A recent article on our bariatric society web site quoted top military officials as complaining about obesity in the 17-24 age range. Currently about 27% are too overweight to join the military. As an "old guy" from the Vietnam War era, I never even knew this could be a reason for rejection! I took my chances with the lottery and fortunatly did not get drafted due to a favorable number. How times have changed. The pedicatric obesity problem has gotten a lot of press as has the general population problem, but I'm not sure this particular age group ha gotten much press. This is the age where folks should be in their prime. This is the time to look back on when our health begins to fail: "If I were only 21 again!"
How can we help people see the course they have set for themselves? Children are dependent on parents, adolescents heavily influenced by peers, but this group is in the process of maturing fully. As a society we need to find ways to help with positive body image, mature patterns of eating and activity, and a sense that life is to be lived fully, not just observed on a screen. Yes, the business of life gets in the way, but all the more reason focus on staying healthy.
Tuesday, May 4, 2010
Thursday, April 1, 2010
April Foolish Advice
With tongue fully planted in cheek I offer the following weight loss advice:
1. Use that newly released secret recipe that the medical community is hiding so they all don't go broke. It results in excellent weight loss and improved health (as long as you take it at least three times per day after 60 minutes of vigorous exercise)
2. Eat less and exercise more. That's all it takes! (Actually this is somewhat true but often results in weight gain on a practical basis. People find it hard and give up because it is not as simple as it seems!)
3. Want to lose weight, go to bed earlier.(Also some truth in this! Getting less sleep is associated with weight gain, but an earlier bedtime is usually not sufficient to result in weight loss on it's own.)
4. When your doctor stops recommending rest and starts recommending diet and exercise, change doctors! (You may not lose weight but you will gain a co-dependant!)
5. You are a strong independent American and can do it on your own! Don't bother trying to get any help. (Actually 25% of people can lose 20 pounds on their own but most cannot keep it off.)
6. Join NASA, in outer space we are all nearly weightless!
7. Don't investigate any claims of pills or providers who promise miracles. After all, they wouldn't be allowed to say it if it wasn't true, right? (BTW, I have this bridge in Brooklyn you may be interested in....)
8. Wait for the weight to come off. It's bound to happen as soon as _____ (fill in in the blank) starts or stops. (BTW, about that bridge....)
9. Keep your tongue in your cheek. This will make chewing and swallowing impossible with resultant impressive weight loss.
10. Laugh it off. Actually some truth to this also. Stress is reduced by laughing, and you can at least lose that heavy mood!
1. Use that newly released secret recipe that the medical community is hiding so they all don't go broke. It results in excellent weight loss and improved health (as long as you take it at least three times per day after 60 minutes of vigorous exercise)
2. Eat less and exercise more. That's all it takes! (Actually this is somewhat true but often results in weight gain on a practical basis. People find it hard and give up because it is not as simple as it seems!)
3. Want to lose weight, go to bed earlier.(Also some truth in this! Getting less sleep is associated with weight gain, but an earlier bedtime is usually not sufficient to result in weight loss on it's own.)
4. When your doctor stops recommending rest and starts recommending diet and exercise, change doctors! (You may not lose weight but you will gain a co-dependant!)
5. You are a strong independent American and can do it on your own! Don't bother trying to get any help. (Actually 25% of people can lose 20 pounds on their own but most cannot keep it off.)
6. Join NASA, in outer space we are all nearly weightless!
7. Don't investigate any claims of pills or providers who promise miracles. After all, they wouldn't be allowed to say it if it wasn't true, right? (BTW, I have this bridge in Brooklyn you may be interested in....)
8. Wait for the weight to come off. It's bound to happen as soon as _____ (fill in in the blank) starts or stops. (BTW, about that bridge....)
9. Keep your tongue in your cheek. This will make chewing and swallowing impossible with resultant impressive weight loss.
10. Laugh it off. Actually some truth to this also. Stress is reduced by laughing, and you can at least lose that heavy mood!
Thursday, March 25, 2010
Save your brain with the Mediterranean diet?
According to Gad A. Marshall, MD (Instructor in Neurology, Harvard Medical School, and Associate Neurologist, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston) two recent studies demonstrate a reduction in the risk of mental decline in people who follow a Mediterranean diet. In a study in New York City, risk this showed up as a decline in the risk of Alzheimer's dementia in those who followed a Mediterranean diet, exercised regularly, or both. The hazard ratios were 0.6, 0.67, and 0.64 respectively. The study was large, well controlled of confounding factors and followed people for over 5 years. It would appear that in this population the diet reduced the risk of dementia by about 30-40%! A similar study in France, which was smaller, showed reduced cognitive decline (better maintained brain function) but not reduced risk of dementia. This study may not have been powerful enough to show benefit in preventing Alzheimer's, but results are still encouraging.
It seems to me the more we learn about diet and exercise, the more benefits we find. Perhaps Hippocrates was on to something when he recommended healthy (presumably Mediterranean given his location) diet, fresh air and exercise!
It seems to me the more we learn about diet and exercise, the more benefits we find. Perhaps Hippocrates was on to something when he recommended healthy (presumably Mediterranean given his location) diet, fresh air and exercise!
Thursday, March 18, 2010
An example of good parenting!
I was sitting on our front porch this evening because it was warm and beautiful. Lots of people were walking by, walking dogs, riding bikes etc. A mother with a boy about 4-5 years old passed. He was riding a bike which hit a bump and he went sprawling hands first onto the sidewalk. It almost looked like he leaped forward. He rolled over onto his butt and was clearly unhurt. He looked up at "Mom" for a reaction. I would expect to see her concern, maybe some sympathy, even offering a cookie or treat. Many times I've seen the "Oh, oh are you OK" response which usually just make the child cry. This Mom remained smiling. Her response was "So, did you catch the rabbit?" How inspired! He did look a lot like my beagle when she tries to jump something, only difference is no howl from the kid! I couldn't tell the mother what a good job she did, and I doubt she will ever read this, but at least I can tell someone. Hope it helps you keep your stumbles in perspective. May you "catch the rabbit!"
Wednesday, March 10, 2010
Wholistic, holistic or integrative?
There are a lot of terms around to describe the attempt to integrate body mind and spirit into health. Some of the more common terms are integrative, functional, mind-body, holistic and wholistic. None of these terms yet conveys anything very specific about the practitioner or style of practice. I'd say this is in development, but if so it has been for a long time! When I first became interested in "wholistic" medicine it was spelled with a "W" and done mostly in church basements. The "holistic" moniker has often been used by chiropractors and often includes nutrition, supplements and the like as well as manipulation. Integrative and functional are more recent terms used by a variety of practioner types, including a few of us bolder MD's. It implies bringing together multiple disciplines to improve health and/or treating function rather than disease.
As I reflect on my preferences, I find myself gravitating toward the older "Wholistic" for a few reasons. The concept of "whole" including multiple aspects of body, mind and spirit. I know the actual root of "holistic" is "hol," the same root as Holy. It seems to imply more focus on the spiritual. Although this emphasis is not a bad idea given the subordinate position the spirit is usually given, a more even emphasis is more to my liking. I think as a wholistic practitioner I should be willing to address body mind and spirit in any combination and not value one above another.
Comments?
As I reflect on my preferences, I find myself gravitating toward the older "Wholistic" for a few reasons. The concept of "whole" including multiple aspects of body, mind and spirit. I know the actual root of "holistic" is "hol," the same root as Holy. It seems to imply more focus on the spiritual. Although this emphasis is not a bad idea given the subordinate position the spirit is usually given, a more even emphasis is more to my liking. I think as a wholistic practitioner I should be willing to address body mind and spirit in any combination and not value one above another.
Comments?
Thursday, March 4, 2010
Monday, March 1, 2010
What is a doctor?
The mind body expo this weekend in Minneapolis gave me a different perspective on my title. If I said I was a "doctor" or a "physician" I got constant requests for clarification! The only unambiguous title was "MD" but this was not always a welcome one. Considering insurance companies now insist on calling me a "provider" (which I always thought was something I helped do for my family, being one of only two) I'm beginning to wonder if society has a role for people like me. Surely the education, study and practice of the past 30 years are of value. I know my skills are helpful to people and believe in my own worth independent of titles, but they do help people understand roles. I am not really ready to given them up either to generalization from "physicians" who have had much less training, or to be downgraded by insurance to a generic cog in the wheel- the role is only to see patients and generate revenue.
This brings me to what I should call the people who come to me for care. For decades I have used the term "patient" (and many of them have been VERY PATIENT with me, especially in the early years!) but I am coming to prefer the more modern term of client. This puts us on more of an equal footing which I do like. We are really collaborators in health.
Once the relationship is established, I don't think it matters as much what we call each other, but names do have implications.
This brings me to what I should call the people who come to me for care. For decades I have used the term "patient" (and many of them have been VERY PATIENT with me, especially in the early years!) but I am coming to prefer the more modern term of client. This puts us on more of an equal footing which I do like. We are really collaborators in health.
Once the relationship is established, I don't think it matters as much what we call each other, but names do have implications.
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