The Nevada capital is adorned in blue to draw attention to diabetes, the timing couldn’t be better. More Americans than ever suffer with diabetes. Increasingly, this disease is afflicting old and young and the vast majority of cases stem from obesity. A small percentage, less than around 5% today, of all diabetes is type 1 diabetes, a condition that typically comes on in young people and is related to a loss of function of pancreatic data, islet cells and diminished insulin production. The remainder of cases stem from the complex metabolic disorder known as type 2 diabetes. Most such cases arise with weight gain and age, but today with more and more teenagers and children becoming obese, we see a dramatic rise in type 2 diabetes among young people.
Hopefully, greater awareness will lead to more resources, thoughts and effort being applied where it will yield the greatest results: in prevention. Visit obesitypreventionfoundation.org for ways you can help.

It seems like in this modern era we have all become very skeptical of the motivations of corporate philanthropy. Most of us experience no surprise whatsoever when we learn that corporations that are giving money to charities do so with a calculus that counts exactly how much PR the philanthropy buys them and balances it against advertising dollars. We all form our own judgments about the purity of philanthropy and charity when we see similar behavior from individuals.
But, I must say I am quite pleased that there is often an intersection between commercial success, good PR, and doing the right thing, especially for kids. So I am quite gratified to see the National Football League among many other organizations has turned its attention to the problem of childhood obesity and has organized a campaign and a message to fight childhood obesity. If their campaign can raise the level of consciousness in the public and among the leadership of the country to a higher level it may, one day, lead to some powerful and tangible solutions to this pervasive and devastating problem.

It’s never too early to think about strategies to protect your newborn from dangerous weight gain and obesity. Numerous clinical studies have demonstrated a significantly reduced risk for unhealthy weight gain among children who are breast fed. In recent years several large meta-analysis studies have examined the relationship between breast feeding and what is termed “pediatric overweight”. Three of these studies compared many other clinical studies that have been published over the years in order to reach their conclusions. In some, breast feeding is associated with healthier weight children and less development of overweight and obesity. The duration of breast feeding is also significant and for each month of breast feeding up to age nine months, the odds of the child becoming overweight decrease by around 4%. Interestingly the protection against the child becoming overweight continues on into the teenage years and even adulthood.

There are many important reasons why breast feeding is healthy for both mother and baby. Infants experience less illness and receive important hormones and antibodies from the mother. Children have less ear infections, less diarrhea illnesses, less incidents of sudden infant death syndrome and many other health events. Mothers experience less postpartum depression, type II diabetes and less breast and ovarian cancers.

The United States Surgeon General recommends breast feeding for the first six months of an infant’s life for all of these reasons. To get the best start in preventing childhood obesity, I recommend breast feeding your infant through the first six months of life.

At the 10K mark I felt surprisingly good as we pounded down St. Kilda Road and wound our way around beautiful Albert Park Lake roadway. I had stuck with El Conejo with little effort and could still run for stretches with my mouth closed, one poor-man’s way to test exertion level. Hmm, how long would this last? Where should I set my sights, on my pre-race goal of finishing under 4hrs, or perhaps doing a little better? I felt it to be wiser to stay contained and measured in the approach to the midway point. There were many miles left to go and plenty of opportunity to self destruct like I did in Phoenix at the Rock and Roll marathon around mile 20. Never want to do that again. I’d battled the monster that day for the worst 10K in my life, half walking, half stumbling the last 6 miles dehydrated, frustrated, and in immense pain.

But this day, from around 14K to 22K I felt a stirring euphoria. The scenery proved positively amazing, the weather now perfect, and the crowd welcoming if subdued. It had thus far felt like a medium-paced weekend run to me, and even though I had fallen way off my training regimen in the busiest two months of my work year, I had the sense this was going to be a good run for me. My two aces in the hole have always been training at altitude – most of my training runs occur at 5000 feet or above – and my passion for the race. Perhaps I could push it a little and still not self destruct? Better stick to discipline, I thought, and I continued to walk for 45-60 seconds each time a fluids station appeared that had their electrolyte drink. This was another interesting thing about the Melbourne marathon compared to U.S. races I have run, relatively fewer stations, perhaps 18 in the 42K race, half of which just offered water. And still no clocks.

Each time I walked to take in fluids, and on two occasions to slurp down a Gu, El Conejo moved out ahead along with the pack of runners sticking to his tail. In all, it looked like a cluster of about twenty-five runners clumped around the short man carrying the pacing sign. But after each walk, I caught up very quickly and fell in step with the group. We ran along the magnificent Beaconsfield Parade, a long flat stretch of beach front boulevard that stretches along the water for many miles, with blue sky, a glowing moon, and azure Australian waters coloring our landscape. The surprising moon remained bright enough to easily dominate the cloudless sky as we ran west along the shore. At this point our pack could see the race leaders loping past us from a turnaround point, and I made out two lean Africans leading, followed by some long-legged white runners. Then interestingly, the scattering of runners ahead of and just behind the 3 hr pacer looked rather average to me, not seemingly in better form or noticeably faster than my pack. Hmmm, could I ever one day run with them?

Around 22K, I was passed by two runners I had seen at other moments earlier in the course, a beautiful feline-looking female with an effortless but powerful stride I nicknamed the lioness, and a husky muscle-bound man in his late forties I called Bruiser who appeared to be out for a morning jog – so little did he appear to be exerting himself past the half way point. Both certainly were heading for sub- 3:30 finishes I thought. I did a mental check, yes I felt that good, but I let them go. Discipline. Think of this as just a training run, there will be others to come, to build upon this one.

At 25K after nearly stumbling over El Conejo’s feet I finally said “to hell with it” and passed my faithful 3:40 pacer. For the first time in my life I breathed the rarified air of those runners that finish with times starting 3:3-. It felt exhilarating, but maybe too ambitious. I had the sense I was a Tour de France rider who had been sitting on the wheel of a team that pulled me along and now I had broken out into the full force of the headwind, my turn at the lead of the peloton. How long could I last?

The scenery only continued to improve as we threaded our way around the parks and city streets that make up south Melbourne, tree lined, flat or very gently rolling, the course maintained its true form of being smooth and easy to navigate. I decided that if I still felt this good at 32K I would put the hammer down and start seeing if I could pick up the pace a bit. The long tree-lined boulevard called St. Kilda Road led to increasing crowds and more cheers for their loved ones. I became increasingly confident that I was nowhere near blowing up in this race. And for the first time I accepted a simple notion that I had been unwilling to say out loud – but that now felt absolutely undeniable with the sun warming my brow and my feet turning over with machine-like repetition – that I am a marathon runner. And I am the happiest person in the entire world.

As many of you know earlier this year I completed the 2009 Melbourne Marathon. This was a great experience for me and I would like to share the experience with you in the hope that maybe you can find a hobby that improves your health and quality of life for you. Why not start today and try walking or running for yourself. I certainly welcome you to join us for this year’s Rock-N-River race in Reno, NV (check back for more info on this as the date gets closer). So without further delay, here is my personal experience running the 2009 Melbourne Marathon.

The race started easily enough. Both the crowd and race announcer seemed to be very low-key compared to my experiences at races in the USA. There were about 4,000 runners in all, and I worked my up to near the front. When I saw the 3:40 pacer I hoped to latch on to him to keep my pace goal. He was a squat man, probably in his late forties. El Conejo, I’d call my pacer. I’ll need to stick with him and not let him scurry too far past me. The weather was cool, but very tolerable. I discarded my thermal race blanket and had wisely chosen to leave my gloves and cold-weather gear behind. I pressed play on my iPod and tapped my toes as The Fray played warmly in my earphones.

I was never a runner until nearly age 40. What I now experienced while running as reverent and calming, back then I’d found monotonous and unsettling. Career changes, a divorce, raising two kids, and perhaps the benefit of some years digesting the horrors of 110-hr-a-week surgical residency left me at forty both contemplative and restless, each quality now strangely satisfied with long distance running. But was I really a marathon runner? I’d been shy to tell people I was running races, embarrassed I might be discovered as a pretender. It was only the kids that allowed me to publicize my running, the overweight ones I work with in my practice and with the KidsFirst! Obesity Prevention Foundation.

At the start I felt fresh and energetic, buoyed by the crowd and the energy of the runners around me and the bright moon overhead. Despite traveling for the past three days, I had little sense of jet lag. I’d flown Wednesday from my home in Reno, Nevada to Chicago to speak at a conference on outpatient weight-loss surgery. I’d been able to sneak in one last training run, an easy paced seven miles along the cool Lake Michigan shore. I believe I mentioned my last minute training day in an earlier blog post. Online, the weather in Melbourne looked only marginally better, with a chance of rain. Then Thursday and Friday were spent in the air and at connecting terminals en route to Melbourne, Australia. Additionaly, due to the peculiar phenomenon that is modern time zone travel, an entire day evaporated somewhere. So, after a restless single night of sleep, I found myself awakening at five AM to journey to the starting line.

After the horn sounded, the pace scurrying along Batman Avenue seemed fast, but I had left my Garmin GPS device at home so I did not know how fast. I’ve been having some trouble with my Garmin Forerunner 405 failing to charge when I leave it on the charger overnight, plus, my fear of experiencing trouble with the satellite resets in the southern hemisphere that others have experienced led me to leave it behind. Unfortunately, what I did not know was that in Melbourne, although the race route was magnificently marked and laid out, there were no clocks or timing displays anywhere on the course! This meant that my only source of information was the pace runners, whose flags were not especially visible until you came very close. And El Conejo was particularly hard to spot until you were right on his heels.

I found the athletes around me very inspiring. Many were running for causes, like I am to raise awareness of childhood obesity and fight to prevent it. Many were overcoming disabilities and courageously competing. And many were running well despite stocky builds and wheezing lungs. I thought of all these kids back home with already-huge weight problems. Could they ever overcome the disadvantages of lousy family nutrition education, fast food as school lunch, irresistible TV shows and computer games, predatory food advertising, and simple inertia and ever get out here one day? I looked around me and thought what a long road back to heath it will be for most of those kids. For many, the challenge is already sadly insurmountable.

At 8K I passed the Irishman, a man in his sixties wearing a Shamrock shirt and huffing like the 3 pack a day smoker he used to be. By the look on his face, he was already doing battle with the monster, that grizzly beast of whole-body pain, air-hunger, and muscle fatigue that makes you question why you have chosen to spend a Sunday morning doing anything this life-threatening. So far so good for me, no monster yet and I was hoping it would stay that way.

I set out to Australia to run the Melbourne marathon and I am proud to say: “Mission Accomplished” Thank you to all who encouraged me. I am looking forward to running more races to continue to support childhood obesity awareness and the the Obesity Prevention Foundation.

Most Americans gain several pounds a year and it is believed that around half of that weight gain occurs during holidays. It probably starts around Halloween when the candy begins proliferating everywhere, at home, in the office, and just about everywhere you travel during your day, but then it continues right on through Thanksgiving, Christmas, Hanukkah, Kwanzaa and New Years.

In thinking back to my own childhood I remember Halloween as a free hall pass to go eat as much candy as I could get my hands on. And while the causes of childhood obesity are numerous, it is undeniable that this explosion of candy and sweet consumption throughout the entire holidays contributes in a negative way.

Think about it, the marketing and scale of Halloween candy blips dulls anything that we saw as children. We want our children to remain healthy and not grow to an unhealthy weight or develop Type 2 diabetes right? So, how do we confront the commercial Halloween and holiday candy consumption beast? Here are a few important strategies:

• Start now. Prepare your children for the idea that they can enjoy a few, special pieces of Halloween candy, but the rest will be given away or tossed.

• Let your children know how important it is that they feel good, feel fit and active, have healthy teeth and look good.

• Stick with your kids at trick or treat time and let them know at the end of trick or treat time they can pick out their special pieces of candy and all the rest are yours.

• Let them know how much better it is to truly enjoy those few pieces of special Halloween candy rather than to gobble up an entire bag of junk food and get sick to their stomach.

• Don’t add to the candy proliferation at your own house.   Keep the candy filled up until the trick or treat day arrives and then immediately toss any left overs after the last trick or treat visitor has gone.

The obesity problem in the United States and even worldwide for that matter has grown to such an epic status it can seem to be an insurmountable problem.  This is not the case. We can succeed in changing the momentem away from increased obesity rates and toward healthier lifestyles.

When many people become aware of the problem of today’s obesity epidemic, they do want to help, but often don’t know where to begin.  The answer to this is simple. Start with yourself and them try to help others. There are so many avenues to explore and pursue in order to address the obesity crisis.  No matter which path we choose to help the cause, the cause is most helped when we take steps to control our own habits.   For instance, make healthier food purchasing decisions even if your weight is already at a healthy point.  It will not only keep you healthier in general, but also send a message with your purchasing power. The more people who choose to buy healthier foods, the more healthier foods will be made available for people to buy. The point is every little bit helps. Living healthy is  great way to promote obesity prevention and encourages those suffering from the effects of obesity to improve their health too.

Everyone can do it.  There is a great article about a 9 year old girl encouraging her friends to hula hoop for fitness. If a child can learn a new physical activity that promotes exercise and then actively pursues this hobby, it is a huge victory for childhood obesity prevention and public health in general.

You don’t have to teach a class to encourage these sort of activities. Try just going for a walk or a bike ride with your children. Invite the neighborhood kids too. It’s a great way to burn calories promote good health and maybe increase the sense of community in your neighborhood.

The toxic environment for our children I am refering to is the one in which they are frequently served high calorie, high carbohydrate, fast food meals and are not provided frequent opportunities for vigorous exercise. This is referred to as an “obesogenic environment”. But how do we clean up this toxic environment?

The solution lies in a dedicated, focused effort by the parents and the family. It starts with very strictly limiting the carbohydrate intake that is occurring on a daily basis. Once you pay attention to it, it becomes rather alarming how much high fructose corn syrup your child is consuming in the form of soft drinks, juice boxes, treats, candies, and snacks. Educate your children about the idea of high glycemic index foods and help them to understand that simple white flour carbohydrates are counted roughly the same whether they come in the form of stackable potato chips, juicy drinks in a box, or popsicle’s and desserts. Create an awareness in your child about these. Help them keep track of how much these foods they are consuming.

Share with them the joy of consuming fresh fruits and vegetables, proteins and whole grains. Discover amazing recipes together, be imaginative, create games, contests and challenges around exploring great recipes with healthy ingredients. Establish routines that involve drinking only milk or water at mealtime and snack time and involve foregoing desserts except for special occasions. Believe me, if your schools and neighborhoods are anything at all like mine, there will be plenty of treats, snacks, birthday cakes, desserts, sodas, marshmallows, pop tarts and everything in between that your child will be enjoying, so creating some limits will not cause great deprivation. Foster an environment that encourages and celebrates physical activity. Set the example by being active, working out, running, taking walks, hikes and participating in other activities, both with your kids and by yourself.

Next, speak up. Be vocal in your schools, daycare’s and other locations where children spend time. Insist on eliminating a high calorie, high carbohydrate sweetened drinks. Insist on milk or water as beverages (milk is a lower glycemic index beverage and has important calcium and vitamin D). Encourage more physical activity. If neighborhood safety concerns limit the extent to which children can run loose outside, then creatively work around this problem by establishing indoor activities such as, jumping jack contests and striving to meet the President’s physical fitness certificate criteria, most of which can all be done in a small, indoor space.

In short, fixing the toxic environment is entirely possible. It may require a little work and a little creativity, but the alternative is to provide an environment in which children gain excess weight and suffer excessive risks of diabetes, asthma, and overall worsened physical and mental health.

34% of US children are overweight or obese, a striking rise in the last twenty years. We are beginning to develop a better understanding of why the rise in obesity is occurring, and so rapidly.

Several authors have coined the term, “toxic environment” to describe the setting in which so many children find themselves today. This “toxic environment” includes neighborhood and school settings that no longer encourage physical activity. It includes home and daycare environments that involve a great deal of television and other sedentary “screened” activities, rather than outdoor physical ones. It is an environment that provides excessive calories at every meal, and in between meals. It is an environment that has seen a tremendous growth in the production and provision of high calorie simple carbohydrates.

Young people today have had no significant alterations in their genetics over 20 or 30 years. As humans all our biology is the same. What is radically different is the environment in which these children find themselves.

More about what we can do to help prevent childhood obesity from affecting our children in the next post.