and it’s called

CHILDHOOD OBESITY

It just can’t be true!  How can a mere 12% increase in our daily caloric intake result in a three-fold (300%) increase in the childhood obesity rate in just a single generation? According to statistics from The United States Department of Agriculture (USDA) this is precisely what occurred in the United States between 1980 thru 2004. While I am not one to rely on statistics, in this particular instance, the stats literally do add up, and they point squarely at the cause of the  world-wide Obesity Epidemic;

IT’S THE FIBER, STUPID!

This 12% increase in calories translates into each American eating an extra 300 calories per day, nearly half (138) of which came from refined grains. A review of the basics of cellular metabolism will show how this seemingly small amount of refined grain can have  an exponential effect on our nation’s collective Body Mass. Just a few generations ago in our country we ate mostly whole grains, an excellent source of fiber, in our diets. Based upon its having six Carbon, twelve Hydrogen and six Oxygen atoms (C6H12O6)fiber is a carbohydrate. However, unlike other carbohydrates, such as sucrose (table sugar), fructose (fruit sugar) and lactose (milk sugar) which all contain four calories per gram, the inner lining of our digestive tracts does not have an enzyme that allows fiber to gain access to our bloodstream where cellular metabolism takes place. Therefore, in reality fiber has no calories, and by its remaining within our digestive tract, it enhances satiety (our sense of feeling full) thus making us eat less. Even more importantly, fiber slows down the absorption rate into our bloodstream of the other nutrients, carbohydrates, fats and proteins that we eat along with it. As a result of this slower absorption of nutrients that fiber promotes, the 40 trillion cells that makes up each one of us human-beings, can extract more of the energy from our food for us to use and not store it as fat in our bodies. Paradoxically, the same physical and chemical properties that make fiber indigestible are the same properties which allow fiber to optimize our metabolism.

Now we can understand why there is so much evidence that the proper amount of fiber in our diets reduces the risk for developing diseases, such as coronary heart disease,1 stroke,2 hypertension,3 diabetes,4 obesity,5 and certain gastrointestinal disorders, such as diverticulitis.6 The right about of fiber in our diets will improve our serum lipid (cholesterol) concentrations,7 lower our blood pressure,8 lower blood sugar levels in those of us with diabetes,9 promotes regularity,10 aids in weight loss,11 and even improves our immune function. The bad news is, the average fiber intake for children and adults in the US is less than half of the levels required for all of these great health benefits!

My always being the optimist, there is a silver lining in the USDA’s statistics. Rather than what has become our collective obsession over what we should not to eat, we can turn our attention to a much more positive and practical message about what we should eat. To illustrate the rationale for this paradigm shift, here is some food for thought. Imagine eating a slice of chocolate cake and then testing yourself for the glycemic index of the piece of chocolate cake. Simply stated, the glycemic index measures how much of the energy from the piece of cake is turned into real energy available for our bodies to use versus how much of the energy from the piece of cake will go unused,  thus stored in our bodies as fat. Now imagine eating a second piece of chocolate cake identical to the first one, the only difference being that this piece has 3 grams of fiber added to it, which you won’t even taste, by the way. The glycemic index after  eating this piece of cake will be much lower than the first piece. By simply adding a small amount of fiber to the food we eat allows us to get more useable energy and store less energy as fat. In other words, from the perspective of cellular metabolism (the only relevant perspective when discussing nutritionobesity, which is the result of unusable energy from the food we eat being stored in our bodies as fat, in reality, is cellular malnutrition.

The processing of our food breaks down whole grains causing a metabolic double whammy. By refining whole grains we immediately remove these two major benefits of fiber; increased satiety and optimization of our cellular metabolism. And what do whole  grains become once they are refined? That’s right, refined grains are the metabolic equivalent of pure sugar! So when we eat processed grains, we are not just eating processed grains, we are eating them in place of whole grains, which means that we need to eat more of them before we feel full and it also means they are absorbed too rapidly for our 40 trillion cells to metabolize them efficiently so they store more of the energy in our bodies as fat.

When we view the processing of whole grains from the perspective of cellular metabolism, we now see that it is no coincidence that in the same 25 year period that we added an extra 138 calories per day of refined grains to our national diet that the rate of Childhood Obesity tripled! Thus, what we need to do to lead them by example, and what we need to preach to our children from this time forward is perfectly clear; let them eat their cake but they need to eat their fiber too!

End

Mitchell R. Weisberg, MD

Founder-CEO

Internist-Psychopharmacologist and Personal Physician at:

Optimal Performance MD

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The Current State of Workplace Wellness Programs

While Workplace Wellness Programs may be working well for employers, could they be working better? My answer is, yes. In fact, when we take a close look at how well they are working in their current format, we will see that Workplace Wellness Programs are grossly underperforming, and with some relatively minor tweaking, these programs have the potential to get the kind of return on investment that can put a real dent in an employers runaway healthcare inflation. 

Step one on the journey to enhancing the value of Workplace Wellness Programs is understanding the statistical principle, selection bias, the error in choosing the individuals or groups to take part in a scientific study. As a direct result of their well-intentioned effort to get all of their employees to take part in their Wellness Programs, employers have, in fact, been non-selective, inadvertently creating a selection bias which drastically effects these programs returns on investment. If all employees are equally incentivized, those most likely to take part in a Wellness Program are those employees already predisposed, to the virtual exclusion of those employees that are not already predisposed, to wellness. Why is this of such great importance? As it turns out, employees’ wellness, or well-being directly correlates with their work performance and productivity. The best evidence for this comes from the basic metrics every employer uses for tracking their lost workforce productivity, such as absenteeism, presenteeism, disability costs, employee turnover, employee attraction and successorship, all of which are directly affected by employee health and wellness, and when all tallied, cost employers far more than their direct employee healthcare costs. In spite of this well established interdependence of workforce well-beinghealthcare costs and lost workforce productivity, only healthcare costs have a column on an employer’s balance sheet, and therefore, command most of an employer’s focus and attention. To successfully resolve runaway healthcare inflation, employers need to adjust their focus so they bring the whole problem into view; then they will see, it’s not just the cost, it’s productivity lost!

In conclusion, the selection bias that now pervades Workplace Wellness Programs is causing most of an employer’s investment to be spent on their most well employees, who have the least to gain and that cost employers the least, while excluding their least well employees, who have the most to gain and that cost employers the most in both direct healthcare costs as well as in lost workforce productivity. Since their being non-selective caused this selection bias, perhaps becoming more selective as to which employees should take part will dramatically increase employers yields from their Workplace Wellness Programs. The time has come to:

Leave Well Enough Alone:

the first ever,

Performance driven Workplace Wellness Program

in my next post, so please stay tuned.

END POST

Mitchell R. Weisberg, MD, MP

Internist-Psychopharmacologist

Founder-CEO and Personal Physician at:

Optimal Performance MD

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