Wednesday, September 5, 2007

Childhood Obesity -- An Ecological Solution

This from “Childhood obesity,” JAMA 2007;298:920:

“In addressing this disturbing trend and preventing its spread, physicians are challenged to look to the broader environment. Successful treatment will require improving the health of individual patients and the larger community (an “ecological model.”) For physicians, this means reviving their traditional role as trusted advocates for good health of the public.”

Amen: as doctors, we need to recapture our community role in public health. The greatest improvements in longevity and health have come from simple interventions in the community, such as sanitation and clean water, and not from drugs or expensive technologies. We need to step out of our busy offices to meet the health challenges threatening our fellowmen, especially our children. There is no bigger threat than the epidemic of obesity cutting short their lives.

The JAMA specifically mentions what we could be doing in this arena:

“The “ecological model” suggests that doctors must get involved in the community, not just in their exam rooms. Doctors are to (1) demand that all food available in schools meet USDA nutrition guidelines; (2) require daily physical education and active recess for K-12 grades; (3) help parents and kids organize energy-burning “walking school buses” along safe routes; (4) campaing for sidewalks, playgrounds, bike paths and recreational facilities; (5) advocate for eliminating unhealthy foods; (6) call for supermarkets to provide affordable produce; (7) insist that hospitals eliminate fast food outlets and (8) advocate healthy lifestyles and healthy communities using public venues.”

Next month, docs at the Utah Medical Association will begin a program called “Adopt a School,” whereby UMA members and any other community doctor will adopt a school of their choice to implement these measures. Dr. Wheeler, a former UMA president is spearheading this worthy endeavour.

Forget About It -- Alzheimer's to Increase 285%!

By the year 2050, the incidence of Alzheimer’ disease will have increased by 285% in the USA (J. Alzheimer’s Dementia 2007;3:s168.)

Truly “Alzheimer’s is the health care crisis of the 21st century.” (J. Neurology Reviews, volume 15, page 1.) Yet, very little research money is going to this problem, while we spend as a society billions of dollars to get huge erections and perky boobs: sadly, we won’t remember what to do with them.

Here are some tips on what you could do to lower your risk of winding up in a nursing home trying to remember why you are there:

  • Avoid second hand smoking: if you have been exposed for 30 years, your risk of dementia goes up 30 %. Imagine what smoking directly does.
  • Avoid al the factors that lead to heart disease, particularly insulin resistance, or pre-diabetes: lose weight. Eat the Mediterranean diet and avoid refined sugars and transfats.
  • Consider going vegetarian.
  • Supplement omega oils, especially DHA.
  • Supplement B-complex vitamins, especially folic acid and SAMe.
  • Optimize bowel function.
  • Supplement COQ10 and antioxidants.
  • Supplement sex hormones if necessary, including DHEA.
  • Avoid unnecessary general anesthesia
  • Avoid aluminum in antiperspirants and pop cans.
  • Consider red wine.
  • If you like herbs: sage, huperzine and curcumin/turmeric.
  • Learn to play a musical instrument, avoid being lonely and exercise more.
  • Consider coffee: it helps women remember more. Do they really need any help remembering what their men have done wrong?