The facts, says Dr. Sean Bourke, are clear: The U.S. is being overtaken by an epidemic of obesity. He wants to replace it with a very different epidemic -- one of good health.
A medical doctor from Portola Valley, Dr. Bourke is co-founder of the company JumpStartMD, a chain of what it calls "wellness centers" that aims to help people lose weight by encouraging them to eat fresh, whole food and make lifestyle changes.
Founded in 2007 by Dr. Bourke and by Dr. Conrad Lai, JumpStartMD has 13 centers, including in Menlo Park, Palo Alto, Mountain View and Redwood City.
Portola Valley home
Dr. Bourke, 48, is a Portola Valley native who moved to Palo Alto at age 5, graduating from Palo Alto High School. He lives in Portola Valley with his wife, Sinda Mein, a gastroenterologist who works at the Palo Alto Medical Clinic, and their three children, Alfie, 6, and Willa, 8, who go to Ormondale School, and Finn, 10, who goes to Corte Madera School.
His wife, whose grandparents William and Sally Mein lived in Woodside, grew up in Menlo Park. Although their parents were acquainted, the two did not meet until both were taking courses needed for medical school admission at the University of California, Santa Cruz.
Mr. Bourke says he did not originally intend to become a medical doctor. But after graduating from Yale University with a history degree, he ended up in India working in Mother Theresa's Home for the Destitute and the Dying. That experience led him to medical school at the University of Southern California, where he attended on an Air Force scholarship.
Obesity has grown at a mind-numbing rate in the U.S. in recent years, Dr. Bourke says. For decades, he says, according to the Center for Disease Control, the level of obesity in the American population was about 12 percent. As recently as 1990, no state had an obesity level greater than 14 percent, CDC figures show.
By 2011, no state had less than a 20 percent obesity rate. By 2014, the last year for which statistics are available, only five states, including California had fewer than 25 percent of residents defined as obese by the CDC. In 2014, 21 states had obesity levels at more than 30 percent and three states had more than 35 percent of their residents defined as obese.
In addition, by 2010, 11 percent of the population had been diagnosed with Type II diabetes (compared with less than 1 percent in 1961, Dr. Bourke says). Another 25 percent of the population is pre-diabetic, he says, and many more who are on their way to becoming diabetic may not know it.
Why obesity matters
The obesity rate matters because research has tied excess weight to a multitude of medical problems, Dr. Bourke says. They include dementia, stroke, mental health, hypertension, cancer, pulmonary disease, depression, gallbladder disease, gynecologic abnormalities, infertility, osteoarthritis, phlebitis, gout, diabetes, steatohepatitis, cirrhosis, fatty liver disease, heart disease, hypoventilations syndrome, obstructive sleep apnea and cataracts, Dr. Bourke says.
The problem affects the pocketbook, as well. Dr. Bourke says the U.S. spends $2.7 trillion annually on health care, with 75 percent, or $2 trillion, going to treat chronic diseases that could be preventable with lifestyle changes. Only 3 percent of the health care spending goes to preventative care.
The solution, he says, is not spending even more on drugs, research and medical procedures. "We treat with pills and scalpels what could more often than not be prevented and treated with forks, knives and a mountain bike or its equivalent through healthy lifestyle changes," he says.
Part of the problem is that Americans are confused by the ever-changing guidelines about how to eat a healthier diet.
The reality is, Dr. Bourke says, is that "half of Americans believe it's easier to figure out how to do their taxes than eat more healthily."
The fat fallacy
One of the more harmful nutritional guidelines counseled that fat is the culprit in American diets. The food industry reacted by flooding grocery stores with "healthy" low-fat foods, many of which were loaded with sugar. The truth is just the opposite, he says, noting that medical studies in 2010 and again last year have shown that intake of saturated fat is not connected to heart disease or stroke.
Advice that all calories are the same has also been proven false, he says. A study published in June 2015 looked at obese children put on three different diets with the same number of calories. One was high fat and only 10 percent carbohydrates (like the Atkins diet), a second was Mediterranean style with a low glycemic index (40 percent carbs, healthy fats, minimally processed grains), and the third was the American Heart Association's recommended diet of low fat and more carbohydrates.
The researchers found, Dr. Bourke says, that the children burned the equivalent of 300 calories a day more on the Atkins-type diet, and 150 more on the Mediterranean diet, than on the heart association diet. It took the equivalent of an hour a day of additional exercise to burn off the same calories.
Most people retain a number of faulty conceptions about their diet, Dr. Bourke says. For example, he says, a hamburger is healthier than a Coke because the sugar in a Coke, current science says, can increase cholesterol, inflammation and accelerate aging, he says.
Orange juice can be almost as unhealthy as a Coke because the orange juice contains so much sugar, he says. A Snickers bar, he says, can be healthier than a bagel, especially if the bagel is made from refined flour, which can cause a spike in blood sugar levels while the Snickers bar contains protein, fat and fiber, which slow down the metabolizing of its sugar.
"Perhaps the phrase 'cereal killers' is more apt than the makers of Wheaties and corn flakes would have us believe," he says, noting the average American eats the equivalent of 130 pounds of bread a year and just as much sugar and potatoes. What these foods have in common are lots of carbohydrates.
Sugar, he says, can be found in up to 80 percent of the items in a grocery store. Consumers may not notice just how much sugar is in a food item because on the nutrition label, Dr. Bourke says, the only nutrient that doesn't have a recommended daily amount (RDA) is sugar. "That's because the food industry doesn't want you to know that even your poppy seed muffin is double the American Heart Association's sugar recommendation, just like the tobacco industry didn't want people to know that smoking caused cancer and heart disease," he says.
Some people, he says, are addicted to carbohydrates, which are found in the highest levels in sugar and flour. Most fats and many meats do not contain carbohydrates. Dr. Bourke says that in a study of cocaine-addicted mice, when given a choice of sugar or cocaine, they chose sugar 40 out of 43 times.
JumpStartMD teaches its customers, who it calls members, how to change the way they eat and live to achieve and maintain healthy weight.
Food as medicine
"Food, not pills and procedures, can be your medicine," Dr. Bourke says, or, quoting Hippocrates: "Let food be thy medicine."
Not that Dr. Bourke doesn't believe in prescription medications. He says up to 45 percent of JumpStartMD customers use some type of weight-loss medications. The company also offers bioidentical hormone replacement, in which hormones such as estrogen, testosterone and thyroid are replaced with hormones that have a chemical makeup nearly identical to the hormones they're replacing.
New customers have a wide array of tests done to help determine if they are sensitive to carbohydrates or other nutrient groups before a personalized program is developed.
"The diet that's right for you might not be right for the next guy," he says.
He says the program is very successful, with members losing three to four times as much weight as those on other programs do. If they continue with the program, members are also very successful at keeping the weight off, he says, with 99 percent of those who lost 5 percent of total body weight maintaining that loss; and 86 percent of those who lost more than 10 percent of their body weight doing so.
Dr. Bourke says that members who have preferred provider (PPO) insurance often have more than half the cost paid by their insurance after meeting their deductibles.
Dr. Bourke and his wife both did their residencies at Stanford University. He says that the two were not yet engaged when he asked the residency director how they could do their residencies at the same place. She told him he should marry her.
So he proposed. "That was the smartest thing I ever did," he says. They have been married since 1998.
Dr. Bourke fulfilled his three-year obligation to the Air Force at Lackland Air Force Base in Texas and Travis Air Force Base in California and with two tours to the Middle East.
At their home in Portola Valley, the family has 70 fruit trees, 22 chickens and a vegetable garden.
"I'm a bit of a foodie," Dr. Bourke says. In fact, he and his brother started the Hale Mary winery in Sonoma County, where they make pinot noir, which is available at a number of well-known restaurants.
He admits that he does sometimes give in to his children's requests for junk food; but that "they don't get any of their calories from soda."
Steps to better health
Dr. Bourke says that following some basic tenants can lead to better health:
● Eat real (nutrient dense) food (i.e., food that come directly from the earth rather than a factory) including non-starchy vegetables, limited fruits, meats and seafood, and dairy products without added sugar.
● Do your best to limit carbohydrates, especially the more refined such as sugar, high fructose corn syrup and white flour.
● Embrace (or temper fears of) healthy, natural fats, including nut, seed, avocado, olive and canola oils, as well as fats in meats, seafood and whole-fat dairy.
● Exercise for well-being rather than weight loss.
Each person's body and metabolism are different, so he offers the following advice:
● There's no such thing as a one-size-fits-all diet. Each person needs to personalize a program to optimize weight, health and well-being (based on underlying genetics, habits, and likes and dislikes).
● Successful diets need to focus on realistic, sustainable long-term lifestyle changes. Deprivation diets don't work.
● More information on the topic of obesity, its health effect and the American diet are available in the documentary "Fed Up," available from the San Mateo County Library System.