• Mar24

    Hunger in America is largely hidden, yet Feeding America’s 200+ foodbanks feed one out of 6 Americans. The USDA reports that in 2011, 46.7 million Americans—or roughly one of four adults — received food assistance from one of 15 federal programs.  Here is the meal map.

    This is amazing in so many ways: because when you have little money and less time, the cheapest, quickest thing to eat seems like the best.

    Yet we know where highly processed food has taken the U.S. and Australia, and soon Mexico, Western Europe, and then South America, Asia, India and China: to insulin resistance, obesity, metabolic syndrome, pre-diabetes and diabetes.  Not to mention heart disease and breast cancer and colon cancer.

    It’s a fact that some food–starchy, sugary, high glycemic index  food makes you hungrier–in adolescents and adults.  But millions of people have survived on soda and white bread and instant noodles and donuts. And when you’re hungry and have no time, other facts seem less relevant.

    It may seem bizarre that obesity and its medical problems are so intimately related to hunger and food insecurity: that obesity and hunger are two sides of the same coin. And the global health burden from obesity is now greater than the global health burden from hunger, according to a huge Lancet study.

    But there is a direct relationship: less money, less time, cheaper, lower quality food: more hunger, more highly processed food, more inflammatory food, more obesity.


    The solution, as Jeff Bridges says above, and his wife Susan Bridges demonstrates in a video we shot for the FoodBank of Santa Barbara, is not just charity.  It’s education, training and skill development.  How to plant and maintain a household garden. How to cook what you get out of it. How to plan ahead for day-to-day food security.

    And at a larger scale: how to link Foodbanks and health care organizations. How to create partnerships with clinics, pharmacies, health care systems.  How  to conduct simple health care screenings at food distribution sites, and offer healthier, non-disease-causing food for pickup and purchase.

     
  • Jul11

     

     

     

     

     

    from an anonymous, “other” facility…I still use these tidbits in talks: most still get a laugh!

     
  • Apr10

    TEDMED is about to transform the conference into a platform for change, instead of a giant intellectual cocktail party (and a very good one at that).

    This year (it’s in DC, not San Diego, sadly), attendees winnow down 50 “large, intractable problems of health care,” to the most important 20 great challenges. And if your institution participates by remote simulcast called TEDMEDLive, you can vote too.

    Competition is a big motivator (especially for guys, it seems, in obesity, which is Challenge #2). I haven’t had the privilege of presenting at TEDMED (just TEDx, which was terrific), but I think the competition in DC will be on steroids, and would love to go next year: this year, I’m insanely overcommitted already!

    It may be impossible to figure out which is more important than another:  (e.g., @rodrigoatcg writes “‘The Obesity Crisis’ is not one challenge, but many many different challenges: from how we teach nutrition in school to subsidies for corn and everything in between”) but starting somewhere is better than not starting.

     

     
  • Oct28

    34 people whittled down from 50 were followed over 16 months after a 10 week crash diet and lots of counseling: they lost 29# on average, and gained back 12#. Their hormones (leptin, peptide YY, cholecystokinin, insulin, ghrelin and gastric inhibitory polypeptide) continued to scream…eat!

    And they were hungry, thought about food, and wanted to eat way more than when they started.

    This is a very small study with no control group: it’s not the last word, except that maintaining is harder than losing.

    But it’s getting lots of attention, because it proves something every dieter hopes: it’s not my fault. And that’s right: keeping weight off is not about willpower: it’s about planning.

    It’s not my fault that I started eating tortilla chips, fudge ripple and layer cake. It’s not my fault that I feel like eating and I’m hungry all the time.

    My take: Yes, your hormones are screaming. And yes, you can plan for it. Thousands already have, and won.

    Over 5500 people nationally have shown that you can lose 66 pounds on average, and keep it off for an average of 5.5 years.

    I’m proud that some of my patients are in that group. And you can be too–it takes being accountable, and taking a first step.

    Two quick reality checks: first, the researchers didn’t measure estrogen and testosterone: I think these hormones, especially for men, figure in to weight loss and maintenance.

    And second, your hormones are not destiny. You are not your pancreas, or adrenal or thyroid, or inner GI track: after 50, your health is mostly your choices, not your genes.

     

     
  • Sep7

    Employers are going to begin being asked to pay for childhood obesity treatment. And it may be in their best interest to do so.

    The two largest health care costs for employers are employees who are “heavy users” (interestingly, the same term is used in the fast food industry for diners who eat-in 14x/week or more)…and kids.

    One-third of large employers’ beneficiaries are dependents under age 25. Kids and teens are responsible for 14.7% of a typical large employer’s health care costs.

    Obese kids have twice as many MD visits and 3x the hospitalization rate as normal weight kids. That’s where the dollars are.

    The National Business Group on Health has a Toolkit which highlights case studies, covers benefit plan construction, identifies employee education opportunities, suggests how to make the most of on-site facilities and looks at bang-for-the-buck philanthropic opportunities.

    The Institute on Innovation in Workforce Well-being, a coalition of Fortune 1000 employers (Gen Mills, Amex, Cardinal Health, Coca-Cola, Costco, Dell, Express Scripts, Fidelity Investments, Honeywell, IBM, J&J Ethicon, Kellogg, Kraft, Medtronic, Microsoft, among others) and representatives from Weight Watchers, the CDC, HHS and United Health, underwrote the Toolkit.

    There are many routes to success in this area.

    I hope one of the routes is showing how helping kids learn to cook with their parents improves employee productivity and lowers health care utilization…of the entire family.

    I’m working on a Santa Barbara Foodbank program–a reality TV pilot (sort of a Dr Oz meets Jamie Oliver in the Foodbank and at home)– to do just that, later next year.

    Access the toolkit free.