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Health Care Advice: The Problem of Health Information Overload

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The first "Food for your Whole Life Health Symposium," spearheaded by Dr. Mehmet Oz, was held June 6 and 7 at the Grand Hyatt Hotel in New York City. The event was free. The first day open to the public drew 1,000 visitors. The second day, just for professionals, mostly dietitians and media, there were about 500 of us.

Interestingly, but I suppose not surprisingly, it seemed 492 were women. It was most obvious when during the guided stretch break I was in a sea of female arms swaying back and forth, and here and there a grey-suited gentlemen remained seated.

Almost a dozen cutting-edge doctors, researchers, food and social scientists and chefs came together to share their knowledge of how food and lifestyle choices affect our overall health, and to equip dietitians with information to help patients make better food choices.

In fairness, I have to say I didn't attend the conference on it's first day, but in truth, while I applaud the intent of the conference, I have to question how successful it was "equipping dietitians to help patients make better food choices." I'll tell you why in a bit.

Too much information
I find it enormously interesting that with constant information coming at us these days about health and healthy eating -- the daily reports on TV morning news shows, the growing legion of food-based reality shows, every food ad that no longer shows a family happily gathered around the table engaged in joyful eating, but instead a single box or can with its fortified vitamins and fiber content listed -- that people are continuing in record rates to get fatter. Two out of three American adults are overweight and one in three obese. Seventeen percent of children ages two to 19 are obese!

In a few short decades we have moved from ingesting 2,057 calories/day to 2,674 calories/day. So, my question is what isn't working?

I asked the same few questions of everyone I met at the event in-between lectures and while standing on the long line for the ladies room:

"Why, with all the information out there on healthy eating, are people fatter than ever?"

"Why are half the people with type 2 diabetes not managing their diabetes very well?"

"What has to change so that people change their behavior?"

I got the same reply from everyone almost verbatim: There is too much information out there and it has become too confusing. Some of it is contradictory, and none of it is laid out for people to act on easily. One dietitian trying to solve the problem said, you can't just tell people, "Eat spinach, it's good for you." You have to tell people what type of spinach to pick, fresh or frozen, how much spinach to eat, how often, how to prepare it...

And right there is my question about the utility of this conference for health professionals: How is giving them more information helping them become more effective?

I interviewed key speaker, Dr. David Katz -- a Yale University researcher and authority on nutrition, weight management and the prevention of chronic disease and a leader in integrative medicine and patient-centered care. He confirmed the participant's observations about information overload for most people.

He also told me, lowering his voice so as not to offend my Huffington Post badge, that the media colludes with keeping up the confusion. With an endless need for "new" news and a ravenous appetite to titillate, the media barrages us with an endless supply of findings that has left the general public reeling. The result: people ignore the information and do nothing.

I had a follow-up question I also asked everyone after they answered the first few.

"What do we need to change about what we're doing -- you, the health professional, the government, the media and food manufacturers so that people start making healthier choices?"

To my surprise, very few people could answer my question. Most hesitated, some looked as though I'd just told them I had kidnapped their child. There was a frozen moment and I'm not really sure why. Frustration? Despair? Too many obstacles they're too familiar with? Lack of thinking outside-the-box? No encouragement to think outside-the-box?

What has to change?
Some said we have to just keep getting the message out there. Others said we need more funding to get the message to more people. Yet, that seems hardly the answer to me since the message has been out there for a decade and everyone's already confused.

Some dietitians and nurses talked about making our environment less toxic. To treat bad food as we finally did cigarettes when no one could any longer deny that they were killing us. Of course, it's a lot harder since one doesn't have to smoke, but one does have to eat. But I know I'd certainly like to be able to easily find something healthy to eat while zipping through airports around the country.

Dr. Katz also told me, in a tone with which I knew he was setting me up, "Yes, we can set new standards in schools, tax junk food... (now I'm waiting for the "but" and then it comes) but, as Michael Pollan says, we need a food bill not a farm bill. We need to subsidize foods that are actually good for people and the planet. We need to make it financially, and in every way, desirable to produce, buy and eat healthy food.

Katz admits we have failed to turn what we know into policy, practices and social solutions and believes we must empower all individuals to become nutrition experts, and give them tools so they can provide themselves with a "healthy future" just as they work toward creating their "financial future."

Katz believes we need to give people tools, not more talk. I found him to be very interested in thinking about and providing solutions.

The missing ingredient
For me in general, I found the lack of solution-thinking and solutions offered the missing ingredient at the conference. If the basic problem is that we are suffering from information- overload, so that it becomes too confusing to act -- like freezing in front of 50 breakfast cereals wondering which is best to buy -- then how does two days of more information help dietitians aid clients to eat healthier and change their lifestyle habits?

Katz then introduced me to his passion-project, "NuVal™" that he and his described "dream team" have been working on. Kroger, a chain grocery, is piloting it in 23 stores in Lexington, KY and he anticipates Kroger will roll NuVal out to their additional 2500 stores in 31 states. Currently NuVal is in 600 stores with another 400 stores rolling it out maybe somewhere near you later this year.

NuVal is a nutritional ranking system that ranks foods from one to 100 as a guiding system on nutrition to help consumers make healthier choices among a category of food. For instance, you'll know the healthiest crackers among all the available crackers in the supermarket. Katz believes if people can choose the most nutritious foods in each category of food that these small shifts can make a significant health difference.

Perhaps, as most change comes, this one was also born of personal experience. One day Katz's Ph.D. wife returned home from grocery shopping with five loaves of supermarket bread in her arms and said basically, "Well this one has the most fiber, but too much salt, and this one has less salt, but it's not whole grain... You pick the healthiest one!"

Putting muscle behind the talk
Dr. Michael Roizen, Chief Wellness Officer at the Cleveland Clinic and Dr. Oz's writing partner, closed the event with Cleveland Clinics' progressive "Lifestyle 180 Program." Walking their talk, Cleveland Clinic first test-piloted the program on employees and found not only were the results remarkable in helping employees transition to a healthier lifestyle, but the program yielded a cost-savings to the Clinic almost four times its investment.

Briefly, the program is a six week immersion geared to change the four factors 75 percent responsible for chronic illness: smoking, food choices and portion sizes, physical inactivity and stress. Emphasis is given to overhauling one's cultural climate. This largely means clearing your kitchen of toxic foods, having participants experience "I can do it" aha moments, muscle memory of right eating and exercise and a buddy system. An encouraging take-away messages is: While our genes are our inheritance, our lifestyle determines whether they get turned on or not.

One example Roizen gave regarding people with type 2 diabetes who went through the program, is that 60 percent were able to discontinue one or more of their medications for blood sugar, cholesterol or hypertension (high blood pressure) within six months.

Dr. Roizen conveyed an urgency about people taking back their health as he sprinted around the stage, and here are just some of the lesser known stats: 81 percent of hospital admissions today, he said, are due to chronic illness. Fatty liver, a major cause of heart attack, stroke and memory loss, which was only present in one percent of the population in 1990, was found in 35 percent of the population in 2005.

Perhaps it was at this moment that I had an "aha" moment. I realized young children and teens are growing up in a world where everything is super-sized and portions are twice what they should be. That this is their "normal," where most of their foods are processed, full of additives and chemicals, and as Michael Pollan says, not "real food" but "food like substances." This is all they have ever known; they have no reference point to know that what they consider an ordinary bran muffin was once one-third its size.

And this was my other aha: Of the 4 factors that influence purchases: Health, Price, Convenience and Taste - which would you guess most influences what people buy? Taste!

If you didn't make it to the event, they plan to download on the web site portions of the presentations in the next few weeks.

I did manage to sample a few tasty treats from some of the sponsors of the event including delicious Maine wild blueberries. I managed to grab a few packets of 1 oz servings of walnuts - that's about 7 whole, unshelled walnuts. Unfortunately, I also managed to forget the bag I stowed them in, leaving it under my conference table. Obviously I need to eat more nuts and berries to improve my aging memory.

Overall, I came away from the conference knowing what I already know: Eat mostly fruits and vegetables, whole grains, lean protein and healthy fats. Don't drink too much and burn more calories than you eat. Seems so simple amid all the confusion. But doing it, as most presenters said, is not easy.

And so I left hopeful and disappointed. I am hopeful that this is a beginning, as Dr. Katz said, of bringing what we're doing to a grinding halt so that we can turn this ship, already far into dangerous waters, around. I am hopeful many people went away with a greater sense of urgency.

I am disappointed that there wasn't more offered in the way of what we can and should do, other than talk, to create change in people's behavior, and in our environment. I wonder from time to time where that passion and activism of the 60's and 70's has gone? I expected more hands-on suggestions and solutions.

I hope next year that's exactly more of what we'll hear.

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