Preventive Medicine Column
Dr. David L. Katz
Surprise, somewhat surprisingly, has emerged as a theme in my recent work. A little over a week ago, I was in the beautiful Alpine town of Gmunden, in Upper Austria, participating in a ‘surprise factors’ symposium. The provincial government of Upper Austria convened a think tank of experts to help them anticipate and prepare for upcoming, societal surprises, in pursuit of the best possible health, and social vitality, for their population of 1.6 million people.
Yesterday, I participated in a childhood obesity conference at the Cleveland Clinic, convened jointly by the Clinic, and Slate Magazine. I was privileged to share the podium with, among others, Dr. Toby Cosgrove, Cleveland Clinic CEO; the CEO (or ‘Tea-E-O’ as he prefers) of Honest Tea™, Seth Goldman; Dr. Ezekiel Emanuel, until recently a health policy advisor at the White House; the mayor of Oklahoma City; and Melody Barnes, the architect of the First Lady’s ‘Let’s Move’ program.
Following my comments, and those of others, I was interviewed by a reporter with the Cleveland Plain Dealer who asked me to note any surprises the conference had revealed.
The first part of my answer was…none, really. After all, when you are asked to speak on a topic in which you ostensibly have expertise, you really aren’t supposed to be surprised. An entry level criterion for being an ‘expert’ is knowing the important things going on in one’s field. By and large, if you are surprised in a discussion of your own field, it means you haven’t been doing your homework!
So my colleagues’ comments did not surprise me, any more than mine surprised them (although they may have been surprised that I made mine in rhyme…). We all agreed on the urgent peril of epidemic childhood- and adult- obesity; we agreed on its multifactorial origins in modern social and environmental changes; and we agreed on the need for an aggregation of solutions in every setting to get us all to the prize of better health and vitality.
But then I thought about the juxtaposition between what was going on in that auditorium, and outside of it- and did have a surprise to share.
I am surprised, and even more so concerned, about how readily people with good common sense switch it off when it comes to weight control and the illusory promise of a quick fix. While experts in an auditorium were discussing menu boards, sidewalks, school food, worksite wellness, and the Farm Bill- people in the real world were lining up for the Dukan Diet, the HCG Diet, or perhaps the imminent ‘fructose free’ diet.
Each of these is at present something of a phenomenon, and through the filter of either expertise or common sense, none deserves to be!
The Dukan Diet is a best-selling global phenomenon because it has helped several women in the royal wedding party- including bride-to-be Kate Middleton- slim down for the nuptials. But the diet is tried-and-failed low-carb nonsense, just with a French accent this time. Of course you lose weight when you cut out all carbs, and consequently cut down enormously on calories. You could just as well lose weight eating ONLY carbs, as the infamous Twinkie Diet showed us.
The Dukan Diet is not healthful, and not sustainable. It offers nothing new- just a new label. The princess, alas, is destined to gain back any weight she lost with this quick-fix approach. It is surprising how perennially, even among intelligent and highly educated people, weight loss hope triumphs over experience.
The Dukan Diet is merely bad; the HCG Diet is potentially deadly. This diet, too, is wildly popular- which is not just surprising, but shocking. The HCG Diet combines hormone injections which all published studies show to be useless for weight loss, with extreme calorie restriction that studies show can be lethal. I have been contacted by a forensic pathologist investigating the sudden death of a formerly healthy, 34-year-old mother of two. She was three weeks into the HCG Diet, and from all I’ve heard so far, that was the only smoking gun on the scene.
Then, there was the recent combination of a YouTube video by Dr. Robert Lustig, and a NY Times Magazine article by Gary Taubes, suggesting that sugar in general- and fructose in particular- is poison. The popularity of this concept is an open invitation to food manufacturers to start inundating us with ‘fructose free’ junk food. Fructose-free soda is already here, with labeling implying a virtue the product assuredly lacks!
So, the divide between our common sense and our common behaviors is…surprising.
At the conference in Cleveland, we acknowledged how challenging it is to change some of what stands between our families, and better health- such as a Farm Bill that favors the interest of ‘big food’ over you and me. But in response, I noted that we moms and dads in our multitudes have the potential to be the greatest, most unstoppable “special interest group” of all time. Our special interest is the health of our children!
So I hold out hope that our common sense will lead us to common cause. That we will reject false promises and quick fixes, and rally around the policies, practices, and programs that will situate weight control and health on a path of lesser resistance for us all. What a happy surprise that would be!
Dr. David L. Katz; www.davidkatzmd.com