Sweet Rolls

Like most of America, my husband and I have been eating sweets for the past couple of days. I enjoy the alchemy of baking; turning simple ingredients into delicious, sweet treats for my family and friends. These are orange butterhorns, my mother's creation. The original butterhorns, with orange juice and hot chocolate, were the standard Christmas breakfast fare when we were growing up. Mom created the orange version when she did catering for a year. She would even make them bite-sized. So this food evokes my childhood like little else does, especially my mother's love. Every mother has a few special recipes. I have often said that I would like my mother-in-law's recipes except for one or two that she should keep, write down, and only teach them to me just before she dies. Our first experience with food is from our mothers; it is the best way to show love--feeding our children, our families. It says we care like nothing else.

So today, I move on to my next assignment: reviewing an article on the causes of obesity in American society. I am gazing at a map of the US that shows that every state except Colorado has more than 15% obesity. WHOA! I didn't realize it was THAT bad. In 1985, about the time I started in medicine, no state had more than 15% of people who were obese. I, myself, am overweight bordering on obesity. Both grandmothers were obese. Others in my family are obese. And having had breast cancer this last year, this is a topic of intense interest. How do we prevent obesity and hence decrease breast cancer? How do I get to the point of losing weight,so that I prevent a recurrence of breast cancer? What is my relationship to food and why do I overeat? When do I overeat? What factors are contributing to my weight?

The first thing this article notes is the decreased daily physical activity by American workers. Many jobs are much more intellectual than physical whereas fifty years ago we had many more farmers. steel workers--what's that list from the Alabama song honoring our workers? Even in high school, we don't work pumping gas, or mowing lawns anymore--we have jobs in fast food restaurants, cell phone and electronics stores. Who wants to be out in the snow and rain? There is also a genetic component to obesity, though with the increase, that certainly isn't all. So what do the extremes tell us?

Obesity in the American Indian populations, a major health problem, is thought to be due to a metabolism that is geared to a time when they lived on grains with meat only occasionally. Most primitive civilizations have this kind of diet. Further, research has shown that we are programmed to metabolize fat while in utero. Children of Hindustani mothers who ate a vegetarian diet during pregnancy, when they come to the US and eat a standard American diet are MUCH more likely to get coronary artery disease. So it isn't just what genes we have, but what genes were turned on, or off as we developed. We also add in the psychological meaning of food. Another major change in society is the number of women in the work force---is this obesity an outgrown of a nation who hasn't had enough mothering and is eating to make up for it. A nation of oral fixators who have given up their cigarettes and taken to food?

One of my role models, a cousin who is a past president of the World Organization of Family Physicians, stated that the challenges for family physicians in this millennium would be genetics and behavioral modification. Obesity is exactly the disease that requires our skill with both. Frankly, genetics is easier to learn, less complex. How do we modify behavior? By modifying our thoughts which result in that behavior, which takes us back to the need for mothering. Our mothers are stressed out. We cannot be superwomen, and we have taken a long time to realize this. It is better to get pregnant young, raise the kids and then do a career, not try and combine all three--kids, marriage, career. Yes, fathers can do mothering things as well. I am not advocating for the society of the '50's in any way,shape,or form. But we need to face the reality that we are not superwomen and that children need time--quantity and quality, and plan for that in our lives. AND so do MEN! There's no reason that they can't be at home to take care of the kids some of the time--best would be if our society allowed our jobs to be adapted to the needs of our family, and we could return to the days when our priorities were God, Family, and then work--for all mankind, not just the women.

So how do we limit our "sweet rolls"? Increase activity, decrease calories--but how do we get to the mental state to do that in a rational consistent way? We need to start with giving enough nurture when nurture is appropriate--but it cannot be a one person job. This is what Hilary Clinton should have meant when she commented, "It takes a village to raise a child." (I don't know her real meaning or thoughts. I've just heard it out of context.)We should allow others, with the discernment of asking who is a healthy person, to also parent our children. We are not just primitive metabolizers, we are tribal and need to have a tribe to which we belong.