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Culture Clash How We Win the Battle for Better Health PART I Dr. Steven Aldana CEO WellSteps
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Four Part Agenda Part I. Whats the Problem Part II. How Our Culture Has Changed Part III. Culture is the Cause: A New Culture is the Solution Part IV. How to Create a New Culture By Creating Islands of Health
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Percent of Americans Who Are Obese
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Estimated
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Obesity by State 2009
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Diabetes Prevalence 1994
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1995
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1996
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1997
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1998
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1999
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2000
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2001
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2002
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2003
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2004
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2005
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2006
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2007
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2008
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2009
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Life Expectancy
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New Normal
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Talking to me? Talking to yourself? Talking to someone else?
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New Normal
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Burrito Grande
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What is the Problem? Our food and activity patterns have changed Our nations health is poor and getting worse Individuals are dying prematurely and quality of life is declining Health care costs continue to increase which creates a burden to employers
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How Do We Fix the Problem? 1.We need to know what is causing these changes. 2.We need to address the direct cause.
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What is Causing These Changes? Genetics? Environmental toxins or chemicals? Something in the air or water? Changes to our culture? Something else?
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Its Our Culture
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Proof Its Our Culture:
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Percent of Adults Overweight USA England Canada Austria France Korea
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Percent of Adults Overweight USA England Canada Austria France Korea Brazil
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It is actually cheaper to eat fast food than cook healthy food at home here. There is now an overrepresentation of cheap fast food in the region which is driving our diabetes epidemic. Dr. Darwiche Rashid Center for Diabetes United Arab Emirates
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RankingCountryCases of Diabetes (in millions) 1India31.7 2China20.8 3U.S.17.0 4Indonesia8.4 5Japan6.8 6Pakistan5.2 7Russian Federation4.6 8Brazil4.6 9Italy4.3 10Bangladesh3.2
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RankingCountryCases of Diabetes (in millions) 1India31.7 2China20.8 3U.S.17.0 4Indonesia8.4 5Japan6.8 6Pakistan5.2 7Russian Federation4.6 8Brazil4.6 9Italy4.3 10Bangladesh3.2
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The Dark Side of Capitalism
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New Exposure
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Greater Exposure Rates
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Lifetime Risk of Diabetes for Children Born in 2000 Venkat Narayan, JAMA 2003;290:1884 49%
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Diabetes Among the Pima One-half of adult Pima Indians have diabetes and 95% of those with diabetes are overweight. Am. J. Epidemiol. (1978) 108 (6):497-505.
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Proof Summary: Greater exposure to a Western culture is associated with greater obesity and diabetes Rapid acculturation is associated with rapid declines in health Health worsens faster for those who were healthiest to begin with (Pima)
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Quiz
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How old is the human race? a)6,000 years old b)10,000 years old c)100,000 years old d)1,000,000 years old
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Two parts to this problem: Unhealthy culture Our ancient physiology
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60,000 BC
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100,000 BC present
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100,000 BC present
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100,000 BC present
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100,000 BC present
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100,000 BC present
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100,000 BC present Milk
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100,000 BC present Milk Sugar
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100,000 BC present Milk HFCS Sugar
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100,000 BC present
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What did they eat and how do we know? 1.Look at people who are still hunters and gatherers 2.Study the remains and living environments of Paleolithic peoples 3.Study the bones of our ancestors
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+/- 50% wild game (35-70%) +/- 50% plants More hunting than gathering. Meat then was different than todays meat.
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Todays meat is different: Steroids Growth hormone Antibiotics Feed lots fed Genetically manipulation More saturated fat
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What about todays plants and food? Whole grains, refined grains Herbicides and insecticides Dairy Cheese Salt, Sugar, and Fat
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Lucky Charms: Oat flour, marshmallow bits (sugar, modified corn starch, corn syrup, dextrose, gelatin, calcium carbonate, yellow 5&6, blue I, red 40, artificial flavor), sugar, corn syrup, corn starch, salt, calcium carbonate, color added, trisodium phosphate, zinc and iron (mineral nutrients), vitamin C (sodium ascorbate), a B vitamin (niacinamide), artificial flavor, vitamin B6 (pyridoxine hydrochloride), vitamin B2 (riboflavin), vitamin B1 (tiamin mononitrate), vitamin A (palmitate), a B vitamin (folic acid), vitamin B12, vitamin D, wheat starch, vitamin E (mixed topopherols) added to preserve freshness
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Modern Discord: Culture Clash We have ancient bodies We live in a modern world Our bodies have not had enough time to adapt Adaptation is a slow process – European descent vs native populations
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Maladaption Hypercholesterolemia Hypertension Hyperglycemia Osteoporosis Chronic diseases including Alzheimers
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Medications
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Treatment Protocol 1.TLC (Therapeutic Lifestyle Change) 2.Medications Most physicians dont believe patients are able to change lifestyles.
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Percent of Adults Overweight USA England Canada Austria France Korea Brazil
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Common Questions: Are we sure its our culture? Are we confident we know what our ancestors ate? Who wants to live like a caveman? Humans are living longer, how can there be a problem with our health? Isnt this just your opinion?
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Summary Our health is getting worse Our culture is the most likely culprit There is nothing we can do to speed up human adaptation Since we cannot change our genetics, the only thing we can change is our culture and environment
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Up next.. Part II How Our Culture Has Changed We will discuss the only realistic solution to our poor health We will learn how and why our current culture has changed. We will understand the different pieces of our unhealthy culture and how to avoid or replace them
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