Thursday, May 29, 2008

Wellness Weekly

Many times in the past I have started out by saying, this one will be brief... and ending with anything but brevity. This week will be different. So, thoughts in brief:

Labeling: There is open commenting at the FDA for the next 90 days or so regarding possible drug labeling changes on medication risks to children of pregnant or breast feeding mothers. At this time, most drugs, including OTC meds, are classified as A thru D and an X. I do not recall what they all mean, though in my profession the issue does come up. For example, some have been found to be safe, some have been found to not cause harm, some were tested in animals and some were not tested at all. ETC. Sometimes the drugs are combined in a category so one doesn't know which of the classifications applied. This system is being changed so that the person taking the medicine might know the science behind its determination as safe or not safe. What I found hard to believe when reading about this is that drug makers are not mandated to change a label when a drug becomes SAFER, only when a new adverse event or risk is determined. The article in USA Today indicated that there was not much incentive for companies to change the label as it was a costly process. OK, but all I am saying is if the researchers finally deem Chantix as safe there is NO WAY Pfizer isn't going to change their label, that is all I am saying.....

Speaking of Chantix: If you would like to read someone else's opinion on the medication and a sound explanation as to why the drug may not be as bad as some say, check out the blog of Dr. Jonathon Foulds, at Healthline.

More Smoking Semantics: Okay here is a good one. GlaxoSmithKline which makes several nicotine replacement products put out a little press release in preparation for World No Tobacco Day on May 31st. They promote cessation by stating that children of parents who do not smoke or who have quit are less likely to become smokers themselves. Quitting smoking is hard and the NRT can help. They do report that research shows these products as being helpful and that is true. But never before in lecture or print have I heard of Nicotine Replacement Therapy being called, Therapeutic Nicotine Products. GSK must be taking euphemism lessons from the government.

Obesity: Back to my favorite subject, the prevention of obesity that is. A report out from CDC researchers (who reviewed NHANES data) implies that the increase in childhood obesity is stagnant. In other words it may be as high as it is going to go. Good news? Hardly, that stagnant rate is a startling , incredibly whopping 32 percent , excuse me, the rate is of overweight and obese combined, none the less, that is in the population of 2 - 19 years of age and by actual measurement not telephone survey.

What is a Healthy Snack? I respect that Kraft continues to try to offer healthier snack foods to us and that they are now reformulating their Kool Aid, but what is healthy? Low calorie is good, but if it is still empty calories I wonder what the benefit of eating it is. And if it is non nutritive and they add vitamins is that the same thing as healthy? I think not. Those Special K bars, nothing. The Quaker Oats bars, pretty much nothing. Low calorie but low protein and fiber as well. Guess I should stick with hummus and lighter cheeses.

See I am brief today

Wellness can be yours! Take the adult fitness test. I did! I scored at or above the 80th percentile for my age and gender, it is true. My sister was my test assistant!

Friday, May 23, 2008

Wellness Weekly

Angioplasty: Angioplasty is the procedure used by cardiologists to unblock a clogged artery. It is almost always an emergency procedure and not getting to an ER or OR in a timely fashion can be fatal. According to a Reuters article by G. Emery, 60% of us do not live near a facility that can do the life saving procedure. In an angioplasty, a surgeon opens blocked arteries with a balloon and again from the article, I learned this is also called percutaneous coronary intervention or PCI. I recall that this saved my dad’s life at least the first time he had a heart attack. The story was not about the effectiveness of PCI but the lack of effect of 2 drugs meant to save lives between MI onset and surgery. They do not seem to work and that is bad news especially because 60% of us are not near angioplasty ready centers and heart disease is the number one killer of American’s.

ACS Challenge: Cancer is another of America’s big killers and perhaps on more minds this week due to Senator T. Kennedy’s diagnosis of a brain tumor. Though not all cancers, heart disease or diabetes can be prevented, many experts believe a healthy lifestyle to be a protective factor against all three. Even if you have a genetic or environmental (radiation, SHS, etc) risk or especially if you do, a healthy baseline will improve your treatment outcomes and quality of life. So take heed. The American Cancer Society is urging everyone to take on its challenge to get active and stay active. Sign up at,

Merck and Pfizer: bad week for both companies and an apparent continuing downslide for Merck, even if it is winning some of the Vioxx lawsuits. Merck makes cholesterol lowering drug Vytorin for persons who have high cholesterol at least partly due to genetics. This week it halted a study on a similar drug. Both were being developed for the purpose of lessening plaque buildup and neither has worked better that the older cholesterol lowering drugs. I always hated the marketing of Vytorin as it seemed to encourage reliance on a pill over diet and exercise. As for Pfizer, Chantix has taken two hits this week, first from the FAA regarding pilots and air traffic controllers and now with some truck drivers as well. The drug is not on the safe list for these occupations as it may affect their ability to function on the job.

No Chantix- Try Your Friends: As you may recall I am a tobacco educator and quit smoking counselor so I have to pay attention to all tobacco research. So re: the above blurb, let me say, I DON’T KNOW?! I have clients on it and the Public Health Services recommends it, but I worry pretty constantly. My more off the record belief is this. If you are ready to quit, you will quit. This week’ s research that finds increased quit success when ones’ friends stop smoking makes both intuitive and theoretical sense. It is what we in the biz call, social norming. The researchers are the same that told us that we get fat when our friends get fat.

Cause of Death: We are far from the days of communicable disease devastation in this country. In fact, many industrialized countries have seen this epidemiological switch from contagious disease death to lifestyle related disease death. The World Health Organization reports this week that not only has that trend continued, it has incorporated many more countries to the extent that chronic disease is now the chief cause of death globally. Diabetes, obesity and asthma are rising across the board. It is also noted that the “single largest cause of preventable death – worldwide – is tobacco use.” The deaths related to tobacco use include ischemic heart disease, stroke and COPD.

Wishing you wellness

Friday, May 16, 2008

wellness weekly

Less Weight Better Gas Mileage: MSN recently ran a story on line regarding the money that could be saved if Americans lost their excess weight. Though we are not all overweight and some are morbidly so, in the story by Shirley Steel, it was felt appropriate to say that the average American had twenty too many pounds. Losing the extra weight could improve gas mileage of cars and planes, reduce productivity losses and insurance and medical costs and save an estimated 4000 dollars per household.

Speaking of Productivity: Another article forwarded to me recently from Business Week, covers workplace wellness. The reason I received the email is because I am 100% for “junk food free” workplaces, fruit and water at meetings, higher prices for unhealthy food, and lower prices on insurance for those who modify their lifestyles based on a wellness profile. A point made in the story is one I feel quite strong about and that is – if the message is eat well move more, or some such variation, then the opportunity to do so must also be offered. And if we are encouraging our employees to eat less junk food than as employers we need to offer less of it or charge more for it. This is the same strategy that makes quit smoking programs more successful. Conversely, offering quit smoking programs and meds while also allowing employees to smoke at work sites isn’t only counterproductive, its counter intuitive. Now I realize that many people who smoke or eat junk food get upset by these kinds of policies. However, this is not about an infringement on the employee’s rights. I believe that companies that offer insurance as a benefit, or simply employ us, have a right to ask us to live as healthy as we can. You can smoke (as long as it is legal) and eat as you like, at your home, but the less opportunity you have to do so and the less acceptance you get for doing so, then the less you will do it. This may allow you the benefit of more healthy active productive life years. That will benefit you, the employer, and the general tax payer. Harsh, but research based truth.

Serving for One? Having seen a few commercials in print and on air, regarding certain frozen pizza’s sold in single serving packages, I reviewed one at the grocery store. The calories for this one serving were approximately the same as four slices of pizza hut cheese pizza. How crazy is that? If this is how the food industry plans to regulate itself, we are in trouble. The average person doesn’t know calorie and fat recommendations per meal or per day or per their own body. It is very likely that an average person would choose a product like this and believe that they were doing themselves some good. In fact they may end up eating MORE calories not less.

Fitness Test: Ah, something I like! Well, I should clarify. I did not like the fitness tests that we had to take in school and to hear that this new fitness test was inspired by the adults who miss those tests was a little surprising. None the less, the government is allowing us to test our fitness (children get to take the President’s Challenge and receive a certificate, not so for us!). We can however, see where we rank in fitness compared to others our same age. You do the test on your own and enter the data on line. The items or tests include running or walking (depending on your own baseline), push ups, sit ups and a stretch. You will also be asked to enter your weight and height. I haven’t done it yet, but probably will this weekend. The address is:

Less Weight-Less Rx: Drugs are one of the things we can all spend less money on if we lose that average 20 pounds. Losing weight improves health and thus productivity. It also enables us to exercise more and more vigorously which can enhance our built in disease fighting capability as well as our antioxidant properties. We will age with less loss of function. We do have quite a way to go to make that happen. Research out this week and noted in an article by L. Johnson from AP provides these numbers. Over 50% of Americans who have insurance are taking a prescription medication for a chronic illness (diabetes, hypertension, high LDL) on a regular basis. Some of the more disconcerting points made in the article include that the biggest jump in chronic disease is in the age group that one might expect to be healthiest, 20-44, and worse, one in four children/teens, that is 25% of them, take a prescription medication for chronic disease control. The side effects related to long term use of these meds are far from understood and could be devastating. The physicians interviewed for the article stated that the problem stems from obesity and so, to come full circle, I don’t have a problem with workplace wellness programs that push low calorie foods.

Wishing you wellness

Friday, May 9, 2008

wellness weekly

B vitamins and Inflammation: Inflammation has been indicated as a marker for heart disease and heart attack risk. In the past this blog has noted C Reactive Protein and Homocysteine as blood proteins that indicate a certain amount of inflammation. A diet rich in fruits and vegetables as well as fiber, can keep inflammation levels low. Research on lowering already high levels with vitamin supplements, B and folic acid, did not equal lower risk of heart attack and stroke. In other words, there was some positive effect. The supplements did lower the levels, they just didn’t lower the adverse health outcomes. That being said, continue to do what you have the power to do and that is, maintain a healthy weight and activity level while eating foods that are low in saturated and trans fat, sugar and chemicals. I cannot say often enough, pills are not going to save you.

Cops on Diets? A law enforcement officer has many physical demands. It is important that he or she be physically fit to do their job and to do their job without having a heart attack. I have often seen police officers and security officers for that matter of whom I thought, well, what I thought was rude. However, if your job revolves around protecting people I think physical fitness and strength should be a prerequisite not just for hire, but for continued employment. In the LAPD when recruitment was down, the standards on weight and fitness were lowered. This hasn’t helped the force by any measure. They now have a dietician on board that works with the officers. The most important message that they are receiving is the advice to have fruit and even peanut butter and jelly sandwiches on hand. The fast food meals that they eat on the run are loaded with artery clogging fat and far too many of the wrong kind of calories. Kudos to the LAPD.

Gene Tests Again: Because the anti discrimination law regarding gene testing has been passed, this issue continues to get a lot of press. It should be stressed often. The tests are not 100% accurate, they can be marketed directly to consumers and their worth is not known. There are situations where a disease is caused by a certain confluence of genetic factors and can be prevented perhaps, if two people decide to not have children. More often than not however, a gene may tell you that you have a higher risk than the person sitting next to you and that everything that applies to them, is just that much more important for you. I.e. no one should smoke and maybe that applies doubly to you. No one should be overweight and you especially shouldn’t. These tests will NOT free you from the obligation of caring for your body. If you know that being overweight can cause diabetes and you do not lose weight, will you lose it if you ALSO know that you have more gene susceptibility for diabetes? I, at the least, think that genetic testing should not be marketing directly to consumers. Hasn’t the pharmaceutical industry already done enough damage?

Smoking and Teens: A couple of news items out this week related to keeping the levels of teen smoking going down. Remember, the cigarette companies have to find new users for their products as there are now more former smokers than smokers. People who used tobacco the most have either quit or died. So the companies target younger and younger persons, not overtly of course, but they have their ways. Public Health advocates have ways as well. This includes pointing out that the coolest, most successful kids and celebrities do NOT smoke. Another way, research is showing, is to have smoking bans in restaurants. In states with the most restrictive bans, the rate of teen smoking is declining. The less places that smoking is seen and the less persons seen doing it, the less common and accepted the activity becomes. The CDC recommends comprehensive tobacco control programming and SHS policies are strongly encouraged.

Over Medicating: Research from the esteemed Wake Forest University School of Medicine was released this week and indicated some memory and function problems related to common medications. These meds are referred to as anticholinergic as they block acetycholine (a brain chemical). I am not sure why acetycholine which is related to memory is a problem in high blood pressure, incontinence and allergies but those are the health problems associated with some anticholinergic meds. Those taking them have decline in memory and function. This is true for persons not already diagnosed with cognitive decline but more pronounced in persons with degenerative brain diseases, like Alzheimer’s. Remember, these meds are chemicals. Chemicals effect more than what they are targeted to effect.

Kraft: I have mixed feelings about Kraft, whose products I purchase and often get excited about because they can be healthy. The live active products seem a scam to me, but the sensible solutions and south beach diet options at least have some calorie control behind them. As the company is poised to add at least 80 new products, a lot of them single serving and or portion control, I realized that this would involve a lot more packaging and waste.

: I attended a seminar on preparing for disasters and three things were most important or at the least NEW to me. Put your documents, social security, birth certificate etc, in water proof containers. We always think of fire, but what about flood! Secondly, have a high powered whistle. If rescuers are looking for survivors they may hear you whistle but not hear you shout. Lastly, get a tag for your pets with his name and your phone number. He doesn’t have to always wear the collar, but if a hurricane is expected, you can put it on him then. [the seminar was sponsored by Gulfcoast South Area Health Education Center]

Wishing you wellness and safety

Friday, May 2, 2008

wellness weekly

Update Beijing: The government of China has been unsuccessful in its attempt to ban smoking in restaurants and bars, but most public buildings will have become smoke free as of yesterday. A BBC report noted that one out of every three lit cigarettes is lit in China. Their average smoke rate is 25% where the U.S. national average is 19. However, Kentucky and West Virginia are even higher with 26 and 28, respectively. The media has us believe that the Chinese government has absolute power, so what’s the deal with this?

Smoker’s Cough: Try smoking related lung disease. Chronic Obstructive Pulmonary Disease is common in smokers, is caused by cigarette smoking and can lead to death. Astra Zeneca is seeking approval for its asthma drug, Symbicort, to be used and thus advertised for use as a treatment for COPD. The article headline referred to the disease as smoker’s cough which doesn’t denote the seriousness of the illness . There is already a drug used for COPD so in essence Astra Zeneca is competing for market share. It is unfortunate that our drug companies have to spend so much time, effort and money on treating a disease that is almost exclusively a preventable disease. And it isn’t like food either, so don’t give me that. (meaning next I will want to ban twinkies). No one HAS to smoke, they just think they do, I know, because I thought so too. Now about those twinkies….

Really. Actual vultures. Some vultures are not fairing very well. The oriental white backed vulture, as well as several other types, has had a significant decrease in its numbers.. As you might have guessed, the cause is anthropomorphic, or related to humans! An anti-inflammatory medication that we developed and used to treat injuries in animals or livestock, is poisoning the vultures who dine on the carcasses of said animals. The medicine, diclofenic, is no longer manufactured for veterinary use but is still manufactured for medical use. It is used to treat pain in humans which is often related to some type of inflammation. Since no one said it could not be used in animals the people version continues to be used and is blamed as I said, for the significant decrease in population numbers of certain vulture.

Be Happy:
A very interesting index has been created and administered to approximately 100,000 Americans. The index was created by Gallup and its intent is to assist employers. The initial results indicate that many Americans are classified as either struggling or suffering when the goal is to be “thriving”. The scientists rate persons based on where the person places themselves on the step of an imaginary ladder. If you are on step 8 to 10, life is indeed good. The survey is being used in other countries as well. By comparison and in congruence with our global health status, America is not doing as well as one would expect. Denmark fairs much higher on the well being index, for instance. One thing that brings us down is the number of employees with at least one chronic medical condition. This leads to absenteeism, poor productivity, increased health care costs and loss of income. At least 66% of employees fit into that category.

Fit and Lean: The theory that fit and fat can equate to health has just lost more ground. A large study that lasted around 11 years and included 39,000 women, reports that over weight and obese persons who exercise at least 30 minutes a day are still at significantly higher risk for disease than slimmer women who do the same amount of exercise. It is important for all of us to heed the exercise and weight recommendations as heart disease continues to reduce not only our number of life years, but our healthy life years as well. It is the number one killer. Remember that heart disease is directly related to at least the following: obesity, high cholesterol, high blood pressure and smoking.

Just some odds and ends here. Boost smoothies?. Hmm. Well, they have 9 grams of protein and as much calcium as a glass of milk. They also have 240 calories which is way too many for me to DRINK> It is interesting that the label states it has as much calcium as a glass of 2% milk. Why 2%? I found skim milk with more calcium than whole milk. Weird. Citrucel has new fiber soft chews, the first ever soft chew. Oh and they have calcium too. These two products are meant for people who CANNOT get energy, vitamins, minerals, fiber etc, from food. They are getting second rate nutrition, it doesn’t supplement anything. It is a substitute and good when needed. Lastly and most concerning. Beef jerky. I saw an ad for beef jerky that is high in protein and low in fat as if that made it healthy. That is like saying Zero Carbs on a water bottle. Anyway, beef jerky is still the type of meat product that increases the risk of colon cancer.

Wishing you wellness and a discerning mind!