Stateside with Rosalea: Blue, blue my food is blue

Being still a relative newcomer to the US, I'm sometimes at a loss to understand the correct etiquette in a particular situation. Is it bad manners, for example, to sock a supermarket checkout operator in the chops when she holds you up by reading carefully all the ingredients on a packet of crackers she's just scanned and then announces that there are other brands containing far less hydrogenated oils.

Naturally I err on the side of politeness, smile sweetly, and say: Thanks for the tip. Which is something she will never get the opportunity to say to me, I might add. Fact is, I didn't even know what hydrogenated oil is... but as chance would have it, that same day in the mail I received a book I'd ordered from some earlier junk mail, and that very term was explained in it.

The book is 'The Wellness Kitchen', and it's written by the staff of The Wellness Kitchen and the editors of the UC Berkeley Wellness Letter. Samples of the eight-page monthly newsletter are available online at www.WellnessLetter.com, and if you subscribe to it, you get offers such as the book. Many other universities in the US with public health research departments have similar online and mail newsletters, but I happen to work at UCB so that's why I bought this one.

Sometimes I even go to public talks at the School of Public Health, such as one back in February entitled 'How many deaths in the US are due to obesity?', which was given by Dr Katherine Flegal from the National Center for Health Statistics of the Centers for Disease Control. The talk was pretty much over my head, since it was a detailed analysis of the statistics tossed about by the media when they say things like "300,000 deaths a year are caused by obesity."

I did glean that that particular statistic comes from a 1999 journal article which said deaths due to obesity numbered about 280,000 (or one-tenth of the annual 2.8 million deaths in the US). But seventy- five percent of the people who die in a year are over the age of 65, including the forty-three percent of deaths occuring in people over the age of 80, and - according to Flegal - the 1999 article failed to take the high risk of death in the elderly into account in any meaningful way.

While it may be true that something about obesity causes "excess deaths", even the government measure of obesity is under challenge. A BMI (body mass index) of 30 or more is the accepted standard, but lots of lean, well-muscled athletes fit that definition. Many other questions were raised in the talk. Is the cause of death less a case of obesity and more a case of poor nutrition and lack of exercise? Will returning to a pre-risk state (ie losing weight) result in a better relative risk? Since weight loss itself is associated with excess deaths, how can anyone know which cause to blame?

The unreliability of the statistics boils down to the fact that there are only two sources of data: death certificates and indirect estimates. Only about 11,000 death certificates in the US each year list obesity as a cause of death, which seems too low but is not surprising, Flegal said, given that obesity is not always thought of as a medical condition. She said the deaths associated with obesity annually in the US may be substantially less than 300,000, but they are also likely substantially more than the figure from the death certificates.

Lifelong obesity is listed as one cause of death on my mother's death certificate. She was a couple of months shy of 65 when she died. Despite being as round as she was short, me mum moved so lightly on her feet that she was a champion ballroom dancer in her youth and could sneak up on you unheard without even trying until arthritis took its toll late in life.

Which is not to minimise any negative role obesity played in my mother's life or that it might play in mine as I increasingly conform to her body type rather than my tall, lean father's. Nor would I minimise the role bad nutrition and lack of excercise has played in the poundage I've acquired over the past three years. No longer is a sandwich two slices of thin bread with maybe some slices of tomato or cheese. It's a $5 thing that is the standard in the US, big enough for two meals but eaten all at once anyway, after a while, as you acclimatise to the food environment here. (Is there such a word as "agluttonise"?)

Getting back to the book, 'The Wellness Kitchen' is subtitled 'Bringing the latest nutrition information to your table' and it contains recipes that give you - in food form - the many vitamins and minerals that people tend to take as dietary supplements. There is a myriad of information about how to cook food to get the most nutritional value out of it (no recipes using frying or boiling, for example), and a 'Color Yourself Healthy' chart to put up in your kitchen.

Pigments, the chart says, are essential to good health. It divides food up into colour groups - red, yellow/orange, orange, yellow/green, and red/purple/blue - and lists the health properties of the various pigments that produce those colours. The anthocyanins that color bluish/red foods, for example, may stimulate the immune system, help keep your heart healthy, and support healthy ageing. Don't peel that grape, Beulah!!

I don't know about you, but this pigment thing is all news to me, and ten times more fun - and therefore more likely to be followed - than any other food regime. "Make your grocery basket and your plate as colourful as you can" exhorts 'The Wellness Kitchen', and by golly I think I will! But I won't be abandoning the brown food groups entirely - without crackers, how can I spread my Vegemite? And without beer, how can I wash them down?

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