Raees Mohammed

As a young adult concerned with the health of America's youth, I was more than pleased to have the opportunity to educate local elementary school students on the importance of diet and nutrition. Last semester (Spring 2009), I volunteered to partake in community outreach through the Joint Educational Project (JEP), at USC, specifically, the Peace Games program, which encourages elementary school students to create safe classrooms and communities. Although this program has structured goals dedicated towards promoting peace in surrounding neighborhoods, its coordinators offered an open format for student volunteers to produce and implement their own curricula. Given this freedom to develop a course plan and my background interest in the field of biology and wellness, my co-instructor and I proposed the concept of health education focused on proper nutrition and diet for growing children. After conducting research on the generally poor eating habits of young people today, we narrowed down their essential dietary needs and formulated a six to eight week syllabus to provide insight into desirable food and consumption strategies. The course plan included an introductory PowerPoint (uploaded as an artifact below), classmate interaction, a guest lecture and a variety of simple class assignments. In addition to presenting information, we emphasized student interaction and teambuilding by organizing a garden on Norwood Elementary school property, which gave students the chance to plant their own fruits and vegetables. During the project I was able to apply health theories from the classroom to a real world situation. In retrospect, I believe this was essential to my growth as a student because when I execute health programs in the future, I will need to have an understanding of what works and how to influence target audiences effectively. Through completing the project, it was apparent that health education is sorely lacking among many segments of the population struggling economically; and while the absence of good information and proper behavior with regard to a healthy lifestyle was troubling, it nevertheless increased my enthusiasm for assisting those in need.

For the past six months, it has been impossible to turn on the television, browse the Internet, or listen to the radio without encountering the latest news surrounding the growing H1N1 pandemic. More commonly known as swine flu, the H1N1 influenza originates from a viral strain found in pigs, which mutated to infect and spread throughout the human population. In America, the virus continues to rapidly sweep across the nation, currently affecting individuals in forty-six states. According to the World Health Organization (WHO) the swine pandemic has taken the lives of over one thousand United States residents and close to five thousand worldwide. This alarming increase in number of cases and fatalities have led United States health officials to address the issue by directing vaccination companies to commence the mass production of a swine flu-shot (pictured to the left). However, minimal optimism looms as vaccines are being manufactured at a much slower rate than initially intended, directly leading to a shortage of vaccinations and a surge in demand. In addition to the production of enough vaccines, scientists and physicians have to overcome the challenges of high production costs, unpredictable side effects, and minimizing fear surrounding the safety of unfamiliar flu shots. While Americans wait in line for the vaccine, the growing swine flu outbreak has forced President Obama to declare the H1N1 influenza virus a "national emergency," as he stated: "the rates of illness continue to rise rapidly with many communities across the nation, and the potential exists for the pandemic to overburden health care resources." Although this state of national concern is necessary, it indirectly creates additional hype and frantic paranoia facilitated by the media, leaving many Americans uncertain in their decision towards obtaining the vaccine. There is no denying that vaccinations are a crucial component in gaining control of the virus, but increasing fear promoted by the media has distorted influenza preventative mechanisms. The approach towards battling this contagious flu should therefore include diminishing negative media influence among the broader population. Furthermore, to gain control and reduce the spread of the virus, providers need to diverge from the impossible challenge of vaccinating the entire nation, and toward a more feasible task--immunizing smaller segments of the population with higher risks of transmission.

As a result to the increasing coverage surrounding the severe H1N1 pandemic, drug makers are gearing up for the upcoming flu season by preparing millions of doses of swine-flu vaccine, which promises an estimated seven billion dollars in earnings for the vaccine industry. While politicians are willing to take on this financial burden to gain control over the outbreak, drug companies are struggling to produce the intended number of vaccines. Recent reports from the Centers for Disease Control and Prevention (CDC), indicate that the rate of production is about half of the initial estimate--16.1 million doses produced compared to the promised 30 million by the end of the month. CDC director Thomas Frieden expresses his frustration on the issue by stating: "We are nowhere near where we thought we'd be by now." Further analysis on the situation suggests that the actual process to prepare successful medicine is extremely time consuming and can take up to "six to nine months to produce vaccine once a flu strain has been identified." In addition, patient concerns over unforeseen side effects have delayed the operation by lengthening the final requirement to attain approval by the Food and Drug Administration. Even if vaccines become more available, the latest H1N1 story in the media is the anxiety that many believe the swine flu vaccine has unintended harmful consequences. The major questions involve thimersol, a mercury containing substance found in syringes, which has been linked to negative health defects--specifically autism. Although scientists face multiple obstacles to produce a solution to the problem posed by the virus, encouraging research has suggested that current forms of the H1N1 vaccine are hopeful in reducing the spread of influenza. University of Pennsylvania vaccine researcher and pediatrician Paul Offit finds it hard to believe that people still link the two: "there have been six exhaustive studies [of a possible link between thimersol and autism....] They each came back with a definitive answer: No." Significant research and computer-based models have proven that vaccines are the "absolute best protection" available at this point in time; however, scientists need to work in conjunction with the media to reduce extraneous paranoia and promote accurate H1N1 awareness.

Though mass media--television, newspapers, radio, and the Internet--has often been effective in presenting the latest facts to the public, it can have an adverse result: distorting information and creating unnecessary hype. A primary example of this faulty communication was the media's initial reaction to the outburst of swine flu. Los Angeles Times journalist James Rainey harshly criticized the way in which the media, specifically the World Wide Web and television, handled the uncovering of H1N1 human infection. Rainey argued that some news outlets "have a congenital inability to tell this story with precision" and went on to further castigate CNN's website for headlines such as: "Bracing for the Worst." Further analysis of Rainey's point of view suggests that this type of reaction by the media can lead to audiences succumbing to avoidable paranoia, which develops into societal stress as seen by the current vaccine shortage. While mass media occasionally gets carried away and misconstrues facts, the media outlets can also have a positive influence on health--creating appropriate awareness and making valuable health material accessible to the community. A past study conducted by the California Department of Health Services analyzing anti-smoking campaigns highlighted the media's ability to have a beneficial impact. As stated in the report, "a meaningful proportion of adult smokers in California were at least partially influenced to quit by the media campaign's anti-smoking messages," which apparently signals success in increasing health among Californians by improving communication and awareness of the risks of smoking. Other instances of progressive communication by media outlets include television programs, such as The Daily Show. Recently, host John Stewart (seen above), aired a segment depicting exaggerations of mainstream media towards possible effects of the H1N1 vaccine, and ultimately satirized the media's tendency to distort information. Taken as a whole, it would appear that certain types of media exposure could act as a major contributor to managing the influenza pandemic and improving overall health in America.

In order for the media to maintain a sense of legitimacy, it is essential that they constantly work on editing and providing factual information. Media outlets should not operate with fear-based tactics, but to educate the masses, minimizing extensive publicity that can lead to unnecessary waves throughout society. In an ideal world, an intensive regulatory regimen would be a perfect cure for the media's ability to create unwanted hype. However, in reality, government regulation is rightfully limited due to the First Amendment--freedom of speech and press. Therefore, it is essential for the media to hold themselves accountable and work with the federal government to disseminate a more precise message. Additionally, it is important for viewers to be educated and question inappropriate material presented through assorted media. In cooperation with the media, the federal government should strive toward minimizing the spread of swine flu by targeting segments of the population with the highest risk of transmission. A report recently published in Science discusses the option of vaccinating children between the ages of five to nineteen and adults ranging from thirty to thirty-nine. With the use of a simulation model, researchers proposed that the best strategy to control the flu is to vaccinate portions of the population with a high chance of transmission (as mentioned above), instead of those that are highly susceptible to contracting the disease--infants and elderly. By reducing the rate of transference of the virus, health officials can only hope to decrease the negative hype surrounding the H1N1 pandemic, which has been amplified by the media. Identifying the portions of the population at risk and presenting accurate health information can help to confront the current obstacles generated by swine flu.

As suggested in previous posts, implementing a healthy and nutritious diet is essential in maintaining a physically fit lifestyle; however, current scientific findings imply that daily intake of food can also have a positive affect on one's mental health. A recent study published in the Archives of General Psychiatry, analyzes consumption patterns and incidence of depression among a large group of Spaniards to explore the possible association between depression and the Mediterranean diet--an abundance of olive oil (pictured below), fish, vegetables, fruits, nuts, and a moderate amount of alcohol. According to researchers at the University of Navarra, the Mediterranean diet is potentially "linked to health benefits" because of the "low levels of unhealthy fats found in butter, cheese and red meat and higher levels of good fats, found in olive oil and fish." These hypothetical advantages stemming from fatty acids in the diet have led scientists to conclude that individuals with "eating habits" that are "closely aligned with a Mediterranean-style menu were less likely to be diagnosed with depression" over an extended period of time. While results support the relationship between the Mediterranean diet and lower heart disease risks, doctors cannot act as quickly to diagnose the link to depression. Due to a variety of risk factors--lack of social support, physical illness, genetic predisposition, and environment--the role of diet can be overshadowed and influenced by other components of life. In addition, the identification of depression is complex, and often case-dependent based on patient history and self-reports. The proposed correlation between diet and depression has yet to be fully accepted in the scientific community; but the Mediterranean diet's overall outcome has been proven to increase the standard of health and lifestyle among individuals who follow it. Consistent experimental results, which link the Mediterranean diet to healthier individuals, have promoted the continuation of studies searching for additional health benefits, including mental health advantages. Therefore, this week I chose to address a post by Consumer Reports Health blogger and British Medical Journal patient editor Sophie Ramsey, entitled "The Mediterranean diet: good for your mental health too?" The entry refers to the publication, "Association of the Mediterranean Dietary Pattern With the Incidence of Depression" reported in the Archives of General Psychiatry. My response to Ramsey's post can be found below and at the Consumer Reports blog on health.

"The Mediterranean diet: good for your mental health, too?"
Comment

Considering my current interests in wellness and my seemingly infinite quest to discover a regimen promising health perfection, I was drawn toward your informative entry promoting the scientific discussion between a Mediterranean dietary pattern and improved health. I appreciated your acknowledgment that the "study was not designed to show cause and effect;" therefore, it is difficult to prove that "eating a Mediterranean-style diet was what lowered" the risk of depression. While researchers claimed to justify this procedural flaw by taking into account other influential factors related to depression, I believe their assertions lacked major credibility due to alternate explanations and experimental design. Although results indicate a lower incidence of depression among subjects following a Mediterranean diet pattern, the study failed to incorporate external variables. According to the report published in Archives of General Psychiatry, "some individuals more vulnerable to depression could be also predisposed to several unhealthy behaviors because of genetic or environmental factors." Further analysis implies that it takes certain qualities--commitment and discipline--to maintain a healthy lifestyle, which alludes to the hypothesis that healthy individuals are less likely to develop a case of depression. In consideration to the potential effects of outside factors such as: culture, upbringing, gender, social support and personality; do you think the suggested health effects of the Mediterranean diet outweigh those of the environmental and genetic elements? If not, do you think sustaining an unhealthy diet makes an individual more probable to develop depression? In regard to the study's assumptions, would depressed patients using anti-depressants see a decreased need for prescription drugs if they followed the Mediterranean diet?

Analyzing other features of the diet, it is evident that Mediterranean-style eating habits have been "linked to a lower risk of heart and circulation problems." Still, like many other dietary recommendations, the outcome is only advantageous when combined with healthy lifestyle habits and behavior. You mentioned that researchers believe increasing "good fats" and lowering the level of "unhealthy fats" in the diet provide substantial health benefits. However, these "good fats" contain calories, and over-consumption will lead to an increase in weight, resulting in poor overall health. Since weight gain can occur during the Mediterranean diet, do you think the level of physical activity affects the chances of developing clinical depression? Will an individual following the diet with consistent exercise be less likely to feel depressed compared to a person solely committing to the food guidelines of the diet? My opinion is that a variety of physical and environmental determinants lead to the onset of depression. Furthermore, I believe that additional experiments and exploration of the topic are necessary before any valid connection can be made between the Mediterranean diet and depression.

Is organic food really better for the body? Although this question seems straightforward, the vast array of websites available via the Internet leads to multiple answers that contradict one another. Still, with a few smart keyboard strokes and a click of the mouse, one can be directed to a website entitled Health (pictured below), which provides accurate and valuable information concerning the advantages of incorporating organic food into a daily diet. According to Time magazine, Health was one of the "fifty best websites in 2008," because the site "tackles the most serious matters" while doing "a better job of addressing the related emotional issues" associated with serious health matters. As Health continues to present "trusted" material, there are millions of pages that clutter the web and have the opposite effect--supplying false and outdated knowledge to the public. In order to create a sense of legitimacy and contribute additional resources, I chose to focus this week's post on a thorough quest of the Internet to identify trustworthy and reliable websites and blogs that center around health and wellness. To facilitate access to these sources, I have organized them underneath the heading "recommended sites" located to the right of the page. With regard to conducting an exhaustive search of the World Wide Web for reputable references, I utilized the following search engines: Google, Cuil and Bing. Then, with the aid of the Webby Awards criteria--engaging content, organized structure, aesthetically fulfilling and general functionality--I was able refine my search to discover the best possible and most consistent web pages related to well being. These extensive search tools directed my attention toward the sites of the National Institutes of Health, Centers of Disease Control and the United States Department of Health and Human Services, which all demonstrate a solid foundation and governmental perspective of health in society. Furthermore, I encountered pages concentrating on the wellness of individuals and publications addressing a fit lifestyle for both sexes; for example, Health and Fitness, My Optum Health, Men's Health, and Self. Specifically, My Optum Health exhibits a creative interface inviting the web user to follow a plethora of links ranging from calculating body mass index to learning about the symptoms of diabetes. In addition to compiling select websites, my exploratory intentions were to come across worthy and superb blogs dedicated to discussing health and its impact on society. Following the guidelines of 21st Century Information Fluency, I developed a rating system to determine the quality of blogs that I encountered while using prestigious blog engines--Technorati, Blog Flux, and Healthcare 100. Ratings were based on the qualifications of the actual blogger, content, and citations. As a result, the blogs with greatest level of professionalism and variety stemmed from the health section of newspapers and included Booster Shots, Wellness, Health Blog, and Well. Other blogs possessed a more direct viewpoint--Diet Blog, Marks Daily Apple, and Food and Health--which target nutrition and make suggestions to the maintenance of living a healthy lifestyle. Overall, the recommended sites are up-to-date and hopefully enrich the reader's resources and understanding of personal health and well being.

As mentioned in my previous post, addressing the concern of obesity in America is an important issue, one which politicians are seriously considering solving through the form of taxation. A recent study published in the New England Journal of Medicine, uses past trends of soda consumption throughout the world to explore and determine possible economic and health benefits that would result from a taxation on sugar-sweetened beverages--soft drinks, energy drinks, sports beverages and juices. According to the proponents of soda taxation, the new economic demands could result in decreased sugar consumption, leading to a possible decline in obesity across America. The proposed soda tax claims to parallel current tobacco taxes, which decreased consumption of cigarettes and tobacco-related products. In addition, revenue from the newly implemented taxes can go toward federal funding for health care costs and initiatives. While those in favor of the taxation on sugar-sweetened beverages possess sound arguments, the results are not all sweet. Due to a struggling economy, the beverage industry has been suffering from an economic standpoint. The proposed increase in taxation estimates to raise taxes by one cent per ounce of beverage. Although this seems minimal, simple calculations indicate the tax would generate about 14.9 billion dollars in one year, leaving the beverage industry severely weakened. From a scientific perspective, researchers have yet to provide a significant link between the reduction in sugary beverages and a decrease in obesity. While the topic of taxation has always been dismissed in the past, the soda tax is generating political popularity and has even elicited consideration from President Obama. Therefore, this week I chose to address a post by Los Angeles Times blogger and MIT alumnus Karen Kaplan, titled "Soda taxes back in the limelight." The post is correlated to the recent report, "The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages" published in the New England Journal of Medicine. My response to her post can be found below or at her Los Angeles Times blog, Booster Shots.

"Soda taxes back in the limelight?"
Comment

As a young adult concerned with the increasing rates of obesity in America, I was more than pleased to come across your thought provoking post discussing the possibility of implementing taxation on sugar-sweetened beverages. I appreciated your declaration that reducing calories by decreasing soda consumption does not eliminate alternate poor habits such as, "taking extra helpings of food" and having "less need to exercise." Although proponents of the tax on soda use tobacco taxation to draw possible similarities, I believe their argument is subjective because the products being taxed are extremely different. In the case of tobacco taxes, cigarettes and related products were scientifically proven to cause cancer and other fatal diseases. However, as you pointed out, sweetened beverages have not been isolated as the sole cause that results in obesity. While soda intake may increase the likelihood of becoming obese, there are a plethora of other food products and eating habits that influence the path to obesity. Considering the fact that other food products--fast food and candy--in combination with soda are a more probable link to obesity, do you think implementing a slight taxation on a majority of proven unhealthy products can have a beneficial impact on decreasing obesity? Or, are there too many personal choices, environmental and genetic factors that limit any chance for taxation of food products to achieve the goal of improving overall health?

Moving past the possible health implications, there is an obvious economic impact that can occur due to the taxation of sugary drinks. Your attitude towards the possible revenue of "14.9 billion in one year" seemed less than optimistic. Although the numbers seem too good to be true, it did not stop President Obama from commenting on the possibility of using that money to lighten the load of obesity in America. Currently, the government allocates funds towards obesity and weight-related programs on a statewide level; do you think these are effective? With more money, is it possible for the government to implement programs or alternative solutions to obesity? My personal opinion is expressed in a point made by the study published in the New England Medical Journal, which stated: "obesity is unlikely to yield any single policy intervention, so it is important to pursue multiple opportunities to obtain incremental gains." This particular statement refers to reducing caloric intake in a variety of ways, which I think is the start to decreasing obesity. In addition to regulated caloric intake, I am a firm believer that proper exercise and eating habits will direct individuals toward living a healthier lifestyle, and eventually lead to a healthier America.

GNC. Vitamin Shoppe. Lapband. It is nearly impossible to walk down a busy Los Angeles street without encountering an advertisement or product related to weight loss. However, American society's infatuation with image and weight should not catch anyone by surprise because nearly two-thirds of the American adult population is considered overweight, with one-third of them facing the reality of obesity (see left). According to the Centers for Disease Control and Prevention (CDC), the number of overweight and obese individuals has been steadily rising throughout the past twenty years. In addition to the growth of the morbidly obese, physicians continue to report a surge in heart disease, hypertension and diabetes, which indicates a correlation between obesity and various medical complications. With this alarming increase in poor health, it is evident why scientists are persistent in their search for a solution, which appears in a variety of forms--fad diets, lifestyle changes, counting calories and dietary supplements. Still, it is the perilous fixation with dietary aids in the form of a pill that remain most prominent and continue to dominate research and marketing in the multi-billion dollar dietary supplement industry. The attitude towards losing weight and maintaining a healthy lifestyle has shifted away from eating balanced meals and increased physical activity, and toward trying the latest capsule that guarantees physical perfection. There is no denying that these dietary drugs work to a certain degree, some better than others, but what is lost in the ongoing quest for the perfect pill is the determined mindset and emphasis on proper nutrition required for natural weight loss. While questions linger about negative side effects witnessed by past supplements, the combination of an inactive approach towards losing weight and an increasing dependence on pharmaceutical weight loss drugs provide a faulty recipe for success--indirectly setting dietary supplements up for failure.

Recently, promising trials of a new drug named Qnexa sent company shares booming and pharmaceutical companies watering at the mouth to capitalize on a vulnerable market. While drugs like Qnexa perform well in tests and seek approval from the Food and Drug Administration (FDA), some scientists and consumers are left to question the actual impact of dietary supplements. As stated in an editorial by New York University School of Medicine professor Gerald Weissmann, "almost anything that really affects the structure or function of the human body might have an unwanted side effect." Weissmann not only addresses the physiological hazards of dietary drugs, but additionally thinks that supplements go through "regulatory loopholes" to reach the market. Yet, the American population remains un-phased by such warnings, spending 23.7 billion dollars annually toward the development of refined dietary drugs, such as Qnexa. New York Times journalist Andrew Pollack believes Qnexa's campaign for FDA support is hopeful, considering favorable numbers from clinical trials: "seventy percent of the patients under full dosage of the drug lost at least five percent of their body weight, compared to only twenty percent of the patients subjected to the placebo." Although these trials imply optimism for the future of dietary drugs, there are some concerning parallels to unsuccessful predecessors that make it hard to ignore a dreadful past, one that is highlighted by the failure to consistently maintain a diet drug on the market. Qnexa is composed of doses of two separate drugs, tompimarate and phentermine; the latter, a major component of the once popular drug, Fen-phen, which was recalled after a variety of cases related to heart valve complications. Even though phentermine was only part of a combination of drugs that led to the unpredictable side effects, the stigma surrounding it provides enough reason to remain skeptical about Qnexa's future success. In addition, Hydroxycut (pictured below), which was a prominent player in the dietary game, struck out after Federal drug regulators filed numerous reports on the product's unfavorable influence on individual health. Overwhelming trends by past dietary drugs related to unforeseen detrimental medical consequences experienced down the line often limit the drug's chances of success on the market.

Plagued by a tainted past surrounding FDA recalls, dietary drugs have developed a negative connotation; nevertheless, some of these drugs still possess benefits, as seen by their ability to assist weight loss. According to a recent study by the University of Surrey (England): "findings support the idea that Orlistat [a diet drug] works not only on a physical level, but also psychologically--as it encourages people to see their diet as a cause of their weight problem." While this research indicates a successful pairing between weight loss and a modified lifestyle, associating the two can also lead to the opposite effect. Patients using certain dietary supplements often refuse to make the necessary behavioral changes recommended by the National Institutes of Health--exercise, eating healthy, and reducing caloric intake--because of their attitude and false sense of security provided by the drug. Obesity is a complex problem, and using any method only incorporating dietary drugs is the wrong solution. Physicians and nutritionists need to address the causes that lead to overweight individuals--portion size, unhealthy food choices and lack of physical activity--then implement programs and policies to assure improvements in health. According to the CDC, the Division of Nutrition, Physical Activity, and Obesity (DNPAO) provides funding to twenty-five states, in order to confront health challenges. Upon analyzing the population trends, Colorado was the only state to have an obese population percentage below twenty. Health officials associated with the LiveWell Colorado program identified direct sources leading to obese individuals and made it their mission to "inspire and advance policy, environmental and lifestyle changes that promote health through prevention and reduction of obesity." The results were an increased focus on physical activity (Get Fit Colorado) and better food options (Smart Meal Seal Program). In addition to financing statewide programs, the federal government can increase taxation on sugary drinks and fast food options; however, before the current Obama Administration can implement guidelines that would lead to a healthier America, the general public needs to come to terms with the negative effects of obesity, and cooperate by refining its attitude and behavior. Presenting calorie content on menus and increasing the cost of soda at restaurants lacks purpose when individuals choose to have two servings instead of one, or spend the extra few cents to splurge on a soft drink. How and what Americans eat are a personal choice, and taxation of unhealthy foods will not necessarily elicit any change. Identifying the origin of obesity and formulating interactive health education can eliminate current obstacles facing society. Creating awareness of the unfavorable outcome of obesity and dietary drugs can positively influence young people to alter health habits and attitudes, thus contributing toward a more fit future for America.