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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 »

Learning Lessons From Patients: Attitude Is Everything

When I was in the 8th grade and honored at the “A” team honor roll breakfast, the speech was one that I never forgot: “Attitude is Everything.” Essentially, having a good education and good grades give you the tools to be successful, but having a great attitude toward any challenges ASSURES that you will arrive at that success.

Being a pediatrician AND an endocrinologist, I am blessed to work with many graceful children and their families who face medical endocrine challenges with great attitudes.  I can recall numerous examples but will share one of my favorites: A now 11-year-old vibrant female with hashimotos thyroiditis who was diagnosed at 5 years old. Initially, she required frequent lab checks for medication adjustment (~5-6) which then decreased to ~2-3 annually thereafter for further medication dosing adjustments of synthroid replacement as she outgrew prior lower doses.

Her attitude towards her lab draws has always stuck with me because surprisingly she actually looked forward to them AND to her endo visits! She and her mother would always go out to eat and spend special quality time together whenever she had to have a lab draw. They would always choose Mexican food for these special outings, and in fact would limit all Mexican food intake, making it that much more special. Read more »

Why Is Healthcare Reform So Complicated?

A common question that I get as a practicing physician with a public health background is: “Why is healthcare reform so complicated?” I feel that the question of who’s responsible for healthcare payment is not always an easy one to answer. An example from my most recent weekend on call covering an academic pediatric endocrinology practice demonstrates this point:

“Bill” is a 16-year-old African American male on state Medicaid insurance with type 1 diabetes since the age of 10.  He is followed regularly every three months by another colleague in the endocrinology clinic. Review of his last several clinic notes on the electronic medical record reveal that he has been in moderate control of his diabetes on NPH/Novolog twice-daily insulin regimen. Approximately one year prior he was changed to this insulin regimen due to concerns with missed insulin shots on another insulin regimen that provided superior control but which required four shots of insulin daily rather than the two shots daily on his current regimen. Read more »

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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