Taste-Bud Dysfunction: Let’s dial down the Salt and Sugar in Snacks
January 18, 2020
The great thing about this blog, is that @drplasticpicker can write whatever I want. And what I want to do is save the earth and the oceans, save my patients and their families, and for everyone to be healthy and equal. Is that too much to ask? One way I can get what I want, is to expound upon the objective truths I know as someone who has been a pediatrician for over 15 years. The cause of a lot of the worlds’ problems is that kids have learned to snack on foods that are too processed, too high in salt and too high in sugar. Processed foods with too much salt and too much sugar lead to Taste-Bud Dysfunction. I have coined a new condition. You, the many toddlers in my practice who are picky eaters . . . Yes You, the teenagers who are prediabetic. Many of YOU have Taste-Bud Dysfunction. Something is wrong with your Taste-Buds that you can’t taste the natural sweetness of an apple or the natural flavor of unsalted food. This is not your fault, it is the fault of big corporations that have fooled at least two generations to think that packaged food is food. Indeed most packaged food is not food, it is junk, and for drplasticpicker – it is also trash that litters the beach.
I took my OFF afternoon earlier in the week to catch up on calls to patients regarding labs and many of those calls are the same. I have young patients sometimes as young as 7-years-old with prediabetic-range Hemoglobin A1c. They mostly have a strong family history of diabetes and are overweight as well. I went into pediatrics wanting to work on obesity. I remember during my pediatric endocrine interview at my home program. We discussed my desire to work on the pediatric obesity epidemic. The attendings, who were all Professors and reknown researchers, looked at me and asked, “but what about obesity? Are you interested in the adipocyte cell? Are you interested in Type 2 Diabetes?” They had helpful suggestions and mentioned a local lab that was working on HIV associated lipodystrophy. At that point I was already a seasoned senior resident and selected to be chief resident, and had a child of my own. I remember picturing my own toddler at home and he was so chubby. Mr. Plastic Picker and I were still in training and working so much and had not figured out how to be parents yet ourselves. Our son’s grandparents who lived with us were doing the best that they could. I saw my problem mirrored in the problems of my patients. I did not want to work in an HIV associated lipodystrophy lab, I replied honestly. But I still wanted to work on the pediatric obesity epidemic.
I was accepted into the program, I think because I had been a strong resident and personable. I cherished the clinical year working with mostly type 1 diabetic patients, and we did very little to further the work on obesity because there were no answers. The country had not figured it out. I spent a month with one of the Pediatric GI attendings in the morbid obesity clinic that mostly saw adults prior to gastric-bypass surgery. We saw kids as well, and they were not yet candidates for bariatric surgery. But that did not make sense to me. Were we going to let kids get that big and then surgerize all these kids? Then I had a premature baby that was very ill, and after she was stable I headed down to NIH to complete a research year in sleep medicine and bone density in premenopausal depressed women. Even further from my desire to work on pediatric obesity.
And then the winding road of life and career and family led me to my current career. I like to call myself a rogue endocrine fellow, and always made sure to provide letters from my old program director explaining that I was not kicked out of my training but that l had taken a break and never came back after doing a research year away. Just one year left. But I happened back upon just old fashioned outpatient general pediatrics, and realized that just by being a pediatrician I had a bigger impact on obesity than if I had worked in the HIV-associated lipodystrophy lab. That lab is doing phenomenol work, but I needed to be doing things now in the physical world and not the cellular world.
So I am a middle-manager at our large HMO, and I am responsible for leading our group in multiple quality metrics. One of those quality metrics is called NEST, Nutrition Exercise Screen Time. This metric is if a health care group/your doctor’s office asks you a series of questions about lifestyle that factors into rising childhood obesity rates. What NEST is, is really 5-2-1-0. So organizations that grade health care groups look at whether we ask you these questions at least once a year and if we provide counseling. To satisfy the metric, there can be documentation of verbal counseling a set smart phrase in our note or information in the after visit summary.
But this is where drplasticpicker continues my tradition of being rogue. I was a rogue endocrine fellow, and now I am a rogue middle manager. Remember, this blog has no official status and it’s for entertainment! The metric of NEST or 5-2-1-0 is probably THE MOST IMPORTANT THING WE NEED TO DO AT VISITS. Yet, do we do it honestly and do we do it well? No one knows what actually happens in the exam room except the physician and the family. I will tell you, that even though this is not a metric upper management is pushing – drplasticpicker cares about it deeply. Because if children eat more fruits and vegetables and get their 5 in a day and 0 sugary beverages, children will be healthier and there is less plastic pollution! Win-win.
So I have created my own disease (Taste Bud Dysfunction). I will start putting it in my clinic notes, but will need a different diagnosis code for billing. There are many that we use. But to combat Taste Bud Dysfunction, the cure is actually simple. No pharmaceutical company will make a plastic encased medicine and siphon off a billion dollars a year (like Miralax) to treat it. All you have to do, is eat real food for snacks that are not processed, not sugary and not high in salt. Generally less plastic around it the better.
“What kind of snack food?” a parent asked me this week. Parents always ask pediatricians for advice about what to eat, not knowing what our hemoglobic A1c is. I can tell you my Hemoglobin A1c is okay but mostly because I have a pretty good family history. But I am a parent also and I have somewhat figured it out. I will supply some links to organizations that do a much better job than I do with snack suggestions. But honestly, just make it easy. Don’t drive yourself crazy using cookie cutters to make fun shapes out of fruits. Make your children self reliant, and let them learn to eat an entire apple by biting into it and eating it directly. Saves you time and money, and teaches them to live with less plastic and more fiber rich foods. When they go to college, they’ll be able to grab a piece of fruit and just eat it.
I can tell you the common foods our family eats as snacks. Again, we are far from perfect. It’s best to limit snacks to twice a day, and then your hunger before the meal becomes the best sauce. Hunger allows children to eat well during the main meals which hopefully is home-cooked and rich is vegetables.
Over the last two years, we have taken out all the “healthy” cereal bars, sweetened kid yogurts, and Eggos. I loved Eggos as a kid, but my kids hate them. I think because I used to give it to them a lot. Now these are the common snacks I will pack for them, or what Mr. Plastic Picker and I will snack on.
- Medium Apple with Peel
- Medium Pear with Peel
- 3 Cuties wrapped in a Hankerchief
- Precut Watermelon when it is in season
- Small Container of Dry Healthy Cereal (aka Kashi)
- Half of a Sandwhich
- Dollup of Peanut Butter on anything (apple, bread, or just by itself)
- Hard Boiled Egg
- Sweet Potatoes steamed
- Half of a Corn on the Cob
- Small Container of Lightly Salted Popcorn
- Roasted Peanuts with shell, this is usually at home and kids will eat while studying.
- Toasted 1/2 pita bread sandwhich
- Small mug of bland cereal with milk
I am guilty of the occasional veggie sticks and goldfish packets for them, but we are getting better and better.
Here are links to some other sites that provide suggestion for snacks.
- Snacks To Fuel Your Brain from Let’s Go https://mainehealth.org/-/media/lets-go/files/childrens-program/parents/snackstofuelyourbrain.pdf?la=en
- Healthy Food by Texture https://mainehealth.org/-/media/lets-go/files/childrens-program/parents/iddhealthyfoodsbytexture.pdf?la=en
- Choosing Healthy Snacks for Kids from Healthychildren.org and the American Academy of Pediatrics https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Choosing-Healthy-Snacks-for-Children.aspx
Thank you for going on this journey with me. Becoming drplasticpicker has brought me so much healing. Professional healing as well. I have been able to live my dream through this blogpost, and have coined a new disorder (Taste Bud Dysfunction) which I have objectively seen over 15 years. I have given you the non-pharmaceutical and non-exploitive cure – which is to eat less processed snack foods. This indeed will help the world and create more healthy children and reduce the plastic pollution for all of us.