Updated on: November 29, -0001

The Ying and Yang of Ordering Breakfast in the Cafeteria

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Original story posted on: May 22, 2020

I came in very early to visit with a friend who will be going home with Hospice today. It has been a stressful time for the patient and the family. I changed into my COVID costume and as I walked past our ICU break room, I was confronted with the cosmic dietary duality that is gone out of kilter in this age of COVID madness – donuts, lots of donuts. Normally our diets are controlled by balance of ghrelin and leptin – the Yin & Yang of are appetites – which keep our intake of carbs and fats in harmony with veggies and proteins.

There in on the table was evidence of the stress fracturing of the equilibrium ghrelin and leptin. Psychological stress and inadequate sleep drive lab animals and real-life animals – like us – to crave sugars and fats. And there is was, spread out on a table in my hospital and tens of thousands, maybe hundreds of thousands, perhaps even many millions of other tables – the unbalanced but now normal COVID breakfast which will be followed by lunches and dinners equally imbalanced. Perhaps, all the body hiding COVID garbs, all the staying at home, all the grieving for simpler times have dulled our eating instincts. We have all become adherents to the Old Testament admonition in the Book of Ecclesiastes, “Let us eat and drink, for tomorrow we shall die.” 

The fat craving, sugar obsessed Yin of ghrelin is in disequilibrium with the vitamin fiber loving, antioxidant seeking Yang of leptin – in our shelters from COVID we are bingeing on those great ghrelin comfort foods.

I paid my respects to my friend and feeling hungry and stressed I headed for the place I could relieve both – the cafeteria.

There I vowed to follow the better leptin angels of nature and planned to order scrambled eggs – “just eggs” my dietary Yang was whispering. 

“Two orders of scrambled eggs, please,” I said struggling to maintain my dietary harmony.

Then, in an instant, the cosmic dietary forces of ghrelin – this Yin of fats and carbs, this COVID evil spirit – sprang forth from my mouth.

“…and a piece of scrapple!”

Michael A. Salvatore, MD, FACP

Dr. Michael Salvatore was a pulmonary medicine/critical care physician for 35 years. Since 2012 he has been the physician advisor and medical director of the palliative care team at Beebe Healthcare in Delaware. After earning his MD at the University of Arizona, he trained in internal medicine and PULM/CCM at Duke University. Dr. Salvatore is a member of the RACmonitor editorial board.

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