NYC Bans Trans Fats From Eateries

Maybe I'm proposing a few more hikes for bad health practices.

Some will never respond, but hopefully most would try living better....

 

I, too, believe higher rates are a fair and equitable practice for individuals that don't practice healthy lifestyles. Unfortunately, this scenario is logical but not workable. There are far too many variables for an insurance company to be able to identify those that don't live "healthy". The term itself is even subjective. What one considers healthy, another may not. The only means by which an insurance company could determine an individual's health is by questioning the individual. They are the only person who knows how they eat, if they work out, if they smoke, if they do drugs, etc. I'm sure a lot of people wouldn't be disclosing accurate data in this regard.

 

<div class='quotetop'>QUOTE(SSimon @ Dec 7 2006, 04:31 PM) [snapback]359000[/snapback]</div>

You are naive.

First, 'healthy' to an health insurance company is similar to 'good driver' for car insurance. It is a money question, and quite answerable as such (if not dogmatically).

Second, many surrogate tests are available to risk stratify lifestyle illness. Just to name a few: CO for tobacco, cholesterol panel, blood sugar, blood pressure, CRP (for CAD), HIV test etc. Last but not least, the almighty SCALE. Heck, it would be easy to demand that every member prove they can exercise 10 mets for 10 minutes on the treadmill at their local gym every five years or so, or risk being dumped.

In point of fact, just try buying health insurance as an individual, and you will see how much stratification (aka cherry picking) is already being done by the companies. The systemic inertia IMO is more likely explained because of umbrella coverage offered to companies, and the large group of uninsured in the US where **really* awful lifestyles are rampant.

 

"In point of fact, just try buying health insurance as an individual, and you will see how much stratification (aka cherry picking) is already being done by the companies."

This just proves my earlier point that health care cannot be provided by for-profit corporations. They will leave the sickest and poorest in the dust. That's exactly why most countries have universal government-run health insurance. Health care is a social good, not a private good. It is like clean air and water. It cannot be turned into a capitalist commodity. To the question "why should I pay for my neighbor's operation?" there is a very simple answer - because tomorrow, he will help pay for your operation.

 

<div class='quotetop'>QUOTE(jared2 @ Dec 7 2006, 05:52 PM) [snapback]359047[/snapback]</div>

And because if you leave the poor to rot, the disease that breeds there will work its way into the rest of society sooner or later.

 

Jared, countries that have universal coverage differ from the US in one, usually more, of the following ways:

1. The population takes better care of itself
2. Medical care is rationed
3. The population is a less conspicuous consumer

You cannot have everything. Universal, all you can demand, care for a nation of obese gluttons is more than I want to pay.

 

<div class='quotetop'>QUOTE(EricGo @ Dec 7 2006, 05:13 PM) [snapback]359032[/snapback]</div>

I was responding to the discussion of charging an individual higher premiums based on whether or not an individual involves themselves with healthy lifestyle practices (i.e. healthy eating, exercise....) not based on whether or not they are actually physically or mentally healthy.

 

The dilemma with national health care seems to revolve on having a balance of adequate care without abuse running up the costs.

Heavily Socalized Medicine: Everyone is served, but wait lists could be long, and technology/patient care may not be optimal

Heavily Privatized Medicine: Best possible care for those who can affored it, no care for the destitute, others lose their life's savings.

I think the "sweet spot" is the patient spending enough of their money it's not frivilous, while they don't go the other direction and put it off until it's much more expensive.

In a perfect world, everybody would take care of themselves, but of course it does not happen.

 

<div class='quotetop'>QUOTE(SSimon @ Dec 7 2006, 06:05 PM) [snapback]359051[/snapback]</div>

It is irrelevant how much oatmeal you eat every day. What matters is your statistical risk of cardiopulmonary disease, diabetes, and cancer. Insurance companies today have the werewithal to figure it out. I'm an internist, and I can tell you, it is easy, at least in gross terms that insurance rate tiers requires.

 

<div class='quotetop'>QUOTE(jared2 @ Dec 7 2006, 08:07 AM) [snapback]358886[/snapback]</div>

If you do not have a garden or a farmer's market, canned and frozen vegetables may be a better choice than the so-called "fresh" produce in many cases. The better brands of frozen foods are often frozen right from the field, and foods once canned stop deteriorating.

But a lot of people never eat anything that wasn't manufactured by a chemical process in a factory with giant sputtering machinery. Think Boris Karlof, rubbing his hands and exclaiming gleefully: "I've done it! I've created food out of petroleum!"
<div class='quotetop'>QUOTE(Subversive @ Dec 7 2006, 09:51 AM) [snapback]358930[/snapback]</div>

Actually, there is a big difference. Pastries made with Crisco do not taste as good as those made with lard. (I still don't eat lard. That's my choice. But the artificial stuff does not taste as good.)
<div class='quotetop'>QUOTE(Subversive @ Dec 7 2006, 09:51 AM) [snapback]358930[/snapback]</div>

Not true. I eat a nutritious and delicious diet and I use almost no fats or oils of any kind in my cooking. Six months ago I bought an 8-ounce jar of grapeseed oil, and it's still about 2/3 full. I use oil rarely and in small amounts. I get my essential dietary fats from eating actual foods that contain fats. Most foods do. Grains, seeds, nuts, even potatos have a small amount of fat.

Characterizing a vegetarian diet is "rabbit food" shows a real lack of understanding of what a vegetarian diet is.

The things I do have to live without are junk foods and McD's gut bombs. In other words, a strict vegetarian is forced to eat a healthier diet.
<div class='quotetop'>QUOTE(SSimon @ Dec 7 2006, 10:54 AM) [snapback]358962[/snapback]</div>

This is just one more example of how laws are written for the convenience of corporations rather than for the health of consumers. I think a similar ruling applies to saturated fats. Less than about 5 grams, they get to label it as zero. Bottom line: if it contains partially-hydrogenated oil, it probably contains trans fats, even if the label claims it is free of trans fats!

 

The threshold was set to mirror amounts found in milk and meat.

Reasonable from the standpoint of people who simply want their pastries made from butter/lard rather than crisco. And reasonable from a public health standpoint, since the general idea is to turn the clock back to the pre manufactured trans fat era.

 

<div class='quotetop'>QUOTE(EricGo @ Dec 7 2006, 05:17 PM) [snapback]359056[/snapback]</div>

the idea of a comprehensive insurance pre-screening process involving calculating your statistical risk for diseases x, y, and z based upon lifestyle, genetic and work environment properties scares me to death.

i live a healthy lifestyle but cancer runs in my family, along with other things. DH was in great shape until his sleep apnea slammed him down hard... it was not caused by obesity but by narrow nasal passages prone to collapse.

so despite making good choices, we'd still be hit hard with increased insurance premiums when we needed good coverage the most. i have a feeling we're not the only ones who are in this kind of situation.

 

<div class='quotetop'>QUOTE(Subversive @ Dec 7 2006, 02:51 PM) [snapback]358930[/snapback]</div>

HAHAHAHA....Hey, welcome back, at least I haven't noticed you for awhile.

Save a carrot....eat a cow!

 

<div class='quotetop'>QUOTE(galaxee @ Dec 7 2006, 06:52 PM) [snapback]359113[/snapback]</div>

A civilized country would provide free health care for everyone, and would provide free education for everyone. Thus poverty would not prevent anyone who wanted to, and who had the ability, from becoming a doctor, or from getting both preventative and curative medical care.

 

<div class='quotetop'>QUOTE(daniel @ Dec 8 2006, 04:08 AM) [snapback]359185[/snapback]</div>

I agree....but it is the American CULTURE that prevents it. All the way from people who have so much and do not want to share to people who have nothing and WANT others to give them everything.

From each according to his ability and too each according to his need has proven to be unworkable for the human. So, all we can do is come up with the most reasonable for all.

My thoughts center around informed choices, REAL choices, health care based on your lifestyle choices (rationed heath care) combined with user pays (if you can afford it, you can have any health care you want), limited liability for doctors (a very high incompetence threshhold for liability and for sure...damages only) and clinic systems where hospitals would be ALLOWED to send people away who do not need ER's fo their sniffles.

 

<div class='quotetop'>QUOTE(daniel @ Dec 8 2006, 02:08 AM) [snapback]359185[/snapback]</div>

Sounds like you admire Cuba, Venezula, Russia, Iran, North Korea.

<div class='quotetop'>QUOTE(Schmika @ Dec 8 2006, 06:06 AM) [snapback]359224[/snapback]</div>

Are you referring to the Gates and Buffet who have combined given more to charity than the GDP of many countries - only in America can a charitable foundation have nearly $100 BILLION to distribute. How is that for American culture. I also believe we are the MOST CHARITABLE country on EARTH - yes or no?

Your second paragraph is subjective.

Let the marketplace rule in health care and limit external forces like med mal and governmental interference.

 

<div class='quotetop'>QUOTE(galaxee @ Dec 7 2006, 10:52 PM) [snapback]359113[/snapback]</div>

You are imagining a bleak orwellian future, but there is no reason for it to be so. If society wanted to risk stratify to the nth degree, all that is required is to absolve insurance. My desire is to increase rates for people with poor lifestyles that lead to expensive healthcare. A couple of examples follow ..

Every health insurance company knows how much it spends on cancer care, and it also knows that ~50% of the cancer load in society is tobacco related. Smokers should pay in premiums that load, and not have it spread across the insured base. As I mentioned earlier, it is not difficult to identify smokers by testing.

Hypertension, tobacco, obesity, diabetes, and diet related dyslipidemias account for around 90% of vascular disease. Excepting Type I childhood onset Diabetes, these are close to 100% modifiable conditions. People who do not care to fix these problems, should pay for the eventual complications and not rely on the rest of the insured populace.

COPD is a tobacco related disease in > 95% of cases. Same treatment as above.

Alcohol and Drug Abuse: Same treatment as above.
Hepatitis C and HIV: Same treatment as above.

YOU WOULD BE AMAZED, at how little morbidity is left over once people avoid destructive lifestyles, and look after themselves in a sane, reasonable manner. It does not take new-age nonsense, trips to whole foods, or yoga. Just stay slim, exercise, and refrain from ingesting/injecting toxins.

Or not. But then expect to pay the full cost for at best partially effective medical care. I know of *one* case of OSA (in a physician, actually) not related to hypothyroidism, sedative or alcohol abuse, or obesity. Spreading that person's medical care cost across the population is trivial, when the other couple hundred OSA cases I have come across from modifiable lifestyle problems are not. I *know* someone is going to object, because this approach discriminates against people "with bad genes". On a public health scale, "bad genes" do not become a significant health care load unless poor lifestyle brings them out. As an example, I like my sister am a heterozygote for one of the common lipid metabolism disorders in the caucasion population. She has bags of lipid accumulation under her eyes, and an LDL of about 200. My LDL is in the upper range of normal. Difference ? Diet. I don't know her HDL, but I'm willing to bet odds it is considerably lower than mine. She is obese, and is sedentary. I am neither. She smokes tobacco, I do not. She can expect to suffer from vascular disease complications by the time she is 60; I can expect to live into my 90's without any vascular disease. Simple choices.

 

<div class='quotetop'>QUOTE(dbermanmd @ Dec 8 2006, 05:08 AM) [snapback]359234[/snapback]</div>

It would be amusing, if it were not so pathetic, and somewhat insulting, the way you love to categorize people with overly-simplified categories of your own invention.

I do indeed admire the accomplishments in health care, education, and economic justice of the Cuban Revolution. In no other country of the world with such few economic resources is there such a high standard of public health and education, and in no other country is the difference between the richest and the poorest so narrow.

I also admire Hugo Chavez for his work to help the poorest of his people rise above the destitution poverty that prevails on the rest of the continent, and for his willingness to characterize W as evil: a sentiment I share.

The Bolschevik Revolution accomplished some remarkable things in health care and education, while at the same time yielding to the most extreme excesses of tyranny. You, David, think everything and everyone must be all good or all bad. You are apparently incapable of recognizing that a country can have some very good things and some very bad things all at the same time, as was the case of the old USSR.

I have no idea why you threw Iran into the mix. Perhaps just because you don't like Iran so you imagined I must like it, since we disagree on so much. Iran is pretty much irrelevant to this discussion, being a capitalist country.

North Korea is one of the most repressive of present-day countries. I admit to ignorance as to whether they've managed to provide health care and education to a large segment of their people. So I don't know whether to lump them with the Bolscheviks (some good with some terrible evil) or with Iran (as irrelevant to this discusion.)

In conclusion, you try to discredit my opinions about health care and education by accusing me of supporting countries that you and many Americans dislike, therefore avoiding addressing the real issue, and making yourself obnoxious, which, of course, is nothing new.

<div class='quotetop'>QUOTE(Schmika @ Dec 8 2006, 03:06 AM) [snapback]359224[/snapback]</div>

It actually does work in band-level societies.

Anthropologists categorize the level of social organization of societies into 4 levels: Bands, Tribes, Chiefdoms, and States. Bands are very small groups of people with no permanent leadership. A skilled hunter may lead a hunt, for example, but after the hunt he is again merely a member of the band. Typically bands share everything, including work, equally. There are generally gender differences (e.g. women are the gatherers and men are the hunters) but within those groups every individual works to his or her ability, and whatever is brought in is shared equally, and even tools are borrowed without the need to ask. Thus, at the band level, humans are perfectly capable of the Marxist ideal. It is only with more complex social organization and larger populations that such ethics seem to break down.

FWIW, tribes are characterized by larger groups and earned leadership: Leadership is not inherited, but earned on an individual bases, and the leader must constantly earn the support of his people to retain his position. Chiefdoms are characterized by larger size yet, and by inherited leadership. States are characterized by market economies, and have no upper size limit.

Generally, economic inequality increases with the increasing social complexity. Hunger is nonexistant in band-level societies, and there are no differences in status or possessions between individuals. (Though elderly people are generally respected for their experience and wisdom.) As you rise in complexity to tribes and then chiefdoms, you begin to see differences in status and wealth among individuals, though real poverty only arises at the state level of organization.

 

<div class='quotetop'>QUOTE(Dragonfly @ Dec 5 2006, 10:30 PM) [snapback]358271[/snapback]</div>

They should do that everywhere.

Please do not for one minute think this is a "freedom of choice" issue. It is a health issue, and our government has caved in to lobbyists and failed to look out for our health.

Here's some personal history:

I've had bad cholesterol for years. My doctor should have gotten after me about it sooner, and I should have been more proactive, since it is my health.

15 months ago, (and the preceding years) my cholesterol was awful. My LDL was way too high, and my HDL was way too low. I was in the highest risk category for heart attack/stroke. I was becoming more proactive about my health due to several run-ins with the scalpel due to skin cancer. My short-term memory was getting progressively worse, and frankly I was running scared about my health.

Some Googling quickly put me on target: I had been eating lots of cookies and peanut butter sandwiches, all of which at the time were soaked in trans fats from partially hydrogenated oils.

My doctor put me on 10 mg of Lipitor, the smallest dose, and at the same time I banned trans fats from my diet.

Trans fats were in cookies, french fries, any restaurant fried foods, donuts, peanut butter, muffins, pancakes, etc, etc.

Ban trans fats from your diet by reading ingredients and not consuming anything with partially hydrogenated oils. Note: food can be labeled 0 grams trans fat and still have partially hydrogenated oils. There is a cut-off point, where food labelers can cheat if the trans fats are below a certain point, they can claim 0 trans fat, which is a lie.

Results: my cholesterol numbers are excellent now. I've gone from highest risk category for heart attack/stroke to lowest risk category.
Note: years of high cholesterol not only risks heart attacks, it causes short-term memory loss, cognitive decline, and eventually Alzheimers.

Still think trans fats is a "freedom of choice" issue?

High cholesterol can also cause erectile dysfunction.

Trust me, you need to ban all trans fats from your diet. I am proof that doing so will turn your cholesterol situation around. I have the test results to prove it.

The simple fact is that trans fats raises your bad cholesterol, LDL, and lowers your good cholesterol, HDL. That double-whammy makes partially hydrogenated oils poisonous to humans, and it should be banned from all our foods.

good health,

Harry

 

I'm sorry but I have to disagree with the people who say "trans fat in moderation is ok for you".

I would classify the regulation of trans fat more in the category of something like "lead paint" than "saturated fat". There really is no "good" level of trans fat for you, whereas you need things like saturated fat (though in the US we eat too little Omega 3) as part of your diet.

You do not need trans fat as part of your diet, it provides absolutely no benifit to you. There are alternatives and there is no excuse to use transfat/partially hydrogenated oil/shortening in food. This ban is a good thing. Even if it is overturned, hopefully it will help educate the general public (and even a number of doctors) on the topic.