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.

There's an awful lot about our society that is at odds with the basic message of "don't smoke, be active, eat a healthy diet, and by the way control stress and get enough sleep." We don't make those things easy. We ideally would make health lie along the path of least resistance. But if not the path of least resistance, there at least needs to be a path so you don't have to bushwhack your way there.

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.

I think basic disease care access and basic access to health care is a human right. If we need a constitutional amendment to put it in the Bill of Rights, then that's what we ought to do. Nobody with a conscience would leave the victim of a shark attack to bleed while we figure out whether or not they could pay for care. That tells us that at some level, health care access is a basic human right. Our system should be aligned so that our policies match our morality. Then within that system where everybody has access, we need to incentivize prevention, both for the patient and the provider.

We have literature indicating that overwhelmingly, health is influenced by a very short list of modifiable behaviors topped by three: tobacco use, physical activity and dietary pattern. You could modify those three things; you can change people's fate. I wanted to change those. Smoking cessation, important but relatively simple - a lot of people are working on that. Physical activity: important to me, important to health but also relatively simple. I like nutrition. It's complicated; you really need to learn a lot of stuff to be an expert there.

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."