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>>Lori Casey: Coming up next on Being Well our special guest
is Dr. James Early director of clinical preventative medicine at the University of Kansas School
or medicine. Dr. Early will be talking about lifestyle related medical issues. Mainly obesity
stay tuned to find out more about how you can make small yet permeanent changes that
can result in better health for years to come. [music]
>>Lori Casey: Dr. Early thanks for stopping by Being Well you should explain first what
brings you to Charleston Illinois because you're from Wichita Kansas correct?
>>Dr. Early: I'm from Wichita Kansas that's right University
of Kansas medical school though. I came to out here to visit Sarah Bush Lincoln to really
talk about their development of health related programs, lifestyle program specifically weight
management programs there. >>Lori Casey:
Well tell our viewers a little bit about your background.
>>Dr. Early: By happy to, I'm a physician I started out
as a family doctor, did some time at the Indian health service delivering babies and taking
care of some of the Native American population. Came back and did an internal medicine residence
and then was an intensive care specialist for a period of time did a lot of intensive
care medicine during that time really understood that lifestyle issues were huge. In the intensive
care unit having to do spinal taps and liver biopics and all those things became very difficult
if people were significantly overweight or if they've been heavy smokers, and had respiratory
problems. So I thought I'm going to dedicate myself more to preventing these things. Twenty
years ago helped to start the department of medicine at the University of Kansas medical
school is Wichita. Started a weight management program there actually was instrumental in
starting a masters of public health program there and have been really dedicated now to
keeping my own health up as I get into my late sixties. And helping people not get sick
basically which I believe is a noble calling. >>Lori Casey:
Well you're you've got several areas of specialty but I know one of them is lifestyle related
medical issues, do you want to talk a little bit about that and what sort of drove you
towards that? >>Dr. Early:
Sure I think the more I looked at it the more I understood things like diabetes and high
blood pressure, sugar diabetes were really lifestyle illnesses and they were totally
avoidable. Most of our adult diabetics would not be diabetic is they were exercising and
an ideal body weight. So the idea that they need medicine no they need a life change.
High blood pressure tremendously affected by exercise and diet so understand that I'm
really on a campaign to get rid of high blood pressure, get rid of diabetes, and most injuries.
You know broken hips, back problems they revolve around not having good posture, not having
good exercise habits, and even nutrition. >>Lori Casey:
We've had a lot of guests on Being Well and we talk about different diseases and it seems
like ways to prevent them, health diet, healthy weight, no smoking there's so many things
that can be prevented when you take care of those three main things.
>>Dr. Early: They are but we are floating in a pond of
difficulty it is very hard when out there there's wonderful tasting foods that are high
in calories, high in sugar, salt or fat and so we have to find ways to make physical activity
and nutrition more fun. We have to find ways to really bring joy into the right side of
the health equation. >>Lori Casey:
Right because we tend to actuate fun and family gatherings which is nothing new I mean that's
been a part of family gatherings for generations. >>Dr. Early:
There's nothing wrong with that just what food. Can't we really be exciting about some
new ideas around fun and physical activity and food?
>>Lori Casey: Well let's before we started taping we were
talking about how you know the family table and the food on the table changed like back
when people actually sat down and had a meal. Talk about how that has changed.
>>Dr. Early: We don't eat fruits and vegetables any more
we've cut that by 75% I've sat at an old table on a farm we had corn, stewed tomato, green
beans and new potatoes, we had peaches and it was. Grandma insisted you have a bit of
everything cause she worked *** every one of those dishes and if you're going to
have the apple pie at the end and you're going to eat the meat you're going to have all those
other things too. So we got a lot of color, we got a lot of variety; we got a lot of fruit
and vegetable whole grain foods. >>Lori Casey:
When I think about that table yes she may have made that pies crust with lard probably
cooked in butter, but none of those foods came out of a box.
>>Dr. Early: No they didn't and there were problems with
those foods. In terms of saturated fat and many people two generations ago did have heart
disease. But we know better and many of our products have reduced that. What we also reduced
though is the good general nutrition out of the garden. The fruits the vegetables and
what not and then I hear the argument all the time well we can't afford to eat well.
That's not true. We really need to become educated about how to eat more fruits and
vegetables and what not inexpensively. You can do it; ten pounds of potatoes are not
expensive. How do you garnish them how do we get ahold or mixed vegetables and what
not. We can buy them in huge quantities at places like Sam's and Aldi's I don't know
what groceries you have that are discount but there are ways to learn to cook vibrant
foods. Story. The other day we had some young folks over and we had cut up root vegetables,
turn ups, carrots and potatoes put a little olive oil on them some thyme and rosemary
but them in the oven and roasted them. One of the guys from a neighbor�s son said this
stuffs good it tastes almost like meat. I said yeah it is good. These are vegetables
he said no these aren't vegetables mom fixes vegetables and these aren't vegetables. So
we've missed the art of cooking good food well and that's what we need to get back to.
>>Lori Casey: Yeah cause we think of good food now as something
that comes through comes either in a box or through a drive thru window.
>>Dr. Early: We've forgotten that we can actually fix great,
healthy food and have fun doing it. >>Lori Casey:
Well we had talked earlier that society has changed very rapidly I think you said form
1990 to 2000 in the incidence of obesity really increased fairly quickly.
>>Dr. Early: This kind of started in 1980 for kids it started
for fast food two liter coke instead of the 6 oz. coke if you're going to have that and
fast foods really made a difference. Also the computerization you know everybody's like
this now. Where we use to actually walk to school, and we didn't do our I Pad and iPhone
at the same time. >>Lori Casey:
So I would imagine as obesity has increased all those other diseases that are related
to obesity have increased as well. >>Dr. Early:
It's scary it's really scary because I never in the early part of my career I never saw
a ten to twenty year old person with adult diabetes and we see it all the time. It's
purely because of lack or exercise and poor nutrition. These people if their diabetic
at 18 because of this at 38-40 their going to be in kidney failure and have all kinds
of problems. The surgeon general�s office made the statement not long ago that this
current young generation may be the first generation to die earlier than their parents
did. What a sad thing given all we know about medicine today why should that have to happen.
>>Lori Casey: Right well I think you know we see because
of that because people are more and more overweight, new products on the market all the time, new
diets on the market, what are your thoughts on product related diets or theme related
diets, do they work? >>Dr. Early:
I'm not crazy about theme related diets because I think you know when you look at sort of
the Mediterranean diet the epidemiologic that means what countries over what period of time
lived the longest and did they best and they ate lots of fruits, lots of vegetables, lots
of whole grains, some fish in the diet, the oil were generally olive oil or monounsaturated
oils. We know that works for people that live a long time. So whatever gimmick may be used
and in our programs we use meal replacements which are very nutritious but it's only a
vehicle to get people to a vibrant lifestyle. So get them eating those fruits and vegetables
to teach them how. To teach them the joy of cooking there's a cookbook called that by
the way. So if the program is not leading to really an education based program that
can take people and help them find the joy in activity and physical exercise that's not
easy but using some motivational techniques using excellent education using skilled and
pathic people we can get there. Most programs are upfront take this do this, protein one
or that if that's all there is it is not going to work long time and I challenge anybody
to show me data that shows me any of these programs will work long term if you don't
also include the ability to change people�s lives. The ability to get in and help them
changes their lives. It just doesn't work I can show you the data.
>>Lori Casey: You need that educational component.
>>Dr. Early: Right and the empathy and the skill to be
able to help people whose lives are often in chaos get enough organization and enough
family cooperation and enough worksite cooperation to really make these changes.
>>Lori Casey: So how would you help someone says it's the
mom that's overweight that trying to lose weight, trying to cook for the family for
the husband and not getting a lot of support cause it is the whole it's I would imagine
it has to be the whole family involved it can't be just this one person trying to do
this on their own. >>Dr. Early:
Absolutely you're absolutely correct. I think some of the things that we try to do and good
programs to in general is we do try to motivate with weight loss up front because if people
don't have some upfront success in terms of their weight loss it's very hard to stay motivated.
So there's sort of a phase one of most programs and certainly ours. Where people lose weight
and become empowered then in phase two there's a lot of discussion of grocery shopping, how
do you make some of these better foods more attractive, how we talk to our family and
try to get them enlisted. Do we bring them in the class occasionally do we do tours of
grocery stores, do we try to help now it's not always supposed to work. No sometimes
there's resistance that you just got to overcome and sometimes the timing is not right for
it too. But it is probably the most complex area of medicine that there is. It's helping
people modify their home and work environment to successfully manage their nutrition exercise
and health. It takes tremendous amounts of skills any super short cut is doomed to fail.
>>Lori Casey: That's what I was going to ask what do you
think is the number one thing that causes people to fail when they try and actually
the losing weight is sometimes the easy part it's the keeping it off is difficult.
>>Dr. Early: I think we have not pushed the fact that this
is a life change. We've made a diet and a lot of commercial programs are at fault here
by having the pictures on T.V that make it look like you know all you got to do is come
to us and we're going to change your life. No. We can give weight loss but unless their
programs are really substantial and well run overtime and affordable it isn't going to
happen. I think the problem is the quick fix mentality it's the pill based diet based mentality
and we have to figure that one out. >>Lori Casey:
There have been prescription medications that have come out to aid in weight loss. Some
of them are no longer on the market anymore because most created...
>>Dr. Early: There's a couple new ones out nothing is massive
in terms of it's we had thin thin in the past which in terms of that which is terms was
good decreasing peoples appetite. I have no doubt that over the years we will probably
develop some pills that do help people that have driven appetites. Those people whose
chemistry really drives them to eat. That will be helpful but the big thing is going
to be the social and public health changes that occur, like with cigarettes. Yesterday
CVC said smoking rates are down to 18% now why? Policy, environment, laws, and taxes
we have pulled out every stop to try and reduce smoking. We're only beginning to do that by
rewarding nutrition by coming up with more policies, more vending machine policies, more
dietary I mean when we serve meals in the hospitals and businesses some businesses are
beginning to change the way they do that. Incredible wants they started to do that change
and start really exciting recipes and have the grains and quiona salads people begin
to say wow I didn't know you could do this with good food. That's when things will begin
to change and it's starting. >>Lori Casey:
Well and they even know one of the fast food restaurants now lists their calorie counts
right on the menu do you think that deters people? It deters me when I see wow that...
>>Dr. Early: I'm not interested in deterring people what
I'd like them to do is to take those calories and integrate them into their plan. Okay I
can save some calories here and most people don't understand and aren't able to build
the calorie map for themselves. So one of our jobs is to help people understand how
to put meals together. How to put days together and really have exciting and fun nutrition
and exercise at the same time keeping the calories down. Because calories in the end
are what cause weight. >>Lori Casey:
Right. >>Dr. Early:
If you reduce the calories you reduce the weight.
>>Lori Casey: So do you think a lot of the problem with
obesity is people are just not informed they don't know how many calories they should be
eating? They don't know that you should be having a variety of foods or is it.
>>Dr. Early: Nothing is that simple you know we've spent
billions of dollars marketing foods that are easy to maintain, don't have a lot of you
know the old ad that said a Twinkie can sit on a self for a hundred years and it's still
edible. Companies that sell foods if they�re not perishable then they don't lose money
with the perishable foods so we marketed things that aren't perishable. Now you know we really
have to begin and the new farm bill it's still doesn't really promote fruits and vegetables
and good nutrition it's a political instrument. We really need it to be sustaining by pushing
the issues of good nutritious low calorie high nutrition food. Fruits and vegetables
have that list and whole grains. We need to be promoting those everywhere.
>>Lori Casey: I'm sure you see this too it's a generational
thing if this generation to if this generation doesn't eat healthy and doesn't know about
this it gets past down to the next generation. >>Dr. Early:
Absolutely. >>Lori Casey:
This generation of children as you said are heavy are going to have more healthy problems
than their parents. >>Dr. Early:
They don't know how to cook many of them don't. We've taking home ec out of classroom and
we don't raise gardens as much. Now I was out in Colorado last week and there's some
real efforts I was in Glenn Wood Springs there's community garden right by the hotel where
I was staying. He did hikes every morning I mean it wasn't surprising to me that in
general the population looked pretty good. Is there obesity there of course it's everywhere.
But it was really interesting you could see the difference in population across the country.
If you're in middle Mississippi for example versus Middle Colorado you can see the difference.
>>Lori Casey: Colorado I think is one of the healthiest
It is but even there the obesity rates are rising you know. It's hard to resist the national
trends. >>Lori Casey:
So what what would you what do you think needs to happen cause as our discussion has gone
along it's not just one little thing it's a it's big thing.
>>Dr. Early: Well I'm semi-retired so where am I dedicating
my time. I'm teaching medical students to look at the future, I teach some medical futurism.
I'm teaching motivational interviewing so their better at having conversations with
their patients. We've just enlisted over two hundred companies in Kansas through a federal
grant to begin work site wellness programs. Why? Because if we're trying to help anyone
be healthier, eat better than their worksite needs to be healthier, their school needs
to be healthier, their church needs to be healthier and by getting into work sites and
really helping them change their environments and policies we can provide eight more hours
of support for people that are trying to be healthier.
>>Lori Casey: So what kinds of work place wellness things
are you looking at? >>Dr. Early:
Well we're changing environments they're writing up policies for the food they serve in their
meetings, the way they run their vending machines, pathways, the ability to take twenty minutes
off during the day and exercise. Adding showers and what not adding breast feeding rooms.
So that women can breast feed because children that breast feed tend to be less obese. So
we're asking businesses to partner with their employees for better health and lower healthcare
costs. >>Lori Casey:
Right healthier employees are they're not sick as much.
>>Dr. Early: Their workman's comp claims are much less
and the thinner a person is the lower their work comp days off are the lower the cost
of a work comp are. The reasons for business to be concerned about their employees. Work
absenteeism all those things that happen when their employees aren't healthy.
>>Lori Casey: So you're working with medical students who
will be doctors someday I would imagine. Tell me when you�re a doctor if you had a woman
come into your office and say I'd really like to lose weight what would you do versus what
would your doctor tell you today? >>Dr. Early:
Well when I started I was heavy so I would be embarrassed and by the question and I would
be silent about the question well you know do what you think you should do. Weight watchers
which is fine but I didn't have any conviction about it so things have changed a bit and
I find the new students interested in lifestyle issues. This is really a fairly recent pneumonia
plus, medicine is beginning to change, we're beginning to have some through the new affordable
care act we're beginning to reward outcomes to some degree. So if doctors thousand patients
and the blood pressures falling for the whole group to some degree they may get a bonus.
If they're getting there diabetes as a group healthier they may get some reward financially
and as that becomes more you'll see a huge change in medicine. When they're not just
rewarded for how many times people come to the office but how well they're doing with
their problems. That's you know that's actually matching up with the real world. There's one
person from an aircraft industry that told me if we have a plane fall out of the sky
we're done. You know if we have a surgery that goes wrong we do another surgery and
charge twice. It's a different outcome and Medicare is beginning to say if you readmit
a patient because you didn't do something right the first time we're not going to pay
the second time. So as we begin to insist on quality more and more and outcomes more
and more I think we'll get there. I'm very hopefully I'm very hopefully.
>>Lori Casey: Is obesity on the decline or
>>Dr. Early: No but it's stabilizing a little bit. The
data came out yesterday it was two tenths of one percent in the recent national nutrition
study. So we're stabilizing but we really need to get aggressive now. That's the reason
I'm so excited that Sarah Bush Lincoln is instituting a serious weight management program
that will get results but also be fun and engaged. I'm excited about that.
>>Lori Casey: So it seems if you know someone sitting at
home okay I need to eat better and I need to exercise it seems so easy but it hard what
are some advice that you could give to someone to get started because it could be very overwhelming.
Maybe they also smoke and their overweight and it's just all this all at once. How do
you sort of look at that problem and go okay I want to take this one step as a time?
>>Dr. Early: For an individual without going to a program
or what not which many will need but the first thing is what consistent positive change can
I make. The key word being consistent am I going to walk twenty minutes at least four
or five days a week and I going to do that if I'm going to do that how can I make that
a consistent change. Kind of enlist the people around me to make sure that that�s a change
that I make long term. I said consistence, consistency, consistency is the key don't
start something and stop. Don't start something that you know you can't continue. So start
with a small step see if it works. If it doesn't if you just can't get it done get help. Tell
your doctor about it. If you decide to make a change tell your friends and your doctor
what you're wanting to do and ask for their help and advice.
>>Lori Casey: Don't take on too many lifestyles changes
all at once it's really difficult. >>Dr. Early:
If you are going to do a serious program do a good program? Smoking sensation, weight
management, don't go for the quick fix. Go for legitimacy.
>>Lori Casey: That's kind of how we got into this mess in
the first place. >>Dr. Early:
It is how we got into this mess in the first place.
>>Lori Casey: Well Dr. Early thank you so much for stopping
by I know you've had a couple of busy days here in Coles County.
>>Dr. Early: A fun couple of busy days.
>>Lori Casey: You're headed back to Kansas what's next for
you? >Dr. Early:
Basically some worksite wellness workshops for businesses in Kansas right now. The next
month is filled with those and those are fun to. I'm seeing these business and they're
eyes wide open we can do this and we can do that and we can help our employees be well.
Every time I hear that I get excited. >>Lori Casey:
Alright well thank you so much it was a pleasure meeting you and having you on Being Well.
>>Dr. Early: Thank you it was nice talking with you.
[music] >>Monica Becker:
Sometimes doctors have to be detectives to stop the villain that�s making their patient�s
lives miserable. And sometimes, when the condition is rarely seen and the body�s own defenses
are to blame� it takes a specialist. Here�s Dennis Douda for Mayo Clinic News Network.
I play volleyball, soccer, golf.
Bethany Pautsch has loved sports all her life. But, she feared her athletic days were over
when she was incapacitated by a mystery illness.
As it progressed, I couldn't get out of bed. I wouldn't be able to lift up my arms.
For a year Bethany battled severe and painful symptoms that made doctors suspect everything
from strep infections to mononucleosis� blood diseases and rheumatoid arthritis. Not
until she saw Mayo Clinic rheumatologist Timothy Bongartz did she get an answer. She has a
rare condition called Still�s Disease.
Drains you. It feels like having a very bad flu. But in addition, she had a violent, very
violent immune reaction to her joints, resulting in very rapid destruction, especially of her
hips.
Dr. Bongartz explained to Bethany that her immune system had started attacking her joints.
The cause is not known. Still�s patients tend to have high fevers,
arthritis and a rash. Symptoms may also include throat pain, swollen lymph nodes, high white
blood cell counts or high levels of ferritin, a protein that binds to iron. Because there�s
no simple test for it, diagnosis involves a process of elimination, ruling out diseases
it mimics like other forms of arthritis.
In Still's disease, you often see very prominent involvement of the wrist with severe narrowing
of the joint space and the knuckle joints are, you know, barely affected.
Bethany needed joint replacement surgery in both of her hips to get her back on her feet.
But only after Doctor Bongartz first brought her condition under control. Regular IV infusions
of a biologic drug that tames her over-active immune system may be a life-long necessity.
I'm not really sure, but even if I just have to do the infusion once a month, it -- I'm
able to live a healthy life so it's fine. Small price to pay.
I'm healthy again. I'm able to do all the things I was able to do before I got sick
and I have my life back.
For the Mayo Clinic News Network, I�m Dennis Douda.
Thanks for watching this episode of being well. Join us online anytime at youtube.com/weiutv.
Here you can view current as well as past episodes. Just look for the being well playlist
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[music]