Tiago Villanueva: The obesity epidemic in Mexico

I recently learned that about 38% of the calories consumed by pregnant women in Mexico comes from the consumption of sugary drinks, like sodas. Mexico also has the highest consumption of Coca-cola per capita of anywhere else in the world. Not surprisingly, Mexico also has the highest growth of obesity rates in the world. Mexico’s […]

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Suchita Shah: HIV and health in the Navajo Nation: why historical trauma matters

The dry New Mexico wind whips up a dust cloud in the distance. Alone on a highway that stretches for miles through expanses of arid desert soil, I am travelling to visit Donald Chee, a public health community liaison at Diné College, the first Indian*-owned college in the USA. “Diné,” in Navajo, means “The People,” […]

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Edward Davies: Health and politics: time to end the filibuster

The machinations behind the current attempt to defund Obamacare are politically complicated and have a prelude several years long. The evolving story on the federal budget and the rights and wrongs of both it and the Affordable Care Act are well covered elsewhere, but as I type this Senator Ted Cruz is entering the 20th […]

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Richard Lehman’s journal review—23 September 2013

NEJM 19 Sep 2013 Vol 369 1106 I’m starting with the second paper about colonic cancer screening in this week’s New England Journal of Medicine, because it takes us to one of the places where it first began: the state of Minnesota. Up there, just under Canada and just west of the Great Lakes, 46,551 […]

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Georgios Lyratzopoulos: Overdiagnosis—is informed decision making by patients the way forward?

I enrolled for the Preventing Overdiagnosis conference assuming that the focus would be on cancer screening, but I was thankful that the conference covered every clinical specialty, including paediatrics, psychiatry, and cardiology, as well as surgical specialties and emergency medicine. After all, and as recounted by Jim Guest, it is possible for patients attending the […]

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William Cayley: Does uncertainty and fear of the unknown drive overdiagnosis?

Edward Davies hits the nail on the head: “The fear of both patient and doctor can sometimes override the best knowledge, research, and information known to man.” I do not think, however, that it is just fear of getting sued that drives us physicians towards over-testing and overdiagnosis. Rather, it is existential fear of uncertainty, […]

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Leana Wen: Where to begin the conversation on overdiagnosis

One of the many takeaways from this week’s excellent Preventing Overdiagnosis Conference is that it’s hard for doctors to tell their patients that too much care is bad. For so long, the rhetoric has been about the danger of too little care. Newspapers brim with stories of death from missed diagnosis and lack of access […]

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William Cayley: Measurement—at the expense of success

“Doc, how’s my blood pressure? What about my cholesterol? How about my weight?” “There’s room for improvement,” I say. “How much do you exercise? How many fruits and vegetables do you eat?” “Oh, I’m too busy right now for exercise—and I have to eat what I can get when I’m on the road. But I […]

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