Thursday, February 12, 2009

Wellness Weekly

Effectiveness Research: There is an issue in the stimulus bill that I believe has not been axed as of yet which calls for research to determine which medicines and medical devices are actually effective. This will help insurance companies, including MCR/MCD; determine which treatments they should cover. The drug companies and medical device industries are very much opposed to this measure, and I support it. Their concern is that the outcome would be government rationing, or.. that they will make less money. I do believe that if a medicine does not work, we should not take it. Crazy I know. There has been more than one version of this bill. One of much debate includes comparing costs not just effectiveness and that scares a lot of people. I again, believe the most effective medicine should be used and if there are two that are equally effective, the cheaper one should be the gold standard. Now there may be individual cases where the more expensive medicine is better due to genetic or biological factors. I do believe there is a lot of waste in this system and we have to start somewhere.

Sugar: An Indian newspaper reported a story from the EU regarding the misconception about the deleterious effect of sugar. I agreed in theory with the concept that it is not so much sugar but total energy intake and output that affects weight and subsequently insulin resistance. The Comite Europeen des Fabricants de Sucre suggests that more study is needed but that lack of exercise and excess calories of any type are the causal factors for diabetes type 2. I have the occasional snack with sugar, less than 8 grams a serving though.. and I mostly eat whole foods and fruits and veggies. The end of this story offered a little bias; this CEFS is a sugar industry group!

Adverse Birth Outcomes: The issue of maternal obesity is staying in the news. This week a study offers more about what exactly can go wrong in this situation. I have to say that this is reminiscent of how scientists came to warn us on the dangers of tobacco smoke and pregnancy. For now, the JAMA has published a study that links diseases in newborns to obesity but does not yet explain the etiology of said diseases. The reported outcomes were spina bifida, heart problems, cleft palate and additional neural tube defects. I envision the country’s Healthy Start programs tackling this problem in the future.

Pain Meds: The fate of Darvon is still undecided but in the meantime, the FDA is addressing the issue of pain killer abuse and hopefully, the accidental deaths that have occurred because of misuse. The targets of the attention and an upcoming meeting are makers of opiates and especially long acting ones. These can be pills or patches, but their potency makes them especially dangerous. The FDA and the drug makers can work together to formulate a plan to increase safe use of these medications. On the table, stronger warnings, letters to prescribing docs and restrictions on who gets the meds. Good start.

Now starts the section of Oh Boy.. I was right about that… or Vindication Validation

Multivitamins: Let me reiterate.. When scientists and epidemiologists say that “these certain people are much healthier than others and they eat a lot of fruits and vegetables etc”, that does not mean that taking a PILL with the same ingredients or nutrients of that food will provide the same result. Nutrition is almost always best received from a plate not a package and not a pill and not a drink. Research this week was undoubtedly a disappointment for many, but vitamins failed to lower the incidence of heart disease and cancer in those who took them in this 8 year study of over 160,000 women. A similar study with men had the same outcome. In this AP story, an ACS epidemiologist was quoted as saying that his group “does recommend maintaining a healthy weight and eating at least five servings of fruits and vegetables daily, while limiting red meat.” The ACS believes that those lifestyle behaviors WILL reduce the risk of cancer and heart disease. I prefer Dr. Willett’s verbiage. He says to eat three or four servings of fruit and to eat vegetables with abandon. There is a difference in types and that is why I want to work in this area as a professional health communicator… it is not any fruit or any vegetable.. i.e. if you eat five servings of potatoes every day… you will get fat esp. if you fry them. (maybe)

Protein: For many years, I have told my friends who ask that I believe that refueling after or during vigorous exercise is important and that for me, a protein carb snack is most beneficial. Now Nancy Clark, RD, a respected sports nutritionist reports the same advice. She even recommended the very snack I eat on all my long runs… PBJ on wheat… yeah. Protein rebuilds muscle… My diet is absolutely high in carbohydrates as I eat complex whole grains and many fruits and veggies every single day, all day. Ms (DR?) Clark also noted milk, yogurt, lentils, tofu and tuna as good protein sources, and again, these are the foods that I currently eat.

Peanut Butter:
Ok, this is my last, I knew that item. For Christmas I received a subscription to a magazine called Real Simple. This month they have an article on the best natural peanut butters. They reviewed 56 products and came up with three winner s and three runners up. Don’t you know it; my Smucker’s All Natural was in each category. The other four were not major brands, i.e. no smart balanced or peter pan… etc. This is the PB I use for my running energy! PS this has not been recalled and you can make your own nabs with a whole wheat saltine…

OOPS: I was closing up my little newsletter folder and saw an article I forgot to report on. It regards the risk and lack of benefit with many X-rays and MRIs for back pain. The scans do not usually change the course of treatment and they expose the patient to radiation which is a risk factor for cancer. I for one have refused both on my back. I have done a back exercise program and used ice for flare ups (i.e. I did not take opiates for my back pain). Currently my back pain is resolved.. but it comes back and that is ok… I will deal with it.


Happy Weekend…

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