As a pediatric gastroenterologist, I am a specialist often asked to help children with metabolic syndrome (hypertension, high blood sugar, dyslipidemia and increased abdominal fat). For years, I accepted the conventional wisdom that the only way to treat this was with “diet and exercise”, combining calorie (primarily fat) restriction with increased physical activity. Yet for years, I rarely saw a child improve, even when they followed my advice for months. Nothing was more disheartening.
It got to a point in my clinical practice where I started to seriously doubt the efficacy of these recommendations, yet since all leading medical experts continued to expound that “diet and exercise” should work, it’s what I continued to advise. Needless to say, I began to lose enthusiasm and motivation for treating these patients.
And then, around two years ago, I was introduced to the work of Dr. Robert Lustig. For the first time in my career, I felt like I was experiencing a moment of epiphany. Dr. Lustig’s detailed and clear explanations on the causative role of fructose in metabolic syndrome inspired within me a new passion for wanting to offer this new recommendation to all of my patients.
Ever since then, my experience treating kids with metabolic syndrome has been completely transformed. Instead of asking kids to focus on their weight or caloric intake, I began to passionately explain how fructose affects the liver and causes insulin resistance, and then boldly advise families to remove added fructose from their diets. My advice is that they stop drinking juice, cut out all soda, and learn to read food labels so that they can avoid foods with added sugar. I also explain that they should try to avoid processed foods as much as possible. I advise families to try to cook at home; that kids should eat wholesome, natural foods, incorporating more fruits and vegetables; and to drink more water. But first and foremost and above all else, cut out sugar!
And now finally, for the first time in my career, I can say that I have started to witness my patients truly start to feel better, reversing their symptoms of metabolic syndrome. Even more dramatic is how quickly some of these effects are occurring. Despite months of failing to see improvements on low-fat diets or calorie restriction, kids who did just one thing (cut out sugar), have started to improve within mere weeks to months! Nothing could be more inspiring! The effect, being relatively quick and palpable, is motivation in and of itself!
I used to feel helpless each time a child came to see me, for help with problems related to their “obesity” but now, thanks to the amazing work of Dr. Lustig, treating kids with metabolic syndrome has become one of my passions and a primary focus of my clinical practice.
Uma Pisharody, MD, FAAP is a Pediatric Gastroenterologist practicing at Swedish Medical Center in Seattle. She is a passionate patient advocate who, after telling her patients to avoid soda and juice and opt for water instead, was disheartened when a patient's mother told her that her child was offered juice after a medical procedure at Swedish, something that was standard practice. Dr. Pisharody spearheaded the task of eliminating juice from the pediatric hospital. Her initiative was taken seriously and met with great success. Swedish's main campus is already working towards becoming juice-free and the satellite campuses hope to be by the end of the year. Dr. Pisharody is a true champion for childhood metabolic health!
We're sharing a series of three blogs by Dr. Pisharody this week. For more insight into her clinical inspiration, read Nine Days to Metabolic Health and for the story of her juice-free initiative, read Getting Hospitals to Set Good Examples.
For more brilliant articles on an even greater variety of topics, visit Dr. Pisharody's Swedish blog.