Child Obesity - Paging Dr La Puma

Aug24

Short Trip to Sacto: Obesity Testimony

Posted in: Child Obesity, Obesity and Weight Loss, Wellness and Health
Tomorrow I’m testifying at a Legislative Informational Hearing on Diabetes and Obesity at the California State Capitol in Sacramento on what works in practice.

It’s not unfamiliar, but still a challenge. I did testify before the U.S. Senate Subcommittee on Aging about the care near the end of life in the 1990s.

Now the time seems right to be part of change about obesity and public policy.

You can read the press release about my appearance, and sneak a quick look at my prepared statement.

I think this will be fun, and hope you’ll find ways to advocate for change not just in school lunches (which California is leading in, within the U.S.), but also in “seat-belt-equivalents” (my term).

Seat belts save more lives than any doctor ever will. We need something like them in obesity and diabetes prevention. What would it be?

Here’s a 90 second viewer success story in diabetes: a viewer of my Chef MD segment on Lifetime TV followed my plan, wrote to me, I encouraged her, and she transformed her life. Gotta love how powerful Susan is.
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Jul21

Vending Machines in Kids’ Hospitals

Posted in: Child Obesity, Obesity and Weight Loss, Wellness and Health
The most visible food in the hospital is in vending machines. And it isn’t pretty: see the unedited photo at right.

In the U.S., we have 25% more vending machines in each children’s hospital than does Canada. In fact, U.S. kids’ hospitals average 9.3 vending machines each.

What’s in hospital vending machines? 99 out of 101 kids hospitals have soft drink vending machines. 30% of all beverages inside are soda; fewer than 20% are water. One quarter of offerings are candy: more than any other food.

In schools with vending machines, kids buy more sugar-sweetened soda than anything else. And soda, more than any other food, causes childhood obesity. Candy and chips, the next best-selling vended items nationally, are second and third.

But the people who make their way down to the glassy doors of treats 365/24/7 are not just kids.

They’re adults: parents, visitors, staff. Chef Clinic research has shown that in-hospital eating is one of two major predictors of physician obesity.

Many people overeat when they are stressed, and turn to junk food as comfort. The vending machine provides that. And makes you fat, at the same time.

Good vending choices do exist from usual vendors and healthy vending others. Some health care institutions in California have developed policies that set nutrition standardsfor foods and beverages in vending machines. That’s the right direction.

But you shouldn’t have to wait, the next time a child is sick, for food that helps you stay healthy and strong. After all, it’s a hospital.
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Jul16

Prevention Will Be Cheap. But Fun?

Posted in: Child Obesity, Wellness and Health
For 43 million Americans on September 23 and probably the rest of the U.S sometime in 2011, preventive services just got cheaper.

No co-pays, no deductibles, no direct charges for stuff that works.

Now, we must figure out how to make it fun, sexy and easy. For kids and adults. But doctors getting paid to do it? Way fun.

Which services?

Blood pressure, diabetes and cholesterol tests; many cancer screenings; routine vaccinations; prenatal care; and regular wellness visits for infants and children; screening and counseling for obesity; and tests for HIV. Kathleen Doheny at WebMD has a comprehensible short list; healthcare.gov has a long one.

These are mostly to diagnose disease, but the vaccines and obesity counseling are to prevent it. What about obesity?

“The USPSTF recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults….and screen children aged 6 years and older for obesity and offer them or refer them to comprehensive, intensive behavioral interventions to promote improvement in weight status.”

Does this mean that the intensive Ornish program, designed for heart disease treatment and on the verge of approval by Medicare would qualify, but something milder, like Diet Plan of the Month, might not?

If insurers cover weight loss counseling, there will be a lot more clinicians interested. And that will start the change in obesity treatment in health care.
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Jun18

You Are What You Eat Out

Posted in: Child Obesity, Obesity and Weight Loss, Wellness and Health
I was having lunch out with a friend last month, and we couldn’t decide what to order.

Everything in the deli case looked good, from the lasagna squares to the sauteed kale. But not until we tasted the food and read the labels did we know what was in it: not just calories, but the extra sugar, starch, preservatives and fat that had no business in a couscous, salad or a chicken sandwich.

It turns out our healthier-than-average deli shares some of the same, completely fixable problems of most top chain restaurants. Restaurants that have no nutritional info online include the Hard Rock Cafe, The Cheesecake Factory, TGI Friday’s, Tony Roma’s, Maggiano’s Little Italy, Waffle House, Ruth’s Chris Steak House and Bennigan’s.

When this info is uncovered, it tends to be by groups like CSPI, which recently showed the Individual Tostada Pizza without chicken or beef to mean “1,440 calories and more than a day’s saturated fat (27 grams) and sodium (2,630 mg) to each diner.”

Most chefs are happy to modify dishes so they fit your palate or your allergy status. But chains have rules, and with the push to change obesity in this country, their nutrition information needs to become more well-known. Or consumers will make it known, and be outraged.

Top 100 Chain Restaurants Nutritional Clicks
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Jun6

Chefs Saving Lives: Childhood Obesity

Posted in: Child Obesity
* Over the past three decades, childhood obesity rates in America have tripled.

* Today, nearly one in three children in America are overweight or obese.

* One third of all children born in 2000 or later will suffer from diabetes at some point in their lives; many others will face chronic obesity-related health problems like heart disease, high blood pressure, cancer, and asthma.

* A recent study put the health care costs of obesity-related diseases at $147 billion per year.

* Obesity is now one of the most common disqualifiers for military service.

And the power of cooking, the way food makes us feel, think and grow: America’s chefs are stepping up to Let’s Move. And Mrs. Obama mentions "healthy weight"! Which is just what our Santa Barbara Institute is about.
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