20 Years at Mayo Clinic

It was 20 years ago today, on April 3, 2000, that I began a new career working in the Division of Communications at Mayo Clinic.

My 2005 Mayo Clinic staff photo

After working in politics and government for 14 years in various roles at the local, state and federal level, I was ready for a career change. I had been on a pre-med track in college, but having met my future bride (now my wife of 35 years) during the first months of my freshman year, the prospect of college, medical school and residency seemed daunting. That contributed to me taking a different direction for my first career.

Having an opportunity in 2000 to get into health care in a supportive role was therefore really exciting, and to do it at Mayo Clinic was amazing. My initial role was as part of the media relations team, and also providing support for some of Mayo Clinic’s diversification strategies, including some of the consumer books and the launch of what was then MayoClinic.com.

I’m so grateful for all of the opportunities for exciting, interesting and important work I have had at Mayo Clinic. There’s no way I could have imagined the full spectrum of what I would get a chance to do.

Until I started at Mayo Clinic, I had only been on an airplane for trips to Washington, D.C.

I didn’t have a passport.

With the evolution of media, and what became social media, my role at Mayo Clinic evolved and led to opportunities to visit places including

  • Australia
  • Canada
  • China
  • France
  • Italy
  • Kenya
  • Mexico
  • The Netherlands
  • New Zealand
  • Russia
  • Sweden
  • United Arab Emirates
  • United Kingdom
  • and something like 40 of these United States.

I often say my life has become “Norman Rockwell meets The Jetsons.” We live in my hometown of 25,000 people, and yet because of Mayo Clinic (and social media) I have gotten to make these global connections.

Teleworking on my 20th anniversary

A few months ago I wouldn’t have expected that I would spend my 20th anniversary at Mayo Clinic teleworking from my bedroom in Austin, Minn. And yet that was the case today, as it has been for the last two weeks.

I’m thankful that technology allows this, and there’s obviously a big need for health care communication right about now. I’m also proud to be able to work at Mayo Clinic, and of the contributions our staff are making to fighting this global, from development of new tests to leading this national study of convalescent plasma treatment.

More than all of that, though, I feel blessed to have made so many good friends in health care and communications, certainly within Mayo Clinic but also literally around the world.

As we work and pray toward the end of the COVID-19 pandemic, may that day come soon.

A Calorie is NOT a Calorie

Just as not all studies are created equal, neither are all calories.

This isn’t new news in the scientific literature. In fact, a study from the 1950s showed that carbohydrates, protein and fat in the diet have significantly different impacts on metabolism.

And yet today we still hear the refrain: “A calorie is a calorie is a calorie. Weight is simply a matter of calories in vs. calories out. If you want to lose weight, the solution is simple: Eat less. Move more.”

A paper published in The Lancet in 1956 by Kekwick and Pawan (embedded at the bottom of this post so you can read for yourself) tells a much different story.

The paper reported on three diet studies involving obese patients.

In the first, when the proportion of protein (20%), fat (33%) and carbohydrate (47%) calories were held constant (20%), lower daily calorie intake led to greater weight loss.

No surprise there.

But the results of two other series of diets seriously undermined the theory that “a calorie is a calorie is a calorie.”

In the second series, 14 subjects were put on three different semi-starvation diets, each of which fed them 1,000 calories per day with 90% of calories coming from either carbohydrates, protein or fat. On the 90% protein and 90% fat diets, the subjects lost 0.6-0.9 lbs. per day, while on the 90% carbohydrate diet they actually gained weight.

Let that sink in: obese subjects gained weight on 1,000 calories per day.

On a semi-starvation diet.

When the calories came from carbohydrates.

In the third diet series, patients were put on a balanced diet of carbs, protein and fat at 2,000 calories per day, which caused them to maintain or gain weight.

When they were placed on a 2,600 calorie diet that was mostly fat and protein, four out of five lost weight.

With 600 more calories each day, as long as they came from fat and protein, the patients lost weight.

This study involved a small group of subjects, and the authors noted that “many of these patients had inadequate personalities. At worst they would cheat and lie, obtaining food from visitors, from trolleys touring the wards, and from neighbouring patients…. At best they cooperated fully but a few found the diet so trying that they could not eat the whole of their meals.”

That last point is important: if patients were on a 2,600-calorie protein/fat diet and found they couldn’t eat their whole meals, that’s kind of the goal, isn’t it?

It’s reverse cheating. They can eat as much as they want…but they just don’t want.

As the authors noted, high-carb diets tend to promote water retention, while protein/fat diets lead to loss of water weight. And even though those water weight losses aren’t permanent, it still demonstrates the underlying point: your body is not a bomb calorimeter. It doesn’t “burn” calories.

While the laws of thermodynamics are true, they aren’t the major driver of body weight issues.

Different types of calories are metabolized differently.

A calorie is NOT a calorie.

This was shown more than 60 years ago. And yet well into this century the U.S. government was officially recommending 6-11 servings per day of bread, cereal, rice and pasta.

I first learned about the Kekwick-Pawan paper in The 4-Hour Body by Tim Ferriss, which led to me adopting the Slow-Carb Diet and eating eggs for breakfast every day.

Tim’s podcast also introduced me to some interesting researchers, thinkers, authors and podcasters, whose programs and publications led to others from whom I’ve learned.

I’ll introduce you to the first of these next time.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.

How I Got Here

That’s the title of a new podcast series by Touchpoint Media, hosted by Reed Smith, and I’m honored to be the subject of the first episode.

I’ve known Reed for more than a decade, and he’s been a great friend and trusted advisor as we developed the Mayo Clinic Social Media Network. Likewise with his Touchpoint Media partner, Chris Boyer.

I hope you enjoy our conversation as much as I did, and that it provides some insights you might find helpful in your career and life.

I look forward to the rest of the series, which features some old friends like Ed Bennett as well as others I’m looking forward to getting to know better.

Listen on iTunes or Stitcher and be sure to subscribe.

Trim Healthy Mama Plan

That’s not the name of a diet I would have expected to find myself trying.

I guess the fact that I did it in response to Lisa’s invitation is a sign of my desperation.

In October 2016, Lisa got blood test results that showed her fasting glucose at 102, and her doctor said she should cut back on carbs and sugar.

Meanwhile, my daughter Rachel had been on a diet called Trim Healthy Mama Plan, and Lisa asked if I would try it with her.

If I had watched the video below that explains the basics, I’m not sure I would have gone through with it.

But I was getting it second-hand, interpreted by Lisa, so I was willing to go along.

As Peter Attia, M.D. says, compared to the Standard American Diet (SAD), almost any diet plan is an improvement.

As I understand it, this plan gets some important things right, which is why I think lots of people have found it helpful. I lost about 15 pounds using it. Some of those good points:

  • Eliminate sugar.
  • Choose carbs wisely, avoiding starches and other carbs that spike blood sugar levels.
  • A healthy view of fats.

They also have some tasty recipes in their cookbook. That was helpful for Lisa in meal planning.

I think their advice on fuel separation is somewhat dubious:

  • Limit carbs to 45 grams per meal in what they call the “E” or Energizing meals.
  • Eat until you’re full when you have “S” or Satisfying meals, but limit carbs to 10 grams.

Their biggest error: recommending that you eat every three hours to keep your metabolism going. Your body isn’t a furnace, and the flame isn’t going to flicker out if you go six hours without eating.

Did our ancestors eat six meals a day?

As I said, I did pretty well on this diet, losing about 15 pounds in three months. Lisa was somewhat scarred by her experience with it though: she only lost three pounds. It made her gun-shy about getting on a scale, because she worked so hard and the lack of results was demotivating.

Another of the downsides of this diet is that with the recommendation to eat every three hours, you’re literally always thinking about food.

Lisa is quick to point out that different diets work for different people, and that with her thyroid issues and being post-menopausal it makes weight loss more difficult.

But it meant that we needed to look for a different plan, and so in early 2017 we switched to something that worked somewhat better for both of us.

More on that next time.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.

Before and After

While I used to joke that I was “working on my ‘before’ photos,” the reality is that three years ago I wasn’t eager to actually capture them.

So the following is the best I can do to show the before and after results from the changes I’ve made since then.

Tomorrow I’ll start with the story of our journey toward health and fitness, through eating and exercising differently, and I’ll continue to share on Facebook, Twitter and LinkedIn.