February 2nd, 2011 by Jennifer Shine Dyer, M.D. in Health Tips, Opinion
Tags: America's Food Culture, American Diet, Childhood Obesity, Children's Diets, Children's Health Services, Diabetes Epidemic, Dietetics, Dr. Jennifer Shine Dyer, Fatness, Food and Nutrition, Food-Culture Change, Healthy Diet For Kids, How Americans Eat, Local Foods, Obesity Epidemic, Overweight, Pediatric Endocrinology, Processed Foods, Whole Foods
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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 »
February 2nd, 2011 by Edwin Leap, M.D. in Better Health Network, Opinion
Tags: Compromising Patient Care, Doctors On Call, Dr. Edwin Leap, Emergency Medicine, From Hospital To Office, Future of Medical Practice, Healthcare Politics, Healthcare reform, Hospitalist Medicine, Lack of Medical Staff, Medical Office, New U.S. Healthcare System, Public Health, Telemedicine, The Future of American Healthcare, When Doctors Leave Hospitals Behind
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My partners and I have long struggled with the lack of specialty back-up at our hospital. Semi-rural hospitals, out of the way facilities, just can’t always attract specialists. So, we’re happy to have cardiologists every night, but understand that we only have an ENT every third night. We’re thankful to have neurologists, even if they don’t admit anyone. We’re glad to have radiologists, even if they don’t read plain films after 5PM on weekdays.
Still, I continue to scratch my head about why only three of seven community pediatricians take call, such that family physicians have to admit their patients. I was bumfuzzled that our neurologists were previously going to require us to use telemedicine for stroke evaluation when their offices were close by the hospital. (In the same year they were called in roughly three times per neurologist for urgent stroke evaluation.) That problem was resolved, thank goodness.
Now, I find that the problem has returned and grown. We will, very soon, have no ophthalmologist on call, despite the fact that we have three in the community and that they are contacted with remarkable rarity to deal with on-call emergencies. Soon, we will have no neurologist on the weekend. And the pediatric problem remains.
Of course, I’m using my local experience to highlight something that isn’t a local problem at all. It’s a national problem. All over America, specialists are relinquishing their hospital priveleges and staying in the office. Proceduralists are opening surgery centers that are free from the burdens of indigent care. Primary care physicians are allowing hospitalists to do all of their admissions.
In the process, not only are patients losing out, but referral centers are being absolutely overwhelmed. The cities and counties that lie around teaching hospitals are sending steady streams of patients, since they have fewer and fewer specialists. Those referral and teaching centers want patients, but they can’t take all of the non-paying patients, all of the complicated, or even all of the mundane patients with no local coverage. Those facilities, for all their shiny billboards and “center of excellence” marketing, will collapse. Read more »
*This blog post was originally published at edwinleap.com*
February 2nd, 2011 by Harriet Hall, M.D. in Book Reviews, Opinion
Tags: Caloric Intake, Cardiovascular Disease, Dr. Harriett Hall, Fatness, Food and Nutrition, Gary Taubes, Low Carb Diets, Low Fat Diets, Metabolism, Obesity, Overweight, SBM, Science Based Medicine, Weight Loss Diets, Why We Get Fat
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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*
February 1st, 2011 by DavedeBronkart in Better Health Network, Opinion
Tags: Apple, At the Time of Diagnosis, Dave deBronkart, e-Delivery of Test Results, E-Patient, e-Patient Dave, e-Patients.net, Electronic Medical Records, EMR Revolution, Healthcare and Internet Technology, Medical Technology, Society of Participatory Medicine, Steve Jobs, Technology and Medicine
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I have a Google alert for “e-patient,” and sometimes I’m surprised what it catches. [Recently] it was this:
3 Reasons Steve Jobs Will Be The Ultimate e-Patient
Steve Jobs’ medical leave sets the stage for the upcoming revolution in the production and delivery of medical information at time of diagnosis. 3 things you need to know.
So I’m thinking: “Oh, wow: Is the term ‘e-patient’ going mainstream?” That would be a hoot, because indeed the Society for Participatory Medicine is engaged in spreading the word.
*This blog post was originally published at e-Patients.net*
February 1st, 2011 by John Mandrola, M.D. in Health Tips, Opinion
Tags: Agedness, Aging Doctors, Doctors and Aging, Doctors' Sweet Spot, Dr. John Mandrola, General Medicine, Medical Certification, Medical Competence, Medical Recertification, Older Doctors, Older Physician, Physician Incompetencies, Physicians Over Age 65, Practicing Medicine At An Older Age, Quality of Doctoring, Quality of Patient Care, The New York Times, Too Old To Practice Medicine
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I asked my age-matched colleague the other day: “Do you think we’ll know when it happens to us?” He responded: “I know. I worry about that, too…a lot. I’m getting out before it happens to me.”
We were talking about our fears of being labeled as an “old” doctor. Not just old in years — our children and bifocals remind of us of that — but old in our mindset. We fear becoming one of the dinosaur doctors who get known for their excessive attachment to old dogma, premature dismissiveness of novel new approaches, fear of social media, and of course the tell-tail (pathognomonic) sign of agedness, ranting mindlessly in front of Fox news about healthcare reform in the doctor’s lounge.
This transition can happen fast. One moment a doctor might be in their sweet spot — a period of time where the nearness of training meets with the treasure of experience in a capable mind, body and spirit. Sadly, and obviously this period is finite. It’s limited by aging. Getting older happens to all of us, but the pertinent fact for medical practice is that, like all humans, doctors age at different velocities. Read more »
*This blog post was originally published at Dr John M*
