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David Katz, M.D.

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Dads, Dudes, Diabetes and Duty

Posted: 03/14/2012 8:56 am

I am, and have long been, on the masthead at Men's Health magazine as an editorial advisor, with contributions focused principally on weight control. Proud of it, too.

I do note, in passing, that I don't always agree with my good friends there. They seem to feel that a hefty dose of bacon can cure just about anything that may ail you, and I beg to differ. I submit as evidence in defense of my position a 50-year-old body (Well, 49; but who's counting?) with an elusive "six-pack" -- built and maintained on "mostly plants." But I digress.

More relevant is that I am a father of five kids, and editor-in-chief of the peer-reviewed journal Childhood Obesity.

I am here to talk to my fellow fathers about kids. Paternity, posterity, peril, and promise if you will.

Dads, dudes, countrymen (and city men, for that matter) -- lend me your ears! Manly middles, portly posteriors, and notoriously thick skulls can come along for the ride. I am talking to you, mano a mano. Ladies, please do listen in -- if nothing else, you may want to print this out, roll it up, and smack some guy in the head with it when we're done here.

Guys:

We know that women are the guardians of the family health. We know that women, wives, mothers tend to do the heavy lifting when it comes to medical care, preventive services and diet. We know, consequently, by process of elimination if nothing else, that men tend to stand idly by and watch the women in their lives do this heavy lifting mostly on their own. Not very chivalrous -- but it is what it is. Men often turn up at their own medical appointments only because a wife or girlfriend "made them" do it. Pitiful!

This is even true regarding the health of kids we helped make. And it's not acceptable.

I trust you've heard the familiar litany of bad news about the health of our kids. Childhood obesity is more prevalent in the U.S. than in virtually any other place on the globe, and more prevalent now than ever in history. The fattening of our children propels them to an ever greater burden of ever more dire chronic disease at ever younger ages.

The spread of Type 2 diabetes among children is already yesterday's news. But yesterday -- when I went to medical school -- this disease was called "adult onset" diabetes to distinguish it from "juvenile onset." On my watch -- and yours -- we have witnessed the transformation of a chronic disease of overweight, middle-aged, sedentary adults into a pediatric scourge.

Yesterday's news is bad -- a tragedy, in fact. And a travesty. A disease that should never occur in children has become routine among them, and our collective societal response was to change the name to make it ok.

Still, today's news is even worse.

Today's news is the proliferation of cardiac risk factors among children, and their growing need for treatments that until very recently were limited to adults, such as statin drugs and bariatric surgery. And even... coronary bypass. Today's news is a 35 percent increase in the rate of stroke among 5- to 14-year-olds, with no smoking gun on the scene except epidemic childhood obesity to account for it.

What, I wonder, will tomorrow's news be? I think, guys, that it's partly up to us.

In a culture where real men don't eat quiche, where salad is "the girl food," and where a man's man is tough and beefy, it may seem that eating well and being active to protect our health requires us to get in touch with our feminine sides. If so, it would likely do most of us some good -- but it's not required. There is another way entirely of looking at this scenario.

The wolves are at your door, fellas, and if you are like most guys, you aren't doing a damn thing about it. You are NOT defending hearth and home. Very "un-guy" like.

The wolves are obesity, insulin resistance, metabolic syndrome, Type 2 diabetes and behavioral disorders -- with heart disease, stroke and cancer to follow -- stalking our children.

So... Grab your (proverbial) muskets, and defend hearth and home! That is what guys do. That is time honored "guy stuff." In all too many cases, these wolves have already sunk their teeth into the tender flesh of our kids.

To cultivate the health of your children, you must cultivate your own. Even if you are too tough and manly to care about the minor inconveniences of open heart surgery or the occasional amputation -- no guy gets "toughness" credit for failing to care about, or look out for, his kids.

If your kids love and respect you, they will do as you do. If eating well is too big a bother for you, it will be too big a bother for them. If worrying about health and nutrition is limited to "nutrition nannies" (like me, I suppose), then your children, like you, will roll their eyes at the very choices that could immunize them against a future of foreshortened joy and forestalled opportunity.

If you are too busy, too unconcerned, too manly to exercise, what will motivate your son to be otherwise? If physical activity is not instilled by you as a family value, what will inspire your daughter to seek and gain its incomparable benefits?

I have been taking care of patients for 20 years, so I have met a lot of you guys. If I hadn't -- if I were younger, more naïve, or simply more hopeful -- I might ask you to pursue health for your own sakes. But I have learned the hard way how thick the average guy's skull is. (Ladies, don't worry -- if you do roll this up and hit a guy in the head with it, chances are he won't feel a thing.) Most of my male patients get religion about their own health when staring up at the harsh ER ceiling lights from a gurney. Sometimes they get to come down from that gurney and try a new way forward. Sometimes, alas, that chance never comes. But either way, the timing leaves a lot to be desired.

For me, it's a personal loss every time something bad happens to someone good who just couldn't be bothered. Who only ever really cared about preventing a heart attack -- or stroke or cancer -- after the diagnosis. The unnecessary loss of years from life and life from years is the recurrent tragedy against which I channel my every effort. But you know what they say: You can lead a horse to water... So I fail all too often; the teachable moment comes after the calamity and the cycle of preventable loss and lamentation goes on.

So I pin little faith on talking you into taking better care of yourselves for your own sakes, but I think I can count on the sacred and inalienable bonds of fatherhood to call on you to do it for your children's sake. Is avoidable loss and preventable lamentation something you can countenance paying forward to your daughter or son? No father worthy of the title could say "yes."

Gentlemen: You are role models for your children. Like it or not, you are playing follow the leader -- and you are the leader (or one of them). Lead toward health, your children will follow you there. Lead elsewhere, they will follow you elsewhere. They will do as you do. So do the right thing -- for their sake. Eat well and be active -- for their sake. Be part of their solution or you will be part of their problem.

The mission need not be complicated. Simply acknowledge health as a worthy goal and a priority. Let your kids know that you want them to eat well because you love them -- because you want them to be healthy, and healthy people have more fun. Then, make a conscious effort to eat well, too. No need to make perfect the enemy of good -- just some movement. I'm sure you know the basics of the route, but if not, you can always ask for directions, right?

Just by letting your kids know that you don't want the growing body of a son or daughter that you love constructed out of junk, the mission will be advanced.

Physical activity is even easier. Just walk the literal walk. Be active with your kids. The older and more capable they become, the greater the options, but you can start when they're still in the cradle.

Every aspect of stepping up and being a healthy role model for your children is part of a virtuous circle. By setting the example your kids need for the greatest likelihood of their own healthy future, you'll be laying the groundwork for yours. Just as well, because when those kids grow up and have kids of their own, you may want to be around for it. You don't want to be that guy seeing revelations among the overhead lights in the ER. By making health a shared pursuit, you'll have things to talk to your kids about and things to do together.

As fathers, we are charged with no responsibility more sacred than protecting our children. So I am asking you, mano a mano, to protect yours. Their future vitality -- their future joy or misery -- will be determined in part by the choices you make.

For all the guys out there too tough to care about their own health until it's too late, how about setting a healthy example to defend your kids? It's classic, time-honored guy stuff. It's got "Dad," and "dude,'" written all over it.

It is, in a word, our duty. So let's man up -- and do it!

-fin

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org

For more by David Katz, M.D., click here.

For more on personal health, click here.

 

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I am, and have long been, on the masthead at Men's Health magazine as an editorial advisor, with contributions focused principally on weight control. Proud of it, too. I do note, in passing, that ...
I am, and have long been, on the masthead at Men's Health magazine as an editorial advisor, with contributions focused principally on weight control. Proud of it, too. I do note, in passing, that ...
 
 
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The Seventh Chakra, amazon
01:53 PM on 03/16/2012
I started to read this article and as I read I found a odd dislike for the author. I tried to put my finger on it and still had a difficulty discerning what it was. It was an impression of someone who placed themselves above the mass to dictate the well being to the peons.


It is as if the Avatar came to walk among the mortals but not with them. Pure crap. I found myself skimming the remainder of the article, then dismissing it completely.
11:43 AM on 03/20/2012
Hmm, Dr. Katz spends much of his time in the pursuit of helping people. Your impression is inaccurate. I regularly read Dr. Katz's articles and I have seen him speak. One thing that you should know about Dr. Katz is that he is a poet. Unfortunately, in your mind you equate being a poet with being a snob. This in no way describes Dr. Katz. Keep an open mind. His message is powerful!
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The Seventh Chakra, amazon
03:41 AM on 03/21/2012
After your response I went back to re-review the article. In just less than 1/3 of the beginning of the article he uses the pronoun I, over and over. (I"I" stopped at 11 times.)
I stopped.

Ego, ego, ego...tsk, tsk, tsk.

Now in an opinion, I is acceptable, but to deliver something as informative--well my original thoughts remain.

As for being a poet? In my mind "I" had no idea he was a poet, so how could I equate being a poet with being a snob?

His message may be powerful. I couldn't step over his condescending persona.
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beanbrain
God bless the USA
11:33 AM on 03/16/2012
good article, and a very needed one, men need to step up to the plate (not a food one) and "man up", it's about time, thanks for your article..kudos to you for something that has longgggggggggg needed to be said....
11:06 AM on 03/16/2012
The author of this article is evidently unaware of how much fault lies with our government and healthcare institutions, which cater heavily to women's health and, by comparison, marginalize men's health. Significantly, H.R. 2115, The Men and Families Health Care Act of 2009 (introduced in April 2009, but, tragically, dying in the 111th Congress), which sought to create a federal Office of Men's Health, similar to the long-existing federal offices on/for women's health at NIH, the CDC, the FDA and DHHHS, included the following legislative findings: "(1) Risks to the health and well-being of the Nation's men (and our families) are on the rise due to a lack of education, awareness, and pursuit of preventative screening and care -- (A) men are leading in 9 out of the top 10 causes of death; (B) 1 in 2 men versus 1 in 3 women in their lifetime will be diagnosed with cancer; (C) the life expectancy gap between men and women has increased from one year in 1920 to 5.2 years in 2005." It's time to end the flagrant institutional sex discrimination and make men's health as much of a national priority as women's health.
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William Anderson LMHC
Licensed Psychotherapist, Weight Control Expert
09:26 AM on 03/16/2012
It's not only a matter of being a good role model for the kids. For too many overweight men out there, with the way they are living, they will be dead before they get a chance to see their kids grow up. They will be leaving them to fend for themselves. This is a fact.

One of the most important reasons men come to me for help to lose weight is that their doctor has made it clear to them that there is a good chance they will die prematurely because of their weight. It was one of the things that helped me to turn things around and lose 140 pounds over 25 years ago and keep it off. I was a lucky one, discovering the solution that Behavior Medicine is because that had become my chosen field.

Taking responsibility for being a role model for the kids is only one way being a good father can help a patient get well. It's amazing how a man's kids can help him to be a better man.

Men's Health, eh? If you look back in their archives you'll see I was one of their success stories in 1985! And still successful!

William Anderson, LMHC
Author of 'The Anderson Method - Secrets of Permanent Weight Loss'
www.TheAndersonMethod.com
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dancerctry
I love Gardening and Decorating
08:54 AM on 03/16/2012
Great article from one of my favorite bloggers!!! I have been working with a nutritionist on my hypoglacemia and loosing waist size since that's were I carry my fat (almost there) my son is 2 3/4 and has always been well proportioned. That's from his doctor (and he went strait to formula). While we don't eat perfectly, we don't keep junk food in the apartment and I cook (or family dinner where my mom cooks) every night but fridays.

My MIL never liked veggies so it was either canned green beans or doctored up other veggies. It was a huge battle to get him to eat the steamed fresh veggies that weren't broccolli. He stopped having issues when my son was born because we had had a long discussion about the example parent's set. Zach, my son, eats a lot of healthy food (sometimes the problem is limiting the grapes and bananas to prevent bathroom issues).

Josh, my husband, works in a warehouse as a Quality Control manager. He walks around a lot of the day so he assumes he's getting enough exercise. We try to set it where he can have healthy dinner left overs most days but he still ends up with frozen pizzas a couple of times a week. (I have salad mostly). he has instant oatmeal for breakfast at work.

WebMD says healthy weight but big waist. It takes negotiations to get him to eat healthy!
08:43 AM on 03/16/2012
love you nieghbor as yourself for the love of me
08:34 AM on 03/16/2012
From the female perspective I enjoyed this article and agree with 90% of the information. Thank you Dr. Katz for articulating what I've said for years. Men do not seem to be the leaders of the family anymore. Sorry guys, I'm sure some of you ARE but let's face it many of you are NOT. Of course divorce complicates 50% of the relationships out there and I certainly don't know what to do about that problem (married 40 years). I have seen over and over men not engaged in the daily life choices as they should be. Don't bother snapping back at me that I"m old fashioned, I don't know what I"m talking about. We, as in husband and myself had to seek out food without chemicals, hormones, antibiotcs when it was hardly available. What do you do you ask.... you get busy and find farmers, eat fresh, never buy anything in a box. As for Dr. Katz being sexist, come on he is making an effort to talk to you men. Sheesh, we're all so sensitive now. Let's walk mano-mano down this path for health.
08:12 AM on 03/16/2012
IMO, this whole Diabetes and obesity and cardiac problem with kids could be solved tomorrow. (I know not all could be cured, etc) The problem??? Todays society and electronics. 100 yrs ago when I was a kid, me and my friends went outside after breakfast, and didnt come in until Mom started yelling down the street. We were on the move all day. And living in the city, we drank alot of soda,ate hotdogs, chips, etc etc all on the go. We werent fat, we didnt have diabetes, and we didnt have heartattacks at 12. And we werent sitting inside all day on our electronics. Todays kids get no exercise, theyre on their damn comps all day. The food today is way better,but kids sit inside all day, eat and play games.When I see small kids 100 lbs overweight, I get angry. I blame the parents. Its too easy to shove the kids in front of Videos, computers, games all day. Its their instant babysitter. And someone is buying and feeding the kids this crap at home. Years from now, when they are studying the downfall of man, the computer and electronics age will be number one to blame. It has singlehandedly done more to hamstring and handicap our young than anything. Get your kids off the comp, throw them outside, and force them to play, use their imaginations. Do that, and this so called epidemic will be gone.
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Jessi Stayedo
08:06 AM on 03/16/2012
Manly men! Where? Don't think we have to worry about that much any more. Because there are no manly men out there.
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Carolyn Kostopoulos
06:25 PM on 03/15/2012
just the other day i heard an ad for a hospital boasting about it's cutting edge research into childrens' diseases. what breakthrough were they currently working towards? an artificial pancreas for diabetic children!
now, while this might be a great thing for juvenile diabetics, for it as a product to make enough money to justify the research and development, it's going to target a wider market.
lucky for them, diabetes 2 has reached epidemic proportions!
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David Katz, M.D.
Director, Yale Prevention Research Center; Editor-
07:09 AM on 03/15/2012
Interesting mix in the comments thus far of self-righteous pushback (why should you guys doing things right be offended by this? I'm a guy doing things right- but it doesn't change the very well documented social pattern I describe), and religious piety (which, frankly, seems rather a non sequitur to me). My inclination is to juxtapose the two and ask: are the social challenges described- working hard to make ends meet, and so on- a good excuse for abandoning one's religious principles? If not- if what REALLY matters matters no matter what- then how can the fact that it's hard to model health to one's kids become an excuse for not trying? All I'm saying is it should be a priority for all men. And at the level of our culture- take offense as you may!- it is not.

As for the Spanish speakers noting that 'mano a mano' means 'hand to hand' (or, figuratively, face-to-face), they are of course, quite right. However, the expression is routinely used in English- erroneously- to convey 'man to man,' and I simply propagated that prevailing error. Mea culpa, although intentionally so.
08:34 PM on 03/14/2012
How simple do you want it? Cut all food by 1/2.You will be well fad and move freely. Will it sell?
Try doubling the price!
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Wake Up Call
Poking your brain with a pointy stick.
07:17 AM on 03/16/2012
Oh, don't worry about that. Food prices will be doubling sooner than you think.
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ccdae5
Not a 1%'er...........yet
07:28 PM on 03/14/2012
Wow, what a sexist article. i'm a 52 year old man whose been married for 27 years and I'm perfectly capable of taking care of myself. In addition to maintaining the house, cars, and yard, I can even do laundry and dishes! Imagine that?
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beanbrain
God bless the USA
11:38 AM on 03/16/2012
not sexist at all, you're just one man in millions......
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ccdae5
Not a 1%'er...........yet
08:30 AM on 03/17/2012
I still think he should quit whining or turn in his man card.
kmd4excel
A reality check for progressives
07:05 PM on 03/14/2012
Is anybody but me sick and tired of this guy's sanctimonious preaching?????

Dr. Katz, consider this an open letter to you. You want to do something about childhood obesity? Do something that will strengthen the family structure in this country. You see, Dr. Katz, in this country, most men are no longer the "Kings" of their castle. Most of them lost the first castle, and are working at holding on to the second castle. You see, Dr. Katz, it is very difficult for a man to take up his "musket" when he only sees his kids, at best, for 2 weeks a month. Because of my job, I am in and out of many people's homes. You want to know my casual observations? Those homes where the mom and dad have stayed married, and the family has stayed intact? Very little obesity. Those homes which are 2nd tries, or broken? Far more obesity in the kids. Not scientific, I know, but I can't help but notice. Dr. Katz, you're just 2 years younger than I. So I know you must remember that when we were growing up, childhood obesity was rare. What's changed, Dr. Katz? What's the common denominator? If you looked at a graph illustrating the rise in divorce in this country, and a graph at the rise in childhood obesity, would they be identical, or nearly so? Culture is the issue, Dr. Katz, not preaching about what men are or are not doing.
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dethburger
Who are you?
10:28 AM on 03/16/2012
You couldn't be more wrong. Sugar, fast food and processed foods are to blame.

When I was young, there was only one McDonald's in town and going there was a treat.. Now there are FIVE.

I see entire obese families EVERYDAY.

Post links if you can...prove your point.
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beanbrain
God bless the USA
11:41 AM on 03/16/2012
and you're wrong too! eat half the portions you eat now, and see the pounds fall off... don't blame the fast food places, blame your lack of self control, no one twists your arm to go eat at the junky places.......try a little self control......
kmd4excel
A reality check for progressives
11:46 AM on 03/16/2012
You state that I "couldn't be more wrong", make a blanket statement not supported by anything other than your opinion, and then have the audacity to demand I prove my point? Prove yours, deth!

All three of the things you mentioned have been around for decades: Sugar, fast food, and processed foods. They were around when I was a kid, and I've been around for 5 decades. Since I was a kid, though, many OTHER things have changed. Drastically. And most of those things are cultural. With the breakdown in the basic family unit -- a FACT which is indisputable given the divorce rate in this country, and other issues -- the rise of time crunched single moms/dads has risen dramatically. This is but ONE factor driving the rise in obesity.

My views are driven by logic and observations around me, deth. No one can tell me that the breakdown in the family hasn't contributed -- far more than sugar, processed food, and fast food. The problem with the Dr's thesis, and yours as well, is that you are treating a symptom, not the disease. The disease is in the culture, and an overbearing nanny gov't that wants to intrude into everyones' lives. Obesity is a symptom. Along with kids killing kids, and many other ailments of our nation too numerous for me to list. The longer we slouch toward socialism, the greater the problems will become. And until people of your ilk understand that, you are part of the
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beanbrain
God bless the USA
11:38 AM on 03/16/2012
shutty, the information was very good indeed!
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Edwin Keever Jr
Go to Face Book Mr. Ed The person, not the horse
06:56 PM on 03/14/2012
Men have have three dutys ay home, they are: Sleep, watch football, and drink beer!
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dethburger
Who are you?
10:29 AM on 03/16/2012
I'm a man and I only do one that you listed.

Nice stereotype.
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beanbrain
God bless the USA
11:42 AM on 03/16/2012
det, well we can see the type of man edwin is......
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Edwin Keever Jr
Go to Face Book Mr. Ed The person, not the horse
02:43 PM on 03/16/2012
That was the point, sterotype. I only do one sleep.