| Issue Number 6 |
Tuesday, May 22, 2001 |
|
Don Hall DrPH, CHES
Chairman Wellsource, Inc.
|
|
|
|
|
Nutrition Information
Weight Management
Food
|
More American Children
Are Overweight
The latest findings
from CDC's National Health and Nutrition Examination Survey show
that more and more children and teens are overweight, continuing
the trend documented for the past 20 years. The percent of overweight
children, ages 6-11, is up from 11-13% since the last survey. The
percent of overweight teens is up from 11-14%. Compared to 20 years
ago, the rate of overweight has more than doubled. This alarming
trend continues to get worse year by year.
Dr. Jeffery
Koplan, director for the Centers for Disease Control and Prevention,
calls this disturbing trend an "epidemic of overweight and obesity
that must be addressed so that they can lead healthier lives."
We need to help our young people develop healthier lifestyle, particularly
better eating habits and more physical activity.
Source:
CDC Press Release, March 12, 2001
|
 |
|
Stress
and Coping
Mental Health
|
Mood
and Overeating
What causes
overweight? Numerous changes in our society contribute to this problem
including the wide availability of high caloric density foods, larger
portion sizes, more highly refined foods (high glycemic index foods),
a low consumption of fruits and vegetables (low caloric density
foods), and reduced levels of physical activity. A newly recognized
cause of obesity in many people is their state of mental health.
In a recent article in JAMA the authors point out that as many as
one in four people who see their doctor about a weight problem are
suffering from a mental health problem, usually depression. In these
people, obesity may be seen as a symptom.
Weight loss
programs often advertise that if you lose weight you will
"feel better." Many overweight people need to start feeling better
(treating the depression) before they can lose weight. Thus a good
weight loss program should include a mental health component along
with nutrition education and increased physical activity.
Source: JAMA
July 19, 2000; 284(3):291-93
Detecting
and Treating Depression
Depression is
a common ailment that is second only to high blood pressure as a
chronic condition encountered in medical practice. Estimates are
that as many as 1 in 10 patients who visit their doctor has major
depression. Most cases, however, go unrecognized or untreated. Depression
affects the whole person and when untreated it leads to functional
impairment physically (contributing to many illnesses), mentally,
and socially.
Depression contributes
significantly to loss of productivity being one of the leading causes
of lost time from work, and is a leading cause of health claims.
A World Health Organization study showed mental health problems
(largely depression) to be a greater cause of lost work time than
physical illness. Depression also contributes significantly to increased
mortality from suicide, drugs, alcoholism, and heart disease.
The good news,
however, is that depression is a treatable illness if appropriate
therapy is provided. Therapy can include antidepressant medication,
regular visits with a psychiatrist or psychologist, or both. There
are often other health problems associated with depression including
heart disease, anxiety, and substance abuse, that respond favorably
from treatment.
Depression is
usually a continuum of illness that varies in severity and duration.
Major depression is defined by depressed mood or loss of interest
in nearly all activities (or both) for at least two weeks, accompanied
by at least 3 or 4 of the following symptoms:
Insomnia
or excessive sleep Feelings
of worthlessness or excessive guilt Fatigue or
loss of energy Diminished
ability to think or concentrate Substantial
change in appetite or weight Increased
agitation or lethargy Recurrent
thoughts of death or suicide
Anyone having
symptoms of depression should see their doctor. The doctor will
first check to see if these symptoms are related to some other disease
or hormonal problem. If not, further assessment for depression should
be made and appropriate treatment prescribed.
Source: The
New England Journal of Medicine, Dec. 28, 2000; 343(26):1942-50
|
|
|
|
Proactive
Health Care
Preventing Disease
|
Diabetes
Rates Rise Six Percent in One Year
Diabetes rates rose
a striking 6% in 1999, the last year for which the CDC has complete
national statistics. Since 1991, the incidence of diabetes has increased
by 57%. This makes diabetes one of our country's fastest growing
health problems. Currently more than 16 million Americans have diabetes.
This results in estimated health care cost for diabetes alone of
$98 billion dollars a year. "This dramatic new evidence signals
the unfolding of an epidemic in the United States," says Dr. Jeffrey
Koplan, director of CDC. "With obesity on the rise, we can expect
diabetes rates to increase sharply as a result. If these dangerous
trends continue at the current rate, the impact on our nation's
health and medical care costs in future years will be overwhelming."
Diabetes
is now the seventh leading cause of death in this country and a
major contributor to several serious health problems including heart
disease, stroke, blindness, high blood pressure, kidney disease
and dialysis, and amputations. Approximately 800,000 new cases are
diagnosed each year and about another 240,000 Americans develop
diabetes but aren't diagnosed.
If
we expect to control this disease, the major effort must be primary
prevention. The good news is that "healthy behavior such as controlling
weight through nutrition and physical activity can help ease the
burden of diabetes and may actually prevent its onset," said Dr.
Frank Vinicor, director of CDC's diabetes program.
Source:
CDC Press Release, Jan. 24, 2001.
What
specifically can we do to prevent diabetes (or help control it)?
Here is a partial list of practical steps to lower your risk:
-
If
overweight, lose weight. Even a loss of 10-15 pounds can
help greatly.
-
Eat
less refined and processed foods. The nurses health study
(80,000 nurses studied for 14+ years) showed that foods rich
in dietary fiber (whole grains, fresh fruits and vegetables,
legumes) protected against developing diabetes. Foods linked
to getting diabetes included soda pop, white bread, white rice,
and French fried potatoes.
-
Get
regular physical activity, 30+ minutes daily. Physical activity
works much like insulin, lowering blood sugar levels, and when
done regularly helps the body be less resistant to insulin (an
underlying problem in causing diabetes). People who already
have diabetes also benefit from exercise but they need to get
specific guidance from their doctors. Some studies show that
diabetics who exercise have half the risk of early mortality
than diabetics who don't exercise.
Cholesterol
Levels and Longevity
Does
it matter what your cholesterol levels are? It does if you want
to live a long, full life. Recently, three large prospective studies
were reviewed, looking at cholesterol levels and their affect on
longevity. The Chicago Heart Association study checked cholesterol
levels in 11,017 younger men, aged 18-39. Then they divided the
men into two groups based on their cholesterol levels. After 22
years of follow-up, those men with cholesterols less than 200 lived
6.1 years longer than those with cholesterol levels of 240 or
higher.
The
next large group, the Peoples Gas Company study, checked cholesterol
levels in 69,205 men aged 35-39. After 34 years of study they
found that those men with cholesterol levels less than 200 lived
8.7 years longer than those with cholesterols of 240 or higher.
The
third group was the MRFIT study on 69,205 men for 16 years. Using
the same cholesterol level criteria, those with lower levels (less
than 200) lived 3.8 years longer than those with high cholesterol
levels (240+).
These
are remarkable differences in increased longevity, 4-9 years of
added life. This is very comparable to the affects of smoking on
longevity. A simple cholesterol blood test remains one of the best
biomarkers or predictors of life expectancy.
The
bottom line. Do you know what your cholesterol level is? If
not, get it checked! If it's over 200, take action immediately to
bring it down. The earlier in life you start, the better your chances
for a long, healthy life. In these same studies, people who had
cholesterol levels around 160 (an ideal level, recommended for anyone
with existing heart disease or diabetes) reduced their risk even
further (cut in half or more compared to men with cholesterol levels
between 160 and 199).
Reference:
JAMA 2000; 284(3):311-318.
|
|
|
|
Physical
Activity
Exercise and Health
|
Exercise Enhances Quality of Sleep
Getting a good
night's sleep is a wonderful blessing which many people never appreciate
until they start having sleep difficulties. Sleep complaints is
one of the most common health difficulties encountered by middle-aged
and older adults. Sleep problems are often associated with depression,
periods of emotional turmoil, irregular schedules, noisy environments,
and other common problems. Older adults take sedative-hypnotic prescriptions
to improve sleep at a rate three time more than other age groups,
and usually on a long-term basis. The side effects can cause confusion,
falls, extended drowsiness, agitation, and potentially harmful interactions
with other medications. These problems underscore the importance
of identifying non drug alternatives for enhancing quality of sleep
among older adults.
Stanford, Emory,
and the University of Oklahoma collaborated on a study looking at
sleep disturbance and physical activity. They recruited 43 people,
aged 50-76 who were in good health but sedentary and bothered by
sleep disturbance. They randomly divided the group into a control
group (no change but reported quality of sleep daily) and a group
that started getting regular, moderate-intensity exercise 30-40
minutes daily. They did primarily low-impact aerobics and walking
at 60-70% of heart rate reserve for a period of 16 weeks. Twice
a week they exercised together in a class. At least 2 other days
per week they exercised on their own.
Both groups
kept records of their quality of sleep including getting to sleep
at night, waking up in the night, number of hours slept, and waking
up refreshed in the morning. After 16 weeks, the exercisers showed
significant improvement in their quality of sleep scores. They cut
the average time to fall asleep in half (11.5 minutes faster per
night), and added 42 minutes of actual sleep per night. The exercisers
also saw a reduction in the number of naps during the day.
The control group saw no significant change.
The researchers
concluded that improvements in sleep among exercisers relative to
controls were noted for:
They also pointed
out that it takes more than 8 weeks of regular activity to begin
seeing improvements in sleep. There were no between group differences
at 8 weeks into the study. The bottom line is, if you are
having difficulty sleeping, and are sedentary, a nice 30-40 minute
walk daily may do wonders to improve your quality of sleep on your
overall well-being.
Reference:
JAMA, Jan. 1, 1997; 277;32-37.
Physical
Activity Trends
CDC
tracks key health practices regularly to see trends in the health
of the nation. In the past 8 years, the level of physical activity
has changed very little. Here is their latest data.
Only 25.4%
of people in the US get the minimum recommended amount of physical
activity (30+ minutes of moderate-intensity activities, 5 or more
days per week). 28.7%
get no physical activity.
|
 |
|
Interesting
Facts
Health Stats
|
Heart
Disease Decline Slows
Heart
disease continues to be our nations leading cause of death. Currently
there are about 12 million people in the US that have coronary heart
disease1. Each year about 1.1 million people will have
a major heart event; 460,000 of these will die from their heart
attack, 220,000 or 1/5 will die suddenly before medical care is
available. This stresses the need for prevention as the major strategy
against heart disease in our nation.
In
past decades heart disease rates have been steadily falling. In
the last few years this trend has been slowing. In the past 10 years
little improvement has occurred in preventive behaviors linked to
heart disease such as adequate physical activity, smoking cessation,
and control of high blood pressure. During the same time the prevalence
of obesity and diabetes has been climbing.
CDC
is attempting to change this trend by funding 25 state-based programs
designed to reduce the first heart attack. They are targeting five
major preventive actions: reducing high blood pressure and high
cholesterol, reducing cigarette smoking, increasing physical activity,
and improving eating habits. They feel these preventive actions
can have the greatest impact on reducing risk.
A
new report on the health of American workers gives further evidence
of this problem. They found heart disease to be the strongest risk
factor for reduced work productivity. Workers under age 55 who have
heart disease are eight times more likely to experience reduced
work productivity -- the ability to do their job -- than those workers
without heart problems. Workers with diabetes are six times more
likely to have work limitations, and workers with arthritis are
four times higher. This report estimates that absenteeism due to
health-related causes will result in a least $65 billion in lost
wages annually.
Other
findings from The Health Status of the United States Workforce2
include:
-
37
million American workers have high cholesterol. 67% of these
are not adequately controlled. 41% of those with high cholesterol
are not even aware they have a problem.
-
18
million workers have high blood pressure. 78% of these are not
adequately controlled. 35% are not aware they have high blood
pressure.
-
8%
of workers aged 18-39 screen positive for major depression but
only 12% of these workers are being treated with antidepressant
medications. 2% of employed men and 5% of employed women have
attempted suicide.
This
report estimates that high cholesterol and high blood pressure is
responsible for 90,000 unnecessary heart attacks in American workers
each year. Smoking is responsible for another 74,000 unnecessary
heart attacks.
Here
are major challenges and opportunities to improve the health and
productivity of our American workforce. Worksite cholesterol and
blood pressure screening and education programs are a major need
that leads to nutrition and fitness interventions.
Screening
for depression is another opportunity to refer people to get adequate
treatment and help. A large worksite health study recently compared
health risks with medical claims and found depression to be the
best risk indicator for high medical claims.
References:
1. JAMA March 14, 2001; 285:1287-88
2. NHANES III Study report, "The Health Status of the U.S. Workforce"
|
|
|
|
Products
Seminars
Wellsource News
 |
The Wellsource Online Wellness Center is Here!
Checked out
the Wellsource Online Wellness Center (OWC) yet? You are invited
to visit, look around, and let us know what you think. Our OWC provides
health, wellness, and disease prevention information, tests and
quizzes, and a chance for you to ask us questions. More than 20
health areas are covered-everything from Asthma Management to Women's
Health. Just click on http://owcwww.wellsource.com/demo/
or copy the URL and paste it into your browser. The Beta site won't
be available for long, so pay us a visit now.
Call us at 1.800.533.9355,
and ask how the Online Wellness Center can work with your current
wellness system.
|
|
|
|
Wellsource Inc.
15431 SE 82nd Dr.
Portland, OR 97015
(503) 656-7446
|
About
Making Healthy Choices
Making
Healthy Choices is written by Don Hall, DrPH, CHES president of
Wellsource Inc. with contribution from associated health professionals.
It is available as a resource to Wellsource
clients and other select organizations involved in promoting health.
Content
is general health information from evidence based research. Its
purpose is not to treat disease but to promote healthy lifestyles.
Persons with health problems should consult their physician for
specific guidance.
Top
|
|
|
|
