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Glucose Metabolism and Coronary Artery Disease
The connection between diabetes and heart disease has been recognized for many years and is now considered a major risk factor for coronary artery disease. New evidence is now accumulating that even moderate increases in glucose levels also increase the risk of atherosclerosis and heart disease.
A recent study looked at 234 men with "normal" glucose tolerance but suspected coronary artery disease. They all under went angiography to assess any stenosis or blockage of their coronary arteries. They found that as HbA1c levels increased (indicating higher average glucose levels) so did the severity of atherosclerosis (more arteries in the heart were plugged). An increase of only 1% in the HbA1c levels showed significantly more atherosclerosis in the arteries. Fasting glucose levels in this group did not show an increased risk, only the HbA1c test which best reflects average glucose levels for the past 3 months.
This means that even if your glucose levels are normal, it is still important to keep average glucose levels low throughout the day. In this study, which included only men with "normal" glucose tolerance determined by an oral glucose tolerance test, those with 3-vessel disease (severe atherosclerosis) had a HbA1c level less of 5.6% (less than 5.0% is recommended). Those with no vessel disease had HbA1c levels of 4.7%. The difference was only 1%.
In the EPIC Norfolk study, also done on men with no diabetes, a 1% increase in HbA1c levels increased the risk of death from cardiovascular disease by nearly half (46%).
Action Steps: What can you do to lower your risk of heart disease based on this new information?
If you are 45 or older, get a HbA1c test from your physician. It should be less than 5.0% for good health. If it is over 5.0%, it means you are at increased risk (even though the lab test says it is "normal"). If overweight, losing 10-15 pounds can help lower blood glucose levels. Get daily aerobic exercise, 30-60 minutes. Some studies show that regular exercise can drop HbA1c levels by as much a 1%. Limit refined and high glycemic index carbohydrates (e.g. white bread, white rice, potatoes, soft drinks, snack foods, sweetened breakfast cereals, sweets). Choose healthy carbohydrates (whole grains, oatmeal, legumes, vegetables, most fresh fruits, soy milk low in sugar). Eat healthy proteins and healthy fats at each meal. Avoid overeating. Large intakes of carbohydrate tend to spike blood sugar levels more than smaller meals.
Reference: Glucose Metabolism and Coronary Heart Disease, JAMA 291:1857-1863, April 21, 2004
Health Care Cost Trends
Health care costs continue to rise at twice the rate of inflation. The total amount spent on health care rose 7.4% in 2003, less than the 9.5% in 2002. Health care spending is down last year for several reasons. Patients used doctors, drugs, and hospitals less than the previous year, possibly because insured workers are now paying larger deductibles and co-payments.
Average health insurance premiums increased for employers at the rate of 12% in 2004, down from the 2003 rate of 15%. This is the first year premiums have gone down since 1996. According to a survey of health insurers for 2005, health plans say they intend to raise prices an average of 13.7% but analysts say this may be reduced closer to 10% by the year's end.
What can we do to keep health care costs down?
As you might expect from this newsletter, choosing a healthier lifestyle can cut costs significantly (see following story of one company who started a wellness program). -
The trend to shift a greater portion of the health care expense in deductibles and co-pays to patients may encourage people to be more interested in their health.
As health leaders in our communities we can help people know how to live more healthfully and prevent serious illness. Health fairs, health classes such as the Eight Weeks to Wellness, web based educational initiatives as featured in our web links, and other community wellness programs can make a difference. The bottom line is that health is a personal responsibility. It will only be solved as we all take responsibility in our own lives, in our homes, in our work places, in our churches, and in our communities to promote healthy living, make it a priority, and teach by example.
Source: Health care spending rises at slower rate, USA Today, June 9, 2004
Worksite Wellness - Cutting Healthcare Costs
St. John Health initiated a wellness program for it's hospital employees to help curb health care expenses. After doing a health assessment on 435 of its employees to identify health needs, it focused on six of the most common health concerns identified:
During the year, employees were encouraged to work on specific health needs. Their goal was to help employees manage these key health risks before they became full-blown, costly diseases.
By the end of the first year they saw these kinds of changes in their pilot group:
These healthier lifestyles translated into over $200,000 cost saving in the first year according to Darlene Ephraim, corporate director of St. John Health Occupational Health Partners. Their goal next year is to include more of their 15,000 employees in the program.
They also compiled statistics from 13 other companies who also have comprehensive wellness programs in place for at least 3 years. Their wellness programs reduced health care costs an average of $3.72 for each dollar invested. In addition they saved another $5.06 in reduced absenteeism cost for each dollar invested in the program.
The St. John Health Care wellness program cost about $150 per enrollee for a comprehensive assessment and wellness program for the whole year. Not all companies may want to spend that much to start with but they can start and grow into a larger program. When the program saves money, it really isn't an expense but an investment in the lives and productivity of their employees.
St. John Health conducted a survey among other corporate executives to see what they were thinking. Here is what they found:
76% of the company executives agreed that it is the responsibility of the employer to promote wellness and healthy living to its employees -
74% of the companies surveyed had already adopted a formal wellness program to some degree
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45% of the executives with employee wellness programs indicated that they have observed an increase in productivity as a result of their program
58% of executives who did not have an employee wellness program think their companies should adopt one
A proactive wellness program identifies health risk factors and helps workers manage them before they become more costly and devastating to the person's health. This is an effective way to reduce health care costs, improve productivity, and enhance quality of health enjoyed by a company's employees.
Source: Kim Norris, Preventive Care: Wellness Program Works at St. John, Detroit Free Press, June 8, 2004
Exercise More Important in Bone Health than Calcium
A 10 year study of young women (12-22) called the Penn State Young Women's Health Study looked at the contribution of dietary calcium and physical activity in developing strong bones. Researchers collected dietary calcium intake data yearly as well as physical activity records. They found only a small positive association between calcium intake and bone health (not reaching statistical significance) but a strong significant relationship between physical activity and bone health. They concluded:
"Overall, data from the Penn State Yong Women's Health Study indicates that daily calcium intake greater than 500 mg/day during adolescence does not result in clinically appreciable increased body bone accrual or increased adult bone mass." "Our study suggests that exercise is really the predominant lifestyle determinant of bone strength in young women."
It is still important for young women to get adequate calcium, as least two servings of high calcium foods daily, but just taking calcium, without the exercise, if of little value, it appears, for strong bones. It's vital for young women to be active, especially in the years between 13-15 (the most important years for building bone mass in women) to insure healthy, strong bones for a lifetime.
Source: Role of calcium in bone building less than exercise, Journal of Pediatrics, June 2004
B Vitamins and Memory
B vitamins, especially B12, folate, and B6 (pyridoxine) are crucial for normal brain function. A Swedish study tested the memories of 167 older people free of dementia or depression but who were at greater risk for Alzheimer's disease. On the morning they tested memory they also drew blood and tested for B vitamins. The people who had normal levels of vitamin B12 did better on their memory tests than those with lower levels of B12. Folate also seemed to help memory but not as much as B12.
Getting adequate vitamin B12 may help the brain stay healthy and help you retain your memory as you get older. Milk is a good source of B12. Persons who don't eat dairy or meat may be low in B12 levels unless they are taking a supplement. As a person get older, B12 is not absorbed as well, so a lack of B12 is common even in non-vegetarians. The Institute of Medicine recommends persons over 50 get most of their B12 from fortified foods or a supplement because they are better absorbed. Be sure you get plenty of B12 daily. Good sources of folate include green leafy vegetables, legumes (especially lentils), oranges, and food yeast (add to tofu, soups, roasts).
Reference: HealthNews June 2004 (written by the editors of New England Journal of Medicine)
Family History - A Major Risk Factor for Cardiovascular Disease
If you had a parent who died early from heart disease are you at increased risk? Is this because you inherited high cholesterol or some other risk or is it an independent risk factor? These are questions that have been unclear in the past. Data from the Framingham Heart Study offspring sheds light on the importance of family history in predicting risk of heart attack. The study included 2302 men and women, children (now middle-aged) of the famous Framingham heart study.
Here is what they found. Men whose fathers died prematurely (before age 55) from cardiovascular disease (CVD) were 2.2 times more likely to develop cardiovascular disease as well. If both parents died early from CVD (mothers before age 65) the risk increased to 2.4 times. This increased risk was independent of other major risks including age, cholesterol levels, blood pressure, body mass index, diabetes, and smoking.
Women who had a family history of early CVD were also at increased risk; 1.7 times higher for one parent, and 2.8 times more likely to have a heart attack or stroke if both parents died early. These are large increases in risk and the increased risk is independent of other risk factors. If you have a family history of CVD be sure to take preventive steps to lower all of your other risks: avoid smoking, get weight in a healthy range, eat well to keep blood pressure and cholesterol levels low, and get regular physical activity. Family history is an important risk indicator.
Reference:Parental Cardiovascular Disease and Offspring Risk, JAMA 291:2204-2211, May 12, 2004
Stress, Sleep Loss, and Depression
What causes depression? This is a good question. We know factors that contribute to depression, but the causes are not fully understood. The University of Michigan's Mental Health Research Institute is studying college students and depression. Here are some of the factors they are finding that contribute to the likelihood of developing depression.
Stress is certainly a contributor. Social stress, the stress of staying up late, an irregular lifestyle, the pressures of studying and worrying about getting good grades all contribute to the stress load. Excessive stress can lead to anxiety, poor sleep, alcohol and other drugs. Then the stress cycle deepens. Drinking and drug use. Many students experiment with drugs and alcohol. When used at a young age, drugs and alcohol can have profound effects on the brain. These substances make the individual feel good (for the moment) and often become addictive. Drugs release dopamine in the brain's pleasure center, as do other pleasurable experiences. For example, the pleasure of delectable foods boosts dopamine release by 50%. Sex doubles the dopamine released. But the effect on the brain of these natural pleasures is small compared to illegal drugs. Cocaine increases dopamine release by 4-5 times, and amphetamines provide a 10 fold boost in dopamine! You can see how these drugs when used often can fry the brain. Depression usually follows these extreme "highs". Lack of sleep also contributes to depression. Studies show that up to 40% of adults suffer from lack of sleep. Up to 71% of college students report sleep complaints. Lack of sleep fosters a lack of coherence in brain waves which often precedes depression. Staying up late and sleeping during the day also interferes with getting adequate sunlight and this also upsets the body's natural rhythms.
If you want to prevent depression, here are some common sense suggestions.
Keep your life balanced with adequate rest daily. Try to keep some semblance of regularity in your life. -
Keep stress within limits. Don't sacrifice your health by pushing yourself to the limit.
Be active in the sunlight daily when you can. Both sunlight and exercise help the brain to function better. Stay away from alcohol and drugs. They can cause real havoc in a student's life. Take time to eat well. Have at least one warm meal daily. Take time for some simple, natural pleasures daily. Fun social activities, sports, taking a little time for yourself can keep a busy life balanced and is healing to a busy mind.
Source: Stress, sleep loss, and substance abuse create potent recipe for college depression, JAMA 291:2177-79, May 12, 2004
More on Low Carb Diets
Two new studies appeared in the Annals of Internal Medicine this last month (May 18, 2004). The first study was for 6 months. One group followed a low fat/calorie diet, the other a low carbohydrate diet. Those on the low carb diet lost the most weight in 6 months.
The second study lasted for 1 year. The low carb dieters lost the most in the first 6 months again, but by one year there was no significant difference between the two groups. Those on the low carb diet ate 300-400 calories less per day than those on the traditional diet plan. This explained why they lost weight the fastest.
The authors conclude the review of these two studies by saying, "Never-the-less, every diet should emphasize physical activity and healthy sources of proteins, fat, and carbohydrates, such as poultry, fish, nuts, legumes, and vegetables".
Source: More on Low-Carb Diets, HealthNews, July, 2004
Role of Irradiation in Food Safety
Each year in the United States 76 million cases of foodborne illness occur resulting in 325,000 hospitalizations and over 5,000 deaths. This is caused by contamination of food with pathogens, primarily from fecal contamination in poultry and meat, and improper handling, storage, preparation, and cooking of these contaminated foods.
For example, currently only about 0.32% (1/3 of 1 percent) of ground beef is contaminated with E. coli 0157:H7, the strain that causes serious illness if the meat is not cooked properly. However, because the nation eats so much ground beef, about 8 billion pounds annually, some 25.6 million pounds of beef is sold annually that is contaminated with E. coli (it's not possible to eliminate all contamination). This contributes to the 5000 plus deaths annually from contaminated food.
This problem could be largely prevented by irradiating the beef before it goes to market. Many people are afraid of eating irradiated beef or poultry because they don't understand the process. The Centers for Disease Control and Prevention (CDC) estimate that some 900,000 cases of foodborne illness would be prevented if only 50% of the nation's meats were irradiated. This would save about 350 lives yearly (about the same number of soldiers that are dying yearly in Iraq (about 700 soldiers died in the last 2 years).
Here are some facts about irradiated food:
Irradiating food kills pathogenic bacteria but does not make the food radioactive in any way -
Irradiation does not lower the nutritional value appreciably, any more than moderate cooking or other food preservation methods would.
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Animal and human studies have been done for years looking at eating irradiated food and the possible development of any health problems. None occur.
The military and astronauts have been eating irradiated food for many years with no health consequences other than less foodborne illness. Irradiation has minimal change on texture or taste of food. -
Irradiating high risk foods for contamination (meat and poultry) could save hundreds of thousands of cases of illness each year.
Irradiation of foods is endorsed by the US Department of Health and Humane Services, the FDA, CDC, American Dietetic Association, AMA, World Health Organization, and many other government and scientific organizations.
If we want to decrease the large number of illnesses and deaths from food-borne illness, irradiation of food is an available and economic means of doing so. Health organizations are encouraging this technology to save lives. Whether it happens or not is dependant upon the public's reaction. You should look at irradiation of meats as a life saving process similar to the pasteurization of raw milk initiated in the 1940s that has saved many lives from raw milk borne pathogens. Don't be afraid of irradiated foods. Be afraid of the real threat; foodborne illness caused by contaminated foods.
Source: The role of irradiation in food safety, The New England Journal of Medicine, 350:1898-1901, April 29, 2004
Changes in the US Diet and Risk of Type 2 Diabetes
From 1935 to 1966 the prevalence of diagnosed diabetes increased by 8.6 times. It's now estimated that about 50 million people in the U.S. have metabolic syndrome, a condition linked to high risk for developing both diabetes and heart disease. Obesity increased 57% in just the last 10 years. Currently, 2 out of 3 American adults are overweight. What has caused this remarkable change in such a short time period?
An article in the May issue of American Journal of Clinical Nutrition looks at changes in the diet over the past 100 years and has come up with some interesting observations.
Dietary carbohydrate intake decreased steadily in America from 1909 to 1963 (from 500 g/day to 374 g/day), primarily from a decrease in consumption of whole grains. -
Simultaneously, dietary fiber decreased at even a greater rate -- by nearly 40%
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Since 1963, the intake of carbohydrate increased again back up to the 500 grams per day, but dietary fiber has continued to fall. This means that the increase in carbohydrates was from refined sources such as sugars, white bread, snack foods, etc.
During this time total fat increased nearly 30%, protein increased 8%, and total calories increased by 9%. Significant correlations with type 2 diabetes were found during these years with the increased intake of fat, the decrease in fiber, an increased consumption of corn syrup, and the total increase in energy. When all of these factors were adjusted in multivariate analysis to see which factors were most likely the causative agent, only two factors remained significant predictors of increased risk of type 2 diabetes: a positive link to corn syrup intake and a negative association with dietary fiber. Dietary fat and protein showed no association in this model. From 1980 to 1997, total energy intake increased nearly 500 cal/day. Most of this increase (428 calories or over 80%) came from an increase in highly refined carbohydrates. A switch to corn syrup for sweeteners was a major change during these years. Currently, more than 20% of all carbohydrate intake comes from corn syrup sweetener which now surpasses sucrose as the leading sweetener in the US food supply (56% of all sweeteners). High fructose corn syrup is the primary sweetener used in ice cream, soft drinks, and in most "light" foods.
The authors conclude with these thoughts regarding the American diet:
Our analysis shows that during the past century and especially the last 20 years, the American diet has undergone a dramatic change. The increased intake of refined carbohydrate increases the risk of obesity, glucose intolerance, high blood fat levels, and type 2 diabetes. The rapid increase in type 2 diabetes in the US may likely be linked to the rapid increase in the intake of refined carbohydrates. Type 2 diabetes may be reduced by replacing refined carbohydrates (sweeteners, white bread and white flour products, white rice, pastry, sweets, snack foods) with low glycemic index carbohydrates, whole grains, and other high fiber foods (whole wheat bread, oatmeal, vegetables, most fresh fruits, legumes, soy, soy milk, nuts, etc.).
Source: Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the US, American Journal of Clinical Nutrition, 79:774-9, May 2004
Reverse Cholesterol Transport
Atherosclerosis, the accumulation of cholesterol in the arteries clogging the circulation and resulting in heart attacks and strokes, is the leading cause of death in the US and most other countries in the World. Prevention and treatment efforts have centered primarily on slowing down this process by lowering LDL cholesterol, the main lipoprotein causing accumulation of cholesterol in the arteries. Lowering LDL cholesterol is accomplished primarily by reducing saturated fat and cholesterol in the diet, keeping blood pressure down, avoiding smoking, keeping blood sugar levels under control, and losing excess weight. All of these methods slow the development of atherosclerosis by slowing the accumulation of cholesterol in the arteries.
Another strategy for preventing heart disease and stroke is to clear out the clogged arteries, restoring circulation. This might be called reverse cholesterol transport, opening up the arteries. This process is accomplished by the high density lipoproteins (HDL) in the blood. The HDL particles facilitate a reverse cholesterol transport pathway. They remove excess cholesterol from the artery wall macrophages and transport it to the liver where it is excreted in the form of bile salts (such as cholic acid) and cholesterol. This pathway is the only way to get rid of excess cholesterol from the body.
HDL also decreases atherosclerosis by protecting LDL cholesterol from becoming oxidized. Oxidized cholesterol is much more likely to be deposited in the artery walls than non-oxidized cholesterol. Research shows that if you increase HDL cholesterol in your blood by only 1 mg/dL, the risk for cardiovascular disease decreases by 2-3%.
In the April issue of the New England Journal of Medicine, Tufts University and others have been researching ways to raise HDL cholesterol levels with the hope they can reverse atherosclerosis, cleaning up plugged arteries. They reported exciting news of a new medication called Torcetrapib that raised HDL levels in test subjects from an average of 29 to 47 mg/dL (up 61%) in one group, and if taken twice daily from 34 to 70 mg/dL (up 106%) in another group. These are amazing increases and may prove revolutionary in treating cardiovascular disease. The next step in research is to actually demonstrate by clinical trials that taking this new drug will actually decrease heart attacks and strokes.
Meanwhile, you can still use this new strategy of raising HDL cholesterol and increasing reverse transport of cholesterol out of the arteries by making certain lifestyle changes. Research shows that the following changes help raise HDL levels:
Losing excess body weight, especially intra-abdominal fat. A 10-15 pound weight loss can help improve HDL levels considerably. Getting regular aerobic physical activity, 30-60 minutes daily. Fitness research shows that you need to get at least the equivalent of 12-15 aerobic miles of activity to get good improvements in HDL levels. Higher levels of activity increase HDL levels even further. For example, a friend of mine is a world class runner currently training for the Olympics in Athens. I tested his blood recently and from all of his running and lean weight his HDL levels are even higher than his LDL levels. It's considered healthy if your HDL levels are 1/4 of your total cholesterol level. His ratio is more than 1 to 1. His reverse transport system is so high it is essentially impossible for him to have any excess cholesterol in his arteries. Avoid a high carbohydrate intake, especially refined carbohydrates, and eat more calories from healthy fats and healthy proteins. A low fat, high carbohydrate diet will always suppress HDL levels. Healthy fats (nuts, nut butters, olives or olive oil, and other pure unhydrogenated vegetable oils) when used regularly help keep HDL levels high. The newest guidelines by NCEP recommend up to 35% of calories from fat is OK if they are healthy fats. Avoid all trans fats. Hydrogenated fats such as hard stick margarine, shortening, and deep fried foods, lower HDL levels. Foods commonly high in trans fats include most baked goodies (pastry, doughnuts, cookies, cake, pie crust) chips, French fries and other deep fried foods, most margarines, and most packaged foods such as microwave popcorn or packaged noodle or rice dishes. You can make your own cookies using unhydrogenated vegetable oils and eliminate the trans fat.
If you follow these guidelines, your HDL levels will increase and so will your reverse cholesterol transport. When the cholesterol and bile salts are excreted into the gut you need to know that most of them will be absorbed again and recycled unless you also have a high intake of fiber, especially water soluble fiber. The NCEP guidelines recommend 10-25 g of soluble fiber daily for best results in trapping this cholesterol and excreting it from the body. The best sources of soluble fiber include: oats and oat bran, peas, beans, lentils, and other legumes, fresh fruits, vegetables, and the richest source known is psyllium seed. Lowering your intake of refined carbohydrates and increasing the intake of high fiber foods can be just as effective in reducing cholesterol as decreasing saturated fat and cholesterol in the diet.
Now you have two major strategies for protecting the arteries. First, reduce cholesterol levels to decrease accumulation of cholesterol in the arteries. And second, increasing HDL levels to promote reverse cholesterol transport, to clean out the arteries.
Source: Increasing HDL Cholesterol Levels, New England Journal of Medicine 350:1491-1494, April 8, 2004
Cancer Prevention Needs more Emphasis
The cost of cancer is staggering. Last year the US bill for medical costs and lost work totaled $190 billion. While many other diseases have been dropping, there hasn't been much change in most cancers, and some are still increasing. In a recent report some feel cancer may become the leading cause of death in the next 10 years. Because of the great cost and the great potential for prevention, many cancer centers are shifting budgets to give greater emphasis on prevention.
One-third of cancers are caused by smoking. Another third are caused by poor nutrition. Physical inactivity, heavy drinking, and obesity are other modifiable causes. "The best possible way to deal with cancer is not to have it in the first place, so prevention makes great sense," says Dr Robert Young in a recent interview. Dr Young is a past president of the American Cancer Society.
The World Health Organization recently made the following recommendations for preventing cancer:
Maintain a healthy weight (overweight is responsible for as much as 15-20% of cancers) -
Perform physical activity on most days of the week; 60 minutes per day of moderate-intensity activity such as walking. Fast walking and other vigorous activities may give further benefits for cancer prevention.
Consumption of alcoholic beverages is not recommended; if consumed, do not exceed two drinks per day. Overall consumption of salt-preserved foods and salt should be moderate. Have a diet which includes at least 400 g per day of total fruits and vegetables (5-9 servings). Those who are not vegetarian are advised to moderate consumption of preserved meats (e.g. sausages, salami, bacon, ham) Do not consume foods or drinks when they are at a very hot temperature.
WHO, "Cancer Prevention Recommendations", Diet, Nutrition and the Prevention of Chronic Disease, 2003.
QuickFacts Important health facts you need to know and share.
 New risk factor for fractures. High homocysteine levels increase the risk for heart disease. New studies show that high homocysteine levels also increase the risk for bone fractures, doubling the risk for women and increasing risk 4-fold in men. To keep homocysteine levels low, be sure you get adequate levels of vitamin B12 and folic acid. HealthNews, July 2004
Diabetes linked to Alzheimer's disease. Here is another reason to keep your weight down and your exercise up. Based on a 5.5 year study of 823 older persons, those who develop diabetes had a 65% increased risk of getting Alzheimer's disease. This risk remained even after adjusting for age, gender, education level, and stroke. HealthNews, July 2004
Automobile safety. This year over 50 million people will be injured in motor vehicle accidents world wide, 1.2 million will die. This is a high price to pay for transportation. Automobile safety is a world wide problem that is getting worse. We can all improve safety by driving sober (this could eliminate 40% of all motor vehicle deaths or 16,650 lives per year in the U.S.), driving defensively (allow a margin of safety), driving with courtesy, and buckling up. It is a matter of personal responsibility. JAMA June 2, 2004
Heart disease rising in developing nations. World health experts are seeing an alarming rise in heart disease in developing countries. Deaths from heart disease are expected to more than double (increase 137% for men and 120% for women) in the next 20 years. Now is a window of opportunity to help people in developing countries take preventive steps by adopting healthier lifestyles such as not smoking, not overeating, getting more exercise, and controlling high blood pressure and high cholesterol levels. JAMA June 2, 2004
Fitness reduces healthcare costs. General Motors offered a wellness program for 23,500 of their employees. They found that employees who had a regular exercise program had lower healthcare costs of $250 per year compared to employees who did not exercise regularly. Obese and sedentary workers cost $800 more per year. If obese, sedentary workers would exercise regularly, GM estimated a savings of $400-500 per worker per year, even when they didn't lose weight. Amer College of Occupational & Environmental Med., News Release, May 2004
Hand washing saves lives. In countries where diarrhea is a leading cause of child death, instruction in hand washing with plain soap saves lives. A study in a poor section of Karachi Pakistan taught households with small children the importance of washing hands with soap after using the bathroom, before fixing meals, and before eating. Within one year the study communities reduced the incidence of diarrhea by 53% compared to control communities that made no change. Washing hands makes a difference! JAMA June 2, 2004
Good nutrition slows the development of AIDS. A 1078 pregnant women in Tanzania infected with HIV were assigned to receive vitamin supplements or a placebo to see if it would make a difference in outcomes. After 6 years of follow up, those women taking the vitamins had a 29% lower rate of progression on to AIDS and a 27% lower death rate compared to those taking the placebo. Multivitamins assist the body's immune system and delay the development of HIV disease. This is a low-cost means of treating HIV positive women in poor African countries and delaying the more costly antiretroviral therapy. N Eng J Med, July1, 2004
Taking estrogen may increase risk of dementia. More data from the Women's Health Initiative study shows that women who take estrogen therapy are at increased risk of developing dementia. At one time doctors thought estrogen would help prevent cognitive decline but careful studies now show the opposite. The researchers concluded, "These studies further support last year's recommendations that menopausal hormone therapy should not be used to prevent cognitive decline or dementia in older postmenopausal women". NIH News release June 22, 2004
Smokers who quit early in life regain health. Studies at Duke University show that smokers who quit smoking by age 35 and who stay stopped have a life span nearly the same as non-smokers. It takes about 15 years after stopping to reverse most of the risks, but then, ex-smokers can expect health as good as non-smokers. This is good news for smokers! The sooner you stop, the less irreversible damage occurs to your body. Health Services Research, June 2004
High intake of vitamin C in supplements may increase knee osteoarthritis. Animal experiments at Duke University indicate that high intakes of vitamin C may increase osteoarthritis of the knee. Experiments were made using guinea pigs which develop knee arthritis similar to humans. They were given low, medium, and high doses of vitamin C in supplements for 8 months and then studied their knees for osteoarthritis. Those receiving the low and medium dose saw no problems, but those receiving the high dose of vitamin C (equivalent in humans to 1500 to 2500 mg/day) developed more cartilage damage of the knee, bone spurs, and greater severity of the disease. Getting enough vitamin C is important, large doses may be damaging to the heath. Arthritis and Rheumatism, June 2004
A high intake of fruits and vegetables reduces stroke risk. Data continues to show that fruits and vegetables are protective against strokes. New results from the Physicians' Health Study showed that men with the lowest (bottom 20%) blood levels of carotenoids (carotene, lycopene etc.), a marker for intake of colorful fruits and vegetables, had a 40% increased risk of ischemic stroke compared to all other men in the study. Eating brightly colored vegetables and fruits, at least 5 or more servings daily, is good preventive medicine for avoiding a stroke. Stroke, June 2004
Fruits help prevent eye disease. Fresh fruits are also good for the eyes. New data from the Nurses Health Study and Health Professionals follow-up Study (12-18 year study of over 100,000 people) found that those who ate at least 3 servings of fruit daily had a 36% decreased risk of a degenerative eye disease called age related macular degeneration, the leading cause of blindness in people over 65. This impairment affects over 25-35 million people in the world. For good eye health, and good eating, aim for 3 or more servings of fresh fruits daily. Archives of Ophthalmology, June 2004
Alcohol abuse increases in the US. A survey by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) shows an increase in abuse of alcohol over the past ten years. Rates have increased from 13.8 million people in 1992 to 17.6 million people in 2002. Alcohol abuse rates are highest among young adults. The NIAAA defines alcohol abuse as, "a condition that is characterized by failure to fulfill major role obligation at work, school, or home, interpersonal social and legal problems, and/or drinking in hazardous situations."
NIH, NIAAA, Alcohol Abuse Increases, News Release, June 10, 2004
Power Point Slides
The following slides are taken from studies reviewed in this newsletter and are available to view and download for your use in presenting health information in your local health promotion programs. Do not copy slides to distribute to other people.
You can download these slides and use them in your health presentations.
- Weight, fitness, and health care costs - Data from the GM study
- HbA1c and coronary heart disease - HBA1c is a blood test you can take that predicts heart risk as well as blood sugar levels
- Low carb diets - Research is finally being published. Here are results from two different studies, one 6 month and the other 1 year
- Diabetes and Alzheimer's disease - Diabetes is a risk factor for AD
Featured Health Links
Alcohol and Health, Special Report to the Congress. A 24-page pdf on the effects of drinking on health.
Surgeon General Calls on Americans to Face Facts about Drinking. A recent news release by NIAAA that briefly covers the health concerns of alcohol facing our nation today.
American Indian Health. A new web site for information dealing with native American health. An excellent resource for native Americans and those working with native Americans.
The Health Consequences of Smoking. A new report by the Surgeon General. Read about the latest information on smoking and health. Review the executive summary for a quick overview. Explore the interactive animation of the health consequences of smoking on the body. It's a fun learning experience, especially for teens.
Diabetes and Cardiovascular Disease Toolkit. A series of 24 downloadable PDFs you can copy and hand to your patients/friends with diabetes. Excellent materials.
Taking Steps to Lower the Risk of Getting Diabetes. A 17-page pdf prepared by the government to help people take steps to prevent diabetes. Good for someone who is high risk or who has prediabetes.
Healthy Recipes
Looking for something new and good to eat? Here are a few ideas for you to try that are tasty and good for you!
New Food Pyramid & Healthy Eating Guidelines
The current food guide pyramid published by the USDA has been heavily criticized as being inadequate. Dr. Walter Willett, head of Harvard's Department of Nutrition, is lobbying for a new pyramid that emphasizes healthy fats, nuts, legumes, whole grains, physical activity, and weight control. He published such a guide in the December issue of the Scientific American in 2002.
Wellsource has taken this new food pyramid and adapted it slightly by adding information from the Department of Health and Human Services and the National Institutes of Health's DASH Diet to lower blood pressure and prevent cardiovascular disease. Until we get a new government food guide pyramid, Wellsource has adopted this
Posters of the New Food Pyramid are available in 8.5 X 11 and 11 X 17 inch poster size. 
Healthy Eating Guidelines, Tri-fold brochure
A PDF copy is downloadable if you would like to review it. Put it on your refrigerator as a reminder and guide to making healthy eating choices. Here are the major new features in this pyramid that are improvements over the old:
Emphasis on daily exercise and weight control Fruits and vegetables are near the foundation (DASH diet recommends 8-10 servings daily Emphasis on whole grain breads and cereals Emphasis on choosing healthy fats (vegetable oils) and olives, avocado, trans fat free margarines etc. as part of a good diet (Mediterranean diet concept) Emphasis on eating more legumes (vegetable proteins and high in soluble fiber) Eating nuts daily (linked to less heart disease, a healthy fat) Choosing lower saturated fat protein foods such as tofu, fish, skinless poultry, and vegetable protein foods in place of red meats Using low fat milk and yogurt, or calcium fortified soy milk in place of high fat dairy Limiting intake of red meat and butter, if eaten at all Limiting high glycemic foods such as soda pop, French fried potatoes, and highly refined foods including baked goods high in trans-fatty acids
A new tri-fold brochure entitled "Healthy Eating Guidelines" is available for use in nutrition, weight control, and wellness education programs. It includes:
These materials can be used for National Nutrition Month and every other month in your organization. They are available and ready to order. Ask your Wellsource sales representative for a sample 1-800-533-9355, or e-mail well@wellsource.com. |
