan C. Han. The "sedentary lifestyles of children nowadays" have driven a need for new and better research on how much the "energy burned" end of the equation needs to change, Dr. Han's team wrote.

One thing the Lancet writers -- and U.S. physicians generally -- are not so keen on: bariatric surgery for kids. They call the risks of bariatric surgery for children "substantial" and point out that the long-term safety and effectiveness of such surgery "remain largely unknown." Accordingly, they said, it should be reserved for the most obese children, those with a BMI over 50 or for those with a BMI over 40 who already have weight-related complications such as high blood pressure, high cholesterol, fatty liver or diabetes.

"Even then," they wrote, bariatric surgery should be "considered with extreme caution."

According to a study published this week in the Journal of Obesity Surgery, they are preaching, for the most part, to the choir on this point. In a national survey of family physicians and pediatricians, 48% said they would not ever refer an obese adolescent for bariatric surgery. Few physicians responded that children younger than 15 should be referred to a specialist to consider weight-loss surgery. And the physicians were slightly more likely to recommend surgery earlier to an extremely obese girl than to a boy.

A group of four hospitals led by Cincinnati Children's Hospital Medical Center has been studying the circumstances under which bariatric surgery works best for children. Among their findings: that bariatric surgery significantly improved abnormalities in heart function.

--Melissa Healy

Book Review: 'The New Me Diet' by Jade Teta and Keoni Teta

“Eat more, work out less, and actually lose weight while you rest.” What chubby, chunky or downright hefty gal or guy trying to knock off the pounds wouldn’t want some of that?

The subtitle on the cover of “The New Me Diet” may be technically correct but could also be a little misleading. If you read it to mean “Order up a large pizza, grab the TV remote and lose weight while you channel surf” -- well, no.

What it really means is this: Eat a diet composed of an unlimited quantity of most vegetables, certain fruits and lean proteins; some fat; and a small amount of whole grains, legumes and beans. Do a 30-minute interval and weight training workout that incorporates periods of rest three times a week, and walk every day for 30 to 60 minutes. And you will lose weight.

Now that sounds doable.

"Me Diet" authors Jade Teta and Keoni Teta are brothers who each have a couple of decades of experience as personal trainers and degrees in biochemistry and naturopathic medicine, among other health and fitness credentials. But though their backgrounds are similar, their body types and metabolisms are different, they say.

Their curiosity about why food and exercise affect people differently led them to develop what they dub their Metabolic Effect, or ME, program, which they say is based on the new science of hormonal fat burning. Translated, that means that certain hormones control how fat is stored and burned in the body. The Tetas say you can manipulate those hormones by what you eat and how you exercise.

Their book spends a few pages discussing the science behind their program but quickly launches into the practical matter of how to make it work for you. They divide people into three different types -- sugar burners, muscle burners and mixed burners -- and offer a quiz for readers to determine which type they are.

Many doctors don't discuss diet with obese patients

With the nation's high rates of obesity and the low odds of weight loss, perhaps weary doctors are just giving up. National statistics show that only about half of obese Americans were advised by their doctors to cut down on fatty foods. The rate, from a 2006 survey, has not changed from a survey taken in 2002.

The data, from the recently released 2009 National Healthcare Disparities Report, found that doctors discussed food choices with 52% of their obese white patients compared to 45% of obese blacks and 42% of obese Latinos.

Poor adults and less-educated people were less likely to be told to cut down on high-fat and high-cholesterol foods. The report notes that any obese person would likely benefit from counseling about diet and exercise. It would be interesting to see a survey of doctors on why they would choose not to discuss diet with an obese patient. Do they feel it's useless?

-- Shari Roan

Photo credit: Robert Sullivan / AFP / Getty Images

Book Review: 'The Strong Women's Guide to Total Health' by Miriam E. Nelson and Jennifer Ackerman

Although men may have more heart attacks, more women die as a result of them. Women have stronger immune responses  --  with increased resistance to many infections -- but are much more likely than men to develop autoimmune diseases. Men are more likely to have schizophrenia and alcohol and drug addiction, whereas women have more depression, anxiety and eating disorders. 

Those are just some of the ways women's health differs from men's, according to Miriam E. Nelson and Jennifer Ackerman, authors of "The Strong Women's Guide to Total Health."

"Our gender affects everything from the makeup of our bones and the architecture of our joints, to our skin's response to sunlight and aging, to how we experience pain, react to drugs, and cope with stress," they write.

Until fairly recently, medical researchers considered men's bodies the prototype for both genders. But today women are more than half of participants in health studies, and researchers are looking closely at illnesses affecting mostly them, Nelson and Ackerman write. 

In fact, there is so much health information available to women -- much of it contradictory -- that it can get confusing.

That's where "Strong Women's Guide" comes in. The book aims to summarize the latest thinking on women's health and offer "basic, reliable guidelines for staying well in body, mind and spirit."

And it appears to do so remarkably well considering the range of topics it covers, including reproductive and sexual health; skin, teeth, hair and nails; body weight and metabolism; muscles, bones and joints; the heart and lungs; cancer and disease; vision and hearing; and mental health.

Nelson -- the director of the John Hancock Research Center on Physical Activity, Nutrition and Obesity Prevention and an associate professor of nutrition at Tufts University -- has gained a following with earlier "Strong Women" books on topics such as weight control and bone health. Ackerman is a science and health writer and the author of several other books, including "Sex Sleep Eat Drink Dream."

Their new book is not the place you would go for in-depth coverage of a specific health topic, but it offers solid overviews, useful advice and quite a bit of up-to-date detail. 

The section on birth control, for example, looks at the varied oral contraceptives available today, including a spearmint-flavored chewable pill, the three-month combination pill, the mini-pill, the "no more period" pill and other hormonal options such as a skin patch and injections. The chapter on menopause sorts through recent research findings on hormone therapy and summarizes the options for easing symptoms. A discussion of heart disease details the symptoms unique to women and tells what to look for in cholesterol, triglyceride and blood pressure screenings.

The writing is intelligent, accessible and sometimes personal; amid the matter-of-fact health discussions are anecdotes such as one in the sexuality chapter that describes a nervous first-time trip to a sex-toy boutique. A chapter on changing habits includes a story about how a colleague once chastised Nelson for not practicing what she preached about exercise -- a comment that prompted her to start running regularly to train for the Boston Marathon.

"Strong Women's Guide" is as much a how-to health book as it is a medical reference work. It starts with a health self-assessment section that looks at everything from body mass index to joy quotient. Sprinkled throughout the book are checklists of ways to protect or improve health. The book ends with chapters on managing stress and sleeping well, eating and exercising right and getting the proper screenings, tests and vaccines at every age.

-- Anne Colby

Photo: "The Strong Women's Guide to Total Health," Miriam E. Nelson and Jennifer Ackerman, Rodale Books, $27.99 

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