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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 »

Book Review: “Why We Get Fat: And What To Do About It”

Journalist Gary Taubes created a stir in 2007 with his impressive but daunting 640-page tome Good Calories, Bad Calories. Now he has written a shorter, more accessible book Why We Get Fat: And What to Do About It to take his message to a wider audience. His basic thesis is that:

- The calories-in/calories-out model is wrong.

- Carbohydrates are the cause of obesity and are also important causes of heart disease, type 2 diabetes, cancer, Alzheimer’s, and most of the so-called diseases of civilization.

- A low-fat diet is not healthy.

- A low-carb diet is essential both for weight loss and for health.

- Dieters can satisfy their hunger pangs and eat as much as they want and still lose weight as long as they restrict carbohydrates.

He supports his thesis with data from the scientific literature and with persuasive theoretical arguments about insulin, blood sugar levels, glycemic index, insulin resistance, fat storage, inflammation, the metabolic syndrome, and other details of metabolism. Many readers will come away convinced that all we need to do to eliminate obesity, heart disease and many other diseases is to get people to limit carbohydrates in their diet. I’m not convinced, because I can see some flaws in his reasoning. Read more »

*This blog post was originally published at Science-Based Medicine*

The Obesity Crisis: How It’s Like The Mortgage Crisis

Q. What’s the difference between a public health expert and an incompetent doctor?
A. An incompetent doctor tends to kill only one person at a time.

The deep recession and jobless “recovery” which we have enjoyed in the U.S. for going on three years now was triggered by the bursting of the housing bubble. The housing bubble was created by lending practices that awarded “subprime” mortgages to people with bad credit ratings, and offered to people with good credit ratings adjustable-rate mortgages (ARMs) that enticed them to purchase more expensive homes than they could afford.

Traditionally, banks were always reluctant to award mortgages, of any flavor, to people who obviously could not afford them, since doing so would wreck their businesses. The reason the banks began making bad loans in the 1990s is that new government policies, chiefly the Community Reinvestment Act, strongly “encouraged” them to.

The banks, being businesses, reacted logically to the new regulatory climate, to threats by ACORN and other activist groups, and to the escape hatch opened for them by the government which allowed them to turn over their toxic mortgages immediately to Fanny and Freddie. Banks quickly began turning out as many questionable mortgages as they could write, to as many uncreditworthy individuals as they could find. Read more »

*This blog post was originally published at The Covert Rationing Blog*

The Twinkie Diet

“Hey…where did those cupcakes go?”

Like a never-ending western North Carolina climb where each switchback reveals another uphill, and the finish is shielded by tall pines, the struggle to lose weight and to stay lean is incessant.

In wrestling weight gain, competitive cyclists share the same mat as “regular” Americans. Like jockeys, all competitive bike racers strive for maximal leanness. It’s physics: Weigh less and the same number of watts push you farther and faster, especially when going uphill or accelerating from a slow speed. Remember those velocity problems in Physics 101?

But is it conceivable that losing weight — even if accompanied by lower cholesterol levels — could be detrimental to long-term wellness? Obviously, the question answers itself.

Unless your Internet connection has been interrupted in the last few days, you have probably heard of the “Twinkle diet.” Kansas State University nutrition professor Mark Haub tested the hypothesis that if he reduced his daily calorie consumption from 2600 to 1800 he would lose weight. Read more »

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

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*

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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