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 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.

Epidemic obesity is an enormous problem. It's a pendulum that's swung too far. We have to swing it back. So it should come as no surprise that solution must be built from the ground up on the banks of this flooding river and it must be raised to a height higher than flood waters. Now what does that look like? It looks like policies and programs that cultivate healthy levels of physical activity, healthy dietary patterns in homes, in schools, in supermarkets, in neighborhoods, in clinics, in churches, in workplaces, throughout our society, every place we can reach people.

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.

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.

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.

We are facing a flood tide of factors into our daily lives and the lives of our children that conspire against weight control, and for that matter, health, any single policy or program we use to turn the tide is like a single sandbag. You put down the sandbag on the banks of the river. You could ask the question: Have we held back the flood? A sandbag isn't designed to hold back the flood. A sandbag is designed to be part of a levy to hold back the flood. It doesn't matter if it's a good sandbag, maybe a perfectly good sandbag. By itself it can't fix the problem.