We have a society that monumentally conspires against the pursuit of health. We have wave after wave of labor-saving technology that says don't ever use your muscles for anything, along with messages that you should be more physically active. We have, every year, the introduction of hundreds, if not thousands, of new highly processed foods, the majority of which glow in the dark. At the same time we're telling people: eat foods closer to nature. We have schools where we teach children to sit still all day long so they can become adults we can't get off couches with crowbars.

Balanced, sensible nutrition: eat food, not too much, mostly plants, a healthy diet ala Michael Pollan, modern physical activity on a daily basis, modest weight loss - translated into a 58% reduction in the occurrence of diabetes. A clear indication of the power of lifestyle over health. The challenge now is the development of the community-based programs that will translate what we learned in the diabetes prevention program and put it to work in every town in America.

I naturally gravitate toward the big picture which isn't necessarily advantageous when you go on to a career in research because successful researchers usually choose a pretty narrow channel. So having tunnel vision actually helps you stay where you are supposed to stay. The big picture in medical care was looking at the underlying causes of all of this pathology. I really wanted to do something about that and play a meaningful role in changing the trajectory of people's lives and their health and by changing their health, changing the quality of their lives.

We are creatures. We have a link with a native habitat just like every other species. Throughout most of human history, physical activity was unavoidable, calories were scarce and hard to get. In the modern era, calories are unavoidable, physical activity is scare and hard to get. The traits that allowed our ancestors to survive, and let's face it, the survival of our ancestors is the reason that we're here because the people who don't survive and make very crummy ancestors, are our traits. But they're very much at odds with the modern environment.

When I went to medical school, I was taught about two basic kinds of diabetes: juvenile onset and adult onset. From the time I did my training in medical school to the end of my residency we were already seeing the transformation of adult onset diabetes into Type II, which is what we call it now, which from my perspective is a euphemism we have draped over this condition to conceal the fact that what was a chronic disease in midlife is now epidemic in children. Frankly, Type II diabetes in a seven year old is adult onset diabetes. We just don't want to confront that unpleasant fact.

We don't control everything. There are genetic influences. There are environmental exposures we don't control. I cannot guarantee anyone I counsel that by following what I hope is the good advice I offer them, they will live long and prosper. That's what I'm hoping for but I can't guarantee that. What I can tell them is this: "Look, I can help you firmly grip the wheel, and you can steer the ship. You're never going to control the winds and you're never going to control the seas. But if you sail well you can get through just about anything."

What we need to do now is recognize that it is the sum total of human ingenuity that is responsible for the epidemics of chronic disease. Throughout most of human history, calories were scarce and hard to get, and physical activity unavoidable. Calories are now abundant, and physical activity is hard to get. We took an unstable, uncertain food supply and fixed it. What now passes as exercise and requires specialized footwear used to be called "survival." You had to do it. Now you never have to do it. We solved it too well. Now we don't need our muscles for anything.