Continuing our series of interviews with experts in health, nutrition, and the food system, we recently spoke with Dr. Joseph Barrocas. Of course, we're always blown away by the wealth of knowledge and compassion medical experts bring to their work, and Dr. Barrocas is no exception. If only every patient were so lucky as to have a doctor like him.
Dr. Barrocas' passion for improving lives, preventing disease, and tackling the root of the problem - not just treating the symptoms - is obvious in every part of his work (and this interview!)
Dr. Barrocas, thank you so much taking time to chat with us. To start, tell us about yourself.
I was born and raised in Brooklyn to parents who had only recently left Cuba. I attended Harvard University for undergraduate work before going on to medical school in Buffalo, NY. and from there I moved to Cincinnati for a combined Internal Medicine and Pediatrics residency, where I was also Chief Resident in Pediatrics for a year. I stayed on as a faculty member for ten years as a Clinician Educator, before moving to Davidson, North Carolina in 2005 to join an old friend in practice. I’m married with two girls ages 18 and 16, and a 14 year old son. In late 2016 my wife and I tried a 3 week “cleanse diet”. After initial discomfort, I couldn’t believe how good I felt. That led us to Forks over Knives and we began to empower ourselves with more knowledge about nutrition than we had ever had.
Can you tell us a little bit about your journey in healthcare and how the food system has shaped the way you practice medicine today?
I’ve often been asked about when I decided I wanted to become a physician. On some level, I think I’d have to say I’ve always known, because there was never a time I remember saying this is what I want to do. My parents were immigrants and school was always emphasized. I guess I figured whatever path my journey through medicine took, the end result would be to help others. Who wouldn’t want to do that? That lead me to Primary Care via Internal Medicine and Pediatrics. See everybody, take care of everyone, make an impact.
Twenty-three years into this, I’ve been witness to an explosion of new techniques, interventions and pharmaceuticals that would all promise to make us healthier. They may be better band aids, but even if they were accessible to everyone, they have driven up the costs of health care exponentially. And are we any healthier? Skyrocketing rates of obesity, diabetes, sleep apnea, etc. would argue otherwise. We may have the tools to help patch these patients up, but at what cost and to what end?
Everyone has heard the data. For the first time in human history, non-communicable disease has over taken infectious disease as the primary cause of morbidity and mortality.
I’ve always been conscious of healthy food, but when I cleaned up over a year ago and really started becoming plant based, I realized it wasn’t so hard. But you have to get sugar and sweeteners out of your system to get your palate to change and really enjoy real food. If you have a choice of two delicious meals and one is good for you while the other is unhealthy, why would you choose poorer health?
That’s the message I’ve tried to pass along to my patients.
What is one thing you would change about the food ecosystem in your community that would make a profound impact on your patients' quality of life?
I think that’s at least a two part question. The food ecosystem is huge. Those of us in bigger cities at least have the option to seek out healthy choices. But many smaller towns and rural areas don’t have Earth Fair or Whole Foods to entice people to try new things.
And people like to eat what they’ve always eaten. If the staples of their upbringing are fast food, pizza and prepared frozen packaged foods (nothing like a Swanson Salisbury steak TV dinner), then that’s what they learn. The root of one of the biggest public health concerns of obesity is a lack of knowledge about, and access to, healthy nutritious food.
How many public service announcements about the benefits of vegetable, fruits, nuts, seeds and legumes have you seen that can compare to the creativity of a Taco Bell commercial?
If there has been anything resembling a non-branded approach to advertising food, it’s been all about meat, the incredible edible egg (except for about 200 million of them from my adopted state), and whether or not we got milk.
We’ve spent the last 40-50 years depending on the government to tell us what is best based on science, but the science itself is tainted by industry support and what actually gets put into print is heavily influenced by powerful lobbies.
And then there’s access. Eating healthy plant-based food really is not more expensive than eating processed foods, but you have to plan. There is a significant convenience issue there. That’s another place the government and public health comes in.
Let’s stop subsidizing the industries that kill us and instead use that money to make healthy real food more affordable, accessible and convenient for all. Ten cents of prevention instead of ten dollars of cure.
One change? Tax meat, processed foods, sugary beverages and subsidize plant based food. Money talks. If premium gas was cheaper than regular, wouldn’t your feed your car better gas? It’s worked on some level with cigarettes. But it’s a highly politicized issue. Bloomberg couldn’t make it work in NYC with large sodas, and that’s a pretty progressive city.
When did you first realize your patients struggle unnecessarily hard to lead healthy lives?
I’ve lived in the south for almost 13 years now. Chicken fried steak, Popeye’s Chicken, barbecue, sweet tea. Oh my god, sweet tea. These are staples down here. I met a patient several years ago after he got out of the hospital having lost his leg to diabetes that he only found out about when his leg became gangrenous. As I struggled to control his diabetes with several medications, not understanding why his control was so poor, I finally stumbled on his tea habit. He was drinking it steadily all day long. Never occurred to him it was a problem. We discussed cutting down and hopefully eliminating it completely. “Doc, I don’t know if I can. I was weaned on sweet tea”.
The big Aha moment for me was attending the Plant-based nutrition medical conference in Anaheim last year. A lot of the newer technologies in medicine are out of my reach as a generalist. The evidence I saw presented regarding the far reaching effects we can have by having patients adopt healthier eating habits made me realize that it has to be easier than just developing more medicines and techniques to go after more and more sick people.
It came up over and over. “We have a food system that doesn’t care about health, and a health system that doesn’t know about food”.
That hit home. I wasn’t talking to people much about their diets aside from telling them they had to eat better and lose weight, because I didn’t know what to say. Changing messages about what constitutes a healthy diet over the last few decades have confused everybody. Medical school doesn’t really help to clear things up. Now an Internet where everyone has access to “expert advice”? Clear as mud.
What has you most outraged about your local food system?
I guess outrage is putting it a little too strongly. Until now it’s been the status quo. Very easy access to unhealthful fast food everywhere you turn. I still can’t believe how long the lines are at some of these drive throughs. Disappointment is a better word. The choices are getting better, but you need to know where to look.
How do you choose to impact your local food system? (either in your work through Balanced or other projects you are working on locally).
As I learn more about what Balanced is doing, I hope to arm myself with teaching tools to take some of the advice I have been dispensing out of my exam rooms and into the local hospital system and community forums to hopefully entice and ultimately empower folks in my area to eat healthier and find out about how much better they can feel, how their chronic diseases can become easier to manage, and of course if they need to lose weight, that will follow as well. Once the word gets out, maybe they can tell two friends, and so on…
If you could design the ideal meal for your patients, what would it be?
I think that the biggest obstacle to overcome is that meals do not need to be centered around a large piece of meat. A perfectly satisfying dinner can be a variety of nicely seasoned roasted or grilled vegetables, with or without a whole grain. Or a nice salad with figs, or hemp seeds or chick peas or any of a variety of beans to fill it out. And if they haven’t heard about cashew based creams, they haven’t learned what I think is one of the best plant based hacks out there!
There are so many sites now with great, flavorful recipes available. And like I’ve been telling my patients for years, if they are drinking anything with calories in it, it should be because of the alcohol.
How can patients get in touch with you if they would like to know more about your practice?
Joe Barrocas, M.D
Huntersville Pediatrics and Internal Medicine
17220 Northcross Drive
Huntersville, N.C. 28078
704-384-8720
jbarrocas@novanthealth.org