Primary care doctors play a critical role in the medical system. They form relationships with patients, manage all kinds of chronic and acute conditions, and determine when specialist care is needed. In recent years, however, these front line doctors are finding themselves faced with a conundrum. A growing proportion of their patients are overweight or obese, but most doctors lack specific training on the treatment of obesity, and many simply don’t have the time to discuss appropriate treatment options with these patients. Doctors that are situated within large academic centers may have the luxury of referring patients to registered dietitians, or even to medical or surgical weight management programs. But for doctors in the community, knowing where to send these patients can be a major problem.
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DNA is at the base of all life: plants, bacteria, animals, and humans. I personally have always been fascinated by genetics. As a teen, I would dive into books explaining fundamentals of genetics; as a medical student I did an elective in clinical genetics and strongly considered genetics as specialty (but stuck with my original passion for endocrinology). Yet, as a post-doctoral fellow, I wasn’t sure if I wanted to invest my time in learning about the genetics of obesity and diabetes, since what I really want is to find better ways to prevent those conditions. But I got wrapped into population genetics and still love it.
In the fight against the growing obesity epidemic, sugar-sweetened beverages (SSBs) have emerged as a major enemy. Most people know that soda isn’t the most nutritious choice of beverage, but juice retains an image of healthfulness – after all, it originates from fruit and can be a good source of certain vitamins when consumed in moderation. The problem is that many beverages thought of as “juice” actually contain very little fruit-derived content and lots of added sugars. And while 100% juice drinks may add some vitamins to the diet, they can also contribute to excessive sugar intake, resulting in problems such as tooth decay and obesity.
At an early age, my father stressed the importance of cardiovascular exercise to me. He was looking out for me, both as a physician and as a father who likely passed on his high-risk genes for cardiovascular disease. He ensured that my brother and I were physically active and getting our heart rates up every day, which mostly consisted of running or biking, or cross-country skiing in the winter. As I grew older, I kept this tradition of daily cardiovascular exercise in my routine so that I can hopefully continue to fight my higher genetic risk of cardiovascular disease.
“Are there nuts in that?” was a phrase that I heard over and over again throughout my childhood. My best friend (and current roommate) is allergic to peanuts, tree nuts like walnuts and almonds, and soy. She thinks about and questions every bite of food before it is deemed safe. She finds going out to eat, which for most people is a fun and relaxing social activity, to be frustratingly limiting at best and dangerous at worst. More people now know someone with a food allergy, but are we aware of the mental burden of chronic food avoidance and fear?
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