Dr David L. Katz, MD, MPH
Founder at National Exchange for Weight Loss Resistance
Editor-in-Chief at Childhood Obesity
Chief Science Officer at NuVal
President & Founder at Turn the Tide Foundation
Director at Yale Prevention Research Center
POINT OF VIEW
Using lifestyle to help manage and reduce risk of chronic disease
You are involved in an amazing amount of different causes. What do you enjoy most about what you do?
Making a difference! On a day to day basis it seems pretty hard but overall as I look at the array of activities I’m involved in I feel like I am helping people overturn the tide of obesity and type 2 diabetes. I want to feel good—we’re all a little selfish that way. I feel good when I see the programs that I’m working on are reaching people and helping them lead better lives. The value in recognizing the selfishness is that many of us want to do good and help others. And it helps us to choose the things we really love, it motivates us. It’s important to fall in love with your career choice and my career has evolved in doing that.
What do you think are the biggest challenges facing people with diabetes?
First we have a world that makes it easy to develop diabetes, difficult to avoid and challenging to managing. Type 2 is mostly a lifestyle disease; there was none of this in children before obesity. Diabetes requires for you to swim upstream with a society that markets all the wrong foods and makes activity difficult. We don’t have a culture that enlightens healthy lifestyles. We shouldn’t have to work so hard to avoid type 2 diabetes–we have established a cultural norm in developing diabetes. Besides lifestyle challenges, people also have challenges with blood glucose control and hypoglycemia and the consequences of complications—which is really the hardest part of dealing with diabetes.
Where do you see us in 10 years regarding managing diabetes and obesity?
I like to compare the different things we are doing to stacking levees to prevent flooding. Every policy and activity is a sandbag in a levee. I am always a little careful about being too optimistic since we don’t always agree on what constitutes a good idea to make progress in this area. For example, Bloomberg’s idea of decreasing drink sizes, there is a lot of controversy here as well as different opinions. Every time we take a step forward we get knocked back. We can build the levee together. Our inability to have civil dialogue, talk to others and be persuaded is the enemy here.
If we get out of one another’s way we can make a difference, we have the knowledge. 90% of all diabetes would go away we just have to turn the knowledge we have into the power of what we do. The only thing in the way is us.
What tools do you think would help people with diabetes succeed or adhere to their diabetes self-management programs?
Physical activity daily that fits in no matter what and good food choices. Programs that we have developed or those that others have developed can be used. The averages shopper is mystified; every package is a commercial. Sugary cereals say whole grain, added vitamins and you think it is a good choice. It’s confusing and even if you have the time you might not be able to figure it out. I devoted years of my life to the NuVal® system. It is a simple nutritional value scoring system based on a scale of 1-100. The higher the score the more nutrition. It’s in 1700 supermarkets. A study was done in Harvard with NuVal, the higher the average NuVal score the lower the risk of diabetes. This is an extremely powerful tool and evidenced based system to reduce risk of chronic disease.
We need to create strategies for physical activity every day. We send kids to school all day and physical activity programs are getting cut. ABC for Fitness© (Activity Bursts in the Classroom) is a free program that is used for schools across the county that helps kids be active throughout the day. A-B-E for Fitness (Activity Bursts Everywhere) is for adults and provides a free video library of activities. We have to be clever since fitting in physical activity is challenging. Overall when people use their feet and forks better they will see their diabetes control improve.
It sounds great. Knowledge is also power– if it gets used. I would completely endorse it–sounds like a one stop shop. If you can be guided to a system like that it will make a difference for people. The power of lifestyle trumps all but in the modern world it takes skills and takes power to learn how to use lifestyle.
Anything else you would like to share?
Also, I see two critical issues here. In order to prevent diabetes we need the world to change. If you have diabetes or have a family member with diabetes you need to find tools you can use and find a healthcare professional to help empower you.
Interviewed by Sherri Isaak, MS, RD, CDE, BC-ADM, Fit4D Director of Content Development