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Wednesday, June 24, 2009

Thoughts on Food and Chronic Disease

One of my first patients yesterday was a young man who I diagnosed with diabetes two years ago. At that time he weighed over 200 pounds and admitted he did not watch his diet or exercise much, if at all. We found his sugar to be high, and in time, started him on medications for both his diabetes, cholesterol and diabetes at no small cost to him.

During follow up visits we talked about diet and exercise and lifestlye changes he could make. Initially, there was not much change in his condition, but somewhere along the line, something clicked for him. He began watching his diet, exercising and dropping the pounds. We stopped his medications one by one until at last he came to see me this week. His weight was now down 60 pounds in 2 years and his diabetes, high blood pressure and high cholesterol were gone. No medications needed!

This unfortunately. is a rare scenario in my practice and I would venture to guess the same for many other internal medicine practices across the country. Rare as it may be, it brings home the point that these diseases in ,most cases, are caused by intake of the wrong foods and practice of the wrong lifestyle. It confirms what has been said over and over again by progressive thinkers such as Michael Pollan, Marion Nestle and Mark Bittman. Yet as these writers have said, this is a public health problem as much as it is an individual problem. People need to make the right choices when it comes to food but food policies must change so that it is easier to make those choices.

As I watch the primary care model morph into a quality assurance system where we are increasingly required to document medications started for lowering sugar, cholesterol and blood pressure, I am concerned that the focus is misguided. I am hoping that the slow food movement, the Obama Administration and a whole host of food activists will make a differencenbefore this poor eating epidemic bankrupts our healthcare system completely. Now, let me get to work to make this a useful resource!

Louis Friedman, DO