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8/11/17

Healthy Living: Avoiding obesity combats many health problems



PARKERSBURG — A healthy lifestyle is the key to heading off a number of potential health problems.

According to Dr. Frank Schwartz, director and endocrinologist at the Center for Diabetes and Endocrine Diseases at Camden Clark Medical Center, obesity is a major contributor to all chronic diseases.

“The cascade is, if you can prevent the obesity, you can prevent the diabetes, the heart disease … and even cancer,” he said.


What a person eats also affects his or her “gut microbiome,” a term that refers to the bacteria in a person’s intestine, Schwartz said. Thanks to advances in molecular biology, the bacterial and viral genomes can be identified and characterized.

“(We) now understand that there are good and bad populations of bacteria which contribute to disease and are thought to be affected by our diet,” Schwartz said.

But making healthy changes to one’s lifestyle isn’t as simple as just saying “eat better food” or “get more exercise.”

Some people face socioeconomic barriers. Households living in poverty can experience food insecurity, described by the nonprofit Feeding America as “a household’s inability to provide enough food for every person to live an active, healthy life.”

“So they tend to overeat when the food’s available,” Schwartz said. “If you’re not sure where your next meal is coming from, you can’t eat mung beans, tofu and go to the fitness center.”

At the same time, Schwartz said there is a misconception that healthy food is too expensive.

“If you look, junk food is more expensive per gram of nutrition,” he said.

One way to get healthy food is to grow it, Schwartz said. While that can be a challenge in urban areas, homes in this region usually have available space.

“I have a garden,” Schwartz said. “I’m pulling green beans and squash and tomatoes and lettuce and zucchini, and we’re eating that all summer and freezing it for the winter.”

Some areas in the region have started community garden programs to help promote and make available fresh produce.

Another factor in the nutritional value of food is its preparation.

“Good food needs prepared,” Schwartz said. “And we have lots of working families who like to get prepared foods.”

That availability often comes at the price of nutrition.

Exercise and physical activity are important, but suddenly launching into an intensive exercise regimen is neither practical nor advisable, Schwartz said.

“You’ve got to develop small, incremental changes in lifestyle,” he said.

That goes for exercise and eating.

“You’ve got to pre-plan it,” Schwartz said. “And it’s got to be just as important as brushing your teeth.”

Physical activity can be incorporated into or increased in daily activity, from taking the stairs instead of the elevator to parking as far way as possible at work or while shopping.

People used to get exercise at work, but the rise of automation and a shift in types of employment have changed that.

“Prior to 1950, most workers in the country were laborers or farmers, and they were physically active, and they worked 10-12 hours a day, five or six days a week,” Schwartz said. “Mailmen are some of the healthiest people in the country, believe it or not, because of their walking.”

When he started practicing 35 years ago, Type 2 diabetes was “a rare genetic condition,” Schwartz said. Now, more than half of the children in the region with diabetes have Type 2, in which obesity interferes with the body’s ability to use insulin. This creates insulin resistance and causes the pancreas to secrete large amounts of insulin to no avail, which can lead over time to pancreatic exhaustion and failure, he said.

Caucasian children born in 2000 have a 25 percent chance of developing Type 2 diabetes, but the rate rises to 50 percent for black children and children in Appalachia, Schwartz said.

Lifestyle changes need to be taught to children, but also the adults who model behaviors for them, Schwartz said.

Even if a person is out of shape and prediabetic, their condition can be reversed, he said.

Schwartz has seen such positive changes in patients who are members of what he calls the 300 club — weighing 300 pounds or more, having a blood sugar level greater than 300 and needing up to 300 units of insulin a day. Often having conditions like uncontrolled hypertension or arthritis, they don’t feel good and are less likely to be active.

But recently, he’s been recommending those patients start with aquatic exercise, which offers less impact and resistance.

“They start feeling better; they start doing more,” Schwartz said. “Even when you’re in that status, it’s reversible. You can change.”

Having a support system can help, he said. Camden Clark’s Health and Wellness Center and the YMCA have support groups, and even joining with like-minded friends to exercise together and hold each other accountable can be beneficial, Schwartz said.

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