When I am not reading about food and nutrition, I am a student of leadership. It has always been my pleasure to interview community leaders for this column.
I recently talked to Dave McRae, CEO of University Health Systems of Eastern Carolina, about the obesity epidemic and what health care leaders can do to encourage citizens to Eat Smart and Move More.
I couldn't decide how to start the interview, so I simply asked, "What is your favorite food?"
With a big grin and a twinkle in his eye, Dave said, without hesitation, Thanksgiving food. He says he thinks about Thanksgiving all year long because family gatherings and the foods are special and important. He enjoys the traditional turkey, green beans, cranberry sauce, and pumpkin pie. But it's not just about food, "it's the meal built around family," he said.
Dave reminisced about growing up in a family with four siblings. He said if there were pork chops for dinner, whoever was fastest got the biggest one. He loves to eat and says he would be as "big as a house or maybe a barn" if he weren't careful. He reflects that he might have had an unfair advantage in learning to discipline his eating to avoid weight gain. Although from a family of "big people," he learned quickly, after developing polio, that excess weight created pain and additional problems walking.
He recalled the daily family meals he, his parents and siblings ate together, sharing food and fellowship. He contrasted those days with today's families who eat in shifts or on the run.
He is concerned about the childhood obesity epidemic we see today, which is often attributed, at least in part, to the loss of family meals. Yet he knows it is unrealistic to think that things will return to days of yore.
He believes it is possible to respect family history and culture while learning new ways to be physically active and eating healthy. And he believes firmly that parents must lead the way.
Dave emphatically stated that his wife, Patti, helps him be healthy. Although he can't walk long distances without crutches, they walk every night. They also enjoy and appreciate all types of foods, even country restaurant foods, but always in moderation. Dave thought you might be surprised to learn that he enjoys comfort food in a relaxed, low key way more than high priced "stuffed shirt" dining experiences. He savors anything "green" — green beans, collards, mixed greens, Brussels sprouts and also likes to order a vegetable plate with two or three kinds of dried beans. He recognizes that he is getting plenty of fat with those country vegetables, so when he eats them he goes easy on them.
He thinks people need to find a healthy way to eat for themselves through study, consultation with professionals and then trial and error. For himself, he experimented with the Ornish heart reversal diet and found it too restrictive. Then he tried a no-fat approach and overdid the carbs. So now he reads credible books, talks to nutrition professionals and tries to eat the healthier carbs, healthy fats and lots of fruit. He laughingly said that he had hoped he would have lost his love of sweets, but he still has an appetite for them and needs to be careful not to overindulge.
As CEO, Dave recently signed a resolution on behalf of the volunteer leaders on the UHS Board, which would work to reduce preventable illness and early death from tobacco use, physical inactivity and poor nutrition. They promised to do this work in cooperation with North Carolina Prevention Partners and other hospitals and organizations throughout the state. As an aside, he said he was confident that Erskine Bowles, President of the University of North Carolina system, understands the health care issues of eastern North Carolina. He's also aware of the role that the Brody School of Medicine and University Health Systems play in the future of the region, and the resources needed to make a difference. Dave admits that not all hospital leaders agree with his personal belief that the hospital's core business includes efforts to create and support an environment of wellness and health, including nutrition. He candidly stated that hospitals are notorious for absorbing large resources for technology and salaries, leaving fewer resources and time for prevention activities. He wondered out loud what we as a country would save if the resources invested in end stage illness and trauma were used instead up front to support healthy lifestyles and prevention of accidents and trauma. But he noted that the health care system is not designed that way and so leaders must find ways to support wellness. He rued the fact that the typical work environment and schedules for hospital employees don't readily encourage employees to take a walk to reduce stress or take time to eat healthy.
He believes all leaders in health care — especially hospitals — should be engaged in efforts to promote healthy eating and physical activity. Hospital leadership needs to be responsible for setting the standard, and then educating and encouraging others to create the environment to support healthy eating and physical activity.
Dave said it takes lots of people throughout UHS to provide increased opportunities for physical activity and healthy eating for employees, visitors to the hospital campuses and their communities. In this endeavor, he led the way in 2003 when he instigated the UHS Nutrition Initiative.
Since then, there has been a steady increase in the number of healthy food and beverage offerings provided in the cafeteria, coffee shops, and vending machines.. As a result UHS leads other hospitals throughout the state in improving the quality of the foods and beverages offered. UHS recently earned recognition from the American Heart Association, as well as being named a Center of Excellence in Healthy Eating Environments by the North Carolina Prevention Partners.
Still, Dave agrees there is more to do. Some days as he views the food in the cafeteria he is proud and other days he just shakes his head. But he believes the leadership can't dictate these types of changes. He reiterated, with pride, that his fortitude to press on to make UHS a healthy system comes from his wife, Patti's support. Dave praised other UHS leaders who still make time to volunteer. Many staff and board members are involved in the Pitt Memorial Hospital Foundation's Community Benefits program. Since 2005, PMHF has invested hundreds of thousands of dollars helping our schools, families and community groups find new ways to help children achieve a healthy weight.
As we closed the interview, Dave turned the tables on me. He said health professionals like me have a responsibility to reach out to administrators and leaders to teach them how to create policies that will support healthy eating and physical activity. He went on to say the public must demand no less of all community leaders.
I am glad Dave found the time for this interview. I thank him, and I hope you do as well.
Professor Kathy Kolasa, a registered dietitian and Ph.D., works with the Family Medicine Center, Brody School of Medicine at ECU. Contact her at kolasaka@ecu.edu, or C/O The Daily Reflector, P.O. Box 1967, Greenville, NC 27835.
