Deborah Cohen – The Health Care Blog

Click and Exercise! Amazon, Netflix, Hulu—Are You Listening?

Oct 11, 2019

By DEBORAH A. COHEN

Physical inactivity is a mounting challenge for America. In reviewing the 2013-2015 American time use survey, we found that most Americans report spending their daily leisure time watching screens, and devote only a small fraction of leisure time—24 minutes for men and 14 minutes for women—to physical activity. A recent longitudinal examination of the National Health and Nutrition Examination Survey showed that sitting time increased by an hour a day between 2007 and 2016, with the largest increases among adolescents ages 12-19 and adults, 20 years and older. As mortality rates for heart disease have begun to climb, increases in sedentary behavior bodes poorly for future control of disease and health care costs.

The explosion in streaming apps and content is likely contributing to the increased sitting time. According to the Motion Picture Association of America, TV and movie views have more then doubled between 2014 and 2018. The availability of multiple series and the ability to binge watch can keep people glued to their couches for hours at a time. The immersive quality of the programming makes it increasingly difficult for viewers to pull themselves away from their screens. Yet, the technology could provide options to help viewers watch and still get regular physical activity.

Currently, after each episode, an option is available to allow the viewer to immediately call up the next episode. Why not consider adding a pop-up that can remind viewers that sitting more than 20-30 minutes at a time may not be good for health, and that it’s important to move around to avoid chronic diseases? A narrator could ask viewers to treat themselves to an activity break. Then the viewers could have the option to choose a short video that can guide them through a 10- minute exercise break. Or even a 5-minute break. Something is better than nothing.

There could be many options, from a just a simple stand up and stretch, like the 7^th inning break at a baseball game, to vigorous workouts, like the 7-minute workout published by the American College of Sports Medicine or doing a Bhangra dance with a Bollywood film star.

The FDA Ban on Trans Fat Should Be Just the Beginning

Nov 26, 2013• 41

By Deborah Cohen, MD

It’s been clear for more than a decade that trans fat is a dangerous substance that increases the risk of heart disease. Denmark banned its use in 2003. Several American cities and states have followed suit, but the use of trans fat is still widespread despite the availability of suitable substitutes.

Over the past 10 years, trans fat consumption is thought to have contributed to an estimated 70,000 needless American deaths. Given that universal, voluntary cooperation to eliminate trans fat hasn’t happened, the Food and Drug Administration (FDA) is justifiably seeking to designate trans fats as unsafe.

A nationwide ban on artery-clogging artificial trans fat is a long-overdue first step toward improving American diets, fighting obesity and limiting the risk of chronic disease. But it is just the first step in what should be a far broader campaign to help consumers make healthier choices at mealtime.

Public lack of awareness of the impact of prepared foods on individual health is not limited to trans fat. When dining out, even in establishments that avoid trans fats in preparing food, Americans face a range of health risks often without realizing it. People are routinely served far more calories than they can burn.

They are routinely served too many low nutrient foods and insufficient quantities of fruits, vegetables, and whole grains. What should become routine instead is the availability of menu options that put people’s health first.

Hopefully, the FDA’s trans fat initiative will succeed – previous city/state bans and labeling improvements have already managed to cut daily consumption by Americans from 4.6 grams in 2006 to 1 gram in 2012 – and pave the way for the creation of other standards and regulations regarding the quantity and quality of food that is offered to diners in restaurants.

The lack of such standards makes it difficult, if not impossible, for most people to recognize when they are being put at risk for a chronic disease. If people are served too much of something (like calories), they would have to compensate by eating less later; conversely, if they are served too little of something (like vegetables), they would have to eat more later to neutralize the risk of chronic disease.

But most people lack the information they need to judge or track the quantity and quality of the nutrients they consume.