Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

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 »

4 Super-Healthy Foods

Healthy shoppingRaise your hand if you want to eat healthy.

Healthy eating isn’t just good for cinching your waistline — it’s great for overall health.

From glowing skin, to heart health, to maintaining healthy teeth and bones; eating foods packed with certain nutrients can also protect your immune system and fight infections.  It can boost your libido and decrease that lousy (LDL) cholesterol and boost your good (HDL) cholesterol.

Healthy eating shouldn’t be a struggle. It’s easy to get sucked into the marketing trap when you’re food shopping and you encounter all those in-store specials. Sometimes, those specials are just bad for your health. Read more »

*This blog post was originally published at Health in 30*

Perverted Economics: Eating Healthy Is Too Expensive

I watched a good documentary called “Food, Inc.” It was nominated for an Academy Award. The promo says “you’ll never look at dinner the same way” and they’re right. Since I’m a fan of Michael Pollan and have read “Fast Food Nation,” I was already a healthy-food fan, but seeing how agriculture and farming has changed over the last 40 years was still a shocker.

There’s no doubt that high-calorie, sugar-laden processed foods are contributing to serious health issues in America. And 10 billion animals are raised on factory farms under inhumane conditions.

So when I went to the grocery store today, I made a conscious choice to ask if Safeway had any grass-fed beef for a healthy stir fry I was making for dinner. The answer was “No,” so I journeyed over to Whole Foods where I bought a pound of grass-fed sirloin. The cost was a whopping $16.43.

I have to ask myself why grass-fed beef should be so much more expensive than corn-fed beef. There’s no way the average family could afford to eat the way we should. The impact on our environment and our health is suffering terribly because of these perverted economics.

*This blog post was originally published at EverythingHealth*

America Boycotts Personal Responsibility

How expected. The CEO of whole foods says that government is not the solution to out of control health care expenditures. He says we are. The American people are responsible for out of control health care expenditures. He preaches a life of personal responsibility, of personal choice and actions that lead to health. And what does he get for it?

A boycott. From the article is this commentary:

Pragmatists on all sides of the health care question (and probably every political question) believe that, on the whole, human nature does not change, and we’ve got to fight or not fight the health care war with the citizenry we’ve got, not the one we wish we had. Utopians like Mackey, on the other hand, believe that public-policy debates are only a middle step in the real solution to our problems, which is to change human nature. The solution to our health care woes, Mackey seems to believe, is for all of us to become like him—hyper-rational in evaluating our options, hyper-responsible in following through on them, and devoted to healthy living (that plant-based diet!).

Yes, that is actually the solution, to become more hyper-rational in evaluating our options, hyper-responsible in following through on them, and devoted to healthy living. The fact that this commentator makes a mockery of personal responsibility, instead choosing to support couch potato, Chetoo eating, Oprah watching smokers with for all their health care needs because, well, that’s just what humans do, is pathetic.
If you want someone else to pay for your health care, be prepared to play by their rules. And the rules have to change. Or there won’t be any money for anyone. Ninety-nine trillion dollars says so. Making humans entitled to the side effects of bad habits because that’s just what humans do is a race to the bottom mentality. It’s at the core of the finance quandary. Encourage bad habits by paying for them, and you get bad habits. Nobody can sustain that model of third party financing.
Would you insure a house who’s participants stated up front they would burn it down? Would you insure a car from a driver who said he would intentionally drive it into a brick wall? If not, why would you buy insurance for people who intentionally did things we know destroys them?
The CEO of Whole Foods should be hoisted onto the podium next to Obama for all the world to applaud. Obama should declare a God given right to live healthy (and he should quit smoking for good) and a God given right to pay more for your insurance if you don’t. It’s about personal responsibility. It’s not about handing you a plate of free insurance and saying go smoke ‘em if you got ‘em.

*This blog post was originally published at A Happy Hospitalist*

Is “Plan” A Four-Letter Word When It Comes To Healthcare Reform

On Saturday, posted an article about President Obama’s most recent town hall meetings and closed with the following paragraph: Obama is yet to reveal a detailed plan, but promises to expand coverage, control spiraling healthcare costs, rein in insurance companies and prioritize preventative care.”

I’ve been looking for an actual plan since Health Care Reform was seriously proposed. In July, Rahm Emanuel, Obama’s Chief of Staff, was quoted in the Washington Post, stating that the Administration had decided against having an actual plan for Reform since it would expose the administration to criticism. Yet, I remained optimistic about Reform, and relished the chance to debate the facts as our Nation turned its focus upon a topic I have long been passionate about.

Unfortunately, my optimism waned as an honest and forthright debate about how to implement Reform has become ever-elusive. Disappointed in the turns this debate has taken on its journey through our national consciousness, I am leery of the simplistic viewpoint portrayed so often… “You are with Obama or against him” …. “You’re a Republican or a Democrat” … “You are for Reform or against it …”

Determined to find Obama’s plan, I began my search by reading his speech to the AMA, surfing the White House website, watching his ABC infomercial all the way through Nightline, and observing a number of town hall meetings. I went on to plaster the walls of my home office, to the amusement of my wife, with everything the President had said, color-coded on poster boards.

By July, as I looked around my office I realized that I was surrounded, not by a plan, but by a group of wishes, beliefs, hopes and ideals. I love the way it sounds when I say “prioritize preventative care” and I long for a day when the $100 million salaries of insurance company CEOs has been “reined in.” However, I am not naïve enough to expect this to happen without a coherent plan.

I used to believe the White House would propose a bona-fide plan. Instead they are implementing a strategy that combines the president’s rhetoric with the defensive tactic of refuting critics of Congressional plans or the President’s zeal.

Even after the House passed their Reform bill (the first actual HC plan to come out of Washington), I can’t make myself take down all of those poster boards leaving me surrounded by inspiring and hypnotizing ideals. Yet I fail to see how the House bill will transform these beautiful ideals into reality as it creates multiple new government agencies and burdens doctors’ offices with more clerical responsibilities — new for the busy doctors of tomorrow: the physician quality reporting initiative, cultural and linguistic competence training, financial disclosure reports between providers and suppliers, and national priorities for performance improvement.

John Mackey, CEO of the Fortune 500 company Whole Foods, wrote an op-ed piece about HC reform for the August 11 Wall Street Journal. His editorial includes understandable plans, worthy of intelligent debate while being based in large part on the health care benefits Whole Foods currently has in place for 36,000 of its employees, and includes the following recommendations:

1. Promote high-deductible health insurance plans and HSAs by removing legal obstacles.

2. Equalize the tax laws so those buying individual insurance can enjoy the exact same tax break employer related insurance customers receive.

3. Encourage competition by allowing insurance companies to compete across state lines.

4. Enact tort reform since insurance costs, frequently over $100,000 per doctor, are passed back to all of us in the form of higher prices for health care.

5. Make costs transparent so we can all understand what health care treatments cost.

6. Enact Medicare Reform.

7. Whatever reforms are enacted it is essential that they be financially responsible.

Three days later, instead of arguing the merits or demerits of Mackey’s plan, an ABC News story focused on the controversy his editorial had stirred up after briefly touching on some of his ideas. Spcifically, the ABC story focused on the boycott by many of his customers with one expressing the following belief, “I think a CEO should take care that if he speaks about politics, that his beliefs reflect at least the majority of his clients.” Another described Mr. Mackey’s position as a slap in the face to millions of progressive-minded consumers. The author quoted four customers pledging to not buy their food at Whole Foods anymore and added them to the implied masses gathering on Twitter and Facebook.

Fortunately, one customer, Frank Federer, was quoted as saying, “At a time when most folks are more inclined toward rancor than discussion of facts, I applaud John Mackey.”

So do I.

A realistic map showing us how to get from point A to point B is missing in the Health Care Reform debate. Facts are one thing in short supply to plot a course on this map. While the main ingredient in the fertilizer used to grow Whole Foods produce is in abundance, there’s just not enough for some of Mr. Mackey’s customers.

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…

Read more »

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…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

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…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »