A MD friend who is a general practitioner sent this piece that was set around to a lot of GPs:
Whether you're worried about your weight or not, how you live your life - how you eat and how you play - will markedly impact on your health and well being. In fact it'll impact on your health far more than any drug your physician could ever prescribe.
So why is it that most people have never had their physicians discuss healthy living with them?
Sure, a doc may ask you whether or not you exercise, and might even inquire into your sleep, but do they delve further?
My belief, though unproven, isn't that doctors aren't interested, and it's not that they're unaware of the benefits of healthy living, but rather that they're simply not taught to consider lifestyle in their clinical history taking, nor how to champion healthy living effectively.
So what are the top 10 things I would want physicians to explore with you at a bare minimum?
In no particular order:
How many meals do you eat out (including cafeterias), order in or take out (including prepared supermarket counter foods) per week?
Do you feel comfortable cooking?
How many meals a week do you cook yourself by means of the actual transformation of raw ingredients?
How many glasses of milk, juice, sugared soda and/or alcohol do you drink a day?
What do you put in your coffee or tea, and how many do you drink a day?
What's your typical pattern of daily eating (ie do you miss meals or snacks and what do you typically have for breakfast/snacks/etc.?)?
(If married and/or with children) How many meals a week do you eat together as a family?
What was your favourite sport or activity as a kid and why aren't you doing it today?
How many minutes of simple walking might you be able to add to your day without it being a hardship, and when would it be (ensuring goal here is Specific, Measurable, Attainable, Realistic and Timely)?
(If a parent of still at home children) Are you living the life, food, fitness and health wise, that you want your child to be living, and if not, what do you think you might improve?
While I realize this list is by no means exhaustive (for instance it doesn't touch on other hugely important issues like relationship health, job stress and satisfaction, parental struggles, sandwich generation issues, etc.) and may only scratch the surface of healthy living, it would certainly help a physician to get a sense of how their patients are managing their two most important determinants of health, and provide a myriad of opportunities to try to help collaboratively trouble shoot common barriers to healthy lifestyles.
Unfortunately, while we physicians are all taught to examine the micro level minutia of each and every physical system in our annual review of systems, I strongly and firmly believe that as far as health benefits go, it'd be far more valuable to our patients to review the macro level of how they're are actually living their lives.
Of course asking those questions up above will also necessitate having answers...and sadly, therein lies the problem.
Medical schools and residency programs may do wonderful jobs at preparing us on how to treat illness with pharmacotherapy, but sadly the vast majority do a respectively terrible job at preparing us how to help patients manage, as Yale's David Katz puts it, "medical destiny's master levers" - forks and feet.
Here's hoping that one day, the day will come where forks and feet get the medical respect they so clearly and desperately deserve.
The FCC has released a longish document (pdf) backing up its position on the proposed AT&T T-Mobile purchase. I have only skimmed bits of it, but it appears highly critical of earlier claims. If AT&T intends to procede they need to answer these issues with rigor - they would need to convince independent third parties that the public good is being served.
I don't know anyone who is very happy with their mobile service. Such services have become necessities, but all are flawed in one way or another. The perceived value is low. One young friend notes dealing with her DMV is easier than her wireless carrier. Some businesses are delights to deal with - one wonders if a very clever wireless provider could become "delightful"...
Over 369,000 people died in road accidents in the US between 2001 and 2009. This map identifies the accidnets and gives a bit of information. While cars and roads have improved over the years, there it is still a huge loss - particularly when you add serious injuries.
I have a weakness for mango lassis and have tried to make them with very mixed results. Recently I learned "the trick" used in many Indian restaurants - they use a commercial canned mango pulp. Specifically Rellure was mentioned. I found some on Amazon and went to work with a recipe. If you have some very ripe mangos, go for it, but this is very easy and delicous.
First a warning. The stuff is from India and the cans were in terribly dented. None were breached and there was no indication of pressure, so I went ahead, but I'm letting them know about the low packaging quality (Amazon's packaging was great - it must have happened upstream). The quality of the actual mango pulp seems very good. You may want to check out an Indian grocery if you have one in your area.
This made the richest mango lassi I've had. The taste and mouth feel is that of something made with cream. You might try regular yogurt and perhaps low fat milk. I think you could simulate most restaurant drinks with 1% milk. It helps to chill the mango pulp and milk to below refrigerator temperatures - if they are already refrigerated, put them in the freezer for about ten minutes.
9 ounces Fage 2% plain greek yogurt
4.5 ounces whole milk
4.5 ounces mango pulp
about 4 tsp white sugar (or to taste)
some ground cardamom to taste - I probably used a tsp
blend for a couple of minutes
serve in a chilled glass and sprinkle with sliced pistachios or almonds
Gallup published their anual health survey and notes that self-reported weight is up about 20 pounds in the past 20 years. What is interesting is the perception of ideal weight has also inflated in that period by a roughly similar amount. (pdf of the paper is here). Only 39% of people self-report themselves as being overweight - something that doesn't square with self reported weights or government studies (the later shows about two thirds of the adult population is overweight ... and the obesity rate isn't much different from the self-reported overweight number Gallup finds).
A friend from Northern Europe notes she is shocked when she visits the US - people are much wider here than in Denmark.
Attacking this would probably have enormous healthcare benefits and may constitute low-hanging fruit, but it seems like a very difficult task giving our sedentary nature, the easy availability of junk food and the apparent shift in body image.
“There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "my ignorance is just as good as your knowledge.” ― Isaac Asimov