Happy Healthy Long Life

No More Vegan or Vegetarian Barbecue Blues - I've Finally Found the Perfect Barbecue Chicken & Smoky Hamburger Fix!

OK, I admit it!  Now that summer is here--I miss my barbecued chicken and hamburgers.  They're easy, fast, and just plain taste great.  No, I'm not missing the meat--I'm just missing real outdoor barbecue flavor.  And I'm not ashamed to admit it!

Somehow grilled veggies and vegetable kabobs don't quite fill the bill in the summer-time!

Last week I finally found the fix for my vegetarian BBQ Blues!  First I experimented with barbecued chicken sandwiches made in a flash.  And then I discovered Smoky Portobello Sliders, better-than-real-burgers-with-grilled-onions, in the July/August issue of Vegetarian Times.  Not as quick--but worth it.

The Healthy Librarian's Five-Minute Barbecued Chicken Sandwich

1 package of Trader Joe's Chicken-Less Strips.  Find them in TJ's refrigerated case.  Substitute a package of frozen Morning Star Farms Meal-Starters "Chicken", if you aren't near a Trader Joe's.  I no longer have the box they came in, so I can't fess up to exactly what's in them--but as far as "fake food" goes, they are mostly "real" ingredients, and the taste & texture would fool most chicken-lovers. I'm not a big fan of fake meat substitutes--but for summer BBQ--I'm changing my tune.

1/2 cup more of less of your favorite pre-made barbecue sauce.  My new favorite is Trader Joe's Bold & Smoky Kansas City Style Barbecue Sauce.

4 whole wheat mini-buns.  Once more, my new favorite is to use Trader Joe's whole wheat dinner rolls, instead of the buns.  Less bun, less calories!

1. Oil or spray a grill topper & heat it up on your grill.  For easy veggie grilling just go out & get a grill topper.

"With a vegetable grill topper, the size of the vegetables doesn't become a limiting factor and you don't have to worry about slices falling through the grate," recommends master vegetarian griller, Andrea Chesman.

Recommended topper:  The Danesco Stainless Steel Topper ($19.99; target.com)

2. Quickly grill the chicken strips until slightly browned. Don't let them dry out.  Then brush with sauce.  Continue grilling for a few minutes until the sauce caramelizes & the strips are nicely glazed. You could do the "saucing" in a fry pan, if you wanted, but it does need the initial grilling for the right smoky taste.

3. Toast whole wheat buns on the grill. 

4. Add some extra sauce, coleslaw, avocado slices, or whatever you like on barbecue chicken sandwiches.

One package of TJs Chicken-Less Strips serves 3.   (nutritional info on the strips:  9 strips, 1.5 g fat; 0 sat fat; 0 cholesterol; 330 mg sodium; 3 g carbohydrate; 1 g fiber; 1 g sugar; 20 g protein) 

For the future: I plan to experiment with Trader Joe's Beef-less strips on the grill for both barbecue beef, ribs, & teriyaki flank steak substitutes--especially as salad-toppers.  Chicken & beef for grilled fajitas, too.

Vegetarian Times Smoky Baby Portobello Sliders

 

This one takes a little more time and I've made them as mini-sliders with baby portobellos, and as full burgers with regular portobellos.  The sliders take a little more fussing, but they're fun to eat--definitely company fare.  No exaggeration--these burgers are fantastic--sweet & spicy & smoky & juicy & darn right sophisticated!  It's hard to believe, but they're even better as leftovers--which I would never say about a hamburger.

Note:  the grilled onions can be made up to 2 days ahead, and once you've made the Classic BBQ Rub, it's ready to go for the next time you make burgers.

8 nice sized baby portobello mushrooms, stems removed.  Or 4 regular-sized portobellos, stems removed  Note: I could only find smallish baby ports, & needed to grill more, using 2 per slider.  Or just take the easy route & use 4 regular-sized portobello mushrooms, stems removed.  Full-sized portobellos=Full-sized buns.

3 Tbs. olive oil, divided.

2 Tbs. Classic BBQ Rub (see below for the recipe)

1 large Vidalia, Spanish or other sweet onion thinly sliced.

1 tsp. herbes de Provence

1/2 cup prepared barbecue sauce (I like Trader Joe's Bold & Smoky Kansas City Style Barbecue Sauce)

2 oz. (3/4 cup) shredded smoked Gouda (Trader Joe's has a low-fat version--or substitute Vegan casein-free Follow Your Heart cheddar or Monterey jack cheese)

8 Trader Joe's whole wheat dinner rolls (or mini-challah rolls) if making sliders, or 4 regular whole wheat buns if using full-sized portobellos.

1.  Mix 1 Tbs. olive oil with 2 Tbs. Classic BBQ Rub & rub it on the portobellos. Set aside.

2.  Heat remaining 2 Tbs. oil in a large skillet over medium heat.  Add onions and herbes de Provence, and cook 30 minutes, or until golden, stirring occasionally.  Remove from heat, and season with salt and pepper, if desired.

3.  Heat grill or grill topper over medium-high heat.  Rub grill topper with oil, or spray well.  Place mushroom stem side down on grill.  Brush mushroom tops with barbecue sauce, and grill 3 or 4 minutes until soft & charred around the edges.  (Larger mushrooms may take longer) Flip, and grill 3 minutes more.  Divide cheese among the mushrooms, placing in center of each stem side.  Grill 1 minute more, or until cheese is melted.

4.  Meanwhile, warm buns on the grill.

5.  Spread barbecue sauce on bottom buns, then top each with 1 mushroom, sauteed onions, and top bun.

6.  Wrap leftovers in foil, refrigerate & enjoy the next day.

Serves 4.  2 sliders per serving with baby portobellos, 1 regular sandwich per serving with full-sized mushrooms.

Vegetarian Times Classic BBQ Rub

"This basic spice blend can be added to marinades or sprinkled directly on grilled vegetables.  The recipe makes enough for a number of Smoky Portobello Sliders.  Store in an airtight container to use throughout the summer."  VT

1/4 cup light brown sugar

1/4 cup smoked (or sweet) paprika--or go 1/2 & 1/2

3 Tbs. ground black pepper

3 Tbs. kosher or coarse sea salt

2 tsp. garlic powder

1 tsp onion powder

1 tsp celery seed

1/2 tsp. cayenne pepper

Combine all ingredients in small airtight container.  Mix well to blend.  Store in the refrigerator.

My Big Barbecue Brat Disappointment

 

Kathy over at the The Lunch Box Bunch blog  raved about Tofurky's Vegan Beer Brats.  "They are higher in calories,  but very tasty and a nice plump size. Uses real microbrewed Full Sail Ale in the flavoring. Grill approved. 260 calories, 13 g fat, 27 g protein."  The microbrewed beer is what suckered me in.

I couldn't resist Kathy's delicious photos.  Too bad the brats were such a disappointment. This was supposed to be a real treat for my husband on Father's Day.  We both really really wanted to like them. Didn't happen.

Flat bland taste, an unappealing fake mealy texture, with a bit of a nutmeg in the flavor--not the kind of taste I was hoping for in a brat.  Looks good, tastes--not-so-good.  Actually, I did enjoy the left-over brats cut up on a salad the next day for lunch.  Go figure.

Anybody else care to share their vegetarian barbecue winners?  I'd love to increase my BBQ repertoire.

I want to try these "new to me" Field Roast Vegan Sausages made in Seattle--Mexican Chipotle, Italian & Apple Sage.  Has anyone else tried them?

BMJ Online: Dr. Jeremy Brown's Simple New Test Screens For Early Alzheimer's and Dementia

A new test that evaluates cognitive ability -- and which you can give yourself -- appears to be faster and more accurate than current tests in detecting early dementia, according to British researchers.  

Published in the BMJ online June 10, 2009.  Dr. Jeremy Brown,  Addenbrooke's Hospital, Cambridge, England

Scroll right to the bottom of the page if you want to try out the test.

Is there anything more frightening than a diagnosis of Alzheimer's or dementia? 

Dementia is far more common than we'd like it to be. It's estimated that "24 million people in the world suffer from dementia and the number will double every 20 years."  Certainly, not all dementia is Alzheimer's disease.  Cognitive problems plague those with stroke, Parkinson's disease, head injury, and epilepsy.  And still more will suffer from milder forms of cognitive impairment.

But, as Dr. Clair Nicholl of Addenbrooke's Hospital says in an editorial accompanying Brown's BMJ article, "Without a diagnosis, patients and caregivers cannot access the services they need, so earlier diagnosis is a key component of the National Dementia Strategy in the United Kingdom.  However, early diagnosis is not easy and no definitive test exists.  A quick screening test is needed in primary care and general hospital practice."

Dr. Brown's new "Test Your Memory - The TYM Test" is quick to use, examines 10 skills, and reportedly detects 93% of the cases of Alzheimer's disease.  Brown says this self-administered test is a powerful and valid screening tool, more sensitive than the standard Mini-Mental State Examination (MMSE)  (93% vs 52%).

Remember, this is strictly a screening tool. Further professional evaluation is always necessary, and low scores may be attributed to anxiety or dyslexia.

This test has participants write 10 answers on a double-sided card, and the tasks evaluate a range of areas--the patient's semantic knowledge--the ability to calculate--name objects--recall information.  Looking at the questions it seems clear to me that the test would have to be modified (controlled) for age, ethnic, racial, & cultural biases to work in the U.S.

A sample of the questions:  List 4 creatures beginning with "S".  In what year did the 1st World War start?

It took people who had no history of cognitive problems about five minutes to complete the test. Their average score was 47. However, people with Alzheimer's took longer to finish the test and earned an average score of 33. People with mild cognitive impairment had an average score of 45.

Certainly, longer scales and more thorough testing would be required for a firm diagnosis, but this test looks like it just might be a simple accurate sensitive tool to diagnose cognitive problems.  Dr. Brown claims it is sensitive enough to distinguish between mild cognitive impairments that may likely progress to dementia within two years, from those that likely will not.

Read Dr. Jeremy Brown's BMJ article, "Self-administered cognitive screening test (TYM) for detection of Alzheimer's disease: cross sectional study" here.

Read Dr. Claire Nicholl's BMJ editorial, "Diagnosis of dementia.  The usefulness of screening tests varies according to the clinical setting" here.

And for the best or worst part--try the test yourself.  The scoring is included.  Click here.  **Remember this was developed in England--you might want to substitute the U.S. President for the Prime Minister--and consider the year the U.S. got involved in WWI--I'm by no means a test-maker--but those seem reasonable switches.

For more detailed scoring click here  I wasn't able to access this page at the time of this writing.

For a link to the Press Release about the test, click here.

And while I'm on the subject of dementia & Alzheimer's, take a look at this excellent short article from the New York Times: "Getting Insurance for One's Frailest Years", by Walecia Konrad. Nothing is more devastating to families and finances than getting good care for a family member with dementia.  After reading this, my husband & I are starting to research the options.

PD Reporter Kaye Spector Tries Out Rip Esselstyn's Plant-Based Diet. "Turning A New Leaf To Try Out A Vegan Diet"

Credit: Staci Andrews/The Plain Dealer

"In May, I decided to try Rip Esselstyn's Engine 2 Diet.  Esselstyn believes that a completely plant-based, low-fat diet halts cardiac disease, improves energy and aids weight control.  I can do that, I thought. "

Kaye Spector, health reporter for the Plain Dealer, "Turning a new leaf to try out vegan diet"

One of Happy Healthy Long Life's readers just wrote to tell me about a motivating article appearing in today's Plain Dealer.   Kaye has practical advice on how to make an easier transition over to plant-based eating.  She's a busy reporter, wife and mom.  If she can do it, so can you!  Enjoy.

I haven't eaten meat for a month.

I haven't eaten eggs or drunk milk, either.

Yes, I'm eating like a vegan.

My decision to stop eating all animal-derived products probably had its origins in becoming a health writer six months ago. I began reading more about health and meeting people who touted more healthful ways to eat and live.

Continue reading "Turning a new leaf to try out vegan diet" »

The Vital Trial/Study Is Announced. Can 2000 IUs of Vitamin D & 1 gram of Omega 3/Fish Oil Reduce the Risk of Heart Disease, Stroke or Cancer? New Study Starts In 2010

  

Vitamin D & Omega 3-s (fish oil) are my two favorite supplements. 

I "aim" for 2000 IUs a day of vitamin D, and about 1 gram of omega-3/fish oil--on the days that I get around to taking them.   For my past posts on these supplements click here and here and here.

Researchers have been singing the praises of vitamin D & fish oil for years now--and the evidence keeps piling up.

Now finally, we may (or maybe not) get some answers, when a new randomized controlled study of 20,000 men & women is completed.  Are these truly "miracle supplements" or are we just wasting our money?  This new study is set to begin in January 2010 & run for 5 years.

One big problem:  The study is recruiting women over age 65, and men over age 60!   That seems to be a continuing problem with these studies.  They start out with too old of an age group and they run for too short of a time to really give us good information.  Remember what happened with the Women's Health Initiative?

Dr. Christopher Gardner of Stanford University is usually skeptical of this sort of study.  To be valid, such a trial would have to run for 40 years, because that’s how long it takes to develop a chronic disease, like cancer, heart disease & diabetes.

Dr. Walter Willett, the prominent Harvard nutritionist & epidemiologist notes that it can take many years for nutritional benefits to show up. In the Physician’s Health Study, one of the longest running randomized studies, the cognitive/memory benefits of beta-carotene supplements did not show up after even 12 years.

It took 18 years of taking the supplements for the brain benefits to show up!

According to Dr. Michael Holick, one of the foremost authorities on vitamin D,  infants who are deficient in vitamin D never attain genetically preprogrammed bone density or height.  And the risk of multiple sclerosis increases from a cumulative childhood deficiency of vitamin D.  We all know that heart disease, stroke & cancer take years to develop.  Running a study that last only 5 years, on men and women over age 60 & 65 seems like a case of TOO LITTLE TOO LATE.

Here's the Press Release:

Massive vitamin-D/omega-3 trial for CVD, cancer prevention

June 29, 2009 | Shelly Wood

Boston, MA - A massive, National Institutes of Health-sponsored study looking at whether vitamin-D and/or omega-3 fatty-acid supplementation can reduce the risk of developing heart disease, stroke, or cancer will get under way in January 2010, according to a website for the study. Drs JoAnn Manson and Julie Buring (Harvard Medical School/ Brigham and Women's Hospital, Boston, MA) will head up the Vitamin D and Omega-3 Trial (VITAL).

The study is aiming to enroll 20 000 men and women, one-quarter of whom will be black. According to a Brigham and Women's Hospital press release, the study is intentionally aiming to illuminate a potential racial and ethnic disparity hypothesized to be linked to vitamin D [1]. "African Americans have a higher risk of vitamin-D deficiency as well as a greater frequency of diabetes, hypertension, and certain types of cancer," a press release notes. For VITAL, women need to be over age 65 to enter the study; men need to be over age 60.

Study participants will be randomized to one of four groups: daily vitamin D (2000 IU) and fish oil (1 g); daily vitamin D and fish-oil placebo; daily vitamin-D placebo and fish oil; or daily vitamin-D placebo and fish-oil placebo. The trial will run for five years and is expected to cost US $20 million.

Source

1. Brigham and Women's Hospital. Largest study of vitamin D and omega-3s set to begin soon at Brigham and Women's Hospital [press release]. June 23, 2009. Available here.

For the link to the Official Vital website click HERE.  Enrollment begins after Labor Day.

Gwen Mergian, who writes a blog called: Healthy Habits: Better Nutrition and Better Health for the Albany Times Union just blogged about my What The Experts Say About The Side Effects of Statins.  What Are They?  What Causes Them? Who Is Most At Risk?  How Are They Treated?  post, written on June 27th.
 
Thanks so much, Gwen!  You can read it here.  Gwen is a nurse who completely changed her diet & exercise habits when she discovered she had dangerously high cholesterol levels and did not want to go the statin/medication route.  She writes an inspiring commentary about her experiences living the "healthy life".  And yes, she lowered her cholesterol to amazing levels through an almost vegan low fat diet, ala Dr. Dean Ornish--and she's reaping the benefits.

What The Experts Say About The Side Effects Of Statins. What Are They? What Causes Them? Who Is Most At Risk? How Are They Treated?

Muscle problems are the best known of statin drugs' adverse side effects.  But cognitive problems and peripheral neuropathy, or pain or numbness in the extremities like fingers and toes, are also widely reported.

Dr. Beatrice Golomb, MD, PhD, Director of the UC San Diego Statin Study Group, Dr. Marcella A. Evans,  UCSD School of Medicine
Am J Cardiovasc Drug 2008;8(6):373-418

Because statin-related myopathy will probably become more common with greater numbers of persons starting high-dose statin therapy and the increasing stringency of low-density lipoprotein cholesterol level targets, research to better identify patients at risk for statin myopathy and to evaluate management strategies for statin-related myopathy is warranted.

Dr. Tisha R. Joy, MD, and Dr. Robert A. Hegele, MD, Robarts Research Institute and Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada
Ann Intern Med 2009 June 16;150(12)858-868

In the group that took red yeast rice, the average drop in LDL cholesterol was 43 points in 12 weeks.  We may actually have found a product that may be useful for patients and clinicians to deal with this problem of 'statin-caused muscle pain'.  There is a real potential here, but 'there are still a number of concerns' because the sources of red yeast rice 'are not very' reliable.

Dr. Ram Y. Gordon, MD, Dr. David J. Becker, Chestnut Hill Hospital, University of Pennsylvania School of Medicine, and Jefferson-Myrna Brind Center for Integrative Medicine, Philadelphia, Pennsylvania.
Ann Intern Med 2009 June 16(12):830-839

Those of us who care for patients who cannot tolerate lipid-lowering therapy are often confronted by anecdotes that contradict the findings of well-designed trials.  We still do not know whether statins directly induce muscle atrophy or whether lowering lipid levels by any means in patients with vulnerable muscles causes myotoxicity.

Dr. Paul S. Phillips, MD, Scripps Mercy Hospital, San Diego, CA
Ann Intern Med 2009 Jun 16;150(12):885-6

There's no doubt about it.  Statins provide a tremendous benefit by lowering cholesterol and inflammation and decreasing the incidence of cardiovascular disease.

But...our bodies are all different.  Even the statins, drugs hailed to have a high safety profile, also have the potential for causing adverse effects in some of us--dependent on the dosage, drug interactions, co-existing medical conditions, age, genetics, activity level, gender and other factors.

If you've had questions about the side effects of statins, these four recent articles will definitely give you a better understanding of who experiences statin problems, what might cause the problems, and how to deal with them.

Many of these side effects could be easily dismissed or assumed to be related to something else.  Better to be forewarned.  According to Dr. Beatrice Golomb, the expert on adverse effects,  "physician awareness for adverse effects is reportedly low, even for those most widely reported by patients." 

What Are Drs. Beatrice Golomb, Marcella Evans, David Becker, Ram Gordon, Paul Phillips, Tisha Joy & Robert Hegele Saying About Statin Side Effects? 

 

Golomb and Evans' "Statin Adverse Effects.  A Review of the Literature and Evidence for a Mitochondrial Mechanism"

• Golomb is one of the top experts on the adverse effects of statins.  She has previously conducted a "randomized controlled trial" of persons living in San Diego, examining effects of low dose statins on thinking, mood, behavior, and quality of life.  Additionally, she runs one of the largest observational studies on adverse effects of statins--providing a database for people all over the world to self-report any side effect to statins that they have experienced.  Read more about her work at UCSD here.
  
• Her paper is the first comprehensive review of the subject, covering almost 900 studies on the adverse effects of statins.  It's an exhaustive analysis of the research, including the most highly regarded of studies, the randomized controlled trial.

1.  Top statin complaint:  Muscle pain, fatigue & weakness.  These also include rhabdomyolysis (rare but life-threatening), new difficulty walking, exercise limitations, muscle inflammation, shoulder stiffness and more.

2.  Second most common statin complaint:  Cognitive problems: memory, thinking & concentration,  problems finding the right word, experiencing "holes in one's memory".  Since most people are older when starting on statins, this is often difficult to distinguish from age-related memory loss, but Golomb says many have reported that their thinking & memory improves when they stop statins, or lower the dose.  Read "Do Statins Make You Stupid? Asks Wall Street Journal and the New York Times" for more on Golomb's research.

3. Less common statin complaints: Depression and irritability, non-muscular pain, cancer, liver problems, hemorrhagic stroke, blood glucose impairments, reduction in sleep quality, peripheral neuropathy, sexual dysfunction, male endocrine disorders, aggression, renal problems, neuro-degenerative disorders like Parkinson Disease & ALS and more.

4.  What's causing the problems?   According to Golomb, statin-induced injury to the body's "energy-producing cells"--the mitochondria, is the root cause of many of statin's adverse effects.  When the mitochondria are impaired the body produces less energy and we end up with more damaging "free radicals".  Additionally, statins lower the body's production of co-enzyme Q10, a key component in the mitochondria that is necessary to produce energy & destroy "harmful free radicals".  To make matters even worse, there is a real Catch-22:  Statins not only lower our CoQ10 levels, but they also reduce our blood cholesterol which is the way CoQ10 and other fat-soluble antioxidants are transported throughout the body.   So, not only do we end up with low CoQ10, when our cholesterol is lowered, the CoQ10 has difficulty moving through the body.
**According to Golomb, there is evidence that this mitochondrial/CoQ10 connection relates to both muscle & brain pathology.

5. Age and adverse effects.  Now throw in the fact that as we age our mitochondria (the energy powerhouses) naturally weaken, and we produce less CoQ10--adding statins to the mix may not always be wise.  According to Golomb, "The risk of adverse effects goes up as age goes up, and this (the mitochondrial/CoQ10 connection) helps explain why statins' benefits have not been found to exceed their risks in those over 70 or 75 years old, even 'for' those with heart disease." 

High blood pressure and diabetes are also linked to higher rates of mitochondrial problems--which in turn ups the risk of statin complications for people with these conditions.

"Because statins may cause more mitochondrial problems over time--and as these energy powerhouses tend to weaken with age--new adverse effects can also develop the longer a patient takes statin drugs."  The risks go up as we age, as the dosage increases, and with certain genetic conditions that put one at a greater risk for developing side effects.

Joy & Hegele's "Narrative Review: Statin-Related Myopathy"

• This is the quintessential "cookbook" article on statin myopathy.  Believe me--this gets very complicated. The authors thoroughly explain what statin-caused muscle pain is.  Who is at risk.  What causes it.  What doses, which statins & circumstances increase the chances of risk.  And most importantly, how to make muscle pain go away.
• 10% of statin users experience muscle pain, but those numbers increase with excessive physical activity (which explains why most athletes avoid statins); when the statin dose increases; the older you get; in women; those with small body frames; with grapefruit juice consumption; in those with a family history of statin myopathy; in certain genetic profiles; with hypothyroidism; and in patients taking certain drugs--just to name a few.
• Muscle pain is usually in the thighs, calves or both, but 25% experience generalized muscle pain. The myopathy is described as heaviness, stiffness, or cramping, and is sometimes associated with weakness during exercise.  25% have tendon-associated pain.
• Professional athletes with familial high cholesterol rarely tolerate statin treatment because of muscular problems.  J Clin Pharmacol 2004;57:525-8
• Strategies to combat myopathy. Switch statins, particularly to fluvastatin (Lescol); try alternate-day use of certain statins like atorvastatin (Lipitor) or rosuvastatin (Crestor) because they are longer-acting; use of older generation non-statin drugs that work by inhibiting the absorption of cholesterol in the intestine, like ezetimibe and bile-acid-binding resins; and/or supplementing with CoEnzyme Q10.

Becker and Gordon's "Red Yeast Rice for Dyslipidemia in Statin-Intolerant Patients"

• This was a small study of 62 patients who had high cholesterol but couldn't tolerate statin therapy because of muscle pain.  Half the group were given three 600 mg of red yeast rice capsules twice a day; half took three placebos twice a day.  All 62 patients participated in a life-style change program of diet & exercise.
• During the 24 week study, LDL cholesterol decreased by 43 mg/dL in the red yeast rice group after 12 weeks--then dropped to 35 mg/dL at 24 weeks because of poorer compliance. The placebo group had a 15 mg/dL drop in LDL cholesterol.  Total cholesterol also improved in the red yeast rice group.
• Muscle pain scores, HDL cholesterol levels, weight loss, and muscle and liver enzymes levels remained the same for both groups--indicating that even though the red yeast rice lowered the subjects cholesterol, it did not cause muscle pain--the point of the study.
• Study limitations:  It was too small and short-term to indicate if the observed improvements would continue.  
• Red yeast rice is a dietary supplement and not regulated.  Potencies vary and when too potent they might cause muscle pain.  Lack of consistencies between manufacturers is a major problem with this therapy.

Phillips' Editorial, "Balancing Randomized Trials With Anecdote"

• Phillips is just the right physician to comment on both the Becker/Gordon red yeast rice article and the Joy/Hegele statin-myopathy "cookbook" review.  He runs a statin myopathy clinic, which now exceeds 600 patients, at the Scripps Mercy Hospital in San Diego, CA.  He knows statin-myopathy well--what works--what doesn't.
• According to Phillips, treating statin-myopathy is more of an art--and the clinical trials don't always tell the whole story, or provide clinicians with the best therapies.   "Those of us who care for patients who cannot tolerate lipid-lowering therapy are often confronted by anecdotes that contradict the findings of well-designed trials." 
• Outside of the clinical trials, Phillips' clinic has discovered that vitamin D deficiency explains many mild cases of statin-induced aching. 
• He's also discovered that absorbable forms of CoEnzyme Q10, which may be depleted by statins, seem to help some patients with muscle pain---but most formulations sold over the counter may be inactive. I'm wondering which formulation he would recommend.
  
• Although clinical trials have convinced many physicians to switch patients with muscle pain over to ezetimibe (bile-acid-binding resins), there are many individual reports that suggest that ezetimbe might not be safe for patients who can't tolerate statins. The reason for this--many of these patients have an abnormal lipid metabolism--rendering both drugs unacceptable.
• In spite of the positive results of the Becker/Gordon study, Phillips' experience makes him reluctant to use red yeast rice to lower cholesterol & prevent muscle pain.  Why? Red yeast rice is not regulated or dose-standardized and since it contains the natural form of a lovastatin, it could have the potential for causing serious side effects.  In his clinic he "sees many patients in whom red yeast rice use has repeatedly caused recurrence of muscle toxicity symptoms, occasionally with increased creatine kinase (CPK) levels."
• The red yeast rice study only measured muscle pain.  Phillips wants to know--what about the malaise, fatigue, and weakness that he sees in his patients who use red yeast rice? 
• The FDA continues to warn against inconsistent and possibly toxic formulations of red yeast rice.  Phillips advises physicians not to prescribe it until it has been standardized and tested further.

Two other articles to check out:

Siddiqi, SA, Thompson, PD.  How do you treat patients with myalgia who take statins?  Curr Atheroscler Rep.  2009;11:9-14.

Jacobson, TA. Toward "pain-free" statin prescribing: clinical algorithm for diagnosis and management of myalgia.  Mayo Clin Proc.  2008;83:687-700.

From Becker/Gordon. Ann Intern Med 2009 June 16;150(12)858-868

Approach to Patients With a History of Statin-Associated Myalgias  (based on the Siddiqui & Jacobson articles--see full Becker/Gordon article to follow up on the references below)

1. Initiate or intensify therapeutic lifestyle changes (National Cholesterol Education Program Adult Treatment Panel III Guidelines) (18)
2. Decrease statin dose
3. Discontinue statin and rechallenge at a later date
4. Reduce dose of statin and add ezetimibe (19)
5. Use a different statin or statin-like supplement
    a. Fluvastatin, 80 mg/d (20)
    b. Rosuvastatin at a low dosage (5 or 10 mg/d) (21)
    c. Rosuvastatin once weekly (22), twice weekly (23), or every other day (24)
    d. Atorvastatin, 10–40 mg, 3 times weekly (25)
    e. Red yeast rice, 1800 mg, twice daily
6. Pulse statin therapy (16)
7. Switch class of lipid-lowering agent
    a. Use ezetimibe alone (19)
    b. Combine ezetimibe and colesevelam (26)
8. Check vitamin D levels and replenish if low (27)
9. Low-density lipoprotein cholesterol apheresis in qualified patients (16)
10. Add coenzyme Q10 (ubiquinone), 200 mg/d, to statin therapy (28)

I've never been prescribed, nor taken statins.  I know many who take them without a problem.  I know others who have experienced side effects that they never considered to be statin-related, but found they went away when they stopped taking statins.  I would always recommend discussing this with one's physician, and sharing any of these articles with them, as well.  You won't know what questions to ask, if you don't do the research.

Remember, there's always Option 2: Switch to a plant-based diet, and don't worry about side effects.

Click here and here for information on a non-drug approach to treating heart disease, cholesterol & inflammation.

Tim Kreider Gives Me a "Reprieve" From Fighting House & Yard Entropy. Finding the Sweet Spot Between Workaholic & Slacker. Or If I Want to Smell the Roses, I Better Take Care of Them

I know intellectually that all the urgent, pressing items on our mental lists — taxes, car repairs, our careers, the headlines — are so much idiot noise, and that what matters is spending time with people you love. It’s just hard to bear in mind when the hard drive crashes.

Tim Kreider, Writer, Cartoonist, Survivor of a Stabbing

I'm having another Entropy anxiety meltdown today.  Knowing that without constant effort, work & maintenance, my house & yard will naturally fall apart.  (click here for last year's Entropy meltdown) 

I've been out-of-town for 11 days, jumping straight back into work and papers are piling up, weeds are growing, roses are getting buggy, baby pictures are in need of printing, boxes in my spare bedrooms have been there for over a year and need emptying!, phone calls need to be returned, there are blog posts I want to write, my upstairs bathroom still needs remodeling, the house needs repair...and it's sunny and gorgeous outside and I just want to enjoy it!

To avoid jumping right into getting things done--which is what I should do--I start out the morning with my favorite procrastination maneuver:  browsing the New York Times on my computer.   And by some crazy magic--it appears--I spot it--my reprieve from fighting entropy.

The Reprieve, by Tim Krieder   (for the full article click here.  This is just my edited Cliffs Notes version.  To read more thoughtful happy news, be sure to check out the New York Times Happy Days Blog--The Pursuit of What Matters in Troubles Times.) 

"Fourteen years ago I was stabbed in the throat.  The point is that after my unsuccessful murder I wasn't unhappy for an entire year.

I’m not claiming I was continuously euphoric the whole time; it’s just that, during that grace period, nothing much could bother me or get me down. The sort of horrible thing that I’d always dreaded was going to happen to me had finally happened. I figured I was off the hook for a while.

I started brewing my own dandelion wine in a big Amish crock. I listened to old pop songs too stupid to name in print. And I developed a strange new laugh that’s stayed with me to this day.

I wish I could recommend this experience to everyone.

It’s one of the maddening perversities of human psychology that we only notice we’re alive when we’re reminded we’re going to die, sort of the same way some of us only appreciate our girlfriends after they’re exes.

It didn’t last, of course. You can’t feel grateful to be alive your whole life any more than you can stay passionately in love forever — or grieve forever, for that matter.

Time forces us all to betray ourselves and get back to the busywork of living in the world.

Before a year had gone by the same dumb everyday anxieties and frustrations began creeping back. I’d be disgusted to catch myself yelling in traffic, pounding on my computer, lying awake at night wondering what was going to become of me.

Once a year on my stabbiversary I remind myself that this is still my bonus life, a free round.

But now that I’m back down in the messy, tedious slog of everyday emotional life, I have to struggle to keep things in what I still insist is their true perspective.

I know intellectually that all the urgent, pressing items on our mental lists — taxes, car repairs, our careers, the headlines — are so much idiot noise, and that what matters is spending time with people you love. It’s just hard to bear in mind when the hard drive crashes.

I don’t know why we take our worst moods so much more seriously than our best ones, crediting depression with more clarity than euphoria.

It’s easy now to dismiss that year as nothing more than the same sort of shaky, hysterical high you’d experience after being clipped by a taxi.

But you could also try to think of it as a glimpse of grace.

It’s like the revelation I had when I was a kid the first time I ever flew in an airplane: when you break through the cloud cover you realize that above the passing squalls and doldrums there is a realm of eternal sunlight, so keen and brilliant you have to squint against it, a vision to hold onto and take back with you when you descend once more beneath the clouds, under the oppressive, petty jurisdiction of the local weather."

This year has been a wild ride.  I've seen my mother-in-law die of cancer.  I've seen long-time companies collapse.  I've seen bad things happen to good people.  I've seen friends and family and strangers lose jobs, houses, savings and businesses. 

But I've also welcomed my new baby grandson into the world.  And a lot of other happy wonderful things, too!  The sun still shines, the flowers are blooming, there's still raucous laughter to be shared.

I'm going to get busy on my list of onerous tasks today, and then I'm going to sit on my lawn chair in the backyard, bask in that vitamin-D-healing-sunlight, read a juicy book and take a nap! 

There will always be clouds and work.  I need to remember to take time for sun and fun while I still can.

Happy 100th Father's Day - Dads (and Granddads), You've Come A Long Way Baby!

We Never Know the Love of Our Parents for Us Till We Have Become Parents

Henry Ward Beecher

Forgive me folks!  Today's the first Father's Day for my first-born son. Kind of gives me pause.

Seeing him with his newborn son is a mix of joy & wow--being a Dad just seems to come naturally to him.  Is that really "my son?"  He's giving me advice about the proper diaper-changing-technique?

I've heard this from my friends whose sons are now Dads.  Sort of a thrilling surreal experience seeing your son become a father.

Times truly have changed.  Dads are confident full participants now--doctor visits, diaper changing, reading the child development books, doing baby laundry, whatever it takes--except for nursing.

***Oops! When I showed this to my husband he took a huge exception to my statement. 

"Hey, I did all that stuff, too!"  OK sure.  Definitely the diaper changing & laundry.  Don't remember doctor visits or seeing him reading Dr. Spock or Brazelton.  I still think it's different today.  More of an equal partnership rather than the traditional division of labor of years past.

Day One in the hospital the nurse hands the baby to my son & advises him to hold him on his chest: skin-to-skin.

"That's right!  Take your shirt off and hold him against your bare chest. Babies need that kind of bonding with their Dads, too."

I never gave it much thought until just now--reading Lisa Belkin's Father's Day Facts--but my traditional Dad from my 1950's childhood wasn't so far off the mark from today's New Age Dads. 

• He was home for us at lunch-time & after-school because he worked at home--upholstering furniture in his basement workshop.
• He gladly ironed our favorite blouses if we desperately needed one for school.
• He read to us daily--including the New York Times--and he always helped us study for school tests.
• We had no alarm clocks in our house.  Dad did the waking up duties.
• He knew what was going on with our school work.  Dioramas & costumes--he pitched right in.
• He sometimes helped out with grocery shopping and cooking--never minding a quick trip out to the store for missing ingredients.
• He was always loving and affectionate--in that 1950's Dad-kind-of-way--definitely not hugs & kisses 5 times a day like today's average dads.

From NPR's All Things Considered.  Three Books.  Good Dad, Bad Dad, and Something In Between by Stacy Saunders:

The Good Dad, Atticus Finch of "To Kill a Mockingbird"

Our good dad comes from Harper Lee's classic novel, To Kill a Mockingbird. It is 1935: The Depression is in full swing, Hitler is up to no good and in Maycomb, Ala., Scout and Jem Finch are learning the meaning of bigotry. Their father, a hardworking lawyer named Atticus Finch, is defending an innocent black man accused of raping a white woman.

When the children have to endure taunts about their father from classmates, he tells them to walk a mile in the other person's shoes. And every night, he is a comfortable chair for Scout to curl up in for a good read. Brave, wise and cozy — dads don't get any better than Atticus Finch.

When I saw Lisa Belkin's Motherlode Column this morning, I decided to share. 

Dads---You've Come A Long Way, Baby!  Happy Father's Day to All of You & Welcome Aboard to the New Ones!

---

June 19, 2009, 6:43 pm

Father’s Day Facts

By Lisa Belkin

To commemorate the 100th Father’s Day, a few measurements of Dad:

He is less interested than he used to be in staying home full-time.

CareerBuilder.com’s recent survey, which it calls “Working Dads 2009” polled 797 men with full-time jobs and children under the age of 18, and found that 31 percent “would leave their jobs if their spouse or significant other’s income could comfortably support the family.” That’s down from 37 percent from last year, and 49 percent in 2005. (The survey has a sampling error of 3.47 percent.)

Dads also say they are less willing to take a pay cut to spend more time with their children. (Thirty percent would still do so, down from 37 percent last year.) They are more likely to bring work home than they were a year ago (31 percent, up from 25 percent) and half have missed “a significant event in their child’s life in the past year due to work.”

He isn’t giving himself enough credit.

A “The State of Dad” report by the marketing firm Sullivan Higdon & Sink, which specializes in marketing to men, polled 150 fathers and 150 mothers and found that while 70 percent of the women think their partners are good fathers, only half of the men agree.

The survey (which has a sampling error of 5.7 percent) found a disconnect between what men and women see as the obstacles to being a “good” Dad. While 51 percent of men said “financial responsibilities” got in the way, only 36 percent of women gave that answer; and while 4 percent of women blamed “pop culture/media,” that answer was given by 32 percent of men.

He is more involved in his children’s education.

A survey by the National Center for Fathering and the National Parent Teacher Association, found that the percentage of Dads who bring their child to school increased 16 percent in the past ten years, while 11 percent more attend classroom events and visit their child’s classroom, and 8 percent more attend parent teacher conferences. Perhaps most striking, 20 percent more say they meet with other fathers for support.

There is still some room for improvement, though. Of the 1000 respondents, 74 percent answered “never” when asked how often they have lunch with their child at school; 54 percent never volunteer at their child’s school; and 39 percent never read to their child. (The margin of error is 3 percent.)

He is more openly affectionate than his own father was.

A Lever 2000 survey found that more than four out of five Dads who responded – 84 percent — “show more physical affection to their children than their parents did with them.” (78 percent of mothers say the same.) Fathers hug and kiss their children five times a day, on average, and more than 64 percent “admit to sneaking their sleeping kids a goodnight kiss, even at the risk of waking them up.”

The economy, the survey found is increasing family stress, but also family closeness. Of the 1018 respondents (the margin of error is 3.1 percent) 74 percent said financial worries have increased the level of anxiety in their family, but four out of five of those also say that one result is more family bonding. They report that they are now spending more time at home as a family (66%) and have learned to enjoy the simple things in life (65%), and realize that family is more important than money.

Speaking of money, we will be spending less on Dad this year.

The annual survey by the National Retail Federation found that the average being spent on Fathers Day gifts will be $90.89 this year, down from the $94.54 spent in 2008. But altogether we’ll still be spending $9.4 billion to celebrate Dad.

To anyone who is a father, would like to be a father, or ever had a father — Happy Father’s Day.

Is Your Ab Workout Hurting Your Back? Dr. Stuart McGill Advises to Trade in the Crunch for the Bird Dog, Side Bridge, & Stir the Pot

Click Here for the video if you don't see it.

Stuart McGill, a professor of spine biomechanics at the University of Waterloo in Canada, demonstrates a core exercise program emphasizing all the major muscles that support the spine.

Stuart McGill know backs.  He's one of the world's foremost authorities on the lower back, advising people with the worst back pain, as well as world-class athletes who want to improve their performance by protecting & strengthening their backs.  To hear an extensive interview with McGill click here.

If I had an unsolvable back pain problem I would want to drive up to Waterloo, Canada & consult with Dr. McGill.  When it comes to biomechanics, he knows how backs work, why they fail us, and how to fix them.

Want to strengthen your back?  Want to prevent back pain?  Want a strong core?

Ditch the traditional ab workout or crunch.  Ditch the sit-up on the exercise ball.  It's not helping.  Be careful with Pilates. 

"Is Your Ab Workout Hurting Your Back?"  by Gretchen Reynolds.  New York Times  June 17, 2009 Gretchen Reynolds  

I've never liked abdominal exercises.  They've always made my back & neck hurt--and normally my back is just fine.  I thought that the post-ab-exercise-achiness-in-my-back-and-neck just meant that my back & neck muscles were weak. That may be--but the traditional abs are bad news. Who knew?  Certainly not me! Read Reynolds article to learn more.

So What's the Problem with Sit-ups?

1. According to Dr. Stuart McGill, if you do enough sit-ups you're going to hurt your back.  Our backs only have so many bending cycles in them--everyone is different based on genetics--but our backs are like wire coat hangers.

Bend that coat hanger back & forth so many times and it's going to weaken & finally break. 

Since we only have so many bending cycles available in our backs (a sobering thought), why would anyone want to use them up with something silly like a sit-up?  And as McGill demonstrates in the video, the traditional sit-up is a great way to cause discs to bulge, herniate & impinge on nerves.  According to McGill, "If you did 100's of sit-ups, your back would break before the spine could be trained to a high level!"

2. Lab tests have shown that the traditional sit-up or crunch  "greatly reduces the load that the spine can bear without injury when subjects pull in their belly buttons", press their backs against the floor or an exercise ball, deeply hollowing out their backs.

3. Sit-ups place a "devastating load on the disks".   It's very possible to have 6-pack abs, and a ruined back.

4. The entire core--the muscles & connective tissue surrounding and holding the spine in place--must be strengthened and balanced.  To concentrate solely on the abs destabilizes the spine, pulling it out of alignment.  If the core is strong & stable, the spine remains upright & it can bear heavy loads while the body swivels around it.

There is a better way.  Watch McGill's video & in 2 minutes you'll have the basics with four easy-to-do exercises you can do daily.  They strengthen and stabilize the core, exercising the "important muscles embedded along the back and sides of the core."

1.  A safe effective modified lumbar supported abdominal curl.

2.  Stir-the-pot.  A plank-like exercise done on an exercise ball for strength & stability.

3.  Side bridge

4.  Bird Dog - with 3 ways to increase the challenge.
 

I literally brought my laptop down to the floor to make sure I got these exercises right--and watched them about 5 times until I understood the correct form.  They're easy...but the Bird Dog variations took a while for me to coordinate.  I'm a slow learner!  I definitely plan on incorporating these quick exercises into my daily routine.

McGill's Opinion About Pilates

Gretchen Reynolds asked Dr. Stuart McGill to talk a bit more about Pilates and core workouts.

He said, “Pilates is fine for some people and very troublesome for others. It’s important that each person get an expert assessment to determine who fits in each category, the specific types of Pilates that would be best, the set and rep design to the intervals, etc.”

From the Times of London. "Do Back Exercises Work?"  April 11, 2009  Read the article here.

Core-stability exercise is endorsed by everyone from celebrities to physical therapists, so there has never been cause to question its wisdom. But the beginnings of a backlash have started to appear.

A paper published recently (click here  Br J Sports Med 42:930-31, 2008. Allison & Morris) in the British Journal of Sports Medicine suggests that the benefits of core-stability workouts (that concentrate solely on the transverse abdominals) have been wildly overplayed.  The evidence is just not there.

They cast doubt on the notion that back pain is linked to "less than optimal core stability" and suggest that it is linked to poor trunk rotation and strength instead.

If you hollow in your muscles--as in bringing your navel to your spine--you bring the muscles much closer to the spine and you effectively reduce the stability of the back.

When you lift something or exercise, rather than pulling in from the navel to spine you should brace all the abdominal muscles.  Bracing is stiffening the abdominal wall. Imagine that you are going to be hit in the stomach.  The instinctive reaction is "bracing".

Read more about Dr. Stuart McGill & his work on backs:

McGill's website

A back support to use if you sit long hours at work. Sitting long hours is a key reason for lower back pain.  "Why Sitting In A Chair Hurts Your Back. What You Can Do To Prevent Back Pain" 

British Journal of Sports Medicine 42:930-931, 2008  Transversus abdominis and core stability: has the pendulum swung?  Allison, G.T., Morris, S.L.

***Just came across Dr. Thomas Kerr's post .  Kerr is a chiropractor and a big fan of McGill's work.  He does an excellent job of explaining why a sit-up or crunch is bad news.  It's always good to hear the same thing said in a different way.

The Gorgeous Grandson Arrived on June 5, 2009. The Healthy Librarian Has Been on Happy Grandma Leave!

 

You know how you fall madly head-over-heels-in-love with your kids when they're babies and you can't take your eyes off of them?  Ditto for grandbabies.

The moment I walked into the hospital to meet my new grandson my daughter-in-law generously asked,

"Would you like to hold him?" 

"Oh my, YES!"

I marveled at her generosity, and spent the next 11 days of "Grandma Leave" just staring and cuddling and singing to this beautiful 7 pound 6 ounce bundle-of-wonder who mostly slept, ate, peed & pooped.  The world's smartest, best baby, ever! 

Yes, it's really possible to spend an entire day doing nothing more than staring at a newborn baby.  And shopping and cooking for the new mom & dad.

Who knew that all of this behavior was genetically programmed--part of our evolutionary inheritance?  Grandparents are programmed to be nearby new grandchildren--which explains why it is now so difficult to be 500 miles away.

All of this crazy behavior was made perfectly understandable to me when I read:  Cute, Cooing Babies: The Key to Understanding Social Behavior?  by Natalie Angier, in the New York Times, March 4, 2009.

It's  a fascinating synopsis of Dr. Sarah Blaffer Hrdy's new book, "Mothers and Others: The Evolutionary Origins of Mutual Understanding".  Babies are at the heart of what it means to be human! 

"The extraordinary social skills of an infant are at the heart of what makes us human."

"Through its ability to solicit and secure the attentive care not just of its mother but of many others in its sensory purview, a baby promotes many of the behaviors and emotions that we prize in ourselves and that often distinguish us from other animals, including a willingness to share, to cooperate with strangers, to relax one's guard, uncurl one's lip and widen one's pronoun circle beyond the stifling confines of me, myself and mine."

"Human beings evolved as cooperative breeders, says Hrdy, a reproductive strategy in which mothers are assisted by as-if mothers, or "allomothers," individuals of either sex who help care for and feed the young."

"Our capacity to cooperate in groups, to empathize with others and to wonder what others are thinking and feeling - all these traits, Hrdy argues, probably arose in response to the selective pressures of being in a cooperatively breeding social group, and the need to trust and rely on others and be deemed trustworthy and reliable in turn."

"Babies became adorable and keen to make connections with every passing adult gaze. Mothers became willing to play pass the baby."

"By contrast, (to apes or chimpanzees) human mothers in virtually every culture studied allow others to hold their babies from birth onward, to a greater or lesser extent depending on tradition."

"Instead, it seems that young mothers in many traditional societies have their own mothers (and mothers-in-law) and other female relatives close at hand, and who better to trust with baby care than your mom or your aunt?"  (Which explains perfectly why this "not-so-fond-of-driving-long-distances-and-definitely-not-in-big-unfamiliar-cities" grandma didn't think twice about driving over 500 miles by herself & then daily back & forth into New York City just to be with her new grandson!) My "Stretching in St. Louis" driving experience last summer has paid off in spades!

"New studies have also shown the importance of postmenopausal women to gathering roots and tubers, the sort of unsexy foods that just may help feed the kids in hard times."  (That would be me, gathering "tubers" at Trader Joe's, Costco & the A & P, and cooking them up over the "campfire" in the Bronx.)

"Other anthropologists have made the startling discovery that children have entertainment value, and that among traditional cultures without television or Internet access, a bobble-headed baby is the best show in town."  (Which is exactly what we did.  Who needs internet, newspapers or TV when there's a baby in the house?)

Stay tuned, for a follow-up Q & A with the new parents (if I can convince them) about their experiences giving birth in a home-like birthing room with a midwife and doula.  Read: It's Official Baby Watch Time! Ricki Lake & Abby Epstein's "Business of Being Born" and "Your Best Birth", for an explanation.

And "it takes a village to raise a grandma"!  Huge thanks and hugs and kisses to my wonderful NY friends (B & B) who went above & beyond with their gracious hospitality--providing room & board & directions & support & shuttle service; to my husband, my son(s), my daughter-in-law, my sis, my sis-in-law, the in-law-grandparents, my friends, my co-workers, my relatives, my kids' friends, their colleagues & their community, and Katie for her amazing Friday night dinner.  Thanks for sharing the joy!

The Most Unlikely Book Club to Love Kevin Roose's "Unlikely Disciple: A Sinner's Semester at America's Holiest University"

"When I got to Liberty for the first day of orientation week, I expected to be completely unhappy, mostly because Liberty's 46-page code of conduct – which prohibits drinking, smoking, R-rated movies, cursing, and dancing – wiped out basically 95% of my daily life. After I got used to the rules, though, I actually found that the rigid discipline was actually sort of refreshing. It gave me an incredible amount of structure in my life, and I felt happy and productive there."

Kevin Roose, author of "Unlikey Disciple: A Sinner's Semester at America's Holiest University"

Here's the pitch

Roose grew up in Oberlin, Ohio, "the product of the ultimate, secular, liberal upbringing", with next to no contact with conservative Christian culture.  He was raised a Quaker & rarely went to church. He's smart, savvy, liberal & open-minded. His parents even worked for Ralph Nader in their twenties.  He goes to ultra-liberal free-spirited Ivy League Brown University--the polar opposite of a school like Liberty University. 

No semester study-abroad in Italy or Prague for Roose.  He decides to really broaden his cultural education.  He enrolls for a semester at Jerry Falwell's evangelical Christian Liberty University in Lynchberg, Virginia--"a bastion of Christian purity--sort of the anti-animal house."

This is a self-described "Bible Boot Camp" for evangelicals--Falwell's training ground for the next generation of America's Religious Right.   

Most parents are nervous about sending their college-age kids off to a foreign country--Kevin's parents were scared to death to send Kevin off to Liberty University, fearing some sort of subtle conversion.

His semester turns out to be nothing like he expected. 

With a course load that included Old Testament, New Testament, Evangelism 101, and The History of Life--Liberty's Creation Biology, he had to work hard to get even mediocre grades.

It Was My Turn To Select a Book for Book Club

It was April 15th, and our book club was meeting on May 30th. It was our turn to come up with the next book & my husband & I had finally settled on 2 possible books for the group. 

I was about to send out the email for a vote when I read Gretchen Rubin's interview with Kevin Roose on her blog and my email suddenly changed.  This book sounded terrific.  I quickly added "Unlikely Disciple" to my list of book choices for the group and within hours everyone agreed that they wanted to read Kevin's book.

So Why Would This Book Club Be Unlikely Fans of "Unlikely Disciple"?

Because this book club--made up of couples in their 40s & 50s--are practically like Kevin's parents--remember, they were not too happy about his transfer to Liberty U.

Our book club has been meeting for almost 17 years.  Half of the group are doctors, who value science, and don't exactly understand the teaching of creationist biology in a university.  None of us are Christian, and our politics wouldn't be described as staunchly conservative--for the majority of us, that is.

WE UNANIMOUSLY LOVED THIS BOOK!!!  In the almost 17 years we've been meeting this is only the 2nd book that everyone has loved, hands down.  The other one was:  The Last Town on Earth by Thomas Mullen. The other-almost-favorite was Captain Corelli's Mandolin, written by Louis de Bernieres.

Why We Loved the "Unlikely Disciple"

1. It's wise, funny, compassionate, balanced, hopeful, well-written and entertaining. There's nothing snarky, mean-spirited, cynical or condescending about it--which is a welcome relief.

2. Kevin experiences everything at Liberty: a spring-break evangelical mission to Daytona Beach; one-on-one spiritual counseling with Pastor Seth; dating the old-fashioned way; singing in the famous Thomas Road Church choir; participating in a self-help group that helps student's dial-down their sexual thoughts; and good old-fashioned single-sex dorm camaraderie.

3.  As strict as the rules are at Liberty, on balance, there's a lot to recommend it--and it mostly works.  The students are engaged, healthy, and happy--especially compared to those at many secular colleges.

4.  The book has a lot to say about the danger of stereotyping individuals by their group affiliation--and the value of getting to know people before making judgments.  The students Kevin met were nothing like his preconceived notions--and the same could be said for Jerry Falwell.  Get to know people, and opinions change.

5.  We all got a kick out of Kevin's amazement at how easy it was to awaken in the morning--clear-headed & full of energy--with the help of an enforced curfew and rules barring alcohol.  And he even lost weight minus the alcohol.

Some of My Favorite Quotes

Kevin on Pastor Seth, his spiritual advisor:

"It comes back, I guess, to the difference between the form and content of Liberty's religious system.  I love the way Pastor Seth's faith motivates him to help me in my struggles.  I admire his compassion and selflessness.  I just wish he were calling to see whether I was returning my mom's phone calls, or whether I had left good tips at restaurants, or whether I had been nice to everyone I met today.  Working on masturbation when I have so many other flaws seems like putting fuzzy dice in a car whose transmission is falling apart.  I suppose it's better than nothing, but it doesn't feel like a particularly good use of anyone's time."

On learning the value of prayer--something Kevin has continued to practice since returning to Brown:

"Prayer may not always be entirely about G-d," Pastor Seth said. 
Here, Pastor Seth quoted the famous Christian author Oswald Chambers, who wrote: "It is not so true that prayer changes things as that prayer changes me and I change things."

From his interview with Gretchen Rubin:

"When I was living at Liberty, I had to learn how to pray.  I'm back at secular college now, but I still pray almost every day. Don't get me wrong:   I'm not an evangelical Christian, and I don't believe that G-d sits on his throne in heaven watching our requests flood into his cosmic inbox.  But I do think there's value in focusing on the needs of my friends and family members, trying to empathize with them for ten or twenty minutes a day.  It forces me to be aware of how lucky I am, and I really do think it motivates me to be more compassionate."

On trying to make sense of why certain moral values get higher priority than others at Liberty:

"(I feel) frustration with a religious system that gives issues of personal sexuality higher spiritual priority than helping the poor or living a life of service."

My favorite comment on the NPR story about Kevin:

"Through the whole piece I got the sense that NPR was surprised Mr. Roose found the folks at Liberty likable and even non-judgmental. When I was his age, in college, lol many years ago, I was religious but suspicious of Baptists, Pentecostals and other evangelicals. I volunteered in a Model City neighborhood teaching math skills. The people I kept running into were from evangelical Christian churches. They took very seriously the admonition to care for all God's children. Going back to the dorm where drunks were vomiting or passed out from binge drinking, I wondered which was a better way to live. I never became an Evangelical due to differences on dogma, but there saner, sober life of service seemed more rational (and safe).

Finally, there have been a rash of deaths in MN due to alcohol toxicity or impairment. Where would you want you kid to go to school. A place where, while conservative, was safe or a place that your kid lived a risky life due to the binge drinking?"  Bill Rowe   Sun May 31 09:5615 2009

If you are looking for a book for your book club that has something discussable--this is it!!  There's religion, the appeal of the group religious experience, sexual attitudes, morals, politics, humor, ethics, friendship, deception, as well as what constitutes a well-rounded university education.

We all agreed that this book was just plain good fun to read--all of us looked forward to reading it--and we all really liked Kevin Roose.  What could be better?

To Read More:

Gretchen Rubin's interview with Kevin Roose

NPR's Excerpt from the "Unlikely Disciple"

NPR's segment, "Undercover at an Evangelical University"