The Food Revolution - Michael Pollan

Michael Pollan is the Author of the Omnivores Dilemma. I have just listened to his talk from the 2015 Food Revolution Summit. My notes from this talk are pasted below.

He has recently submitted an opinion article to the Washington Post called "How a National Food Policy Save Millions of Lives" (http://www.washingtonpost.com/opinions/how-a-national-food-policy-could-save-millions-of-american-lives/2014/11/07/89c55e16-637f-11e4-836c-83bc4f26eb67_story.html) - this article has actually turned into an initiative/campaign to encourage the government to develop a national food policy. We don't have a national food policy. We have an agricultural policy. Other countries have a food policy. Food system in a country should keep people well fed and healthy. These objectives need to align with agricultural policies. Right now agricultural policies focus on production of large quantities of cheap, nutrient-poor, and quality-poor food.

The government has been subsidizing a fast food diet with their current policies. We are not regulating agricultural companies to handle the air pollution and waste they produce.

The government is underwriting type 2 diabetes by subsidizing current agricultural industries but at the same time spending an absurd amount of money trying to treat type 2 diabetes. Type 2 diabetes costs the government $245 billion a year to treat! That is equal to 1/4 of our nation's annual deficit. It takes 7yrs off life and markedly reduces quality of life.

Corn and coy being grown that has replaced local crops- these are the building blocks for the fast food diet- sweetener for HFCS, feeding for livestock. Soy makes up the oil our food is fried in. 10% of our calories are from soy oil which is not healthy and another percentage come from sweeteners.

Pollan thinks the ACA will pressure the government to change these food/ agricultural policies. Insurance companies are now stuck with treating the chronic diseases because they can't kick people off for pre-existing conditions.  They will start to realize that for every case you can prevent, that is a lot of money for insurance to save.  If they know what is good for them, they will align themselves with this agenda to make food more healthy.

Now regarding processed foods with added vitamins. These food companies are creating a nutritional facade around processed food products. It is fundamentally deceptive to put a health claim on a bottle of soda due to having some vitamins in it. We have to look at what we are telling consumers about our food.  The rules around health claims need to be re-examined. Fresh produce, there are no claims. He says to have a more healthy diet, don't buy foods that carry health claims.  Quietest food is the food you want to eat.  Vitamins have become a gimmick for selling processed food. They are terribly abused. See the history of the book Vitamania. Vitamins are now unfortunately being used to undermine our health.

They discussed consumer habits- now expenditure for eating out is roughly more or equal to that at home. The way to take back control of your diet is to bring it back home. Obesity epidemic is propagated by the collapse of eating at home. Family meal is conducive to all kinds of health phenomena. Lowers drug use, better relationship with parents, better performance in school. Answer is to get everyone in the kitchen and rediscover the pleasure of cooking food.

About the new dietary guidelines being issued this year- (http://www.health.gov/dietaryguidelines/dga2015/comments/Default2.aspx) lobbyists from meat industry are up in arms about efforts to reduce greenhouse gasses.  Pollan asks this question- How can you have a healthy diet on an unhealthy planet? Healthy environment and our personal health are linked. The new dietary guidelines send a clear message to reduce meat consumption and increase consumption of plants and whole grains. Pollan makes the point that there are ways to raise meat sustainably and we should not overlook this and assume its all conventionally being produced. Also the guidelines have said there should be no more than 10% of calories from added sugar, which is progress. However the guidelines have very little on the microbiome, the role of the microbes in the gut and what implications they have for healthy diet. Pollan believes that eating fermented foods may help our microbiome and mentions that sugar and saturated fats can compromise the integrity of epithelial layer of large intestine.

Pollan says: Eat food. Not too much. Mostly Plants. He says flexitarians are just as healthy as vegetarians. Of course if you ethically do not eat meat that is a reason not to.

More on greenhouse gasses: Nitrous oxide from fertilizer used to feed meats produces lots of greenhouse gasses. Studies show that reducing meat consumption will lower carbon footprint significantly. Conventional fruits and veggies grown with nitrogen fertilizer and till often which produces carbon emissions. If fertilizer is used, that decreases the carbon. 1/3 of carbon in atmosphere right now was produced by tilling and we should be able to put much of it back. He feels like modern agriculture started global warming. especially when you remove trees for agriculture. We were apparently much more healthy as hunter gatherers and our statures were better and healthier then. Pollan says that we may see organic agriculture can out produce conventional agriculture. We may see an increase in food production with a shift to organic production.

Regarding genetically modified food- the question is not good over evil. The question is- is it safe? is it a good idea? We have a scientific, environmental and economic arguments. Diversifying and localizing agriculture is a better solution than modifying our plant seeds. The company has bought up a very large stake in the world's food supply. They argue on the basis of food safety. Critics of GM are now trying to fear monger back. We should be fighting on the ground of transparency and who controls our food supply. People should be demanding to know whether they are eating GM food or not.

Moving in the right direction: Now nearly 9,000 farmers markets exist nationwide. Schools have been dominated by "big food" but now school districts are having farm to school programs. There are some positive developments. Food industry experts are nervous about consumers who are moving away from what has been largely allowed to happen over the last few years. Added by myself- Pressure on large food companies like Chipotle, to become GMO free: http://organicconnectmag.com/project/chipotle-commits-going-non-gmo/ And panera's move to remove artifical ingredients from its foods- http://www.usatoday.com/story/money/2015/05/04/panera-panera-bread-fast-food-restaurants-dining-artificial-additives/26696823/. These are small steps in the right direction.

http://www.nongmoshoppingguide.com/

Uncapping the pen...

It's May 9th, 2015. Three years gave passed since my last post in this blog. I wish I could say that I have been writing elsewhere, chronicling my residency experiences and writing about lessons learned during residency.  Unfortunately, on most days I have been so exhausted from the demands of residency that my blog has shifted down to my last priority.

Moving through the years of post-graduate medical education, I have noticed I always work the same amount of hours. During intern year, my hours were long and scheduled as shifts. My job was to advocate for patients, learn the ropes of the local hospital/clinic and learn how to navigate the medical community (and lets not forget the scut work- someone has to do it!). Second year, my job was to get better at the things I did intern year and supervise the interns closely. My scheduled hours were slightly better and I finally had a chance to start engaging in my neuromusculoskeletal (NMM) specialization and read more on my own time. Third year hours dramatically improved, but my clinic patient load increased. I have been seeing 12 patients in a half-day, and have found that I can keep up with associated calls, forms, messages, but closing the charts on time has been a challenge. I have taken on quite a few leadership roles now that I know the ropes and am familiar with the inner workings of various professional organizations.  I have also dedicated my time to becoming the next chief of my NMM residency. So while my shift-hours in residency will be significantly better this upcoming year, I will be as busy as ever- tending to my leadership roles and helping to promote positive ripples in my residency, the greater orlando community and the osteopathic profession. I am sure this last year in residency will yield memories and lessons just as the last three years have, and I'll try to make it a goal to post more, even if just a couple of lines every once and a while.

Speaking of the osteopathic profession, it is an interesting time for us. The profession has changed quite a bit since my last post.

The ACGME and AOA boards have merged, and this occurred for many reasons. Many fear that DO's will lose their identity in this process, but that does not have to happen. The primary tenets* of osteopathic medicine should be propagated in each profession. Why would we not want everyone in the health profession to observe tenets that so greatly benefit our own patients? We now need to fully open the osteopathic profession and leadership to MD physicians and leaders. Our questions going forward will be: Throughout the board integration process, how do we maintain the separate distinction between DO's and MD's? Throughout the history of our profession, we have struggled with the feeling of inferiority. It is a natural human reaction to doubt something that is not a common practice. When you exist in such smaller proportion than MDs and you are a relatively new profession, you're going to have to work hard at gaining equal recognition. Now we are truly equal, with boards merging. How do we maintain our separate identity in the years to come?  The DO profession should be engaging our medical students, residents and physician members alike in this discussion.

*Tenets of Osteopathic Medicine as approved by the American Osteopathic Association House of Delegates:
The body is a unit; the person is a unit of body, mind, and spirit.
The body is capable of self-regulation, self-healing, and health maintenance.
Structure and function are reciprocally interrelated.
Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

But, now I will tell you a secret--a mystery. Those who suffer need you to be something more than a doctor; they need you to be a healer. And, to become a healer, you must do something even more difficult than putting your white coat on. You must take your white coat off. You must recover, embrace, and treasure the memory of your shared, frail humanity--of the dignity in each and every soul. When you take off that white coat in the sacred presence of those for whom you will care--in the sacred presence of people just like you--when you take off that white coat, and, tower not over them, but join those you serve, you become a healer in a world of fear and fragmentation, an "aching" world, as your chaplain put it this morning, that has never needed healing more.  -Donald Berwick

Donald Berwick, recent Administrator of the Centers for Medicare and Medicaid Services in the Obama Administration and a founder of the Institute for Healthcare Improvement, gave this speech at his daughter's graduation from Yale Medical School on May 24, 2010.

HEART Elective

http://www.sacredmirrors.org/flash/sm_full.html Artwork by Alex Grey

The physician who knows only medicine, knows not even medicine. -Mark Twain

I have finished with the Humanistic Elective in Activism and Reflective Transformation (HEART). What an incredible way to bring my medical school career around to full circle. I decided to do the rotation after hearing great things about it from dear colleagues of mine every year.

HEART is an intentional community, and each year students find a way to magnify their impact on the world through positive intention and collective consciousness. HEART was probably the BEST rotation I did during medical school. I feel physically, mentally, and spiritually transformed. During medical school, our passions and life purpose can sometimes get away from us- this is a great rotation in which to renew that.

Check out this trailer video that was made during my month at HEART!

The dates for HEART next year will be March 24 - April 20, 2013. HEART Website

Just a few of the important tools I'm taking to residency:

 Tips for going into residency:
1. Learn to accept change, for it is the only constant in life.
2. Learn to be flexible
3. Learn to accept the question marks in life and don't try to erase them. That is why we never allow pencil!
4. Nuture relationships
5. Strive for balance
6. Find meaning in medicine
7. Find mentors
8. Have gratitude and forgiveness for others and yourself daily.

The three most important things we can give our patients:
1. Presence- self-care and self-love is important! If we nurture ourselves, we can be more present with our patients, empowering them to do the same.
2. Intention- Be compassionate and loving, non judgmental, and know that there is a complete story behind everything. Be honest, open, and transparent.
3. Appropriate modality- recognizing what situations are best approached with western medicine, integrative medicine, or a metaphysical/psychological/spiritual model.

5-minute Compassion Meditation:
"May you be happy,
 May you be peaceful,
May you be free
From pain and suffering."

Say this to Yourself,
A loved one,
A stranger, and
To someone with whom you have been having conflict.

A Summary of this Year & New Adventures Ahead!

http://paulbates.com/florida-beach-scenic-sunrise-pictures-photos/

I matched into my #1 choice for residency, the Florida Hospital East Orlando (FHEO) Integrated Family Practice/ Neuromusculoskeletal Medicine (FP/NMM) program!!! I hope I can continue to represent my school, my cohort, and my profession in the greatest way possible while I am a resident at FHEO. I am absolutely honored to join the other hard-working, dedicated, and compassionate FHEO residents! Many people want to know what my program entails- it is a four year residency after which I will have obtained my separate family medicine and neuromusculoskeletal medicine board certifications. I know this will be stellar training in medicine, and I'll have the opportunity to really become an expert at osteopathic principles and practice.

Beautiful Florida Manatees

I can't believe it has been so long since I last updated this blog- I decided to leave it alone during interview season due to sheer lack of time to update it. During interview season, I traveled to Yakima, WA, Grand Rapids, MI, Orlando, FL, Southampton, NY, Los Angeles, CA and back to the Bay Area. I had such an amazing adventure, from experiencing two new states- Michigan and Washington, to finding out that Walter and I are capable of finding happiness no matter where we are on the globe.

My journey, summed up in 5 bullet points:

1. Washington is such a gorgeous state. I landed in SEA/TAC on a beautiful partly cloudy day and had an absolutely picturesque view of Mt. Rainier- hues of pink, purple, blue, and silver- it looked like the lost city of Atlantis. There are so many places to hike, and over 600 wineries in central Washington alone. Quite an incredible state, with nice people. I am convinced after spending 10 weeks in Humboldt and 4 weeks in Washington that I personally vibrate on the frequency of the pacific northwest. If you have never set foot on that part of the country, I strongly suggest that you plan to do it at some point in your life :)

2. Grand Rapids, MI is a cool city. I was there during August, and saw some of the most beautiful sunsets and sunrises walking in and out of the hospital. August is THE month to be in Grand Rapids. The only bout of bad weather I experienced was a lightning storm. I woke up that night flying out of the bed because a bolt had literally struck right outside my window. Oh, and the rumor is true- it does smell like ozone when a bolt strikes next to you. Yikes!

3. On top of its super fun theme parks, Orlando, FL has some amazing BBQ and southern food. The city is only 45 min away from the Atlantic and landing/launch site for NASA space shuttles. Also, I actually loved the humidity- I could breathe a lot better than I ever could back at home, interesting, huh? The rumors are true, FL has some beautiful beaches and it also has bugs the size of my face. Love everything.... except the bugs, haha :)

4. The Hamptons is a beautiful place, even in the winter time. I felt like I was the only person living in Hampton Bays while I was there, but the solitude and quiet was almost therapeutic for me while I faced an internal struggle of what specialty I would choose for residency. That area vibrates circa 1650, around the time the English settlers erected the town of Southampton. I kept feeling like I would run into some revolutionary war soldiers on my morning walks... ha ;) And yes, The Hamptons is a gorgeous place. I did not go all the way down to Babylon, which I regret. One thing I loved about this leg of my journey was seeing many of my 1st and 2nd cousins, and my aunt Debie & Uncle Fred. I absolutely love my family and am so thankful that they hosted me for holidays and quick visits!

5. When it rains in California, people FREAK OUT. It does not matter if they are northern our southern Californians, they forget how to drive, what to wear, what to do.... everything. I say this because for the first time in my life, I was rear-ended during a freak 15 minute lightning storm near LAX, literally a few minutes after I had picked up a rental car. Don't worry, I am fine, and the man who hit me took care of the repairs with the rental car company. I still need to get myself to an OMM specialist to make sure nothing was thrown off... I was in LA for interviews and to complete a PM&R rotation at Casa Colina, which is a famous rehabilitation hospital in the San Gabriel Valley. I have never liked the San Gabriel Valley because the smog in LA likes to accumulate in that area, but after a 4 week rotation, I grew to like it much, much more. Perhaps it is because Pasadena is pretty close to that area- still too far from the ocean for my taste (says the girl who is moving to Orlando for 4 years!).

So now that I know where I have matched for residency, I'm coasting downhill from here. That by no means is going to be an easy ride, but it will be a fun one.

I still have my emergency medicine rotation next month. Then after that, I join some of my 4th year medical student colleagues at a 4-week HEART Rotation in Ben Lomond, CA. After that, we've got some time to tie up loose ends in the Bay Area.


Marshall Creek, at The Quaker Center in Ben Lomond

Over the next four months, here is my to-do list:
1. Vacation in Hawaii
2. Ship our belongings across the country and move into an apartment in Orlando, FL
3. My Graduation from medical school My Zadie, Alan Kantor D.O. at his medical school graduation circa 1959 :)
4. Get married!
5. Take a little under two weeks to drive across the country to our final destination!
Map of our trip to Orlando, leaving the Bay Area on June 11, 2012:
Benicia-> Los Angeles-> Las Vegas-> Sedona-> Albuquerque-> Dallas-> New Orleans-> Pensacola-> Orlando! We'll be spending a few nights in Vegas, Sedona, New Orleans, and Pensacola.

What a way to end an amazing chapter of our lives... and with absolutely no break in between, we'll head right into a new one! (That's Robyn-Style, as Walter likes so say)

The expansion of happiness.

"It is neither wealth nor splendor, but tranquillity and occupation, which give happiness." ~ Thomas Jefferson

Learn from yesterday...

...live for today, hope for tomorrow. The important thing is not to stop questioning. -Albert Einstein