Reducing soda intake...and all that jazz.

Music is more important to me than most things, and for years I’ve served on the Board of Directors of San Jose Jazz. Our Summerfest is the biggest deal in town every August, bringing 100,000 music lovers together for a weekend of celebration and performance. This year’s was maybe the best festival yet…

…and yet, when going over the books at our last board meeting we noticed something odd as compared to last year. Soda sales were off. WAY off. Like 50% down!

Fifty percent.

Ticket sales, beer, food, weekend weather…all similar to 2010. Could our efforts to promote a “Soda-Free Summer” be working? Well, let’s look at some facts:

• The Bay Area Nutrition and Physical Activity Collaborative (BANPAC, part of the VMC Foundation) has data that shows parents and kids are starting to get the message and reduce soda consumption.
• There’s been a sharp rise in local media about the dangers of sweetened drinks this year.
• The American Beverage Association (representing soda makers) recently called Santa Clara County’s anti-soda messages “misleading”. They’re not, and we have reams of data to prove it…but they’re worried, and that’s good.
• Kaiser Permanente, the biggest supporter of our “Re-Think Your Drink” efforts in Silicon Valley, became a major sponsor of San Jose Jazz’s Summerfest this year!

Yes – this is a big deal. For the first time, KP was a major player in our Jazz Festival, setting up wellness stations around the Salsa Stage (the most physically active of the Summerfest, with non-stop dancing all weekend). They gave away water with fresh lemon to all revelers, promoting a healthier alternative to soda.

My friend, colleague and VMC Foundation Board Member Kathleen King takes all the credit: “My giving up diet soda this year is personally responsible for the decline”, she joked with me yesterday. But she’s on to something: The fight to reduce unhealthy drink intake is going to ultimately be fought one person, one family at a time. And with obesity and diabetes rates still climbing, a fight is exactly what this is. Please, join us—it starting to work!

A New Direction in Homelessness...

I met recently with Jennifer Loving, the CEO of Destination: Home. They are a great Silicon Valley agency working to end chronic homelessness, and I’m inspired by their effort.

I’ll admit something to you: There are times when I’ve turned away at seeing a homeless person or family, as it’s just too painful. But let’s take the emotion out of the issue for a minute: Our community spends tens of millions annually (yes, right here in Silicon Valley) without addressing the core issue that people need a home.

Because if they had one, we ALL would benefit. Several studies show that a person that is chronically homeless costs $60,000 a year…in shelters, food assistance, law enforcement – but mostly, medical care. In our community, that means Valley Medical Center.

You may know that Jennifer Loving’s team surveyed some of our county’s homeless a couple of months ago. Here’s some of what they learned from the 943 people they met:

- 100 were 60 years old or more
- More than half visited the emergency department in the last 3 months, resulting in
- 644 hospitalizations in a year.
- Half reported a serious medical condition like heart disease, hepatitis or liver disease.
- 144 were veterans (this, IMHO, is a national disgrace).
- Almost all reported a behavioral health issue or mental illness.

There is a ton more data at http://www.housing1000sv.org/ but you get my point: Even if I didn’t care about the homeless (I do), I’d sure care about the money they cost us all. And I won’t live in a society that just lets them die. I’ll leave. Goodbye.

While Destination Home works on longer-term solutions, Valley Medical Center meets short-term needs with an award-winning program called New Directions. VMC staff see frequent users of our county’s Emergency Department and provide housing, transportation and specialized assistance…the goal being to keep them healthier and out of the hospital.

The VMC Foundation raises money to support New Directions, but funds have run dry. If you would like to help, please click here and give as generously as you can.

There are more than 7,000 homeless people in Santa Clara County on any given night. Help us help them, with my thanks.

Giving up your DIET soda...can it make you thinner?

The avid reader of this blog remembers that I gave up my beloved diet sodas a year ago. Today I learned my dear friend Kathleen King has joined me...and she loved her Diet Coke more than I did!

But I hear you: "Sure diet soda isn't GOOD for me, but c'mon...it's not BAD for me, is it?" Well, maybe.

A recent study highlighted in the San Jose Mercury News confirms that diet soda drinkers have much larger waistlines than those that say no to diet (and all) soda.

Reasons given: Some people splurge on calories in their food because they're saving on calories in their drinks. Think Big Mac and super-sized fries with a Diet Coke.

Another factor [the researcher] says plays a role in expanding waistlines is "taste dysfunction." Because artificial sweeteners taste hundreds to thousands of times sweeter than regular sugar, our bodies come to expect sugary foods to be extremely sweet. So we start to seek out more sugar-laden options.

A third explanation is that our bodies are smarter than we think. When we suck down sweet things, our bodies register the sugary taste and wait for the accompanying calories, said Lillian Castillo, a public health dietitian with the Santa Clara County Public Health Department.

Click here to read the full article, which I think misses another key point: Maybe - just maybe - people who drink diet sodas (which clearly aren't good for you) are not as averse to eating other things that - whaddaya know - aren't good for you? Seems logical to me, and I know I am 100% guilty.

But I'm working on it. How about you? Join me in making it a truly soda-free summer!

Soda-Free Summer...but let's not stop there!

It's a pretty rare thing that I reference Men's Health, a publication that spends a lot of time trying to improve one's sex life. But, on occasion, they actually focus on - yes - men's health...which oddly is often the same thing as women's health, and kids' health!

Who would have thought?

Anyway, as the VMC Foundation launches another year of our Public Health Department's Soda-Free Summer campaign, it's important to remember that you can ingest a lot of unhealthy drinks without guzzling Dr. Pepper or Jack Daniels - often without thinking about it, or worse, thinking you're doing the right thing.

Here, then, is a great article from Men's Health that should raise your eyebrows...and hopefully, your water glass. Cheers.

A new troubling study on our health...

What do you suppose makes the biggest difference to your health? Genes? Kicking the cigarette habit?

These things are important, sure, but according to a groundbreaking new study done by our own Public Health Department, racism you experience and where you live are MORE important.

Troubling? You bet it is. I've been fighting racism and injustice where I see it for a long time, and if this study (done in partnership with The Health Trust) doesn't get make you as mad as it does me, then I'm sorry for you.

The way people treat you based on the color of your skin, and the amount of money you make, and the neighborhood you live in have a dramatic effect on your health. This is unfair, and as a society we need to figure out what to do about it...at least that's how I feel.

Check out the study here, and let me know your reaction to it.

Finally, proof that palliative care works...

Dr. Gary Lee (that’s him at the keyboard) came up to me a couple days ago and asked me this:

“Chris, if you had a terminal disease, and you knew there was a drug that would not only make you feel a lot better but also give you three more months with your family and friends, how much would you pay for it?”

The obvious answer is “Everything I’ve got!” Gary’s next sentence was less obvious:
“There already is a treatment like that. We give it away to our patients, and now we can prove it works.”

Gary then shared with me the study in the New England Journal of Medicine that demonstrates the value of palliative care. That’s what Dr. Lee does at VMC, along with Dr. Shoshana Helman and their team. Palliative care, as just reported in the NY Times, “… typically begins with a long conversation about what the patient with a terminal diagnosis wants out of his remaining life. It includes the options any oncologist addresses: surgery, chemotherapy and radiation and their side effects. But it also includes how much suffering a patient wishes to bear, effects on the family, and legal, insurance and religious issues. Teams focus on controlling pain, nausea, swelling, shortness of breath and other side effects; they also address patients’ worries and make sure they have help with making meals, dressing and bathing when not hospitalized.”

So, palliative care isn’t actually a drug or procedure, but rather a better way of thinking about how a patient’s end of life will be for them and those they love. Yes—better, as proven by the study; Patients with lung cancer who received palliative care lived more happily, and actually lived longer.

Doctors Helman and Lee were obviously thrilled at the study’s results, but they weren’t surprised. They’ve been demonstrating it at Valley Medical Center for years, and the VMC Foundation has assisted with grants to expand their palliative care program. Gary and Shoshana are already leading experts in this relatively new field…and now, we’ve got a scientific study to support what they do.

The next step is to ensure palliative care remains in the health care overhaul happening at the federal level. The cries of “death panels” absolutely need to be silenced, and science seems to be the best way to do that.

…not that scientific proof ever throws ideologues off their game. Spread the word about palliative care, because it’s a proven way to improve life and stop thinking of patients as a bunch of symptoms. We’re proud at VMC that our team thinks of patients’ whole lives.

If you haven’t figured it out yet, there’s a reason I posted the photo of Dr. Lee rocking out in our band, Idol Hands. It’s a perfect example of how our MD’s are creative, well-rounded idealists, not just academics in white coats. In fact, it was while setting up for this performance last week that Gary told me about the study. Then we went on to rock the party.

My job? I think I’ll keep it.

Why I oppose toys in fast food (and why you should)

When I directed City Year in San Jose, we called this a "ripple", as in, the waves that radiate out from a rock dropped in a pond that get bigger, and bigger, and bigger.

The alert reader will remember my wacky, mixed-up support for Ken Yeager's new law passed on April 25. Ken is the President of the Board of Supervisors for Santa Clara County, where it is now illegal to sell fast food meals with toys inside. This made national news, you'll recall.

Fast forward to today.

I'm as supportive of the law as I was when it passed, but to offer equal time, here is an opposing viewpoint that mirrors the opinion of many in our community and others. I support the ban, which actually affects very few fast food restaurants in the county (and NO McDonalds), and I'll share my opinion by paraphrasing what I said publicly when the law was being debated:

"President Yeager, members of the board, when I first heard about this proposed ordinance I thought 'come on...surely local government could better spend its time on the budget, or on public safety.' Public safety? Well, that got me thinking.

"And I remembered that as a 17-year-old freshman at San Jose State University, in 1985, it was common practice for tobacco companies to give away their products free in front of the student union. By the time I graduated, in 1989, they weren't there anymore. Clearly, some policy decision had been made, changing the behavior.

"But policy can change more than behavior; it can change culture and attitude. If those same tobacco companies showed up tomorrow and started giving out 'free samples', I bet the community would be outraged, just as you would be if someone walked into these chambers with a lit cigarette. People would go nuts, yet thirty years ago it was commonplace.

"That's what's at stake here. Kids want the toy, they bug mom and dad for the fast food, and our childhood obesity epidemic is further fuelled. This really is a public health issue, and a seemingly small policy change can - and I think will - ultimately change culture and attitude...and we'll look back on the time when fast food companies lured kids with toys to their meals loaded with sugar, salt and fat, and wonder what we were thinking."

The law passed that morning, national media went ballistic...and here's the punchline (which you already know if you clicked the link above): San Francisco City and County is now proposing a similar ordinance!

So that's the "ripple". I hope it spreads, and believe it will. I welcome all thoughtful responses, as always.

Saying goodbye to my DIET soda?

Yesterday was it. I'm quitting Diet Pepsi.

I'm doing this in support of our "Soda Free Summer" campaign, and also in light of some new information about what sweet sodas actually do to you...and by "you", I mean "me."

First, you may have heard recently on the news about Santa Clara County's ongoing effort to convince more families to go soda-free this summer. What you may not know is that the VMC Foundation is the fiscal agent of this campaign, working with Kaiser, our public health department and the Bay Area Nutrition and Physical Activity Collaborative.

The plan is simple: Educate folks about how sodas fuel the raging childhood obesity epidemic, can lead to diabetes and oh-by-the-way, have no nutritional value. A 20-oz bottle of Coke has 17 teaspoons of sugar! As Santa Clara County Board President Ken Yeager said on the news earlier this week, "It's like opening your mouth and spooning in 17 teaspoons of sugar. Nobody in their right mind is going to do that."

No, of course they wouldn't (but they do). "But Chris," I hear you saying, "You said you were giving up DIET sodas...they have no calories and no sugar!"

A Fair point. HOWEVER...it turns out that diet sodas have their own problems, beyond not really knowing what the artificial sweeteners do long-term. "When you drink that much ultra-sweet soda," explains Dr. Rami Keisari, VMC pediatrician, "it seems your body gets used to and craves more sweets...and not just desserts, but also starches. They can make it very hard to lose weight."

Now THAT is a problem I understand! And I know it's true for me - I practically live on carbohydrates, and I can't seem to stop.

So I'm putting down the diet sodas, which I've guzzled since High School. I'll let you know if it helps me lose weight, and if you care to come along with me on this journey, let me know if it works for you. Together, let's make it a SODA-FREE SUMMER!

Wish List success continuing...

The VMC Foundation "Holiday Wish List" is now officially 75% granted, thanks to a great group of folks with big hearts...and led by two of the biggest:

Elaine Elkin, philanthropist and business owner, offered a challenge grant to fund the H1N1 Infection Control Stations this week, which was immediately matched to fulfill the $9,500 needed. VMC will now be stopping flu at the door, thanks to this holiday generosity.

Also, Silicon Valley foundation and development powerhouse John A. Sobrato funded the balance of the "art for oncology patients" program, providing a soothing atmosphere for patients undergoing radiation treatment - hugely important, and we're so thankful!

Click here to learn more about Ms. Elkin and Mr. Sobrato, and if you happen to know them, help me thank them...and watch this space next week for updates on our final "Wish List" item. Happy Holidays!

VMC and our Public Health Officer in the news...

It's likely no surprise to you, but the H1N1 Virus (we're not calling it Swine-Flu anymore, I'm told) is driving a large number of people to Valley Medical Center's emergency department.

But that's nothing new...it just makes a growing problem worse. This article is in today's Mercury News:

While Roy Milligan sped along the freeway on his Harley, a metal chunk flew off a truck and struck his foot. Milligan worried the foot was broken but had lost his insurance along with his job last year. A co-worker at his new job suggested he go to Santa Clara Valley Medical Center.

“He told me they were really good to people who don’t have insurance,” Milligan said.

Apparently, the word is spreading. Since October, Valley Medical Center officials have seen a 10 percent increase in the number of uninsured patients...

Check out the full article here.

Meanwhile, the fight against the outbreak of H1N1 has a great champion. Dr. Marty Fenstersheib is profiled today in the Mercury News as well:

Meet Dr. Marty Fenstersheib and his dark companions: anthrax and bioterrorism. West Nile virus and cryptosporidium. SARS, HIV and TB.

As Santa Clara County's public health officer since 1994, the small-statured, 59-year-old former pediatrician and marathon runner from Pittsburgh is accustomed to finding himself at the center of Silicon Valley's scariest public health threats.

Again, read the full article here - Marty is a pretty amazing guy, and we should all thank our lucky stars that he's looking out for us!

Delicious and deadly...shaking our hypertension

On this Cesar Chavez Day, I thought we’d discuss food: The kind grown in the ground and picked by good people who work much harder than I do.

If I ate more of that kind of food – fresh fruit and veggies – maybe my doctor, Chris Snow, wouldn’t have resigned from VMC last year after taking my blood pressure. There’s no known connection, but still.

I actually do okay with the green leafies, being vegan and all, but the real problem is SALT. I promised Dr. Snow last year that I’d stop dumping the salt shaker over on top of everything I ate, but he explained that wasn’t the main problem…yes friends, the issue is processed foods: Pre-cooked, additive-rich, and pre-packaged. Welcome to the American Diet.

Food from a carton or can or box likely contains tons of salt. All that stuff in the middle isles of the grocery store, and most of the stuff Americans seem to love…it’s all processed. “Oh, but this can of tomato juice is so GOOD for me,” I hear you saying. Check the nutrition facts, and wonder no more why after drinking that can your heart feels like it’s trying to escape from your chest Alien-style.

I’m being cute about it I know, but this is serious: Hypertension kills millions of us every year. Slows some of us down too; my pal Bruce had a heart attack last week. And VMC Foundation major supporter and prominent attorney Richard Alexander just became an evangelist against salt.

You see, Dick Alexander is a big dude like me, and realized he could do more for his health after a no-salt, no sugar retreat he attended. He writes eloquently about why we ALL need to cut back on salt, and you should read it by clicking here.

And then look for me and Dick in the Valley Medical Center cafeteria. We’ll be the guys stealing all the salt shakers…because we “heart” you thiiiiiis much.

A Positive Dental Outlook - Fluoride NOW!

So the situation is that San Jose is the largest city in the nation without fluoride in the water. The situation is also that 1/3 of San Jose’s kindergarteners has untreated tooth decay. How do you think it feels trying to go to school and learn – for the first time – with a toothache?

I cannot relate. I’m 41 years old had have never had a cavity. My dentist, Dr. Sera, says I have the most perfect teeth she’s ever seen. She’s not met my brother, who has also never had a filling. Before you think we’re genetic freaks, I’ll tell you our parents’ mouths are the dental equivalent to the opening battle scene in Saving Private Ryan.

The difference, of course, is fluoride; my parents didn’t have it and my brother and I did. Now, County Supervisor Liz Kniss is joining The Health Trust in fighting to fluoridate San Jose’s water. Why the need for a fight? Because there are still loonies afoot who think that “letting the Government put things in the water supply” leads to mind control or something. No, that’s what reality TV is for.

Seriously for a second – scientists and dentists and public health officers don’t debate this – fluoride is fantastic…yet opposition continues. Why, just this week in the Mercury News, responding to their editorial on fluoride, one guy quoted a British physician: "No physician in his right senses would prescribe for a person he has never met, whose medical history he does not know, a substance which is intended to create bodily change, with the advice: 'Take as much as you like, but you will take it for the rest of your life because some children suffer from tooth decay.”

WRONG! Sorry dude, but doctors thankfully do this all the time. They prescribe Vitamin B12 for vegans, iron for women and folic acid for women of childbearing years. Breast milk for infants. They push vitamin C, and leafy greens, and a good balance of protein and carbs. They do this for everyone, because it’s good for pretty much everyone.

Sorry for the rant, but this whole thing is just silly. And tragic. I love San Jose, but I’m thankful I was raised a few miles to the north and have great teeth to show for it. All kids deserve that, and the cost to fluoridate SJ’s water would be more than offset by keeping kids in school, ready to learn, without the pain of a bad tooth.

Do you disagree? Feel free to let me know. If you want to help, please consider a gift this month to the VMC Foundation...and I’ll make you a deal: Join us, and we’ll help fight the cavity creeps together.

Protecting our Public Health Department (that protects US)

When I was six, my father bought my brother and me two little turtles. They lived in a bowl, ate leafy greens, and gave my father a case of Salmonella.

some species of turtles carry the disease, which we didn't know at the time. The other thing I didn't know until Friday is that my father got lucky. He got better in a couple weeks...but he could have died.

That's why we're ALL lucky that Santa Clara County has a great Department of Public Health, which does lots of important things including monitoring outbreaks of diseases like Salmonella. It's part of the system that includes Valley Medical Center, of course.

You've probably heard about Salmonella recently, and our Public Health Officers wrote a great piece in the Mercury News the other day...you can read it below.

I think there are two valuable lessons to learn here: One is that we need to keep our Public Health Department strong, because Salmonella is just one of many serious risks they mitigate.

The other is not to buy your kids everything they ask for.

Opinion: Salmonella outbreak illustrates importance of public health programs
By Dr. Marty Fenstersheib and Dr. Sara Cody
Special to the Mercury News

Lately, there's been a lot of alarming news about the national outbreak of Salmonella Typhimurium and people getting sick because of eating certain peanut butter and peanut-butter products. The recent recall of cookie dough products affected 13 schools in Santa Clara County. This outbreak is a reminder of the critical role our Public Health Department plays in protecting the health and safety of Santa Clara County's 1.8 million residents.

Nationally, there have been nearly 500 salmonella cases reported in 43 states. In California there have been more than 60 reported cases, including one confirmed case in Santa Clara County. Although most people who get salmonella will get better on their own, others are not so fortunate. Of those infected in this recent outbreak, more than 100 have been hospitalized and seven have died. While these illnesses and others like it are serious, they can be prevented and contained — if local public health departments and other agencies responsible for response are robust enough to act.

In this outbreak, initial reports of illness come to local health departments from community health care providers. The ability of the federal Centers for Disease Control and Prevention (CDC) and state health departments to understand the scope of the problem and respond is only as good as the information that the local health departments can collect and report. If our capacity to rapidly identify, investigate and prevent infection is diminished, so is the national response against the spread of infectious diseases. Local public health departments are the front lines of defense when disease breaks out.

Salmonella is just one of 89 different diseases that are tracked by your Public Health Department. We receive more than 900 reports of confirmed food-borne illnesses each year. Almost once a week we are investigating a disease outbreak. T

he staff of your Public Health Department is on call 24 hours a day, working to keep our community safe from these potentially dangerous outbreaks. Right now the news is about food-borne illnesses, but over the next year and at any given time, we will be dealing with many more public health concerns including meningitis, tuberculosis, measles, sexually transmitted diseases and whooping cough.

Much of what we do is invisible to the general public. So, why does the work of public health matter? Because when it comes to disease outbreaks, immediate actions are taken to protect the health and well-being of every one of us. Those actions include surveillance of diseases, investigation of cases and following up with people who may have been exposed. When it comes to contagious diseases, our local public health department will provide medications and, if needed, will restrict people from going to school or work until they are no longer contagious.

This work is about protecting the health of our community and preventing disease, illness and injury. Everyone in our county wants and expects to be safe from a communicable disease, and we believe they deserve this protection.

Maintaining a strong and stable public health infrastructure is critical to keeping Santa Clara County a safe, healthy place to live. It is an essential part of the front line of defense for the well-being and safety of this community. And yet, even with a new president and heartening promises of commitment and investment in infrastructure and health care, public health departments are facing very serious fiscal challenges and budget shortfalls.

The work of public health is too important to overlook. The work of public health is just too important to each and every one of us.

Dr. Marty Fenstersheib is Santa Clara County"s health officer. Dr. Sara Cody is a deputy health officer and the communicable disease controller for Santa Clara County. They wrote this article for the Mercury News.

You're gonna need a good lawyer...

Your doctor isn’t always the best person to solve your medical problem. Sometimes, instead, it’s a lawyer!

Consider for instance the single mom with two boys, frustrated by their weekly asthma attacks and visits to VMC. They know darned well that it’s mold in their apartment walls that’s causing the asthma, yet her landlord wont’ do anything about it…even after their VMC pediatrician wrote a letter and left voice messages. Can you imagine how that feels?

Now, imagine that landlord getting a letter not from a doctor, but from an attorney, representing the two boys! This has proven time and again to get results, and so here’s what we’re launching at VMC: Legal Advocates for Children and Youth (LACY) has teamed up with the VMC Foundation and First 5, along with some prominent families in Silicon Valley, to start a “Medical Legal Partnership Clinic.”

Beginning today, an attorney will be available on-site at VMC’s pediatric clinic to help families solve problems as only lawyers can. Issues of custody, tenant;s rights, teen motherhood and more will be addressed immediately, and these issues so often have medical implications.

Medical Legal Partnerships have been around for a while, but ours is the first in the nation at a “county/public” medical center…which is ironic, since many of VMC’s patients deal with these kinds of issues all the time…and for too many, they often feel under-represented; that nobody has their back. Well, not anymore – not with this new initiative.

Huge thanks are in order, from Jolene at First 5, to VMC’s LeeAnna Botkin, M.D., to Jennifer Kelleher at LACY, and Steve Harris, M.D., the chair of VMC’s Pediatrics…and let’s not forget Santa Clara County’s Board of Supervisors who continue approving innovative programs like this one.

The results of our Medical Legal Partnership Clinic won't be known for a while, but they have a long history of success. We're pretty sure that, in the case I opened with, that landlord will make some repairs, and the boys' asthma will subside. That means better health for them, fewer missed days at school, and fewer visits to the doctor. Good for the kids, the family, VMC, and our whole community.

Now - who needs a good lawyer?