September 5th, 2008 by Dr. Val Jones in Uncategorized
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This week yet another study has confirmed that losing weight (and keeping it off) requires more effort than we initially imagined. Apparently, we really do have to “work our butts off” to be fit for life. It seems that half an hour a day is not going to cut it. Obese women in this study had to exercise for at least an hour a day to maintain their weight losses.
One commenter simply said that a better idea would be to not become overweight in the first place. Well, the train has already left that station! Still, parents need to take heed – once a child becomes substantially overweight, he or she is likely to struggle with that weight for a lifetime.
Perhaps it is easiest to intervene at the very earliest stages of our lives. As for me (and the >3000 of us in my weight loss group) it looks like I’ll be trying to get a full hour of exercise in every day! Care to join me?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 27th, 2008 by Dr. Val Jones in Uncategorized
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Recently, the FDA has required that supplement manufacturers accurately identify the ingredients of their products on their labels – though this mandate does not address efficacy or safety claims. Supplement manufacturers may make all sorts of claims about their products, without needing to provide evidence to support them. In fact, supplements may even contain ingredients known to be harmful. The FDA provides a short list here.
Does the FDA’s ingredient disclosure rule protect us (note that some manufacturers have until June, 2010 to comply)? I have a feeling that it is a little bit like keeping people honest with their taxes – the threat of a potential audit is supposed to galvanize citizens into proper documentation of their receipts and business expenditures, but the fact that the IRS doesn’t have the bandwidth to audit more than about 1% of the population (and they usually target those with higher incomes) means that some people “cheat” on their taxes.
The same holds true for supplement manufacturers. They know that they’re supposed to accurately represent the contents of their products on the label and engage in good manufacturing practices – but the chance of the FDA actually performing chemical tests on their product (since there are hundreds of thousands of them out there) is so low that they have no real incentive to comply. Many of them probably feel that they’ll cross that bridge when they come to it. After all, supplements are a $20 billion/year industry.
A new study in the Journal of the American Medical Association reviewed the contents of one small subtype of supplements – traditional Ayurvedic medicines. They found that 1 in 5 samples (of 193 products sold via the Internet at 25 different websites) contained lead, mercury, and/or arsenic. I hope that this sobering statistic will make consumers think twice before reaching for that next “miracle cure.”
The FDA has an excellent (though somewhat dated) review article here. In it, they recommend the following:
To help protect themselves, consumers should:
- Look for ingredients in products with the U.S.P. notation, which indicates the manufacturer followed standards established by the U.S. Pharmacopoeia.
- Realize that the label term “natural” doesn’t guarantee that a product is safe. “Think of poisonous mushrooms,” says Elizabeth Yetley, Ph.D., director of FDA’s Office of Special Nutritionals. “They’re natural.”
- Consider the name of the manufacturer or distributor. Supplements made by a nationally known food and drug manufacturer, for example, have likely been made under tight controls because these companies already have in place manufacturing standards for their other products.
- Write to the supplement manufacturer for more information. Ask the company about the conditions under which its products were made.
Interested in purchasing supplements from companies who voluntarily submit their products to rigorous testing? Try consumerlab.com Their mission is “to identify the best health and nutritional products through independent testing.”
However, in my opinion, very few supplements offer any valuable health benefits (beneficial vitamins and minerals for certain populations include Vitamin D, Calcium, folic acid, and Vitamin B12).
The American Academy of Family Physicians found no evidence to recommend a single weight loss supplement. A healthy diet combined with regular exercise is the most important “supplement” you can take for optimum health.
And one thing I’m sure of – you don’t need any extra arsenic, lead, or mercury in your diet. Be careful what you put in your body!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 26th, 2008 by Dr. Val Jones in Uncategorized
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If you’re trying to lose weight, it helps to have a specific plan. I found this out the hard way. Over the past few months I’ve watched my weight creep up very slowly into my discomfort zone. I resolved to reverse the trend by “trying harder to eat healthy food” and to “walk more.”
Seasoned dieters will point out that these vague resolutions were destined to fail, and unfortunately that’s what’s happened. However, my scale has galvanized me into action and I have prepared a very specific plan of attack. I’m going to walk 10,000 steps per day (based on my pedometer) and I’m going to follow the Atkins Diet.
Some of you may gasp, “But Dr. Val, surely you know that the Atkins Diet isn’t healthy!” Yes, that’s what I thought initially too. However, a quick review of the new Atkins Diet site suggests that it may not be as bad as we make it out to be. The old “all you can eat bacon and cheese” approach is not really what Atkins is about. Instead, it’s a staged approach to cutting down on the refined carbohydrates in our diets. The first stage (which only lasts 2 weeks) is quite strict (only 20 grams of carbs/day) but after that you can begin adding back some of the complex carbs that are important to a balanced diet. Spinach has almost no carbs – so I’m going to give Popeye a run for his money this week!
Here’s what I like about the Atkins Diet: 1) it’s really easy to follow 2) you never have to feel hungry 3) I’m an omnivore, so lean meats are enjoyable to me 4) it addresses my personal dietary issue head on: carb addiction.
What I don’t like so much is this: 1) protein can be quite expensive, so expect your grocery bill to increase on this diet 2) you must not cheat, especially in the induction phase – it will throw off the whole process 3) no more cereal or Nutella – ack!
The Atkins Diet is not for everyone – those who have a history of gout, kidney stones, osteoporosis, or kidney problems may not be good candidates as a high protein diet can trigger gouty and kidney stone attacks and can worsen osteoporosis. Also, vegetarians might find it difficult to get enough protein from carb-less sources. And finally, red meat consumption is associated with colon cancer, so if you’re planning to stay on the Atkins diet for long periods of time, try to limit the red meat intake.
However, research has shown that a very low carb diet is an effective approach to weight-loss (perhaps even more effective than other diets) and has a favorable impact on blood cholesterol, insulin, and glucose levels.
Wish me luck on my new journey – and feel free to join me in my online weight loss group so that we can do this together.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 30th, 2008 by Dr. Val Jones in Health Tips, News
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New research suggests that people who live in “walkable” neighborhoods weigh about 6-10 pounds less than those who live in pedestrian-unfriendly communities. Scientists at the University of Utah calculated the body mass index (BMI) of about half a million Salt Lake county residents from a state drivers license database. They then compared the “pedestrian friendliness” of the zip codes associated with the various BMIs.
They found that people who live in more densely populated zip codes (designed to be more friendly to pedestrians) tended to have lower BMIs. This research has not yet been published, so I can’t comment on the details of the study. However, it makes intuitive sense that walking more can make people lighter on their feet.
The study authors mentioned that city planners used to design communities with pedestrian activities in mind, but since the 1950’s this practice has become less common. Many new housing developments are built around the assumption that vehicles are the main form of transportation, making that a self-fulfilling prophecy.
Earlier this year I participated in an 8 week walking program promoted by the Department of Health and Human Services. At their recommendation, I purchased a pedometer with a goal of achieving 10,000 steps per day. It was an eye-opening experience for me (left to my own devices, I naturally walked about 2000 steps per day – and I don’t own a car). Americans simply don’t get the amount of exercise that they need to be healthy. We are seeing the result of our sedentary lifestyle in our country’s increasing overweight and obesity rates.
All I can say is that I’m struggling along with the rest of us – doing what I can to increase my activity level and walk as much as possible. I’m lucky to live in an area where walking is fun and easy to do. I have the utmost sympathy for those who are striving to become more active against the odds. Why not join my weight loss group and we can commiserate? There are over 2600 people in there, encouraging one another to get fit! Don’t let your zipcode determine your destiny.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 14th, 2008 by Dr. Val Jones in Expert Interviews, Health Policy
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I had the chance to speak with John Rother, Executive Vice President of Policy and Strategy for the AARP about the intersection of online health, information technology (IT), and the baby boomer generation. Find out what America’s most powerful boomer organization thinks about the future of healthcare in this country.
*Listen to the podcast*
Dr. Val: Recent studies suggest that Americans age 50 and older are more Internet savvy than ever before. How are AARP members using the Internet to manage their health?
Rother: People over the age of 50 are the fastest growing set of online users, and healthcare is the major reason why they’re going online. They’re looking for health related news, help with diagnosis, and finding appropriate healthcare providers.
Dr. Val: What role can online community play in encouraging people to engage in healthy lifestyles that may prevent chronic disease?
Rother: Our experience is that online communities can be extremely helpful in several ways. First, it provides emotional support for people who have a shared experience, whether it’s as a caregiver, or being recently diagnosed with a disease or condition. Second, people seem to feel more comfortable asking questions of others with their condition than they do their own physicians. And third, online communities can reinforce needed behavior change. Whether it’s weight loss, exercise, or quitting smoking – online communities can be just as effective in encouraging behavior change as a face-to-face community.
Dr. Val: Tell me a little bit about the communities on the AARP website.
Rother: Currently our communities are organized around medical topics, but in the future I think the communities will become more geographical. An online community designed to serve the needs of people in a given location can facilitate information sharing about how to navigate a particular hospital system, for example, instead of just general information about coping with a disease or condition.
Dr. Val: Intel just announced that it has FDA approval for its “Intel Health Guide.” The unit enables caregivers to provide their patients with more-personalized care at home, while also empowering patients to take a more-active role in their own care. What do you think of this technology?
Rother: I think information technology is going to have all kinds of beneficial applications for people with health challenges. Personal health records and this Intel Health Guide are very well suited to the needs of individuals with chronic health conditions, and I expect to see more Internet based tools developed to help people to make appropriate decisions and change their behavior.
General information is helpful, but personalized information is the key. The more these technologies allow you to have your own individual information at your fingertips and allow that to be the basis for recommendations and decision support, the more powerful it’s going to be. This is all very promising technology – the next question is, can people afford it and will the people who need it be able to use it?
Dr. Val: In your opinion, what role does health IT have in reducing healthcare costs and improving access to care?
Rother: Health IT can support almost every aspect of healthcare. It can decrease costs by reducing duplication. Many people with chronic conditions see different doctors – and if you have to go through the same set of X-rays or CT scans every time you see a different doctor, that can get very expensive. A good, common medical record system is critical in reducing costs and improving care.
IT can also reduce the cost of health insurance, in the way that online car insurance has reduced car insurance premiums. If we reform our health insurance market, this could offer substantial savings to individuals.
People often use the Emergency Department inappropriately – for minor issues instead of true emergencies. A good decision support system that helps people to figure out when they need to go the ER could be helpful in reducing costs.
Dr. Val: What are the AARP’s major health-oriented initiatives?
Rother: The AARP is very focused on healthcare because our members tell us that it’s their top priority. The cost, quality, safety and accessibility of healthcare are important to us, so we are involved in a broad spectrum of initiatives.
First of all, extending coverage to all Americans, regardless of their age or health condition, is a top priority for the AARP. Second, In terms of health quality, it varies quite broadly among hospitals in the US. If we could get everyone to copy the best hospital practices, we’d have a much more manageable problem.
Dr. Val: What needs to happen to America’s healthcare system in order for it to serve the needs of baby boomers on its limited budget?
Rother: We spend almost 2.5 trillion dollars for healthcare in the United States, so I don’t think of it as a limited budget, but quite an expansive budget. There is enough money in the system to fully respond to the needs of the population. It’s just that we’re not organized very well and the system has become fragmented.
The healthcare system needs to be organized in a more person-centered way, and we need it to shift from a focus on acute care to a chronic care model. We need a different system of health delivery – one that relies more on nurses and other physician extenders. People need to join support groups to modify their behaviors and risk factors and rely on IT to help them make appropriate decisions.
So you put that all together and you have a pretty big agenda for change. I don’t know if we can achieve this all at once, or if it will occupy us for several years. The upcoming election gives us the opportunity to do this at the Federal level, though there are many private sector initiatives that are currently making important contributions.
Dr. Val: Can you give me an example of someone in the private sector who’s making an important contribution to improving healthcare?
Rother: The AARP just met with the leadership of the Mayo Clinic, one of the most outstanding medical institutions in the country. They provide excellent care at a cost that is less than most other parts of the healthcare system – and with improved outcomes. We asked them about their secret to success.
Mayo has an electronic medical record and all their patients have their information online. The physicians are on salary, so there’s no incentive to order unnecessary tests or procedures, and Mayo has an ethic of patient-centered care, with a long history of attracting the best people and rewarding them.
If Mayo can do it, why can’t everyone else? The AARP believes that the potential is there for most communities to have excellent care – we must emulate the care delivery of institutions like the Mayo Clinic, and put in place payment and information systems that will coordinate care management better. It’s a big job and will take some investment, but we have many opportunities to do a better job than we’re doing today.
*Listen to the podcast*
*Learn more about preventing chronic disease*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
