Dr. M’s Women and Children First Podcast #31 – Dr. Sandra Hassink – Childhood Obesity

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This weeks guest is Dr. Sandra Hassink, an expert in pediatric obesity.
Dr. Hassink has spent her career looking into the pathophysiology and social determinants of childhood obesity. Her career began at the Univeristy of Deleware where she studied Chemistry before heading off to Vanderbilt University to study medicine. After completing her training in Pediatrics at St Christopher’s Hospital in Philadelphia, Dr. Hassink began a long trailblazing road to treating childhood obesity, starting a weight management clinic in 1988 at Alfred I. duPont Children’s Hospital in Delaware well before most pediatricians even realized there was an issue to address.
She is now internationally recognized as an expert in childhood obesity prevention, testifying before Congress and serving as chair of the Delaware Governor’s council on Health Promotion and Disease Prevention and directing the AAP Institute for Healthy Childhood Weight. She has served as the president of the American Academy of Pediatrics, chaired the AAP Obesity Leadership Workgroup, the AAP Institute for Healthy Childhood Weight Advisory Committee, and the AAP Strategic Planning Committee. Dr.  Hassink is the chair of the Institute for Medicaid Innovation Child and Adolescent Subcommittee and a member of the  National Advisory Board. She authored numerous articles for parents and pediatricians and two books: “Pediatric Obesity: Prevention, Intervention, and Treatment Strategies for Primary Care” and “A Clinical Guide to Pediatric Weight Management.”
In a word, she is a teacher.
Today, we have the privilege of learning.
Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 39

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Coronavirus Update #70 GOOD NEWS: This information is so important to help us all understand risk. Stratified risk is the only true way to measure personal risk. Let us look at some CDC data from the spring Omicron BA.1 and .2 spikes versus the fall 2021 delta wave.
Median age of hospitalization has increased from 60 years old with Delta to 64 with BA.1 and 71 with BA.2. Any underlying medical condition associated with hospitalization increased from 89% with Delta to 92% with BA.1 to 95% with BA.2 respectively. Length of hospital stay decreased from 4.8 to 3.9 to 3.3 days. ICU admission was down from 24% to 18% to 13% of admitted patients. Mechanical ventilation decreased from 14% to 8% to 6% of admitted patients. And Finally, death from 12% to 8% to 5% overall.

What we can glean from this data set is very clear. With successive SARS2 mutations coupled to increased population based exposure to virus via infection or vaccine, we are now seriously in a reduced risk state unless you are older than 65 years with a comorbid disease or younger than 65 with a serious disease. 95% of hospitalizations were related to a comorbid disease regardless of age. The other big takeaway was this: if you are in this high risk group, getting every available booster is vital to your survival based on the risk reduction data. For everybody else, the data is clear, you are ok – to boost or not to boost is up to you. But, absolutely work on your general health.

To your health,
Dr. M

Healthy Kids, Happy Moms by Sheila Kilbane M.D., (Book Review Pedcast)

 

Introduction
Welcome to another installment of DocSmo.com, also known as Women and Children First podcast. I’ve taken a hiatus from weekly posts for the past year but I haven’t stopped exploring pediatrics and parenting. Today, I’m going to review a new book by Dr. Sheila Kilbane called “Healthy Kids, Happy Moms”. Those of you who are long time DocSmo.com followers will recognize Dr. Kilbane’s name as she has been a frequent guest on my podcast in the past. Her interviews have been very popular. Now, she has stepped up to being a published author/educator. If after reading my comments you are interested in getting a copy of her book, buy it with the link provided in this post and help support DocSmo.com. You will get Amazon’s best price and a they will throw a few cents to support my blog.

Purpose of Book
Dr. Kilbane has told me numerous times in the past that she is trying to change American pediatric healthcare. After reading Healthy Kids, Happy Moms, I now understand what she meant; a new paradigm to providing health guidance for children with common chronic medical problems. Dr. Kilbane seems to be getting in on the ground level of change by adopting a wider view of disease in children. A quick Amazon book search only revealed two other books with an “Integrative” approach to pediatric medicine. Readers with children suffering from various chronic diseases will benefit most from her writing, introducing the basic concepts of integrative medicine to readers and providing parents with a roadmap to recovery. The topics most discussed are ones all too familiar to parents of young children; chronic constipation, eczema, asthma, food allergies, and recurring ear infections. As she points out, the percentage of children suffering from one of these disorders has been steadily increasing. HKHM says it’s time to try a new approach and presents a clear roadmap to doing so.

Characteristics of Book
Dr. Kilbane has done her homework not only in the research she presents in her book, but also in its presentation. I found the graphics easily understandable and pleasing to the eye. By using the same color scheme throughout the book, the reader is gently introduced to a lot of material in a cohesive way. As I read HKHM, I never felt overwhelmed. Dr. Kilbane’s storytelling ability and her revelations about her own health struggles during childhood, add a pleasing intimacy to her book. The strongest adjectives I can use to describe HKHMs are informative, practical, and well presented.

Criticisms
Providers of healthcare are in the business of offering advice and treatments that is intended to help mitigate or prevent disease. This is our core mission. Pediatricians, whether integrative like Dr. Kilbane or traditionally trained like myself, come at children’s health problems with a set of beliefs and assumptions that evolve and change over time. Take for instance the recent revelation that the treating of young children’s ear infections with antibiotics may have long term negative consequence for the health. Similarly, could today’s anti-inflammatory diet become tomorrow’s nutrient deficient one? I don’t know. While I believe that integrative medicine has moved healthcare advice in the right direction and that much of what they advocate has proven correct, ten years from now we may look back at some of today’s recommendations and see that such advice was shortsighted or not appropriate for all children.

HKHM presents a number of emerging theories as if they are facts, specifically inflammation underpinning all chronic disease, process foods causing leaky gut, and processed food being the proximate cause of damaging inflammation in a child’s body. While these theories may hold up to the test of time, there is a chance that they may not. I feel like this is important for parents to keep in mind as they make decisions about their children’s diet.

And finally, like so much of healthcare, I think its practitioners often over promise results of their advice and under estimate the expense and time commitment required for families to adopt a new lifestyle. Additionally, the natural history of many of the chronic conditions Dr. Kilbane focuses on is improvement and disappearance with time, making it all the more difficult to determine whether it’s the integrative approach is actually working or simply the tincture of time.

Summary
HKHM is a well written, engaging book for parents who are looking for an integrative health approach (primarily dietary) to their children’s well-being. For those parents looking for an alternative approach to many of pediatrics most common chronic health problems, this is a valuable and practical resource. I hope it is well read by today’s parents. The science and recommendations are presented in a clear and understandable fashion. In summary, parents who have children with many chronic common health problems and who are willing to embark on a course of elimination diets and supplements, will derive great benefit from this book. I give it 5/5 Doc Smo stars.

Dr. Paul Smolen “Docsmo”

Link to Book: Healthy Kids, Happy Moms

 

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 38

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Loss has seemed to follow me more this year than any other. Whether it is a newborn baby that never had a chance to take a crack at life, an 86 year old who lived a rich life or now a 20 year old in his prime, the loss is profound each and every time. My exposure is clearly occupational as well. However, how do we continue to process this time and time again? Does it get easier? How do we talk about it with those that have lost? How do we keep the faith and live for our best selves as we are the ones left behind as the dead cannot suffer?

Let’s Explore,

Dr. M

Dr. M’s Women and Children First Podcast #30 – Jamie Manirakiza – The Partnership to End human Trafficking

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Jamie Manirakiza is the Executive Director at the Partnership to End Human Trafficking (PEHT). She is a Licensed and Masters level social worker who studied at the University of Pennsylvania before embarking on a career to shine a bright spotlight on human trafficking while helping those caught and released from that dangerous net. Partnership to End Human Trafficking (PEHT) is a nonprofit organization that provides individuals with a pathway toward healing and independence through community outreach, residential recovery, and economic empowerment.

In this episode, we discuss the realities of human trafficking, what can be done about it and the work to help the survivors.

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 37

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Coronavirus Update 69.

Quick Hits and other musings –
1) In the interview with Dr. Offit there were a few big take aways:
  • Boosters for non risk based teen and young adults are unlikely to provide benefit while offering a small but real level of risk from myocarditis
  • Boosters are offering minimal benefit to the nation from a transmission perspective. At best 8-12 weeks of protection against symptomatic disease
  • Dr. Offit voted against adding omicron antigens to this fall’s booster as there was limited data that it would any benefit. He was in the minority at the FDA advisory meeting, thus this fall’s booster will have new strain genetics in it
  • The boosters could, not shown yet in humans, block future variant immunity to newer strains through viral immune imprinting

A lot more this week to digest.

Dr. M

Dr. M’s Women and Children First Podcast #29 – Dr. Tieraona Low Dog – Mother’s Health

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A mother, wife, herbalist, educator, author, researcher, and medical doctor, Tieraona has trained hundreds of medical professionals as the Fellowship Director at the University of Arizona Center for Integrative Medicine, chaired dietary supplement expert panels for the United States Pharmacopeia, and has been appointed to numerous scientific advisory boards. In addition, she has authored best-selling books (including 4 published by National Geographic) and written over 50 peer-reviewed articles and 25 book chapters. Tieraona was appointed by the President of the United States to serve on a White House policy commission, has received many awards from academia, public health, and industry, and has lectured at over 600 conferences.

She is an incredible teacher with an equally incredible life story. In this episode, we discuss the world of maternal health as it relates to preparing for a healthy life and pregnancy setting the stage for a healthy child’s life.

I hope that you enjoy my conversation with Dr. Low Dog,

Dr. M

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