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Kuwait tops USA in percent overweight

I was surprised to find that Kuwait has just edged out the USA in the percent of its population that is reported as “overweight:” 74.2%.  Forbes has an interesting visual flag display of the world’s fattest nations.

So what happened to Kuwait?  One fairly unhelpful press release suggested that the increase in overweight and obesity was due to changes in diet and exercise habits.  Thanks for that insight.

A recent study concluded that the risk of being overweight in Kuwait was positively influenced by income levels and yet the risk of obesity was inversely related to income levels.  So, if you’re wealthy you’re more likely to be chubby, but if you’re poor, you’re at risk for obesity?  Not sure I understand why that’s so.  Maybe everyone has plenty to eat, but only the wealthy can afford gym membership?

Another study correlated increased weight with frequency of dental visits.  Does that mean that the more dental work you need the more likely you are to be overweight/obese?  I guess Kuwaitis don’t brush their teeth.

What really happened to Kuwait?  This happened.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Relationships and weight gain: Valentine’s Day musings

My friends in the Revolution Weight Management Center asked me to blog about weight and relationships… at first I wondered if they were trying to stage an intervention or something: have I gained that much weight since I started working here? Ha ha. No, I haven’t… but maybe that’s because I have such a skinny husband?

As it turns out, research suggests that married couples are influenced by one another’s dietary habits. If you marry a person with poor eating habits, you are much more likely to adopt them yourself. Also, they say that marriage leads to more regular (read frequent), larger meals and increased financial pressures, stress levels and decreased exercise frequency.

Well, I guess choosing the right spouse has never been more important for weight control? Marriage doesn’t automatically lead to weight gain, but you should eye your boyfriend/girlfriend/fiancé(e) with suspicion at the dinner table. When I was dating my husband I noticed that he ate small portions, never finished his plate, and didn’t like dessert. He liked to run, had good sleeping habits, drank in moderation, and wouldn’t notice a super model if she fell in his lap. Sound too good to be true? I still ask myself that every day. They don’t make too many like Steve, I’ll tell you!

Anyway, I must confess that before our wedding I was in the best shape of my life, running about 20-25 miles a week, shunning all products containing high fructose corn syrup, and taking good care of my health. Now I exercise irregularly, sneak in rich dining experiences, and skip meals. I weigh about the same, but have (I’m sure) exchanged fat for muscle.

What do I make of this? Well, I need to force myself to go running again with my husband (he patiently runs at my pace as I lumber along next to his gazelle-like frame) and be more mindful of my eating habits. This is a never-ending battle for me, but it is made so much easier by having a supportive spouse who never deviates from good health practices.

So as Valentine’s Day approaches, observe your loved one’s eating and exercise habits with a critical eye. You are likely to be influenced by them more than you know. And for those of you who have a “Steve” in your life, thank your lucky stars, put down the box of chocolates, and show him how much he’s appreciated!

P.S. Steve would like to tell you that he (thanks to me) now enjoys dessert and craves ice cream from time to time. I guess my influence on him hasn’t been as positive.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Hospital administrator salaries: draining the healthcare system?

Well, this conversation from the blogosphere gets my blood boiling, I can tell you! In a recent blog post about the ugly under belly of hospitals, I discussed how administrator salaries decrease hospital resources. Dr. Stanley Feld’s excellent blog post digs even deeper:

Paul Levy CEO of Beth Israel Hospital writes a blog called “Running a Hospital”. He has tried to justify his salary after the Boston Globe published his salary of over 1 million dollars per year…

Remember hospitals such as Beth Israel Hospital in Boston are tax exempt community hospitals because they have this community obligation. These tax subsides and others tax subsides are opaque to the public. However, the public pays for these subsides. They contribute to the hospitals bottom line and Mr. Levy’s bonus.

Linda Halderman M.D. wrote an essay entitled “How Much is Your Doctor Worth?”. It is also worth reading. The subtitle should be, “How Much is Your Doctor paid?” The answer after the long essay is $59.50 for a complicated office visit. [If Levy were a clinician,] he would only have to see 168,067 patients in one year or 744 patients a day to generate a gross revenue of $1,000,000 before expenses.

What is more valuable to the healthcare system? A CEO’s salary based on revenue generated incentives and fund raising or good quality medical care?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Sex selection: just because we can doesn’t mean we should

As I read the opinion piece in the New York Times about fertility clinics that permit parents to choose the sex of their baby before pregnancy, I was suddenly aware that I had strong feelings about this. As I tried to analyze my indignation, I realized that my emotions came from a place beyond mere reason.

Although technically, this issue could be reduced to a matter of sperm sorting – we all know it’s much more than that. Choosing the sex of your unborn child wanders into an unexplainably uncomfortable territory – swirling unconscious feelings about the value of human life, sexual equality, and the pain of sexism that many have experienced. We have heard the horrible stories about female babies being selectively aborted, or left to die in the elements in India and China, and we wonder if choosing the sex of a baby is somehow part of the same phenomenon.

Why should it matter which sex the baby is? Why is “family balance” cited as a reason to sex select? Perhaps the balance comes from the makeup of the individual personalities in a family, or maybe from parents who plan for the right number of children, not the gender of them.

Personally, I cannot support the practice of sex selection for anything other than sex-linked genetic disease prevention (and even this makes me feel a little uncomfortable, frankly).

I’m curious to know if men and women are equally disturbed by the practice of sex selection… What do you think?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Should US physicians learn Spanish?

Last night I was having dinner at Charlie Palmer Steak and entered into a conversation (in Spanish) with one of the wait staff. He was surprised when I ordered in Spanish and we had a friendly conversation about the merits of whole grain bread. He asked me why I spoke Spanish. I answered simply, “porque soy doctora” – because I’m a doctor.

Dr. Richard Reece’s recent blog post tackles the issue of language barriers in the healthcare system. He gives some good advice for cross-cultural communications, reminds us that 25% of US physicians are foreign born, and quotes the inscription on the statue of liberty as the reason why Americans should remember to welcome foreigners. However, he also encourages immigrants to learn English and frowns upon illegal immigration.

As for me, I learned Spanish because I was worried that I’d harm a patient by misunderstanding what they were trying to communicate. Of course we try to have an interpreter at the bedside at all times, but in reality it just doesn’t happen consistently. Learning Spanish was my way of practicing safer medicine.

Now it is frustrating that some patients (at least in NYC) seem to feel as if their doctor is obliged to learn Spanish. They sometimes have an attitude of entitlement that I find hard to swallow. I try to put myself in their shoes, but honestly if I were ill in a foreign country I wouldn’t assume that it was my right to receive care in English.

Still, for me, learning Spanish was a wonderful thing. There is a certain caring that I can communicate, and a certain warmth and appreciation that I feel from my patients as they encourage me – that even though I make mistakes with my grammar, they can still understand my meaning quite well. We laugh a lot at the words I find to describe things – and it generally provides a lighter tone to the interaction. Laughter is good medicine, and if my version of Spanish brings laughter to others – then so much the better!

Do you think US healthcare professionals should make an effort to learn Spanish?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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