Jeff Nichols embraces his wife, Madonna, a breast cancer survivor.

On Jan. 6, 2011, Madonna Nichols began a journey that no one wants to face. She was diagnosed with breast cancer, which dragged her through 20 weeks of chemotherapy, a bilateral masectomy and weeks of radiation.

On Jan. 6 of this year, Nichols found herself on an entirely different yet related journey. She and 18 other cancer survivors, ages 29 to 73, and 21 caregivers were trekking through five ecosystems to the top of Mount Kilimanjaro in Tanzania. Those caregivers included Nichols’ spouse, Jeff Nichols, D.O.’90, and Bradley Hiatt, D.O.’97.

“It was the experience of a lifetime not only from a personal standpoint, but also emotionally, physically and spiritually,” says Hiatt, an oncologist with Medical Oncology and Hematology Associates in Des Moines. “You become so close to people in the group. You share everything – the sickness and the joy.”

The group – which included a priest, a viola player, an Army officer, a cage fighter and an insurance executive – took their journey under the auspices of Above and Beyond Cancer, a nonprofit organization established to reduce the burden of cancer. Last year, the organization took another group of 14 cancer survivors to the base camp of Mount Everest, the world’s tallest peak.

Above and Beyond Cancer founder Richard Deming is flanked by DMU alumni Jeff Nichols and Bradley Hiatt.

“Above and Beyond Cancer is a transformative experience for the people on the trip as well as for the people at home,” says Richard Deming, M.D., the organization’s founder and chairman and the medical director of Mercy Cancer Center, Des Moines. “We want to raise awareness of what we can do to reduce the incidence of cancer.”

Toward that goal, the Kilimanjaro group, which had the American Cancer Society as its premier sponsor and Mercy Medical Center, Des Moines, as a major supporting sponsor, conducted the highest-altitude Relay for Life in history at the top of the mountain on Jan. 11. Relays for Life are American Cancer Society events in which teams of people walk or run laps to raise awareness and money for cancer research and other related programs. For its Relay, the Kilimanjaro group set out luminaria to spell the word “HOPE,” which they circled for their laps. They also strung up on the mountain’s 150-foot-high glacier of vertical ice 800 prayer flags, each decorated with photographs, drawings and phrases commemorating the lives of cancer survivors or those who had died of the disease.

“That was a very emotional experience,” Madonna Nichols says. “I’m so glad I did this trip. Cancer changes your perspective on things. We bonded as a group and have kept in touch since.”

That 37 of the expedition participants – 17 cancer survivors and 20 caregivers – reached the top of Kilimanjaro, at 19,336 feet the highest peak on the African continent and the tallest free-standing mountain in the world, is nothing short of extraordinary.

“Everyone had issues – nausea, diarrhea and altitude sickness in addition to the patients’ pre-existing conditions,” says Jeff Nichols, an anesthesiologist at Iowa Lutheran Hospital in Des Moines. “Once people found out I am an osteopath, I had a lot of requests [for osteopathic manual treatment]. I did a lot of OMT on the mountain.

“The trip was a metaphor,” he adds. “The patients all climbed their own mountain with their cancer treatments. Now they were standing at the top of a real mountain.”

Nichols credits the group’s success to the expertise of Deming and Charlie Wittmack, executive director of Above and Beyond Cancer who’s reached the summit of Mount Everest twice, in planning such epic expeditions. Deming gives credit to the two DMU alumni.

“There are cancer survivors who wouldn’t have made it to the top of Kilimanjaro without the professional and compassionate care given by Dr. Hiatt and Dr. Nichols,” Deming says. “They represent the best of what doctors are with their wonderful combination of professional skill and kind care given in a healing manner.”

On a recent crisp, sunny Saturday morning, Sara “Sally” Sutton’s kitchen radiated tantalizing aromas of her beef stew. Individually and in small groups, DMU osteopathic students began to arrive, calling, “Hello, Sally!” instead of knocking, as they shed shoes, backpacks and coats in the foyer. They knew what to do: set the table for lunch.

“I always forget – do the water glasses go on the right?” asks Emiko Ishihara, D.O.’14.

“Above the knife,” Sutton reminds her. She and nine DMU students and one undergraduate fill their bowls and sit around two festively set tables, helping themselves to salad, biscuits and Sutton’s homemade pickles and relish; dessert will come later. This gathering is much more than lunch among friends, however. It’s the prelude to hands-on instruction about osteopathic manual medicine (OMM), which for years Sutton has been providing once or twice a month in her home and on campus to groups of DMU students who learn about her from word of mouth.

Working with students and often behind the scenes, alumna Sara “Sally” Sutton has advanced osteopathic medicine and those who practice it.

Sutton, too, is much more than a meticulous teacher who’s passionate about students, osteopathic medicine and patient care, although those aspects alone make her special. She also has been a longtime national force in promoting muscle energy technique, a type of osteopathic manual diagnosis and treatment. For her ardent advocacy for the technique and years of teaching it with superb precision, Sutton was selected from more than 150 nominees as the American Osteopathic Association’s 2011 Mentor of the Year. She received the honor at the AOA’s Osteopathic Medical Conference and Exposition held last fall.

“Muscle energy diagnosis is basic for most of what we talk about in OMM and somatic dysfunction,” says Jose Figueroa, D.O.’95, a DMU assistant professor and clinician who had a rotation with Sutton early in his medical career. “Muscle energy technique is used worldwide, in part because of Dr. Sutton. She changed my life and changed the whole profession worldwide.”

A bit of history affirms Figueroa’s statement. Sutton was one of two female members of the Class of 1953 at Des Moines Still College of Osteopathy and Surgery, now DMU. While she downplays that – “I didn’t mind the teasing, but I greatly resented the profanity” spewed by male classmates – it was a time when women had few to no internship and residency opportunities. After she graduated, she borrowed her sister’s car to drive around northern Iowa to find a community that needed a doctor and had office space to rent. She started her first practice on Nov. 1, 1954, in Renwick, IA, where she provided general care, obstetrics and emergency medical services for more than nine years before moving to Fort Dodge, IA; there, her practice grew to nearly 8,000 patients.

“She was so thorough in her examinations. She looked at every part of a patient’s skin, in every hole and palpated every part of the body. Because of that, anything abnormal in a patient stood out like a sore thumb,” Figueroa says. “In her mind, that is the best preventive medicine you can have.

“Her idea of manipulation is that it’s integrative with medicine,” he adds. “There’s no distinction between OMM and medicine; OMM is medicine.”

Practice, preserve, promote

OMM principles In the late 1960s, Sutton attended a presentation at an osteopathic convention in Des Moines by Fred Mitchell Sr., D.O., who had developed muscle energy technique. Perhaps because he was a friend of her mentor and DMU faculty member Paul Kimberly, D.O.’40, he agreed to teach her the technique. She traveled several times to his Chattanooga, TN, practice to observe him.

“He had a full-time practice. He’d explain the technique, but he was so busy it didn’t work,” Sutton recalls. “I asked him to come to Iowa to teach a group of us.”

That “tutorial” took place in Sutton’s home in March 1970. Years later, one of the participants, Ed Stiles, D.O., recalled to Figueroa, “Fred Mitchell told me that if the tutorial didn’t work in her home, he was going to stop teaching the technique.”

“Muscle energy technique came about because of Mitchell,” Figueroa adds. “He was trying to promote it, but to do so, he needed Dr. Sutton.”

The American Academy of Osteopathy (AAO), of which Sutton was then an officer, asked her to document Mitchell’s technique. She completed a set of workbooks with Mitchell’s son, Fred Mitchell Jr., D.O.

“Muscle energy is one of the most universal techniques we have – it’s gentle, effective and time-efficient,” says Richard Schuster, D.O., a DMU assistant professor and clinician. He met Sutton at a conference in 2004. “She changed how I looked at muscle energy in a half-hour of working with her. She has such a desire to teach others. Sally is a gem.”

“Working with a legend”

Back in Sutton’s home that recent Saturday, after the tables were cleared, leftovers put away and the dishwasher was loaded, she and the students descended to the lower level, where four OMM treatment tables allow them to practice in pairs and groups. Elizabeth Abbas, D.O.’14, donned a gown; classmate Jeff Ebel practiced techniques under Sutton’s watchful eye. The group was preparing to treat a teenager who’s been plagued by gastrointestinal issues since birth; a previous treatment by the group already had given the teen some relief.

Sara Sutton, D.O.'53, provides precise hands-on training in her home to second-year DMU osteopathic students like Jeff Ebel, who's practicing on classmate Elizabeth Abbas while fellow student Michael Braunsky observes.

“She really makes the OMM part applicable to providing care,” Ebel says of Sutton. “She makes you focus on what you’re feeling for. You realize you’re working with a legend.”

That goes beyond her OMM expertise, the students say. The way she has treated patients throughout her career also inspires. “She doesn’t want us to forget to care about our patients,” says Alexis Beinlich, D.O.’14. “They say there’s pressure to limit exams to 15 minutes per patient. Really? Sally has established a full life treating patients the way she wants.”

These members of the D.O. Class of 2010 worked with Dr. Sutton their first two years of medical school: back row, Matt McClanahan and Tony Kopp; in front from left, Amy Ford, Joanne Genewick, Sutton, Jed Ballard, Sasha Fach and Casey Cook.

Among the many physicians Sutton has inspired is Sasha Fach, D.O.’10, who’s now in the second year of a three-year family medicine residency through the University of Minnesota in Mankato. She was one of “Sutton’s students” during her DMU days.

“She was very adamant about doing a thorough history, a physical exam and a structural exam. Now I use pretty much the entire exam technique she used on her patients,” says Fach, who won DMU’s 2010 Ram’s Head Award for best individual performance in OMM by a graduating senior. “My goal is to integrate OMM into my daily family medicine clinic practice just as she did.”

While she’s dignified and soft-spoken, Sutton’s deeply principled approach to OMM reflects an unmistakable passion for it.

“Dr. Sutton wholeheartedly believes in osteopathy. She is able to help students see how important manipulation is in understanding the whole body,” says DMU Board of Trustees member Susan Beck, D.O.’84, FACOS, a surgeon with Katzmann Breast Center in Clive, IA, and Surgical Affiliates in Des Moines. “She’s an educator who imparts knowledge and learning and also passes on an infectious curiosity and passion. That’s what changes the world.”

During the session at her home, Sutton guides Ebel’s hands as he practices manual techniques on Abbas while the other students observe.

“The ultimate goal with these groups of students is not only to teach the skills, but to integrate them into overall practice,” Sutton says. “I love the students, but I also want to perpetuate the art of touch.”

A Renaissance woman, indeed

Sara “Sally” Sutton is one of Iowa’s only two Fellows (FAAO) of the American Academy of Osteopathy (AAO), an earned postdoctoral degree conferred by the academy.

She’s the only physician in Iowa to receive the Andrew Taylor Still Medallion of Honor, the highest honor given by the AAO.

She served on the DMU Board of Trustees for 22 years and on the DMU faculty for five.

She served as director of the Health Manpower Recruitment Corp. of North Central Iowa, which was key in bringing physicians to rural communities.

Sutton also founded and served as president of the Fort Dodge, IA, Fine Arts Association and the Fort Dodge Choral Society, which is still active more than 40 years later.

One of the many reasons she is a champion for osteopathic medicine: She contracted scarlet fever in the sixth grade, which forced her and her mother into quarantine in their home’s second floor; their family physician, a D.O., visited them every day, climbing a ladder from the outside of the house to avoid contaminating other family members.

She credits her undergraduate years as a music major for her sensitivity to touch as an OMM provider. “I know how to dot my I’s and cross my T’s from choral music,” she says. “I think I apply that in treatment.”

She’s the author of Dr. Sally’s Cookbook, a collection of more than 800 recipes “with and without sin.”

America’s medical resources:
physician supply in the United States

By Richard F. Belloff, D.B.A.; Kari Dyjak, M.H.A.’17;
and Pamela Raye Bostwick, M.S.O.D.

IT IS SAID that the physician is the center of the medical care system. The analogy of a “quarterback” might also apply: Nothing significant happens in medicine without physician involvement in one way or another. For a nation that lavishes spending on health care, it would seem like the U.S. would be brimming with physicians, and patients would see their physician on a frequent basis.

Using available data from the Organisation for Economic Co-operation and Development (OECD), we see that this is far from being the case. As Exhibits 1 and 2 illustrate, America’s overall physician supply is modest when compared with our global counterparts, and U.S. patients seem to be less willing (or able) to access their doctor.

However, U.S. physicians seem to excel in one area: earnings (Exhibit 3). U.S. physicians lead the world in compensation, and by a wide margin. We are experiencing the world’s highest levels of physician compensation coupled with low patient-to-physician “face time.” Generally speaking, one would consider this relationship as bad news.

While America’s physician supply has consistently increased over time, we are not “keeping up” with the growth experienced by our counterparts.

We have examined the underlying dynamics regarding physician supply, compensation and availability and have gleaned a number of factors that might account for the U.S. experience. Several of these factors may surprise you.

Like all of our cohort countries, U.S. physician supply has increased modestly over the past 15 years. However, as summarized in Exhibit 1, other countries have done better in this regard. Numerous factors impact the overall supply of physicians, including medical school capacity, graduation rates, immigration policies, medical licensing and residency practices. Of course, increasing physician supply takes time; there is no “quick fix” (Dill, 2008). This issue is explored in more detail below.

American medical school “capacity” has not increased sufficiently to meet the demands of an aging population.

Physician supply issues can be ameliorated or exacerbated by corresponding changes on the demand side. A shift in the age demographics within developed countries has increased the overall demand for physician services, and the U.S. is not unique in this regard (Dill, 2008).

One positive for the U.S. is that we have plenty of young, bright students who wish to enter the medical profession. Over time, applicant interest in becoming a physician has increased, in spite of the substantial costs and effort required (Dill, 2008).

However, the U.S. simply does not have adequate capacity to train all of the qualified students who want to become physicians. Currently, both medical school seats and graduate medical residency openings will simply not accommodate all applicants; in this regard, the U.S. compares poorly in our overall capacity to generate large numbers of medical school graduates (Exhibit 4).

In economic terms, we call this a “bottleneck” in that it inhibits the entire system from responding to increased patient demand. Over time, this bottleneck contributes to rising prices, access problems or both.

The U.S./Canadian medical education model is more expensive for the student and takes longer to complete.

Surprisingly, considerable variation exists among our cohort countries in how medical training is conducted, when it starts, how long it takes and where it takes place. Differences also exist in funding, in particular with the U.S. model, which relies on American students’ funding most of their education, largely through student loans.

The notable variation here is when medical training begins (Exhibit 5). In the U.S./ Canadian model, most programs require a bachelor’s degree to gain entrance. The student completes four years of medical school and then a three-year residency program. All told, training a primary care physician normally takes 11 years of post-high school education and residency training (Dyjak, 2012). Hence, most newly credentialed M.D.s and D.O.s will be nearly 30 years old before they begin their medical practice.

European students can normally enter medical school directly from high school. Generally, their medical training is shorter; in many cases the cost is heavily subsidized or tuition-free (Dyjak, 2012).

Consequently, European physicians start their practices at a younger age and with less debt (if any) than U.S. medical graduates. They also have potentially four to five more years of practice over the course of their professional lives. Overall, these factors can add significantly to the capacity of European physicians to meet the demands of an aging patient population.

Shifting demographics and cultural trends have lessened the lifetime “productivity” of the average U.S. medical graduate.

For some time now, the U.S. has been training a greater percentage of female physicians. This trend has clearly positive benefits, as the physician population reflects the composition of the patients they treat.

That said, over the course of a professional career, many women physicians are less “productive” when defined by how many patients that can be treated (Sibert, 2011). This lower productivity is tied to several distinct phenomena particular to women: maternity leave and child-rearing responsibilities. On average, female physicians will take time out from their careers for maternity leave and often return to work on a less than full-time basis. During these periods, they see fewer patients and are thus “less productive” compared to their male counterparts. Female physicians also tend to retire earlier, again reducing the sum total of patients they may see over a lifetime of practice (Sibert, 2011).

Another trend evidenced by both male and female physicians is a shift toward employment rather than solo practice. Overall, employed physicians tend to be less productive, working fewer hours and taking less off-hour call (“Physicians working fewer hours per week,” 2010).

So we see that even as physician supply has increased in the U.S., capacity to see patients per physician has been declining. These shifts further exacerbate supply/ demand problems even as the total physician supply appears to be going in the right direction (Dill, 2008).

Shifting demographics of an aging population may lessen the perceived shortage of primary care physicians but will increase the overall demand for physician services.

There have been many calls to increase the number of primary care physicians in the U.S. However, in the long run, this may well be an inappropriate strategy. As our population continues to age and family size tends to be smaller, the need for obstetricians, pediatricians and family practitioners actually diminishes. We will need more specialists that treat the diseases of aging. These specialties may include geriatrics, orthopedics, cardiovascular diseases, neurology and palliative care (“Aging associated diseases,” 2012).

Building medical schools and residency programs takes time!

It seems clear that the U.S. needs to add medical school capacity over the next two decades (Dill, 2008). The good news is that there are new U.S. medical schools currently under development (Whitcomb, 2009). That said, building new medical schools requires large amounts of capital, and the process from conception to completion can take many years.

Moreover, staffing these medical schools with basic science and clinical faculty is challenging. For a nation that is concerned about having sufficient numbers of physicians to treat patients, asking them to train new physicians as well is problematic (Dill, 2008).

Noteworthy is that for international medical graduates (IMGs), the U.S. is seen as an attractive place to practice, and demand to immigrate here is strong (Vognild, 2009). Hence, policymakers may need to streamline the process for IMG immigration.

At the same time, residency training programs in U.S. hospitals could be increased to accommodate the larger numbers of recent M.D./D.O. graduates needing to complete their medical education. Again, these changes require additional capital and, of course, clinical faculty.

For a nation that spends so much of its income on health care, it is hard to accept the possibility of a physician shortage. That said, there are disturbing trends in this regard, and health policy makers should take note.

Richard F. Belloff, D.B.A., ACHE, is an assistant professor in DMU’s College of Health Sciences. He teaches in both the master of health care administration and master of public health programs. Kari Dyjak is a graduate student in DMU’s master of health care administration program. Pamela Raye Bostwick has a master’s degree in organizational development and is a former health care human resources professional. She currently conducts research in the health care administration field.

References

Aging associated diseases including Alzheimer’s, dementia and osteoporosis (2012). Retrieved Feb. 12, 2012, from www. disabled-world.com/health/aging/

Physicians working fewer hours per week (2010). Retrieved Feb. 16, 2012, from www.aafp.org/online/en/home/publications/news/news-now/professionalissues/ 20100315jamaworkinghours.html

Dill, M., & Salzberg, E. (2008). The complexities of physician supply and demand. Washington, DC: Association of American Medical Colleges.

Dyjak, K. (2012). Comparative medical education and the U.S. experience. Unpublished MHA independent research paper, Des Moines University.

Vognild, E. A review of international medical graduates in American medicine. Retrieved Feb. 16, 2012, from www.aspr.org/displaycommon. cfm?an=1&subarticlenbr=512

Sibert, K. (June 11, 2011). Don’t quit this day job! New York Times.

Whitcomb, M. (2009). New and developing medical schools. Georgetown: Josiah Macy Jr. Foundation.

Ben Ahrens admires classmate Stephanie Athman's spring roll handiwork.

Students stream into DMU’s wellness center kitchen, helping themselves to steaming cups of jasmine tea before settling into their chairs. A whiteboard on the wall lists today’s multicourse menu, from soup (miso) to nuts (tofu sesame almond cookies). Members of the wellness staff and faculty bustle around the counter, assembling tools and ingredients.

The scene feels like a dinner party among friends, which in a way it is, but the chefs and students have a mission in this meal: to apply their knowledge of nutrition in preparing healthy dishes that don’t require a doctorate in culinary arts. Joy Schiller, M.S., CHES, director of DMU’s wellness program, and David Spreadbury, Ph.D., chair of biochemistry and nutrition, have co-taught this popular elective course to DMU’s osteopathic students since 2007.

“I’m really interested in health and wellness. This is an opportunity to expand my horizons in cooking,” says Caleb Masterson, D.O.’14. “Plus we get to see Dr. Wilson in an apron.”

Don't let the apron fool you: Associate Professor Wayne Wilson gets serious when he demystifies miso soup.

That’s Wayne Wilson, Ph.D., associate professor of biochemistry and nutrition, who sometimes assists in the class. Swathed in an apron with a kilt motif, the native Scot tonight is in charge of the miso soup and steamed fish packets. Between those two dishes, Schiller demonstrates how to make a tofu-mintveggie spring roll, which garners a round of applause.

“Our goal is to provide basic hints on cooking more nutritiously as well as cooking more creatively,” she explains. “We’re somewhat technique-driven. We also encourage students to stock their pantries so that they can make a quick and healthy meal without having to shop.”

In addition, she and Spreadbury work to reduce food preparation’s fear factor. “Cooking is a creative outlet – it’s like quilting in the kitchen,” he says, effusing about the merits of fish sauce and other culinary delights. “Cook with abandon! There’s a whole world out there to try.”

Wellness Specialist Nicole Frangopol, Wellness Director Joy Schiller and David Spreadbury, Ph.D., stir-fry vegetables while Wayne Wilson sets out rice.

Students assemble spring rolls.

Equally important, class members learn that cooking can be healthy, affordable and doable, lessons that will serve them well in their lives and careers.

Kelly Hunter relishes one of the evening's offerings.

“It’s hard to find time to cook, but I’ve learned it doesn’t have to take a lot of time,” says Emily Morse, D.O.’14. “As physicians, it’s our responsibility to take care of our patients. We can show them that if we have time to cook healthy meals with our busy lifestyles, they can do it, too.”

Stacie Kamada, D.O.’14, says the class has motivated her to eat more vegetables and less fried foods and to think about counseling future patients. “I’ll need to give them practical ways they can reach healthy goals,” she says, as an ooh-and-ahh-inspiring pile of fresh vegetables crackles in two giant woks. “You can’t just tell people, ‘You need to lose weight.’”

What’s Driving Our Diet?

An elective in DMU’s public health program, “We Are What We Eat,” digs into the science of nutrition and then takes bigger bites into the economics of farm policy and food marketing, food origin and distribution, and implications for public health.

“We need to understand the basics of nutrition to shape food and public health policies,” says course instructor and Assistant Professor F.R. “Fritz” Nordengren, M.P.H. “We also need to understand that food systems have to be a keystone to any WHAT SHOULD WE EAT? health policy.”

Students in the course, offered for the first time last fall, examine the economic drivers in agriculture, food production and distribution that also drive our diet. Government subsidies for such commodities as milk and corn, for example, affect school lunch menus and the prices of foods filled with ubiquitous high-fructose corn syrup – in comparison to, say, fresh produce.

“Today’s consumers typically have access to 3,900 calories per day, yet the average person needs around 2,000,” Nordengren says. “At the same time, some people in the U.S. are food-insecure.”

Nordengren is no anti-government, antibig agriculture evangelist on food policy. He does raise free-range, antibiotic-free ducks, turkeys and chickens on his 80-acre property near Grand River, IA, an endeavor he clearly enjoys but one that taught him “small-scale production is not profitable.”

“We need large-scale farmers, processors and retailers to feed the world,” he says. “Food production is not a binary issue. We need producers of all sizes.”

Nordengren applies that balanced perspective in his role as president of the Iowa Food Systems Council. Established in 2000 by then-Iowa Governor Tom Vilsack, the now-member-driven nonprofit studies ways to address the needs of producers and consumers “from food to fork to disposal,” Nordengren says. Its members come from sectors ranging from farmers to food banks to physicians to public health leaders.

“It creates a safe and neutral environment for constituents to meet who otherwise might not come together,” he adds.

Controversies like outbreaks of food-borne illnesses and freerange versus concentrated animal feeding led in part to Nordengren’s work on a new public health course, “Don’t Put That in Your Mouth.” It will explore issues like food safety, security and sovereignty – “what we need to do as a state and nation,” he explains, “so we’re not dependent on things we can’t control.”

He adds that DMU can play a key role in tackling such issues.

“I think DMU is uniquely positioned to not offend producers, whether conventional or organic, because we can look at food issues from a nutritional standpoint,” he says.

Real Food for Real People

Back in the DMU wellness center kitchen, on the last meeting of the seven-week healthy cooking class, students take over, preparing a meal that reflects the healthful, largely plant-based principles and skills they’ve learned. By that point, they know, among other things, that slicing an onion is not brain surgery; that roasted Brussels sprouts are delicious; and, with a little planning, medical students do have time to cook.

Dig in: Watch a video of DMU’s healthy cooking class in action and try some of is recipes.

Despite the huge role diet plays in one’s health, the American Medical Association says few medical schools offer classes that give future physicians hands-on healthy cooking skills. But students in the DMU class say they’ll be better equipped to advise patients about improving their diets in ways that are practical, affordable and tasty. Given food’s role in our health, that’s something.

“We can do so much for our health with relatively minor changes, like introducing healthy foods that will push out some of the bad stuff,” Spreadbury says. “Equally important is how it all tastes. You can come up with the healthiest diet in the world, but no one will eat it if it doesn’t taste good.”

Not too many cooks in this kitchen (from left): Assistant Professor Melita Marcial-Schuster, D.O.; Wayne Wilson; Nicole Frangopol; Wellness Center Manager Missy Gripp, M.S.; David Spreadbury; and Joy Schiller.

A diet for disaster?

At the Iowa State Fairgrounds in Des Moines, 4,700 people packed the Varied Industries Building to celebrate that much-maligned yet even more-loved meat: bacon. Was that just good fried fun or a sign of our epically bad eating?

A big appetite for better eating

DMU is one of the few medical schools in the nation to offer its osteopathic medical students hands-on experiences in the kitchen. Another DMU course digs into food policies, marketing and distribution. Students eat up both options.

Individuals, nations bear increasing burden of obesity

Some might consider surgery a drastic solution to being overweight, but DMU alumnus Moses Shieh and many others consider obesity a drastic problem that merits it.

Web extra: Students sink their teeth into health cooking

Watch DMU’s healthy cooking class in action! DMU is one of the few medical schools in the nation to offer its osteopathic medical students hands-on experiences in the kitchen. Find out why.

I’ve had it. Hand me that pint of Ben & Jerry’s Chunky Monkey and a big spoon.

Seriously, in America and in countries around the world that are increasingly consuming highly processed diets, we face challenges in understanding what we’re eating and what we should eat. Conflicting “wisdom” advises us that some foods are critical while others are evil, and vice versa. If we eat or avoid certain foods, we’re guaranteed to lose weight, reduce joint pain, lower our risk of diabetes, improve our sex lives, get better jobs, win friends and influence people.

We have greater access to food now than at any other time in human history, but do our expanding waistlines and chronic disease rates reveal that we have too many choices, particularly bad ones?

We’re also overwhelmed with food choices, many not so good for our health but marketed like they are. Overwhelming, too, are the ingredient lists on the vast numbers of processed foods in our stores. Pick a product off the shelf and you’ll see a host of unpronounceable additives, artificial flavorings and emulsifiers that extend shelf life or supposedly enhance flavor, often sacrificing nutrition. Would you really eat butilated hydroxytoluene (a preservative also used in jet fuel and embalming fluid) or xanthan gum if they weren’t “givens” in your cereal and salad dressing?

So what’s a body to chew? What can we do to improve the health of people and populations? Many communities and states are wrestling with these questions, and that’s a good thing: It means more individuals, organizations and governments are realizing we need to make positive changes that help people make better decisions in terms of eating and exercise.

In Iowa, for example, Governor Terry Branstad’s Healthiest State Initiative, a privately led, public effort What should we eat? to make Iowa numberone in specific categories by 2016, includes the Blue Zones Project, a collaboration of health insurer Wellmark Blue Cross and Blue Shield and Gallup-Healthways. Described in a book by National Geographic explorer/writer Dan Buettner, Blue Zones are geographically defined areas around the world where people reach age 100 at rates 10 times greater than in the U.S.; Buettner explored the commonalities of these areas that other communities and individuals can practice relatively easily, from ensuring citizens have attractive sidewalks and bike paths to choosing more plant-based diets.

First Lady Michelle Obama praised these efforts on Feb. 9 when she brought to Des Moines’ Wells Fargo Arena her “Let’s Move” campaign to fight childhood obesity. At the raucous event, at which 130 DMU students and employees volunteered, more than 12,000 middle school children joined NBC “Biggest Loser” trainer Bob Harper in push-ups, squats and jumping jacks, then high-stepped the “Interlude” dance, popularized by University of Northern Iowa basketball fans, with Obama and her celebrity guests.

Will these efforts succeed in reversing our current overweight, diabetes-addled and sedentary states? Will we seek salads instead of super-sized? That remains to be seen. But given that 17 percent of our children and more than one-third of U.S. adults are obese, we’d better start somewhere.