This column was originally published in AMA eVoice on September 6, 2007. Dr. Davis is president of the American Medical Association.
How many medical conferences and seminars do you go to, where the breakfast fare features eggs and bacon, or huge (non-whole wheat) bagels and cream cheese, or Danish pastries with that sugary stuff drizzled on top? How about pizza at luncheons for medical students and residents, or at Grand Rounds? Or hot dogs or donuts at fund-raising events?
And by the way, how nutritious is the food at your hospital cafeteria? Or maybe you have a fast-food restaurant inside your hospital?
All of us know the statistics about the obesity epidemic in this country and its impact on diabetes, hypertension, heart disease, arthritis, and many other conditions. So why do we do such a poor job at practicing what we preach?
At the breakfasts now served during our AMA Board of Trustees meetings, I'm pleased that we routinely get fresh fruit and oatmeal and cold cereals, along with juices and skim milk. Scrambled eggs are made with a cholesterol-free egg substitute, whose taste can be spiced up with salsa and chopped tomatoes and green peppers. And turkey sausage is there for those who crave meat.
But I continue to go to medical society dinners featuring a huge piece of succulent beef that rivals the "masculine" (read "macho") portion size for which restaurants in Buenos Aires are famous. Meanwhile, many of those medical societies (including the AMA) encourage their physician members to promote good nutrition among their patients, and they advise restaurants and grocery stores to serve and sell heart-smart food items.
It's time to get our own house (and kitchen) in order. If we want our patients and the public to eat right and get more physical activity and exercise, we must lead the way. That means setting a good example, through the organizations and institutions with which we're affiliated, and as individuals.
Organizations do not need to reinvent the wheel. Two useful guides on serving healthy foods and beverages for meals and snacks at meetings and conferences have been produced—one by the University of Minnesota School of Public Health (PDF, 614KB) and the other by the North Carolina Division of Public Health. Urge your organizations' food services and meeting management staff to follow the recommendations in them, and to require compliance by the hotels, restaurants, vendors, and others who feed you and your colleagues.
In addition, we need to build time into our conferences for physical activity and exercise. Schedule a walk or run for conference attendees each day. Give T-shirts to participants. Make sure the organization's leaders lead the way. Give the attendees information on local paths for walking, running, skating, and biking, and the availability of rental bikes, skates, and protective gear. Give them information on the hours and location of the hotel's fitness club; if there's a fee to use the club, try to get it waived or reduced for conference registrants.
Hardly any physicians smoke these days, but many of us have unhealthy diets, don't get enough exercise, and are overweight or obese. That needs to change. Many of us claim to be too busy to exercise, but each of us should be able to find a way to integrate exercise into our lives. I listen to books on tape while on a stationary bicycle at home. Others go running or walking or to the gym or health club early in the morning or during the lunch hour. Or you can get on the treadmill in the evening while watching your favorite program or sports team on TV.
Dietary change is daunting for our patients and ourselves, given the myriad messages we hear from the experts: low calories, low fat, low salt and sodium, high fiber, more fruit and vegetables, and so on. My personal philosophy on improving one's diet is to do it incrementally—ideally one change a week, but otherwise, one a month—and that's how I've improved my own diet. Switch from whole or 2 percent milk to skim or 1 percent, from regular to diet soft drinks, from ice cream to frozen yogurt or sherbet. Give up cookies and mayonnaise. Get the grilled chicken sandwich (hold the mayo) instead of the double cheeseburger.
Because all of us live in a "toxic food environment"—a term coined by Kelly Brownell, PhD, an obesity expert at Yale University—eating well is an ongoing challenge. So I urge each of you to purchase several subscriptions to the Nutrition Action Healthletter, an outstanding newsletter published by the Center for Science in the Public Interest. For $10 a year, you get 10 issues, each of which is chock full of great tips on choosing healthy foods and following a healthy diet. Take one home for you and your family to digest. And put the other copies in your office or clinic waiting room for your patients.
Please send comments, questions, and replies to amaprez@ama-assn.org.
Content provided by: Ronald M. Davis, MD