Friday, May 21, 2010

Preventing Alzheimer's Disease

According to the Alzheimer's Disease report from the CDC, about 5 million people in the US suffer from Alzheimer's disease. The older you get after age 60, the higher your risk for the disease. And the disease ranks in the top ten causes of death in the United States. While heart disease rates are declining, Alzheimer's disease is increasing.

It is truly an ugly disease that steals family members. I know this first hand, because my grandmother died at a relatively young age from the disease. I recall trying to let her know who I was, as she had no idea and I just remember staring into her eyes, which no longer had her soul in them.

While scientists know that age is one leading risk factor for the disease, along with family history, there is still a lot more to learn with what other factors cause Alzheimer's Disease.

The good news is that according to this study published by the The Journal of American Medicine, individuals who participated in higher physical activity and adhered to a Mediterranean style diet, had a lower risk of Alzheimer's Disease. There have been previous studies conducted, where either a Mediterranean style diet or higher physical activity was associated with a reduced risk for the disease, but no study had reviewed the combined effect on risk factor for the disease with both. The study concluded that for those individuals who didn't adhere to to the healthy Mediterranean diet and did not exercise, their absolute risk for the disease was 19% compared to those individuals who both adhered to the diet and participated in high physical activity whose risk went down to 12%. And according to this study, just adhering to the Mediterranean diet, which consists of a higher consumption of nuts, fish,tomatoes, cruciferous vegetables, fruits, dark and leafy vegetables and reduced consumption of high-fat dairy, red meat and butter could be associated with a reduced risk for Alzheimer's.

I know that this information resonates with me and I am willing to adhere to a better diet and continue my daily routine of regular physical activity. But what about the rest of the country? The diet and lifestyle of Americans needs to change for the better before we can realize a decrease in the new cases of Alzheimer's Disease reported each year. More education and awareness campaigns need to happen to get the word out that a healthy lifestyle and diet are necessities to improved future health.

Saturday, May 15, 2010

Does Subway really deserve all the healthy hype?

I am a long-time follower of the television show, Biggest Loser. I religiously watch my recorded DVR's every week. I find the stories of the people on the show to be very inspiring. Biggest Loser is motivating to be, especially on days when I may not feel like heading to the gym to get my daily workout in. One look at the contestants' struggles and how they are overcoming them pound by pound is enough to get me off of my butt and on the treadmill.

While I find the show to be a positive move towards reducing obesity in the US, I have to say that I am consistently annoyed every week with the explicit marketing plugs that Bob and Jillian shove in the viewer's faces. At least one brand every week gets it's time in the sun, be it Extra chewing gum, Yoplait yogurt or Jenni-O brand turkey. But, the one brand that the contestants are shown eating together almost every week is Subway. Subway has spent some serious marketing dollars to be a HUGE part of the Biggest Loser show every week. Bob and Jillian swear Subway is the perfect choice for a healthy meal. I, however, do not think that is true.

In my opinion, while I think it's good that there is at least one lesser of the evils "fast food" option for people in the market, I don't really think Subway should described and advertised as healthy. I'm sorry, I don't think that a place that claims to be healthy should be allowed to advertise themselves as such, yet still offer soft drinks, potato chips, cookies, meatball subs and Philly cheese steaks to their customers.

Another factor that weighs into the Subway equation is the "health halo" effect. The positive effect of healthy labeling or claims on a product that decreases calories and adds a healthy perception to the product, thus in turn causing the consumer to overeat. This study highlighted here in the New York Times showed that the people in the study who went to Subway actually consumed more calories than those who went to McDonald's, due to the perception that everything at Subway was a healthy option because Subway advertises it's name as such. In fact many of the people added full calorie sodas and cookies onto their purchases at Subway. Another interesting note from Dr. Chandon, who conducted the study, who happens to be French, was that America in general needs to quit obsessing about good foods versus bad foods and focus more on the amount of food that they are eating and practice portion control. I think that is so true. Most people think that a good meal constitutes being stuffed upon completion instead of just feeling satisfied. Maybe if Americans just stopped automatically listening to whatever marketing slogan is thrown their way and actually thought about their food choices more thoroughly, the "health halo" would not be as much of an issue. Better yet, there should be more focus on educating the public about the benefits of forgoing processed foods in favor of those which don't require a nutrition label, such as fruits and vegetables.

Wednesday, May 5, 2010

Not Enough Primary Care Physicians In the US: We Can Blame the Pursuit of the Almighty $

I was not surprised when I read this article highlighting the findings from this Duke University analysis about the large difference in income between a primary care physician and a specialist. Surprise! The specialist makes more money. But, more surprising to me was that the specialist makes about twice as much as the primary care physician over the course of their career in the medical field. According to the US Bureau of Labor Statistics, the annual salary difference between a specialist and a primary care physician exhibited the same disparity. Specialists earn a median annual salary of $339,738 and primary care physicians earn a medial annual salary of $186,044. I knew there was a difference in income, but I had no idea it was that significant.

Money talks and apparently, it is speaking volumes to medical students when they are choosing careers as specialists over careers as primary care physicians in the medical field. This is hindering our chances of reducing the already existing and growing shortage of primary care physicians in the US. Not to mention, the shortage of physicians in rural areas as opposed to urban areas. The US Bureau of Labor and Statistics explains in the occupational outlook handbook that while 75 percent of physician care were in metropolitan areas, only 25 percent were located in rural areas.

My question is what is being done to address this huge and growing concern? Well, according to this article in the Wall Street Journal, there are some actions being taken. For one, the new health care reform bill includes a 10 percent Medicare pay increase for primary care physicians. In addition, more medical schools have opened up around the country and some schools that already exist are raising enrollment totals for first-year students. And one school in Arkansas is working to change the attitude of choosing primary care over specialty, in addition, they are asking students to commit to enter rural medicine practice.

While these are all good steps toward a change, they are very incremental in terms of policy change, just as most of the US government's policies are made. One of my ideas for more significant change includes offering medical students who commit to primary care physician careers before they begin attending medical school either a full waiver or partial waiver of their medical school expenses up front. This could help to eliminate the desire of medical students to go into higher paying specialty careers, simply to eliminate their debt. Another idea would be to offer large discounts or incentives to primary care practice doctors on their liability/malpractice insurance premiums, since this is one of the biggest expenses for physicians. While it is encouraging to see that some small steps are being taken to address this issue, so much more needs to be done.

Saturday, May 1, 2010

A Small Step in the Right Direction

While reading the latest news on the subject of Health Policy, I came across this article in the New York Times. I was happy to see that Congress has approved some great initiatives that are a small step in the right direction for a positive change in the future health of the US.
First, I'm glad to see that the requirement for chain restaurants to post their nutrition information clearly on their menus is now going into affect across the entire country. I was glad when the law was passed in California in 2008 and I'm even happier that there will now be accountability for chain restaurants nationwide. I honestly have no idea why it took this long to happen in the first place! People should have the right to know what is in the food that they are eating in restaurant, just the same as they know the contents of their food when they purchase it at the grocery store. Whether or not a person chooses to look at the information is their choice, but it should be there none the less. Plus, this could have a small affect on obesity, since so many Americans eat out frequently. According to the article, since New York adopted the law, more customers are choosing lower calorie food choices as a result.
I'm also pleased that health insurance companies will now have to provide vaccines, recommended screenings and preventative care without charging the patient a co-pay or deductible. This is a huge win in my opinion. I can only imagine how many lives could be saved by detecting cancers and other diseases early enough to potentially treat them before it's too late.
Lastly, hurray for the new federal trust fund that is in place to create more bike paths, playgrounds, sidewalks and hiking trails! Increasing accessibility to areas that promote more physical activity, such as hiking trails is a way to get people out and exercising more regularly, thus improving overall health.
While I think that these new initiatives are such a good step in the right direction, there is so much more to be done. Some important actions that need to be taken include increasing education about the benefits of nutrition and physical activity in the schools, providing more access to better food, such as farmer's markets in lower-income areas and stricter regulation on fast food and soft drink industry advertisements.