Nutritionist for Logan, Utah

Cache Valley's problem is geography as much as anything. Logan is far enough from the Wasatch Front that specialist appointments mean a canyon drive and half a day gone, which is why so many things here get left. A program that runs by video and text removes the single biggest reason people in this valley put off dealing with something for another year.

The valley also has its own air problem, and it's worse than most residents realize. Cache Valley's bowl-shaped geography traps winter inversions so effectively that it has periodically recorded some of the poorest air quality in the United States — worse, on its bad days, than Salt Lake. That's a genuine seasonal inflammatory load, and it belongs on the list of things we look at rather than in the background.

Beyond that, this is agricultural and university country: farming and dairy schedules that start before dawn, and a student and faculty population on an academic calendar. Both are shift patterns of a sort, and both do the same thing to sleep and blood sugar that any irregular schedule does.