Saturday, December 13, 2008

Wellness Weekly

Healthier Life Steps: Part of my job as a tobacco educator is to present information on treating tobacco dependence to health care providers. For many years, ten or more, there has been in place a clinical, best practice guideline for doing so. It is unfortunate that many providers are still unawares of what is referred to as the 5 As. I bring this up today because the AMA has come out with a similar strategy for identifying and addressing, let me repeat that, addressing, risk factors for disease in the patient. The four targeted behaviors are healthy eating, physical activity, reduced drinking and smoking cessation. The AMA has a survey that the patient would complete in the waiting room which the doctor and nurse could refer to during the visit. The clinical guidelines include handouts and a website. In case you are thinking that your weight or inactivity is not a problem because your doctor hasn’t mentioned it recently (or ever), this should disavow you of that notion. Instead, your health care provider may be uncomfortable addressing the issue.
Family yes, but genes or tradition? We tend to carry weights similar to that of our families, especially if we are isolated. People often assume that it is predestined, a matter of genes if you will. I wholeheartedly agree with Dr. Oz and his ilk. Genes are only about 25% of the issue. What you DO with those genes is really the determinate of weight and health in the long run. This week a research study supports that family lifestyle has at least the same impact on obesity as genes do. Individual behavior would of course have the greatest impact. In the Journal of Sociology, lead author Molly Martin stresses the importance of regular meals and physical activity as protective. A lot of times people, for fear of failure or fear of effort, accept an unhealthy weight as genetic or familial. This is a deadly acquiescence. When people point out my low weight and believe me THEY DO, I take the opportunity to promote the concept by saying, “It is NOT genetic.” It isn’t, there are some heavy people in my family.
Fish Mercury in Doubt? Long time readers are aware of my passion on this issue and my effort to stay on top of the good fish bad fish dilemma. Thus, I am perplexed about a recent headline, recent as in yesterday, regarding the FDAs stand on fish consumption. The official recommendations have not changed; the current issue is rather a political controversy with the EPA and FDA at odds with each other. Most of the mercury in fish is a consequence of coal fired power plant emissions so that makes me suspect the FDAs wavering as well. With the change in administrations approaching and clean coal and cap and trade back on the table, wouldn’t it be nice if methyl mercury didn’t hurt us after all? Fish is a good food for brain and hearts, but please do educate yourself on which fish have the highest levels of mercury and avoid them. (ps, the article I read didn’t mention coal at all, that is info I absorbed in graduate study)
Breast Cancer Test: Yesterday in Texas, a researcher reported that a gene test was more accurate in identifying women at high risk for breast cancer than the model that physicians have been using for some years. The problem is that it is one of five gene tests on the market that have not been approved by the FDA.(there is no current rule that the FDA has to vet them for efficacy) Most oncologists feel that genetic testing, especially direct to consumer, is more likely to cause fear than save lives. There is significant concern that tests like these will lead people into unnecessary surgeries and amputations. There is also concern that people will rely on tests and not take the advice that is offered for prevention of disease, including many cancers. That advice should be common knowledge to you now, but I will happily reiterate. To protect yourself, to control what you can, it is recommended by the ACS, the ALA, the AHA, the ADA, the AMA, and the DHHS, for starters, that people not use tobacco, refrain from excess alcohol use, move(their bodies) EVERY day, maintain a healthy weight and eat a low fat diet high in fiber, fruits and veggies.
Colonoscopy Alert: As I continue to dread turning fifty (ahem.. many years from now) and having to have one of these, more scary news is released. Apparently the two common bowel clearing medications prescribed to patients prior to the exam may damage the kidneys. There is a black box warning on the two sodium phosphate products and certain groups should use them with caution. One of which is people over 55, you know, the ones getting the colonoscopies. From an article regarding this, I want to point out that over the counter bowel cleansing products, (not regular laxatives) may also cause harm and may be under investigation. PLEASE do not consider bowel cleansing a safe activity. Eat more fiber and drink water. Anyways, colonoscopies can be life saving and colon cancer is a serious threat in this country. I do hope though, that this news might encourage insurance companies to promote the non invasive colon cancer screen that is available. Also note that there are other bowel cleansing products that can be prescribed or given for the colonoscopy that do not come with a black box warning.
MEDS: Ugh. I am already anti pill, and a WSJ article worth reading yourselves, only enforces my belief that we do NOT know nearly enough about the pills we take to trust them as we do. Unfortunately, those that prescribe the medications do not know the full story on whether they are effective and whether or not they are harmful either. That is not usually their fault, but the fault of drug companies who do not release ALL of their clinical data. New rules have been established and websites are in place to have all research reported but even then who is going to cull those reports and assuage our fears. I think it may be agencies like Public Citizen and Center for Science in the Public Interest. The article by Robert Lee Hotz is in yesterday’s journal. BTW, I was reading an article on a medication or treatment the other day at work and recall being really stymied by this research conclusion “it is more effective than placebo.” What does that mean, this worked better than not doing anything? Well, how MUCH better and at what cost? Saying something is better than nothing, oh and hey, could damage the kidneys, well that my friends, is a problem. http://online.wsj.com/article/SB122903390105599607.html
PRICES: Last note because it really pissed me off. At the store I noticed that regular highly processed snack cakes cost 1$ and the equally processed but 100 calorie kind, cost 2.50$ or 3$ for the same amount depending on brand. Food in boxes is generally not healthy, but sometimes we do want that processed sweet and right or wrong, many parents buy these snacks for their kids. Which one, especially in this economy, are they going to buy? The price difference is such bullshit.

Speaking of snacks……. I am due for one……… later…

Happy Weekend
Don’t smoke!
Eat Well
Move more

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