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A Food-Culture Change Is Upon Us

As a pediatric endocrinologist, I am on the frontline of the childhood obesity epidemic. In fact, I am now seeing 100-pound two year olds and 150-pound three-year-old kids in my clinic and I am concerned. The obesity epidemic is perpetuated by a processed food-culture that lacks healthier local whole foods. 
Diets dominated by processed foods (refined carbohydrates with high fat- and/or high-sugar content and artificial ingredients) over whole foods (fruits, vegetables, whole grains) spur more obesity and diabetes, and have even been shown to negatively change gene expression of the offspring during pregnancy. All-processed ingredients reflect the balance of desirable factors in the modern way of life such as shelf life (long), taste (sweet), texture (fat) convenience (high), and price (low) — all profitable, all less nutritious, and all with a mass-marketed, generic, “cultureless” appeal that reduces emphasis on local cultures and flavors.

The recent rise of social networking is testament to the fact that people are hungry to connect and yearn to be culturally inspired. Culture (art, food, music) deeply connects people and transcends time, politics, and poverty because it is the language of being human — and something that never changes. Medical research as well as the positive embracing of First Lady’s “Let’s Move” campaign demonstrates an open mind to the idea of a healthier culture and readiness for change. In fact, many of the families that I meet in my clinic are interested in considering whole-food choices, but lack knowledge and guidance.

Food-culture change offers the best hope for transforming obesity and what Americans eat. Oprah’s recent vegan-whole-food-challenge show on February 1st is a step in the right direction and will help to propel the emerging whole-foods movement. Columbus, Ohio is emerging as a center for local whole-foods activism and food-culture change. Just in 2010, the Mid-Ohio Regional Planning Commission released the Central Ohio Local Food Assessment and Plan — the first plan of its kind in the nation — and received an $885 million US. Department of Housing and Urban Development (HUD) grant to create an urban foodscape in one of Columbus’ most blighted neighborhoods. Read more »

Big Breakfast, Big Calories: Rethink Your Morning “Fuel Up”

Haven’t we all learned that breakfast should be our biggest meal? ”Start the day with ‘fuel’ and you can burn it off as the day goes on.” “Eat a big breakfast and you’ll eat fewer calories all day long.”

This advice is probably not true, and in fact a new study published in the January 17th issue Nutrition Journal shows that people ate the same at lunch and dinner regardless of what they had at breakfast. If a person ate 1,000 calories at breakfast (which is easy to do with bacon, eggs, toast, hashbrowns, and juice), he or she had a total increase in calories eaten throughout the day by 1,000 calories.

This doesn’t mean we should be skipping breakfast. The problem may be what we historically think of as an “American” breakfast. It might have worked for the farmer in the past or the laborer hauling lumber, but it’s just too many calories for our current level of activity. Read more »

*This blog post was originally published at EverythingHealth*

Know Thy Calories: Nutrition Labeling Guidelines For Restaurants

As part of the new healthcare legislation (Affordable Care Act), the FDA has now published its guidelines for restaurants to inform consumers of the calorie counts of food. It establishes requirements for nutrition labeling of standard menu items for chain restaurants and chain vending machine operators.

This is important because Americans now consume an estimated one-third of their total calories from foods prepared outside the home. Consumers are generally unaware of the number of calories they consume from these foods, and being overweight or obese increases the risk of a number of diseases including heart disease, type 2 diabetes, stroke, and cancer.

Here’s what the guidelines say:

– Restaurants with 20 or more locations must disclose the number of calories in each standard menu item on menus and menu boards (have 19 chain locations? You get a pass. Daily specials also get a pass.)

– Additional written nutrition information must be available to consumers upon request (total fat, saturated fat, cholesterol, sodium sugars, carbs, fiber, protein, etc.)

– The menu must say that the additional nutritional information is available. Read more »

*This blog post was originally published at EverythingHealth*

Doctors Blaming McDonald’s For Heart Disease?

McDonald'sI’m trying to get off the topic of fatness, but just when it seems right to move on to something less hopeless, we hear that even doctors can be felled by obesity’s resilience.

To the Physicians Committee for Responsible Medicine, a group of well-meaning doctors who are buying expensive TV ads blaming McDonald’s for heart disease, I have just 5 words: McDonald’s is not the problem! Gosh. It’s maddening to think that such smart people could be that misguided — a whole committee of doctors completely devoid of any master-of-the-obvious is hard to fathom.

Don’t misunderstand — I’m not advocating McDonald’s food as overly nutritional, but blaming MacD’s for our obesity epidemic is like blaming guns for violence (for the record, guns scare me), brew pubs for alcoholism, or religion for war. (Sorry, that last one is a bad example.) Read more »

*This blog post was originally published at Dr John M*

A Multi-Prong Attack On Fatness

If I was Surgeon General, I would follow the lead of our country’s first Mom, Michelle Obama. This is serious folks. We as an American society need to solve the obesity crisis, not just for our physical health, but for our country’s financial stability.

Reducing the spiraling costs of healthcare is wanted by all. So far, prevention of the diseases which contribute most to our healthcare costs, (heart disease, cancer and orthopedic issues, to name just a few) has been given only lip service, by our future supplier of healthcare — the American government.

It turns out that the mechanisms to reduce our most costly ailments are the same as those that mitigate obesity. It is like simple math. (If a=b, and b=c, than a=c.)  If lifestyle choices reduce obesity, and less obesity means less consumption of healthcare for heart disease and cancer, than better lifestyle choices means less healthcare consumption. Bunches less. (See, simple math was not so useless.) It is for this reason that I believe the most productive way to reduce health care expenditures is to reduce obesity. Read more »

*This blog post was originally published at Dr John M*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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