The Preventive Medicine Center’s Robert Silverstein discusses global health patterns.

H. Robert Silverstein: You’re talking system wide change.  You’re talking about a revolution in healthcare here in the . . . here in what we call the civilized world – ranging from Russia to South America, and including the Orient.  By the way, the Orient sort of used to do this, and now they’re becoming as westernized as we are.  I can remember seeing an article on (25:49) children in Beijing having a weight problem.  There’s an old adage that goes, “You never saw a fat Chinaman, did you?”  And the answer is now you see them all the time in China.  So calorie restriction would be one of the major, major things.  Again if I had one thing to say that would be most important is I wanna see clear lines of definition and demarcation on the abdomen, because that means an absence of fat under the skin on the abdomen, which correlates with an absence of fat everywhere else.  No I am not recommending anorexia nervosa.  I’m recommending common sense at every step.  We need a diet that is as simple as saying brown rice, vegetables and beans with anything once in a while.  Oh I know I left out the fruit, and the nuts, and the seeds.  And I am not excluding the occasional pizza, or ice cream, or cheeseburger.  But the fact of the matter is the average daily diet should be grains, vegetables and beans, and then you can have some fruit and so on.  The animal size . . .  The palm sized serving of animal protein that is wild . . . for a simple word, “wild game”.  I don’t care whether it’s fish, or chicken, or meat or whatever.  Wild game two to three times a week.  And that would change . . .  Of course no smoking.  Limit alcohol to four times a week, and we’re back to a list that I’ve already given you.  So those would be the major things.  I could spell it out in five minutes to the physicians of the United States and to the American public.  Remember it always takes two to tango, so the American public needs it just as much in the request sense as physicians need to be doing it in the delivery sense.  It is a partnership.

Question: Are certain societies getting it right?

H. Robert Silverstein: There are portions of societies that get it right, and those societies that are less westernized than we are.  For instance a lot of talk recently about the Mediterranean diet.  So now we’re talking not so much Athens, but more the little bit of the back woods of Greece and the back woods of Italy and so on.  They have a much more physical life.  They have a much more family life.  They have a much less smoking life.  Smoking I think is more concentrated to the cities than the countryside.  But their diet is more organic, unprocessed, whole foods.  They probably consume more alcohol than I recommend.  They’re probably heavier than I recommend.  But when you do what I call “put it all together”, there is so much more in this direction.  You know every now and then people talk about bringing the Mediterranean diet to the United States.  The Mediterranean diet, as best as I understand it, is more of an organic, unprocessed, whole foods diet than we will ever be able to deliver here in the United States on a broad basis.  And yet it is widespread in those Mediterranean countries – Crete, Greece, Italy, and Spain and so on.

Question: Why is health such a challenge in America?

H. Robert Silverstein: It’s the commercial unwillingness, I think.  And yet if you wanted to know who you . . .  If you had sway, you could either get me to the potentates in government, or you could get me to the potentates in food industry and even restaurant industry. If I could get to those people to have a single entrée on the daily menu . . .  For instance I just ate at Blue Water Grill here in Manhattan and I ordered two side dishes.  I ordered the spaghetti squash and the broccoli __________.  That was it for lunch.  No fish, no chicken.  Their white flour bread was really pretty tasty, and I did use the smallest dab of butter on it.  But you can get mostly vegetables – organic, unprocessed,  whole foods.  It may or may not have been organic.  It didn’t say so.  But you can get mostly vegetables and beans.  And you can go into restaurants now and get _________ and brown rice.  So it . . .  The information is out there, but who to reach would be, as I said before, the food industry from the commercial sense; restaurants; and growers; and the governmental officials who could make incentives for this.