Dr. Philip Caravella
Caveman diet
What did humankind eat one million years ago and why does it matter?
If you were to look at yourself in a mirror about one million years ago, you would have looked very similar then as you look today with a couple of notable exceptions. You would have been leaner and more muscled, though your facial appearance would have been nearly identical. The concept of being hairy, big and bulky is well should I say; “I don’t think so.”
So why then were we so lean. To better understand what is wrong with our diet, we must know where we have been. We must also have a tangible idea of what our physical work load was like a million years ago. We didn’t go to “the fridge” and pick out lunch. We ran around the woods chasing little critters with sticks and stones, setting traps or whatever else it took. They had to be careful about using up more calories than they ingested during this entire process or hunting or gathering.
In any case, like animals, we ate a natural diet. What is the correct diet? To read about it today, you will not get two nutritionists, nor physicians to agree too much on any one diet as being the diet. We have all heard of the Atkins Diet, the grapefruit diet, The South Beach diet and on and on.
We need look no further than our roots to find the correct diet. Out Stone Age ancestors had the right idea. Actually it wasn’t exactly an idea. It was called eating anything that was edible or starve. That left many options, though few were simply there for the picking unless you discovered a fruit tree, a few mushrooms, or similar items to ingest. Our natural diet is what lived and grew in the woods. It either could be picked or chased (meaning it had a mother).
Has anyone found a bagel bush growing out in the woods? What about a pasta tree? Where is the pudding pond; the ice cream lake? Where are they? OK, that is about it for the diet. If it doesn’t live or grow out in nature, it is not part of our diet. It is part of an abnormal diet but not our intended diet. See how simple this is?
The further you deviate from this concept the worse off you will likely be and the closer you adhere to it, the better off you will be. OK, lets look for a cracker tree, a bread bush, a cookie cash? I don’t think so. When you find them growing somewhere, let me know and National Geographic know.
You are now almost ready to accept a degree in nutrition but not just quite yet. One egg a day (which can be found in nature) would be a great and an acceptable find. Maybe a few small bird’s eggs would be just fine as well. I am sure they were considered some sort of a treat, especially when starvation may have been around the corner. Berries are special and valuable sources of minerals and vitamins. Nuts of various kinds are also quite nice. Beans are your best form of food, having protein and carbohydrates along with minerals and vitamins. Thus as a single food, you cannot beat beans. Let’s not broach the topic of gas for polite reasons on this blog.
Many diseases are related to eating processed foods but that is a topic for another day. Many fruits and vegetables are high in potassium which lowers blood pressure, by the way.
Many experts believe that the population explosion over time led to the development of agriculture and later processed foods. I would say they are right about this, but we are wrong about changing natural foods into processed foods for want of convenience more than necessity.
The next time we will take a look at the Paleolithic era. That should be fun.
Dr. Philip
Tackling Obesity
At the risk of becoming a bore, I wish to define the problem of obesity with a few more facts to highlight the issue a bit more. Research indicates that over 70% of adults are struggling to maintain or lose weight. Over 63% are overweight. Over 20% of children are obese, up from about 7% in 1975 and over 35% of college students are overweight.
Dr. Philip Caravella
Since 1985, the average dress size has gone up from a size 8 to a size 12-14.
Many “experts” want to blame genetics for the problem of obesity, but only rarely are they correct. Even if they were right 100% of the time, we will not be altering our genetic makeup any time soon and therefore other avenues must be attended to, to solve the problem.
If you look at photos taken back during the 1860’s when photography was an emerging art, you will find that nearly everyone was normal weight. Excess weight became an issue related to a change in exercise (or lack there of) status because as you know, our genetics could not have changed substantially over the past 160 years.
Solving the problem of obesity is a matter of survival. At our present rate of increasing weight problems, statistically everyone will be obese in less than twenty-five years.
“Change for the sake of change is not necessarily good. But, change to adapt to the situation is survival.”
Adapt-or-lose! Ohio State Bar Association Report, Vol.XL no.21 (May 22,1967).
My suspicion however is that the Ohio Bar was not speaking of obesity related issues with this article though the statement seems to apply.
In our culture, the average 35 year-old- male gains between one-half pound and one and three-fourths pounds of fat per year until the sixth decade of life, despite a progressive decrease in the amount of food eaten. Even worse, women gain about thirty pounds between ages twenty-five to thirty. This so called normal pattern of weight gain is anything but normal.
Kathleen Ashton, PhD, Department of Psychology at the Cleveland Clinic, believes that certain situations and emotions trigger eating often to excessive amounts as many of you are already aware. On May 5, 2004, at a course entitled, Obesity: Aggressive Management and Outcomes Measurement, Dr. Ashton presented a paper entitled, The Psychology of Eating. She noted several categories of situational or emotional triggers.
Social: Eating when around others, sometimes to fit in or maybe to atone for feelings of inadequacy. Sometimes over-eating when encouraged by others to do so.
Emotional: Eating in response to boredom, stress, fatigue, tension, depression, anger, anxiety, or loneliness as a way to “fill a void.”
Situational: Eating because the opportunity is there as when walking past a bakery or a food vendor and selecting something to eat when not really hungry.
Thoughts: Eating as a result of negative self-worth or making excuses for eating.
Many individuals, are depressed over their love life, job loss, loneliness, work-load, financial worries, family squabbles, parenting issues and then resort to cookies, chocolates, chips, ice cream (my weakness), and other similar “foods” (maybe they are more like poisons) to console themselves. Others resort to alcohol, drugs, shopping sprees, or similar indulgences which are self-destructive.
The outcome is essentially the same regardless of which poor choice we make to slowly destroy our bodies.
Remember, about 27% of individuals are normal weight and most of them are facing the same daily issues that the rest live with. What makes them different? As time goes on, you will see why they are trim (normal) and why you may not be.
How important is fitness? How important is diet? How important are our emotions? We shall see.
The most celebrated Greek of all, Plato, said: ”Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save and preserve it.”
Thomas Edison put it this way, “The doctor of the future will give no medicine, but instead will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.”
That is where I am at today. As we all know the old yet still useful, “An ounce of prevention is worth a pound of cure.”
Dr. Phillip
Get physical
Dr. Eduardo Sanchez, a family physician and Texas Health Commissioner, said in November, 2003, in Austin, Texas, at a conference on patient education, “By 2040, the cost of medical care associated with obesity, superimposed on the cost of care to the elderly, is going to break them system. Super-sized burgers and super-sized fries are the new weapons of mass destruction. We have more to fear from Big Macs than from anthrax.” FPReport, January 2004.
Dr. Philip Caravella
Most of us spend at least one third of our day either in school or at work. To build effective programs to deal with the problem of obesity and long term success, good eating practices and fitness must occur across all spheres of our lives.
Our dollars could be spent wisely on preventive medicine instead of construction of obscure museums, turn-of-the-century wooden bridges (as in one location in central Illinois), $500 toilets, and the like.
Building bicycle paths, swimming pools, ice skating rinks, ballparks (baseball, softball, basketball, soccer, football) and exercise facilities would be a boost to the economy, a boost to fitness and a smack across the face to obesity related diseases. The sedentary life too many of us are dying with, rather than living with, needs to be corrected now. Tomorrow is too late.
Unsurprisingly, a study in the American Journal of Preventive Medicine (Sallis et al; 15:379-397, 2000) reported a correspondence between the location of parks and recreational facilities and an increased level of physical activity among local residents.
It is also interesting to note, a study in the Annals of Internal Medicine (Anderson et al; 1998), found an increased use of stairs in public places when signs were placed to encourage their use. In 1980, another researcher, Dr. K. D. Brown reported in the American Journal of Psychiatry, that when signs were taken down, stair use diminished until the signs were replaced. A little subtle prodding works very nicely for many of us. Maybe you can work with your local governments to achieve some simple, inexpensive signs to guide your fellow Americans into better living. When you do, we will place your name on this web site and praise you and your efforts. Building a new bike path will likely do us more good than another highway. Let’s bike to work, walk to work, and skip to school. The era of the school bus is another contribution to obesity among children in the guise that it is safer. I am sure our seniors, parents and the retired can keep an eye on our children when they walk a mile or two and back each day from school. We could develop a cadre of individuals dedicated to the elimination of the school bus and the resumption of fitness and exercise among our children. Like the Peace Corps, maybe we need The Fitness Corps?
For years, some European countries have taken the lead by building activity areas available to their citizens to improve or maintain fitness.
A. Mary Walborn, M.D., a well-respected internal medicine physician on Cleveland’s West Side has experienced this a “Recently on a trip through Scandinavia, I was impressed with the lack of fat people. The city of Copenhagen has wide bicycle paths, which are greater than twice the width of American bike paths. There is virtually an army of Danes on bikes. Men dressed in suits, women in high heels, even older people with grocery bags, as well as young people in attire from bikinis to sports uniforms, travel the city on bicycles. Actually, Copenhagen has *free bikes* for anyone to use. People using public transportation need to be careful exiting as bicycles have the right of way. You can easily be hit by a flock of 10 speed bicyclists going very fast.”
Much of Norway, Sweden, and Finland have even installed special traffic lights for bicycles. Their commitment to outdoor activities has led to a culture of Nordic well-being. Mr. President, can you help us?
Dr. Philip
His blogs are his own opinions and do not reflect those of his current and past employers.
Obesity questions?
“May you live all the days of your life.” — Jonathan Swift
Life is too precious to be squandered and therefore your role is not just to preserve life, but to improve your well-being and that of your family members to achieve the most out of what life has to offer. In so doing you will provide a legacy of good health for future generations to embrace.
In bypassing the precepts of good health, you emotionally and financially burden your friends, loved ones, and society with unbearable costs. It is estimated that between now and the year 2025, over $2,000,000,000,000.00 (that is 2 trillion) will be spent on preventable diseases. Stacked one-dollar bill upon another dollar bill until the total sum is reached would go from the surface of the earth to the surface of the moon. I think we can do better than that. It is time to save a few bucks.
There is a full range of questions need to be answered to solve the problem of obesity!
1. What did humankind eat one million years ago and why does it matter?
2. What influence does agriculture have on our diet and obesity?
3. Does obesity begin in infancy?
4. Are breast-fed babies more or less obese later in life than are bottle-fed?
5. What role in obesity does genetics play?
6. Do parents and relatives contribute to the problem of obesity?
7. Why is obesity dangerous?
8. How is obesity linked to diseases such as breast cancer and Type II Diabetes?
9. Is Type II Diabetes as dangerous as cancer and can it be prevented?
10. Why do most diets fail?
11. How important is exercise in the scheme of losing weight?
12. What is the minimum amount of weekly exercise needed to lose weight?
13. What is the minimum amount of exercise required to maintain weight?
14. Is there a role for medication in the task of losing weight?
15. What is the role of surgery for the extremely obese individual?
16. How can I be successful and losing and keeping weight off?
17. What are my options for exercise in obtaining my goal of losing weight?
18. Is there an effective diet that will help me to achieve my goals?
19. Who will bear the financial burden of obesity related diseases?
20. Should the federal government play a role in the problem of obesity?
21. Should private business be involved in setting standards since they are often involved in the cost of health care plans?
22. Should over-weight individuals pay higher health insurance premiums?
23. Can you beat the problem of obesity once and for all?
24. Will you join me, Lisa, and others on this site in fighting and defeating the problem of obesity?
“The occasion is piled high with difficulty, and we must rise with the occasion.” — Abraham Lincoln*
Thank you for joining with me in this battle that we will win together!
Dr. Philip
Dieting’s Biggest Taboos and Mistakes
Knowledge is the answer to dealing with any problem and from there you will be able to determine whether or not your recipe for success is appropriate in order to achieve your goals of good health and fitness. You will discover here as time goes on, that maintaining an exercise program, accompanied by a natural diet will comprise the main ingredients for your success. But before we go on about how to fix the problem, we first need to fully understand what will not work. Forgive me if some of these thoughts have already been posted on this site, and if so, a refresher may be helpful regardless.
Beginning a diet by fasting: This practice is flat-out wrong and will not work. It indicates a lack of basic knowledge about the problem. Initially more water is lost than fat during the first week of dieting or fasting so that little benefit is achieved by the use of this self-abusive technique.
Skipping meals: Healthy eating demands three, if not six, meals per day of varying caloric content spaced throughout our waking hours. Skipping meals merely results in eating more calories when we do eat or eating when we should not, as during television viewing time. On the other hand, television viewing should be kept to a minimum since it is one of the main causes contributing to obesity.
Fad diets: These come and go like the wind. The grapefruit diet, the high carb diets, the high protein diets, and others of their ilk are examples of unsustainable diets that will ultimately fail with time. Failure means you will lose weight but gain back what you lost and often then some. All diets with only one exception will fail within nine to twelve months. Which diet will work? Hmmmm. You will see if you stick with this column.
Yo-Yo dieting: This practice implies that brief attempts at dieting for one or two weeks before falling off the wagon will work. If it did, we would all be trim. It implies a lack of understanding of the problem, and even worse, a lack of committment. Obtaining a normal weight and the health that accompanies it will take at least as much time as it took to gain the weight. There is no quick fix as you have already learned.
Impatience: The average dieter wants impressive results too quickly and easily becomes discouraged. Consistency, time in action, and eating the correct foods and amounts will carry the day.
Diet medications: These fail to work over the long haul, if they work at all. Most have long term adverse consequences, are expensive, and do not provide for the fitness part of the equation which as you will learn is the most important part of achieving good health and a normal weight and figure. There are new medications on the horizen, though they will prove to be even more expensive and once again will not provide for all of the health benefits of exercise such as raising good HDL cholesterol, lowering blood sugar, lowering triglycerides, lowering blood pressure, and lowering heart rate, to name a few.
As Josh Billings once said, “I honestly believe it is better to know nothing than t0 know what ain’t so.”
It is time for all of us to sit up and take notice. The standard 27 inch casket has jumped to 33 inches. We now even have up to 57 inches of casket room available to the needy. Wheelchairs are thirty percent larger. Car seats require seat-belt extenders and chairs need to support as much as 600 to 1000 pounds to avoid collapsing. Solving the weight problems we have is an investment in our future. It is the biggest health issue confronting us today and adds to the health care budget more than any other factor including cigarette smoking.
Dr. Philip
It’s never too late.
Dr. Lorilee Schoenbeck, co-author of “Menopause: Bridging the Gap Between Natural and Conventional Medicine.” believes that menopausal women will lose their hourglass appearance. ”It will save them a lot of grief if they will just accept that.”
Dr. Philip
This is another piece of rubbish that needs to be dispelled; though I will admit, preventing the loss of your hourglass figure is easier than obtaining it again.
Patricia Pearson in the June 9, 2004, edition of USA Today was concerned about the media’s attention to “ordinary American women submitting to a months-long regimen of dieting, fitness and plastic surgery, to be not strong and fit, but pretty.” I agree with Pearson in that “pretty” is not the target; good health is.
BUT! Nearly everyone with a trim, fit body appears attractive to others. We have forgotten what normal is. Since two out of three Americans are overweight or obese, when we see a normal weight person we think they are thin or slender. Sorry, folks but they are usually normal. Average doesn’t cut it any more since average is over weight or worse. It is my job to point out reality and then you will have a great chance of fixing your problem. This process will be life-long and rewarding. It will be life changing and amazing. It will be the new you. This is a Call to Action.
The solution to achieving or maintaining normal weight and good health begins as early as breastfeeding and ends at our last breath. You are in a position, not to alter the past but to make changes for your children and yourselves that will correct for our past mistakes. You may becoming a bit late to the table, though it is never too late to make life altering, healthy choices that will provide for the freedom of living life to the fullest.
You can and will make a difference.
The most important thing in life is to show up. At the end of the day, you will want to be able to say to others: ”I was on the field.” — Quint Studer, National Health Care Consultant
Dr Philip
His blogs are his own opinions and do not reflect those of his current and past employers.
Words of wisdom from Dr. Philip:
The most difficult challenges you face are personal struggles rather than those directly affecting others. You correctly believe that you have influenced others. The real issue is what kind of influence did you exert? Was it what you had intended or was it something else?
Your trials and skeletons are the greatest barriers to success in your life. But lifetime struggles are more easily addressed, than what is apparent at first glance.
Step one is to fully understand your needs and to prioritize them. The next is to establish a goal related to addressing your greatest need. Then you must develop a plan. Most importantly, you must place that plan into motion. Emotion and motion is what it is all about. First you deal with your emotions. Later, you place your plan into motion.
Success cannot be achieved without a beginning. Once you have established what you must do to achieve a desired goal, then begin to emotionally and mentally start the process at once: on that day; not tomorrow. Good intentions are only that. Success has its roots in the process and the follow through more than in the planning. The best plans that lay idle have contributed nothing. The Chinese have a maxim: A journey of a thousand miles begins with the first step. The first step must begin at once. There is no time like the present. Your life is too short to drag your feet.
As you will see, complacency, procrastination, and bad health practices have led to many difficulties. I will show you the way to a healthy life style that is achievable by everyone willing to begin the process of renewal. Re-inventing yourself is achievable and will begin once you allow it to happen. Open the door today, to the new you.
I will guide you in the area of many preventive medicine concepts and healthy practices that will allow you to feel good about yourself, that will allow you to conquer your inner demons, and most importantly will aid in advancing your life, and the lives of those you cherish. Success is around the corner, as you practice the principles that I will lay out in this column. You will help others to succeed by setting the example for them. Setting a good example will have the greatest positive affect on those around you and will change how they view you and how they view themselves. Do not suggest to your significant others what they must do to change. You cannot change anyone but yourself unless you do so by setting the proper example. I will show you what the proper example entails when it comes to good health.
Take care of yourself. The rest will follow. Change is influenced by what you do and not by what you say.
Next I will look at life style changes that will lead to improving your view of yourself and how others will see you.
Answering questions that are pertinent to good life style changes will be part of this column. I look forward to contributing to the New You. You are the most important person in your life. If you do not understand that, you will ultimately become a burden to others. As the flight attendants say when describing the use of oxygen masks, while in flight, should an emergency occur; place the mask over your face first before you assist your children. You are less effective to others when you have not cared for yourself.
Thank you Lisa for giving me this opportunity to serve others.
Introduction:
I practiced family medicine with Cleveland Clinic in Cleveland, Ohio, with a special interest in the field of preventive medicine. Being the first family physician to work for “the Clinic” in the field of family medicine, has been interesting and valuable over the past thirteen years.
I met Dr. Caravella and really liked his preventative approach to medicine. I thought you might enjoy hearing from him from time to time.
Prior to working for the Clinic, I taught in the field of medicine for six years at various universities, was in private practice and have published in the field. On December 2, 2008, I began a new adventure as a Lieutenant Colonel and educator at Fort Hood, Texas, involved in the education of residents in the field of Family Medicine. Being a Lieutenant Colonel, will give me other opportunities as well, to help our men and women in uniform.
On a regular basis, I will submit various topics pertaining to preventive medicine, that if practiced regularly, will improve your lives and allow for a longer and a more comfortable life as well.
Preventive medicine is the key to great health and will benefit all that follow the precepts I will present. Some of these will be new to you, some will have a different slant, while others may be just plain boring. I hope few of my comments fall into the latter category and I will look forward to any and all suggestions you may have to improve on what I present on this blog.
The practice of medicine over the years has been intellectually stimulating for me, but more importantly, it has provided many of my patients with a good attitude towards a healthy and wonderful life style. I look forward to your comments and questions. Lisa, who invited me to participate on her blog, will provide wonderful in-site into her own struggle and will also offer many very constructive ideas on how to win. We can all do better at following sound health principles. The trick is to begin each day with a new way of improving your body, your mind, and your spirit, and I am here to help you.
Let’s get started!
