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We were fortunate enough to learn of Dr. Freeman's work after reading an article he wrote about heart attacks during the holiday season. We were immediately struck by his conviction and reached out as quickly as possible. Since then, we've had the great privilege of getting to know Dr. Freeman more and our initial reactions to his work were right: he's brilliant, dedicated, and tireless in pursuit of reducing diet-related deaths and preventable illness. We hope you enjoy our interview with him as much as we've enjoyed getting to know Dr. Freeman. First, tell us a bit about yourself and your history as a physician. I joined National Jewish Health in Denver, CO after completing my training in Philadelphia at Temple University. Prior to that, I completed my internal medicine training at Brown University in Providence, Rhode Island. At National Jewish, I serve as the director of clinical cardiology and the director of cardiovascular prevention and wellness, and I'm an Associate Professor of Medicine. I am board certified in internal medicine, cardiovascular disease, nuclear cardiology, cardiac CT, and echocardiography. My clinical and research interests are in disease prevention, exercise and lifestyle medicine, imaging heart disease, nutrition, and cardiac sarcoidosis. I also host a monthly Walk with a Doc program (http:/Denver.WalkWithADoc.Org) in the Denver area where I volunteers my time to walk with patients on Saturday mornings to teach key health concepts, but also to explore using exercise as medicine for the greater good of the public. Finally, I hold some key leadership positions in the Colorado chapter of the American College of Cardiology as well as at the national level, including founding chair of the Early Career Council and Section, an active member of the Best Practice Quality Improvement committee, co-chair of the Lifestyle and Nutrition Workgroup and a spot on the Patient-Centered Care, Cardiovascular Disease Prevention Council and ACC Digital Steering Committees. I have published scholarly manuscripts on patient-centered care, cardiac sarcoidosis, and served as editor-in-chief of the Patient Centered Care community on CardioSource. I serve as the social media editor for JACC, the country’s number one cardiology journal. As an avid teacher and educator, I teach medical, physician assistant and pharmacy students regularly, and have hosted many community lectures and CME programs. (See, we told you! Brilliant and dedicated!) 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? When I finished my training, like most trainees, I was an expert in the latest in standard Western medicine, diagnostics, imaging, therapeutics and medications. I could treat the most severe disease nimbly… but I was not prepared for prevention and the concept of how lifestyle medicine could actually allow for a potential cure of the very diseases I was treating. Obviously, when damage is done, we must use the tools we have to repair it, but once the repair is made, the next step is allowing for true healing – and this is where the combination of diet, exercise, and stress relief really come in. Even better is to prevent the damage to begin with! When I discovered the power of plant-based and minimally processed eating combined with exercise, stress relief, and connectedness, the results in my patients were astounding… for the first time in my career I took away medicines and watched high blood pressure, heart disease, and diabetes literally melt away. 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? Making plant-based foods readily available everywhere from hospitals to schools to your favorite restaurants. These foods taste wonderful and are cheaper and easier to  make and keep on hand than many other foods, and healthful living should be contagious! When did you first realize your patients struggle unnecessarily hard to lead healthy lives? When I started asking patients what they ate for dinner the night before their visit with me, I was astounded as to what the average American was consuming every night – highly processed, carcinogenic, high calorie, high fat, and high salt foods were the regular issue. What has you most concerned about your local food system? The impact of many of the animal product industries on our planet. The current rate of animal product consumption will strip our earth of needed resources it makes me worried about future generations. Big Food has made it nearly impossible for clinicians and scientists to extract useful and truthful health outcomes data to guide our everyday clinical care. How do you choose to impact your local food system? Locally, we are working hard to implement plant-based food items in our hospitals and have started using Intensive Cardiac Rehab which makes use of the Ornish model (plant-based eating, exercise, stress relief and connectedness) of which I have led the implementation. In this model we literally hold the hand of our patient as we teach them healthy living patterns to create sustainable health and to have positive impacts on our planet. If you could design the ideal meal for your patients, what would it be? It would be a super healthful and tasty curry brown rice bowl loaded with local vegetables and spiced just right! How can patients or our supporters get in touch with you if they would like to know more about your practice? A few ways: for people interested in becoming a patient, they can call 303-398-1355 for an appointment. They can visit njhealth.org/walkwithadoc Or they can visit https://www.nationaljewish.org/doctors-departments/providers/physicians/andrew-m-freeman

Picture this: it’s 8pm and you’ve seen 22 patients today. 18 of them suffered from diet and lifestyle-related illnesses. You spent more time dealing with the EMR system and fighting with administration than seeing the patients who need you. You barely had time to eat, so you grab a crispy-chicken sandwich from the cafeteria - the only place open by the time you leave. Now picture this happening everyday. You probably don't have to stretch your imagination too far. That story is all too familiar for so many doctors. Seeing sick, overweight, hypertensive and stressed people day-in and day-out is exhausting and frustrating. On top of everything else you're responsible for, it's particularly maddening because you know most patients could be living normal, healthy lives if just a few changes were made. The most obvious of which is their food environment. Imagine how much easier your job would be if your patients only had nutritious food options in fast food outlets and convenience stores. No more food swamps where the majority of food outlets sell high-calorie junk food and no more food deserts where communities just don’t have access to fresh fruits and vegetables. No more children getting hooked on chicken nuggets. No more adults over consuming cheeseburgers. No more late night cafeteria chicken sandwiches for you. You wouldn’t lose sleep over the number of preventable heart attacks you see each week. You wouldn’t worry that your commitment to your patients’ health is undermined by the hospital cafeteria. You would, however, have faith your patients' health will improve because all the systems are aligned to help them. I doubt anyone would be surprised to learn that since you began your practice many years ago, the patients you see are sicker and more medicated than ever before. And let's be honest, the problem is only worsening. Over fifty years ago, the Tobacco industry sat exactly where Big Food sits today. It took more than 40 years and 7000 research articles for the Surgeon General to issue a warning against smoking in 1964. How many more years and how many more studies do we need before we get rid of disease-causing food in our hospitals, schools and communities? How many more people have to die before we stand up and demand Big Food be held accountable for serving known disease-causing foods? How much more satisfying would your career be if you weren’t constantly fighting the rising health barriers of diet-related diseases? Instead of talking about Type II diabetes, hypertension or heart disease, imagine if you spent your days finding ways to help your patients maximize their joy and wellbeing in life. You deserve better. Your patients deserve better. And they’re depending on you to help change the system. It's time to change the conversation in our healthcare system. Now is the time to advocate for both individual AND institutional change. Until everyone steps up and demands healthier foods, our communities will only get sicker - and your job will only get harder. If you want to get involved creating systems-level change, now is the perfect time. I'm here to help. The entire team at Balanced is here to help. If your hospital or healthcare facility cafeteria needs a menu revamp, reach out and let's make it easier to live longer and live better. _________ For partnership opportunities or to learn about campaigning for change in your healthcare facility, email lornac@balanced.org.

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

Here at Balanced, we're always eager to connect with experts leading the charge for healthier families. Dr. Yami, founder of Veggie Fit Kids, exemplifies the values most important to Balanced and we could not feel more honored to have her on our side. Dr. Yami's podcast, website, and pediatric care practice are filled to the brim with evidence-based nutrition advice and her many credentials speak for themselves. Check out the interview below and be sure to visit her site and social media pages for EVEN MORE great tips on keeping your family fit and healthy. Tell us a little bit about your journey in healthcare and how the food system has shaped the way you practice medicine today? I wanted to be a doctor since age 4. I always knew I wanted to help people. Medical school taught me all about disease, medical treatments and surgery. But it wasn't until I went through my own struggles and serendipitously discovered a whole food plant-based diet that I made the true connection between our diet and lifestyle choices and our health. I don't blame or shame parents for their habits or food choices. We live in an obesigenic environment that encourages overconsumption of overly processed foods that have addictive potential. I am human too. But if we desire to have better health outcomes for our children and grandchildren, we MUST pay attention to the foods that are being served at home, at school and out in the community. I feel that to be the best doctor I can be, I have to be informed about health promoting foods and how I can guide my patients and their families into developing habits that support their best, joyful life. 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 would reduce the amount of fast food restaurants and replace them with community gardens. We have one of the highest ratios of restaurants per capita in the region and being constantly exposed to opportunities for highly processed calorically dense foods leads to increased consumption of those foods and subsequently increase rates of chronic disease.  When did you first realize your patients struggle unnecessarily hard to lead healthy lives? We all struggle with something. We are all human and we are imperfect. I want everyone to know that I do the best that I can and I struggle too! I see many moms that work 2-3 jobs, get very little sleep and love their children so much that they buy fast food and highly processed foods because they want to make sure that they are getting enough calories to eat. They do want the best for their children, but they are at the end of their rope and don't know how else to do it.  However, with a little information and practice, we can start to integrate more health promoting foods into the diets of their families. It takes time and persistence. What has you most outraged about your local food system? I am not outraged, but I do feel sad. I feel sad because even though I am enthusiastic and optimistic most days, there are some days where I wonder if its too late to swing the pendulum in the other direction. The problem is massive and we have accumulated many years of unhealthy habits that we must work to reverse. I know it CAN be done, but it really is going to require involvement from many concerned parents and citizens. We must take stand for our health and the health of our future generations. I don't believe it has to be all-or-nothing, but we do have to integrate more whole plant foods into our every meal. How do you choose to impact your local food system? I have been teaching live cooking classes for 4 years, educating as much as possible out in the community. I also have a presence online and I work with adults as a health coach. I have helped the local hospital, Virginia Mason Memorial, implement plant-based options into their menus. I see lots of great change coming in the future. If you could design the ideal meal for your patients, what would it be? The meal would include beans, whole grains, vegetables, and fruits, be beautiful and vibrant and full of color and it would be a meal that they would love and feel fully satisfied after eating. How can our readers get in touch with you if they would like to know more about your work? They can see my work at www.veggiefitkids.com and I am active on facebook.com/veggiefitkids and on instagram @veggiefitkids. I also have a YouTube channel @veggiefitkids. Balanced supporters can also hear our executive director, Audrey Sanchez on Dr. Yami's podcast here. ______________________ Please help Balanced keep our services free and available to every family, make a donation today. As a 501(c)3 we depend on the generosity of our supporters to keep Balanced going, and every dollar counts!

Over the last 18 months I’ve come to realize a fundamental truth holding us back from making greater progress toward a healthy food system: we’re fighting each other instead of the food industry. An extension of its personal-choice propaganda, the food industry is exceptional at deflecting responsibility and convincing us we’re the ones to blame for the current state of public health. Instead of taking an iota of responsibility for the stores full of junk food, lunch trays piled high with processed meats, and heart-attack causing hospital menus, these companies have engaged in decades-long misinformation campaigns aimed at making us believe obesity, heart disease, diabetes, and even cancer are the results of personal failure. Explicit in those misinformation campaigns is the idea that if we truly cared about public health, we would focus on improving our willpower or decision-making abilities. Dangerous in and of itself, an unfortunate byproduct of that messaging is we've come to believe it's not only true for ourselves, but that it should be true for everyone around us also. Regardless of circumstance. I see it every day on our social media pages and various other newsfeeds. The bickering. The prescriptive “my way is the right way” posts. The anger, confusion, and despair. All directed at one another. And while we’re fighting each other, the food industry – the very corporations designing our grocery stores, our school lunch lines, our hospital menus, and our restaurants – gets away with serving known disease-causing foods to our loved ones. Let me repeat that. Companies serve KNOWN (scientifically proven, evidence backed, unequivocally true) disease-causing foods to our families and then blame us for the poor health outcomes linked to those products. These companies depend on our collective inaction in order to profit. As long as we stay quiet, or direct our anger at one another, their bottom line is safe. Imagine if we turned our outrage toward the companies poisoning our children and destroying public health instead of against one another. Imagine the power we'd have if we took a stand together. It gives me chills just thinking about it! We will not succeed in creating a healthier food system by fighting each other. Our children won’t be freed from the burden of diet-related disease if our battles stay Us vs. Us. Until we’re united in our fight against the food industry, we’re wasting our time. The food industry fights unfairly. They lobby. They misinform. They pit us against one another. And they have to, because they know the real fight – the one they lose - is Us vs. Them. Unfortunately, right now they’re winning. So, let’s stop fighting each other. Let’s save the arguments about who is right and who is wrong until after we’ve leveled the playing field for everyone and our food system supports healthier choices everywhere. Battling each other doesn’t help the collective fight for a better food system. It just slows us down and plays into what the food industry wants and already expects from consumers: zero accountability. We’ve got too much passion and too much energy to waste it on the wrong target. It's time to turn our attention to the real enemy and hold more food companies accountable for fixing a system that is literally killing the people we love. It's time for a balanced food system. _________________ Please help us fight the food industry by leading a campaign, volunteering, or donating.

Last week, we had the great privilege of interviewing Dr. Blake Shusterman, a board-certified nephrologist at Carolina Nephrology in Greenville SC, and host of the online cooking show, The Cooking Doc (www.thecookingdoc.co). He shared what it's like as a medical professional trying to educate his patients while working to make the food system healthier for everyone. Over the past decade, Dr. Shusterman has witnessed firsthand many of the barriers people face when it comes to eating healthy - from lack of money to grocery store design - and he's made it his mission to tackle those issues head-on. We're excited to share this interview and we hope you'll check out the amazing resources on Dr. Shusterman's website and YouTube channel. 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? As a kidney specialist, I care for patients with diabetes, high blood pressure and chronic kidney disease. Dietary management is a key component of both preventing and treating each of these conditions. When I moved to South Carolina nine years ago and started my current job, I was surprised by the lack of nutrition knowledge of my patients and by their inability to understand how the way they were eating was effecting their health. My patients, especially those in the rural areas, have grown up within a food system that hasn’t prioritized healthy food and healthy living. In these areas, there are fast food restaurants on every corner, screaming with temptation and convenience. If my patients happen to bypass them, the sit-down restaurants will reel them in and serve them fried food, meat and three vegetables (of which the nutrients have been boiled or fried out of them) or all you can eat buffets. And if families decide to eat at home, their food choices may be limited – the cheapest choices are often the least healthy—and a culture that has prioritized larger portions of fried food with gravy, mashed potatoes, sweets and macaroni and cheese instead of smaller, fresher meals. Unfortunately, many of my patients have eaten unhealthy food for so long, they don’t know how to enjoy or how to cook healthier food. As these realizations sunk in, I set out to find a way to change the culture. 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? This is a difficult question to answer because it’s almost impossible to find “one thing” that would make a profound impact on quality of life. As a high impact starting point, however, I would love to see a change in the organization and structure of the grocery stores. It would be amazing to have the grocery store organized into sections that include: Local. Healthy Snacks. Good for High Blood Pressure. Diabetic Friendly. Low Sodium. Whole Grain. High Fiber. These could be the first aisles that you see when you get into a store, as opposed to the high sugar and on-sale processed foods that bombard you when you walk in. The rest of the store can be organized into these sections: High Sugar. Highly Processed. No Nutritional Value. High Saturated Fat. Bad for Your Heart. Salted like the Ocean. Guaranteed to make your Blood Sugar go up. When did you first realize your patients struggle unnecessarily hard to lead healthy lives? A few years after I started practicing as a nephrologist, I was caring for a man in his mid 40s with diabetes, high blood pressure and obesity. He worked full time for many years, but because he had struggled with these issues since his twenties, the burden of his health issues became too much for him to handle, and he went on disability. When I saw him in the office five years later, he was ready to make a change in his health. Once he made that decision, the obstacles for him to get healthy were more than I ever imagined. The first barrier was money. Because of difficulties with health insurance and poverty, he could not afford all of the medications that I had prescribed him. His difficulties did not stop there. He cared for his severely debilitated mother, who required a lot of attention that took away from his ability to make his own food. His kitchen was tiny and he was unable to afford any of the cooking apparatuses that make cooking easier and more fun: such as sharper knives, a blender, new pots and pans, etc. When we decided to talk about shopping in a healthy manner, he described his inability to afford gas money to get to the grocery store, a lack of family support to help him get there and a monthly government check that ran out by the time he paid for his electricity, rent and his mother’s supplies. There was very little money left for discretionary spending on healthy food. He had to make it through one day at a time, and, because of that, the importance of leading a healthy life became a lower priority. It was just too hard and too expensive. Doctors have to remember this as we ask people to lead healthier lives. Health, though important, is only one aspect of survival, and people have to make hard choices each day about how to spend their money and make it onto the next day. What has you most outraged about your local food system? This blog post I wrote last year exemplifies my frustration with the restaurant options in Greenville, SC. Like many other cities in the US, we have made good food a point of pride in our city and have used it to attract restaurateurs and tourists. Unfortunately, there is very little connection between the restaurants that open and the dire need for people to change their eating habits to focus on healthier eating. Individuals don’t want to order healthier foods and restaurants don’t want to focus on creating healthy meals that taste as good as the unhealthy ones. How do you choose to impact your local food system? (either in your work through Balanced or other projects you are working on locally) Through the development of The Cooking Doc, my online cooking show, I have developed a means to communicate to my patients and to other members of my community, highlighting the importance of healthy eating. Over the last year, I have started reaching out to local restaurants and media publications to spread the word. Even if people aren’t cooking my recipes, by educating my patients and others about how to eat in a way that protects their health, I hope to inspire everyone out there to change their eating habits. If you could design the ideal meal for your patients, what would it be? The ideal meal for my patients is the healthiest, affordable meal they can prepare and stick with long term. I try not to tell them to follow a specific dogma such as low calorie or low fat or low carb, but more to figure out what they like and tailor a diet to their likes, dislikes and lifestyle. There are a few suggestions that apply to most of my patients. Each meal should have a fresh vegetable and a fresh fruit. This is easier than it seems—sometimes I tell them to add a few berries and a handful of spinach or arugula on the side of a meal. I also try to encourage them to eat slowly and mindfully. And I want them to try new things: new vegetables, whole grains, beans. The tagline for my cooking show is #ChangeYourBuds which means I want them to change their taste buds to enjoy healthier foods. Many of my patients have developed taste buds that favor unhealthy foods instead of foods that are good for them. Over time, my followers and patients work to #ChangeTheirBuds to like fresh healthier foods, fruits and vegetables, and whole grains. How can our readers get in touch with you if they would like to know more about your work? They can find me at www.thecookingdoc.tv, subscribe to my YouTube Channel “The Cooking Doc” by clicking here https://goo.gl/07Nerb or follow me on Facebook, Instagram and Twitter: @TheCookingDoc Dr. Shusterman is a board-certified nephrologist at Carolina Nephrology in Greenville SC, and host of the online cooking show, The Cooking Doc (www.thecookingdoc.co). He teaches viewers to make healthy and delicious meals and he is passionate about patient education and the importance of diet in the management of chronic diseases. He currently serves as President of Carolina Nephrology and Director of their Chronic Kidney Disease clinic. During the remainder of his time, he directs three dialysis units and oversees the medical student nephrology rotation at the USC School of Medicine in Greenville. Dr. Shusterman completed his residency and fellowship at the University of Virginia and received his medical degree from The Ohio State University.

Just in case anyone missed this news, 2 weeks ago, this report on childhood obesity came out. Spoiler alert: it's not looking good. And just today, Vox published this piece highlighting a new study that links food advertising and junk-food sponsorship of major sports teams to childhood obesity. You can read the original study here. The key takeaway: "The first study to quantify food marketing to children through professional sports organizations in the US, it casts these leagues in a new light: as key peddlers of junk food to children." While the current statistics are certainly grim, the problem is solvable. It starts with holding the food industry accountable. Please help us demand better for our families. Join a campaign or donate to help us keep our programs free for all. Together, we can create a healthier future for our families - and we won't stop until we do.

How far would you go to prevent your child from dying 14 years prematurely? Would you jump in front of a bullet? Lift a car? What about sign a petition or send an email? Would you speak up and demand change from the food industry and the institutions feeding our children? That’s the question we need to be asking ourselves right now — because for the first time since the 19th century, an entire generation of children is expected to live shorter lives than their parents. Not only that, but it’s likely their quality of life will be significantly worse, too. And it’s not because of bullets or cars, or yellow fever, or smallpox. It’s because of diet. Diet-related diseases are at an all-time high, and the age at which our children develop these diseases is at an all-time low. The primary cause? Obesity. In the last 30 years, obesity rates have doubled in adults, tripled in children, and quadrupled in adolescents. At the same time, the number of Americans who eat the recommended amount of fruits and vegetables falls below 10%. As our consumption of health-promoting foods has declined, our intake of disease-causing foods has skyrocketed. A recent survey shows over half the standard American diet is made up of ultra-processed foods like chicken nuggets, sugary pastries, and grab-and-go fast food products. Even our salads have too much junk on them! The reasons behind our changing — and now critically imbalanced — diets are complicated and reflective of our country’s changing culture in a myriad of ways. Admittedly, there’s no one magic bullet for solving this problem. But that shouldn’t dissuade us from trying. Quite the opposite, actually. We should be trying anything and everything within our power to address the fact our children are sick, getting sicker, and will likely die younger than they should. While we certainly can’t deny the parental responsibility to ensure the wellbeing of our children, to ignore the other factors contributing to the current state of public health would be shortsighted. Especially as more and more meals are eaten outside of the home, and those external food environments become less and less healthy. When it comes to our children, one obvious place to start addressing the problem is school. For many of us, our children eat between five and ten meals per week at school. Over the course of the year, that equals nearly 360 meals. Basically, the same number of dinners we serve our kids each year! But unlike when we’re preparing dinner, we have very little say in what our children are served when they’re in the lunch line. Loosely enforced federal dietary guidelines, political lobbies, and even major food companies have much more influence over our children’s school food than most of us are aware. And let’s be honest, those companies and the lobby groups rarely have our children’s best interests at heart. Take a look at most school menus and you’ll see more pizza than vegetables or fresh fruit. In many places, unhealthy foods outnumber healthy ones 4 to 1.8 Although to be fair, as long as there is enough of it, the pizza sauce is considered one serving of vegetables. Despite tomatoes being a fruit. Interpret that how you will. It’s time for more balanced menus in schools, and it’s time we step up and demand better for our kids. Until we take action and hold our schools accountable for making meaningful changes, our children will continue to suffer the consequences of eating too much of the wrong kinds of foods and not enough of the right ones. Calling on schools to replace some of the least healthy menu items with fruits, vegetables, beans, and whole grains is not an indictment of how much schools care about our children. Listen, they’re feeding our kids on shoestring budgets and doing the best they can. Just like us. But, just like us, they need to step up and take responsibility for improving the health of our children. It’s common sense. It’s our collective responsibility. More fruits and vegetables won’t magically appear on menus, and those tater tots and cheeseburgers aren’t going anywhere on their own. We don’t need a raw vegan, macrobiotic, Gwyneth Paltrow approved menu in every cafeteria — but we do need our children to be served fewer unhealthy foods 5–10 times per week. Our current food system isn’t going to change itself. It’s up to us. We can take action at home, AND we can demand action at school. If a few simple changes could contribute to the length and quality of our children’s lives, how can we sit idly by? So, I ask again, how far would you go to prevent your child from dying 14 years prematurely? If you’re ready to take action, join the thousands of others like you who want better futures for our families. ___________________________________ References 1. NIH study finds extreme obesity may shorten life expectancy up to 14 years. (2018). National Institutes of Health (NIH). Retrieved 1 March 2018, from https://www.nih.gov/news-events/news-releases/nih-study-finds-extreme-obesitymay-shorten-life-expectancy-14-years 2. (2018). Retrieved 1 March 2018, from http://www.nejm.org/doi/full/10.1056/NEJMsr043743 3. U.S. childhood obesity rates rising again. (2018). U.S.. Retrieved 1 March 2018, from https://www.reuters.com/article/us-health-kids-obesity/u-s-childhood-obesity-rates-rising-again-idUSKCN1GB2X5 4. Why Good Nutrition is Important | Center for Science in the Public Interest. (2018). Cspinet.org. Retrieved 28 February 2018, from https://cspinet.org/eating-healthy/why-good-nutrition-important 5. About 90% of Americans Don’t Eat Enough Fruits and Vegetables. (2018). Time. Retrieved 1 March 2018, from http://time.com/5029164/fruit-vegetable-diet/ 6. Beck, J. (2018). More Than Half of What Americans Eat Is ‘Ultra-Processed’. The Atlantic. Retrieved 1 March 2018, from https://www.theatlantic.com/health/archive/2016/03/more-than-half-of-what-americans-eat-is-ultra-processed/472791/ 7. USDA ERS — Food-Away-from-Home. (2018). Ers.usda.gov. Retrieved 1 March 2018, from https://www.ers.usda.gov/topics/food-choices-health/food-consumption-demand/food-away-from-home.aspx 8. Cooksey-Stowers, K., Schwartz, M., & Brownell, K. (2018). Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States. Retrieved 1 March 2018, from

I used to resent the tired trope of an informed or protective mother being called a mama-bear. For one, the desire to protect, nurture, and care for our children is not isolated to the ursidae family. Two, it’s entirely dismissive of a parent’s rightful outrage to liken them to an animal as a way minimize their concern. In fact, when a mama/papa bear parent shows up at a school, a store, a playground, or a company, everyone there should take notice. Why? Because a parent’s outrage is emblematic of a problem greater than some trivial misunderstanding or misdirected whimsy. Let’s be honest here, not many of us have the energy to go to battle over small things. So when that mama/papa-bear appears, it’s not because parents derive joy from causing a ruckus — it’s because the problem we’re confronting is serious, and we’re demanding to be taken seriously. In my case, the problem that most brings out my claws, fangs, and superhuman strength: Big Food preying on our children— profiting while serving our children too many known disease-causing foods like processed meats (chicken nuggets, hot dogs, pepperoni, sausage patties) and egg products. Nothing angers me more than food service providers and retailers serving so many foods that both common sense and science show are bad for our children’s health. Perhaps I’m old fashioned — or an overly concerned millennial — either way, I’m pretty sure kids need more vegetables and fruits to thrive. When I show up at a school and there are more chicken nuggets and tater tots on our children's’ plates than vegetables or fruit? I get angry. When companies say they value nutrition above all else, but their menus are more reflective of a McDonald’s menu than a garden? I get angry. And I’m not usually one to tell other people how to feel, but if I were you, now is the time for you to get angry, too. The health consequences our children will experience as a result of Big Food companies putting their profits before our health are terrifying. And if someone showed up at your front door threatening the well-being of your child, I’d bet dollars to donuts you’d take immediate action. Although the threat these companies pose to our families’ health is not as immediate as a knock on your door, the impact of the products they serve are just as dangerous. Unhealthy foods act in slow, insidious, but deadly ways and the results of over-consuming unhealthy foods are showing up earlier and earlier in our children. Unlike Big Food, I’m playing the long game when it comes to my child’s well-being. Maybe I’m being irrational (I’m not), but I believe our efforts to protect the health and wellbeing of our children shouldn’t be undermined by some major corporation looking to exploit our children’s appetite for profit. It’s hard to fathom how Big Food companies in schools and other major institutions serving my child, our children, are comfortable filling their menus with foods full of sodium, cholesterol, and saturated fat. But they are, and they do, and it’s up to us to change it. There’s nothing major corporations fear more than a coalition of angry parents, so let’s unite and stand up to Big Food on behalf of our children. For those of us with food-secure households, our food environments (home, school, work, etc..) are often plentiful — albeit too often disproportionately filled with unhealthy foods and too few fruits and vegetables. Still, even if we have the privilege of selecting healthy foods for our families when we’re grocery shopping, all that hard work goes out the window when the school lunch is sausage pizza five days in a row. For families experiencing food-insecurity, it’s even more critical the food environments that serve children outside the home are in line with the nutrition recommendations of leading public health and health care organizations. As such, we mama and papa bears should be holding these Big Food companies — food service companies, retailers, and major institutions like our school districts, hospitals, and community centers — more responsible for creating food environments that keep our children safe. Not just in the short-term. As parents it’s our job to play the long game, and any person or company who serves our families should be as well. We have the right and responsibility to lead the charge when it comes to transforming the food system affecting our children’s health. So, let’s channel our outrage into action and get to work!