Princess Health and Ashland hospital expands into wellness and prevention programs. Princessiccia

Princess Health and Ashland hospital expands into wellness and prevention programs. Princessiccia

diabetes employers health insurance hospitals jobs physical activity prevention wellness

Gusty 06:12 Add Comment

By Judi Kanne
Kentucky Health News

Hospitals� basic business is taking care of the sick and injured, not keeping people from getting sick. But more and more of them are getting into wellness and prevention, not only to help their communities but to make money.

King's Daughters Heart and Vascular Center

One of those is King�s Daughters Medical Center in Ashland, which has developed an innovative strategy for building relationships with local employers to help their employees live healthier lives.

King�s Daughters began by focusing on self-insured employers, who can get the most direct benefit from reduced health-care expenses. It used one-to-one employer outreach activities such as a farm-to-table employer lunch, to which more than 126 local employers were invited.

The first question for employers, said Matt Ebaugh, vice president and chief strategy officer at King�s Daughters, is �Do you understand what is driving the cost for your employees?� because �Self-funded employers do not always have the analytics or tools needed to understand where those costs come from.�

King�s Daughters used Strategic Health Services of Alpharetta, Ga., to create a portal for health risk assessment, biometric screening results, claims analytics and personal health profiles of employees.

While the program is aimed at wellness, it also finds new cases for the hospital. �We knew if we did a smart thing for local employers, demonstrated value, and coupled it with good customer service, then when employees needed a higher level of care, they would come to us,� Ebaugh said.

By means of screenings for diabetes, cholesterol, and body mass index, employees become patients.

Diabetes screening can be critical. About 86 million American adults are pre-diabetic, but nine out of 10 people who are don�t know it, according to the federal Centers for Disease Control and Prevention. That can be detected with health-risk assessment lifestyle questionnaires.

Beyond individual screenings, hospitals can examine the emerging risks in a population using claims data. That can also help them show employers what�s driving up their costs. Claims also indicate which employees are most likely to use hospital and pharmacy services.

�We need to find innovative ways to motivate individuals to change old and dangerous patterns,� Ebaugh said, because simple lifestyle changes can dramatically cut the risk for developing diabetes.

But getting healthy may require offering financial and other incentives to get people to participate in wellness programs. The Ashland hospital plans to try gamification, incorporating into the workday a set of programmed games and activities that remind sedentary employees to get up, stretch, and move around.

The idea is to make health and fitness fun, a social experience and accessible to as many members as possible. Gamification programs include computer notifications or other reminders that stimulate sedentary disruption and track activity. In some cases, motivation includes team competition in which employees win points by stopping to stretch.

Ebaugh said such programs have been shown to work and are critical in some cases, because a pre-diabetic employee may not be motivated enough to change eating and exercise patterns. �Knowing is not enough,� he said. �We anticipate the energy and participation with gamification will increase as a result of more engaging activities.�

The hospital first started a wellness program for its own employees, and plans to add gamification to it, Ebaugh said: �It�s important our model work well to show our employers the success we are having with our internal employees.�

Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.

Princess Health and Study indicates fast food contains industrial chemicals linked to health problems such as infertility, diabetes and allergies. Princessiccia

Princess Health and Study indicates fast food contains industrial chemicals linked to health problems such as infertility, diabetes and allergies. Princessiccia

allergies diabetes environmental health food infertility nutrition processed food research

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People who eat a lot of fast food have higher levels of chemicals that "have been linked to a number of adverse health outcomes, including higher rates of infertility," especially among men, Roberto Ferdman reports for The Washington Post.

Researchers at George Washington University in Washington, D.C., say the connection could have "great public health significance," Ferdman writes. "Specifically, the team found that people who eat fast food tend to have significantly higher levels of certain phthalates, which are commonly used in consumer products such as soap and makeup to make them less brittle. . . . The danger, the researchers believe, isn't necessarily a result of the food itself, but rather the process by which the food is prepared."

Here's how the study was done: Researchers analyzed diet and urinalysis data for nearly 9,000 people, collected as part of federal nutrition surveys in 2003-2010. "Food eaten at or from restaurants without waiters or waitresses was considered fast food. Everything else � food eaten at sit-down restaurants and bars or purchased from vending machines � was not," Ferdman writes. "The first thing the researchers found was that roughly one-third of the participants said they had eaten some form of fast food over the course of the day leading up to the urine sample collection," which fits with government estimates.

People who said they had eaten fast food in the previous 24 hours "tended to have much higher levels of two separate phthalates," Ferdman reports. Those who said they ate only a little fast food had levels 15 and 25 percent higher than those who said they had eaten none. "For people who reported eating a sizable amount, the increase was 24 percent and 39 percent, respectively. And the connection held true even after the researchers adjusted for various factors about the participants' habits and backgrounds that might have contributed to the association between fast-food consumption and phthalate levels."

The study was reported in Environmental Health Perspectives, a peer-reviewed journal funded by the National Institutes of Health.

"There is little consensus on the harms of phthalates, which are widely used in commerce and give materials such as food packaging added flexibility, except that exposure to them is widespread," Ferdman writes, citing the federal Centers for Disease Control and Prevention. "But there is growing concern that the chemicals could pose a variety of risks, particularly when observed in the sort of levels seen in the study."

Noting several other studies, such as those linking the chemicals to diabetes and allergies, Ferdman reports, "Many governments have moved to limit exposure to the industrial chemicals. Japan disallowed the use of vinyl gloves in food preparation for fear that their use was compromising health. The European Union, which limits the use of the chemical, has been nudging manufacturers to replace it. And the United States restricted its use in toys."

So, why do people who eat fast food seem to have much higher levels of these chemicals? That is unclear, Ferdman writes, "but it's easy enough to guess: the sheer amount of processing that goes into food served at quick-service restaurants. The more machinery, plastic, conveyor belts, and various forms of processing equipment that food touches, the more likely the food is to contain higher levels of phthalates. And fast food tends to touch a good deal more of these things than, say, the food one purchases at a local farmers' market."

Ferdman concludes, "It certainly seems as though eating fast food is more toxic than avoiding it, and not for the obvious reasons." He quotes Marion Nestle, the Paulette Goddard professor of nutrition and food studies at New York University: "Traditional fast food was never meant to be daily fare, and it shouldn�t be," said  "It�s too high in calories and salt and, as we now know, the chemicals that get into our food supply through industrial food production."

Princess Health and Did you know that smoking can lead to Type 2 diabetes?. Princessiccia

Princess Health and Did you know that smoking can lead to Type 2 diabetes?. Princessiccia

diabetes smoking University of Kentucky

Gusty 14:58 Add Comment

Smoking can lead to diabetes, and then cause more complications from the disease. So writes Dr. Laura B. Hieronymus, associate director of education and quality services at the Barnstable Brown Kentucky Diabetes Center at the University of Kentucky, in a column in the Lexington Herald-Leader.

Laura Hieronymus

Smoking can cause resistance to insulin, which helps control levels of sugar in the blood. "Insulin resistance can occur if you have a family history of it, are overweight and/or have a sedentary lifestyle," Hieronymus writes. "Experts report smokers are insulin resistant and the more you smoke, the greater your chances of Type 2 diabetes. Data suggest if you smoke 16 to 25 cigarettes a day, your risk for Type 2 diabetes is three times higher than if you don�t smoke. In contrast, if you quit smoking and stay quit, your risk for Type 2 diabetes actually decreases."

If you have diabetes, smoking can make complications from it more likely, Hieronymus writes: "Damage to the blood vessels and nerves in your body is more common and often to a greater degree than if you have diabetes and don�t smoke. The heavier and the longer you smoke the greater your risk for complications. The bottom line is that smoking and diabetes are a dangerous combination. The good news is that by quitting smoking and keeping your blood glucose optimally controlled, you can greatly lower your chances for diabetes complications."

Princess Health and New Evidence Strengthens the Link Between Hypothalamic Injury, Obesity, and Insulin Resistance. Princessiccia

Princess Health and New Evidence Strengthens the Link Between Hypothalamic Injury, Obesity, and Insulin Resistance. Princessiccia

diabetes overweight

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Obesity involves changes in the function of brain regions that regulate body fatness and blood glucose, particularly a region called the hypothalamus. My colleagues and I previously showed that obesity is associated with inflammation and injury of the hypothalamus in rodent models, and we also presented preliminary evidence that the same might be true in humans. In our latest paper, we confirm this association, and show that hypothalamic injury is also associated with a marker of insulin resistance, independently of BMI.

Introduction

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Princess Health and A looming danger: About 1 in 3 U.S. adults are pre-diabetic, but only about 11% say they have received such a diagnosis.Princessiccia

Princess Health and A looming danger: About 1 in 3 U.S. adults are pre-diabetic, but only about 11% say they have received such a diagnosis.Princessiccia

diabetes heart disease prevention stroke

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Before Type 2 diabetes develops, most people experience what is called prediabetes, where the blood sugar levels are above normal, but below diabetic, Dr. Philip A. Kern, University of Kentucky professor and director of the Center for Clinical and Translational Science, writes in a UK news release.

In America, approximately one in three adults are pre-diabetic, but only around 11 percent are aware of that condition, according to the federal Centers for Disease Control and Prevention. In Kentucky, 289,000 adults, or almost 9 percent, reported that they had been diagnosed as pre-diabetic, according to the 2015 Kentucky Diabetes Report.

"Without intervention, there is a high likelihood that prediabetes will progress to diabetes within three to 10 years," Kern writes. "People with prediabetes are also at 50 percent higher risk for heart disease and stroke."

When a person is prediabetic, many of the diabetic disease processes, like nerve damage, eye problems and heart disease, begin in the body even though the person doesn't have diabetes.

And because prediabetes often has no symptoms and can affect people of all ages, Kern writes, it is important to know your blood sugar levels, especially if you have one of the following risk factors: overweight or obese, fat distributed around the abdomen, history of gestational diabetes, family history of diabetes, symptoms of diabetes (increased thirst, frequent urination, fatigue, and blurred vision), or history of elevated blood sugar levels.

Kern suggests the following lifestyle changes to help prevent the progression of prediabetes to diabetes; he notes that these changes will also help reduce your risk of heart disease, stroke, high cholesterol and high blood pressure:

• Weight loss: Losing just 10 to 20 pounds can reduce the liklihood of prediabetes progressing to diabetes.
• Healthy diet: Choose low fat, low calorie and high fiber foods, like fruits, vegetables and whole grains.
• Exercise: Incorporate 30 to 60 minutes of moderate physical activity most days of the week.
• Sleep: Research has found that getting at least six hours of sleep each night can help reduce insulin resistance. He also notes that sleep apnea can worsen prediabetes.
• Medications: Some diabetes medications are prescribed to prediabetics to prevent the condition from progressing.

If you're interested in learning about opportunities to participate in research about prediabetes at UK, visit ukclinicalresearch.com or call (859) 323-2737.

Princess Health and Insulin Resistance Predicts a Variety of Age-related Diseases. Princessiccia

Princess Health and Insulin Resistance Predicts a Variety of Age-related Diseases. Princessiccia

cardiovascular disease diabetes metabolic syndrome

Gusty 09:57 Add Comment

In the last post, I reviewed a study by Gerald Reaven's group showing that insulin resistance strongly predicts the risk of cardiovascular disease over a 5-year period. In 2001, Reaven's group published an even more striking follow-up result from the same cohort (1). This study shows that not only does insulin resistance predict cardiovascular disease risk, it also predicts a variety of age-related diseases, including hypertension, coronary heart disease, stroke, cancer, type 2 diabetes, and even overall mortality risk.

Read more �

Princess Health and How do diet and exercise influence risk of diabetes? Diet seems more important.Princessiccia

Princess Health and How do diet and exercise influence risk of diabetes? Diet seems more important.Princessiccia

diabetes diet exercise food research

Gusty 14:08 Add Comment

Many people think exercising and eating properly are interchangeable, but a paper by Edwards Weiss, associate professor of nutrition and dietetics at Saint Louis University, asserts that exercising and restricting diet results in specific and cumulative benefits in reducing the risk of Type 2 diabetes. According to the 2013 Kentucky Diabetes Report, 6.9 percent of Kentucky adults have diabetes.

Participants in the study were sedentary, overweight middle-aged men and women who reduced their weight 6 to 8 percent through calorie restriction, exercise or both. Researchers measured their insulin sensitivity levels, which determines risk of diabetes. "Your blood sugar may be perfectly normal, but if your insulin sensitivity is low, you are on the way to blood sugar issues and, potentially, Type 2 diabetes," Weiss said.

The researchers measured twice the improvement of insulin sensitivity in the group of participants who both exercised and restricted their diets than in the other two groups. Weiss notes that exercise helps regulate glucose, even if a person isn't losing weight as a result. The researchers also found that exercised-induced weight loss didn't regulate glucoregulation more effectively than calorie restriction. "What we found is that calorie restriction, like exercise, may be providing benefits beyond those associated with weight loss alone," Weiss said.

Weiss said that though it might seem obvious that a combination of diet and exercise would engender the best results, "there are a lot of people who believe that if they maintain a healthy weight, it doesn't matter what they eat. And others have an appropriate food intake but don't exercise."

Princess Health and One of every three U.S. adults have a combination of risk factors that increase their risk for heart disease and diabetes.Princessiccia

Princess Health and One of every three U.S. adults have a combination of risk factors that increase their risk for heart disease and diabetes.Princessiccia

blood pressure cholesterol diabetes heart disease obesity research

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More than one-third of adults in the U.S. have a combination of health conditions that put them at higher risk of heart disease and diabetes, and this condition affects nearly half of adults aged 60 and older, according to a new study recently published in the Journal of the American Medical Association.

Image: healthyanswers.com

This combination of health conditions, when found in one person, is called metabolic syndrome. It includes abdominal obesity, high blood pressure, increased fasting glucose levels and abnormal cholesterol levels.

The study collected data gathered by the federal Centers for Disease Control and Prevention from adults 20 and older from 2003 to 2012. It found that about a third had a metabolic symdrome in 2011-12, and nearly half of those 60 and older did. Among those 20 to 39, the rate was 18 percent.

The study report says these were "concerning observations" because of the country's aging population. Hispanics, at 39 percent, were found to have the highest prevalence of metabolic syndrome among ethnic groups. Women had a higher prevalence than men in all age groups.

The American Heart Association says the best way to control the risk factors contributing to metabolic syndrome are to lose weight and increase physical activity. It also encourages patients to routinely monitor their weight, blood glucose, cholesterol and blood pressure and treat these risk factors according to established guidelines.

Princess Health andNew diabetes cases in expanded-Medicaid states much higher than other states; 46,000 new Ky. Medicaid clients got screened.Princessiccia

Princess Health andNew diabetes cases in expanded-Medicaid states much higher than other states; 46,000 new Ky. Medicaid clients got screened.Princessiccia

Affordable Care Act diabetes health reform Medicaid obamacare Patient Protection and Affordable Care Act rese research

Gusty 19:55 Add Comment

By Melissa Patrick
Kentucky Health News

New diabetes cases among poor Americans are much more numerous in Kentucky and other states that have embraced the Patient Protection and Affordable Care Act, a medical testing company has found. The diagnoses rose 23 percent in the Obamacare states and barely rose in the others, apparently because state Medicaid programs are encouraging screening for diabetes.

Quest Diagnostics conducted the study by analyzing laboratory test results from all 50 states and the District of Columbia in its large database over two six-month periods, Sabrina Tavernise reports for The New York Times. The authors determined that because in January 2014, 26 states and the District of Columbia had expanded Medicaid and 24 had not, it was a good time to conduct this study, which is reported in the journal Diabetes Care.

The research team used the results of the basic test for diabetes, which measures a form of hemoglobin that has interacted with glucose, A1c. "In the states that expanded Medicaid, the number of Medicaid enrollees with newly identified diabetes rose by 23 percent, to 18,020 in the first six months of 2014, from 14,625 in the same period in 2013," Tavernise reports. "The diagnosis rose by only 0.4 percent � to 11,653 from 11,612 � in the states that did not expand Medicaid."

A Kentucky study indicates that more screening isn't the only reason for such numbers; the Medicaid expansion population appears to be more susceptible to diabetes than normal.

The study by Deloitte Consulting found that chronic conditions, including diabetes, were more than twice as prevalent in the expansion population than other people of the same age and gender who were on Medicaid before it expanded. That comparative group was considered to be the group most similar to the Medicaid expansion population, since the state lacks historical data for the expansion group.

The study found that the Medicaid expansion group had a 102.5 percent higher prevalence of diabetes than the comparative group. About two of every 1,000 in the expansion group had diabetes, compared to one of every 1,000 members of the traditional-Medicaid group.

About 46,000 of the 400,000 people in the expansion group had a diabetes screening in the first year of the expansion. Both studies suggest better access and utilization of preventive care and early diagnosis will promote earlier treatment and better long-term outcomes.

Kentucky ranks 17th among the states in prevalence of diabetes, according to the 2014 "States of Obesity" report.  The state Cabinet for Health and Family Services reports an estimated 233,000 adult Kentuckians have pre-diabetes. For county-by-county data on diabetes, click here.

Quest Diagnostics recognized that its study only looked at changes in raw numbers of the lab results from one company and did not have access to a federal data set. This has caused some to voice skepticism that the study results are a result of the Medicaid expansion. Others, while recognizing that the study did not "have the precision of a scientific drug trial," Tavernise writes, said "the changes in the numbers are real ... 23 percent versus zero," and that "the health-care law was the most plausible explanation for the findings." Another said, "for an observational study, it�s really very strong."

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health andAuthors of The Great Diabetes Epidemic will talk on KET about its causes, myths, complications, treatment and prevention.Princessiccia

Princess Health andAuthors of The Great Diabetes Epidemic will talk on KET about its causes, myths, complications, treatment and prevention.Princessiccia

blindness books diabetes prevention television vision

Gusty 16:56 Add Comment

Kentucky Health News

The message that the authors of The Great Diabetes Epidemic: A Manifesto for Control and Prevention want readers to take from their book is that "diabetes is a serious, but preventable disease, if proper early interventions are implemented through a community-based, public health approach," KET says in a press release.

Authors Dr. Gilbert Friedell and J. Isaac Joyner will discuss this message with host Renee Shaw, and look at the root causes of the high number of diabetes cases in the U.S. and what needs to be done about it, on "Connections with Renee Shaw" on KET2 Friday, March 27 at 5 p.m. ET and on KET Sunday, March 29 at 1:30 p.m. ET.

Other topics discussed include common misconceptions and barriers to treatment, belief systems around diabetes that aren't based on fact, and the significant health ramifications of the disease, including complications such as blindness, amputations and renal failure.

"In Kentucky alone, for example, there are 72,000 diabetes-related cases of blindness and visual impairment diagnosed each year � roughly 200 per day," KET notes.

Princess Health and Is Meat Unhealthy? Part V. Princessiccia

Princess Health and Is Meat Unhealthy? Part V. Princessiccia

diabetes vegetarian

Gusty 11:28 Add Comment

In this post, I'll examine the possible relationship between meat intake and type 2 diabetes. Type 2 diabetes is the most common form of diabetes, and it is strongly linked to lifestyle factors.

Non-industrial cultures

Non-industrial cultures have an extremely low prevalence of diabetes, whether they are near-vegan or near-carnivorous. This is supported by blood glucose measurements in a variety of cultures, from the sweet potato farmers of the New Guinea highlands to the arctic Inuit hunters. Here is what Otto Schaefer, director of the Northern Medical Research Unit at Charles Camsell hospital in Edmonton, Canada, had to say about the Inuit in the excellent book Western Diseases (Trowell and Burkitt, 1981):
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Princess Health and Obesity ? Diabetes. Princessiccia

Princess Health and Obesity ? Diabetes. Princessiccia

diabetes overweight

Gusty 10:10 Add Comment

A new study adds to the evidence that the prevalence of type 2 diabetes is rapidly increasing in the US, and our national weight problem is largely to blame.

The Centers for Disease Control (CDC) currently estimates that a jaw-dropping 33 percent of US men, and 39 percent of US women, will develop diabetes at some point in their lives (1). Roughly one out of three people in this country will develop diabetes, and those who don't manage it effectively will suffer debilitating health consequences. Has the risk of developing diabetes always been so high, and if not, why is it increasing?

In the same issue of the Annals of Internal Medicine as the low-carb vs. low-fat study, appears another study that aims to partially address this question (2).

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Princess Health and Metabolic Effects of a Traditional Asian High-carbohydrate Diet. Princessiccia

Princess Health and Metabolic Effects of a Traditional Asian High-carbohydrate Diet. Princessiccia

celiac diabetes diet native diet

Gusty 15:49 Add Comment

A recent study supports the notion that an 'ancestral diet' focused around high-starch agricultural foods can cultivate leanness and metabolic health.

John McDougall gave Christopher Gardner a hard time at the McDougall Advanced Study Weekend. Dr. Gardner conducts high-profile randomized controlled trials (RCTs) at Stanford to compare the effectiveness of a variety of diets for weight loss, cardiovascular and metabolic health. The "A to Z Study", in which Atkins, Zone, Ornish, and LEARN diets were pitted against one another for one year, is one of his best-known trials (1).

Dr. McDougall asked a simple question: why haven't these trials evaluated the diet that has sustained the large majority of the world's population for the last several thousand years? This is an agriculturalist or horticulturalist diet based around starchy foods such as grains, tubers, legumes, and plantains, and containing little fat or animal foods. Researchers have studied a number of cultures eating this way, and have usually found them to be lean, with good cardiovascular and metabolic health. Why not devote resources to studying this time-tested ancestral diet? I think it's a fair question.

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Princess Health and Help Advance Diabetes Research. Princessiccia

Princess Health and Help Advance Diabetes Research. Princessiccia

diabetes

Gusty 09:39 Add Comment

A University of Virginia researcher named Hannah Menefee contacted me recently to ask for our help.  She and her colleagues are conducting a study on how people with type 2 diabetes use Facebook to manage their health, and how that technology can be leveraged to support effective health communication.

If you have type 2 diabetes, and you'd like to participate in the study, please join their Diabetes Management Study Facebook group.  There, you'll receive more information about the study, you'll receive a short survey, and you may be invited into one of the study phases.

Princess Health and Princess Health andStudy concludes that fasting can reduce cholesterol levels for people in danger of developing diabetes.Princessiccia

Princess Health and Princess Health andStudy concludes that fasting can reduce cholesterol levels for people in danger of developing diabetes.Princessiccia

blood pressure cholesterol diabetes research

Gusty 11:45 Add Comment

New research suggests that occasional fasting can help pre-diabetics from developing diabetes, which is more common in Kentucky than most states.

After 10 to 12 hours of fasting, the body looks for other energy sources to sustain itself, so it removes LDL (bad) cholesterol from fat cells and converts it into energyaccording to researchers at the Intermountain Heart Institute at Intermountain Medical Center in Murray, Utah.

"Fasting has the potential to become an important diabetes intervention," in addition to lifestyle changes and weight loss, said Benjamin Home, the lead researcher.

The study focused on prediabetics between the ages of 30 to 69 with at least three of the following metabolic risk factors: a large waistline, a high triglyceride (type of fat in the blood) level, a low HDL (good) cholesterol level, high blood pressure and high blood sugar after fasting.

"Over a six-week period cholesterol levels decreased by about 12 percent in addition to the weight loss," Home said. "Because we expect that the cholesterol was used for energy during the fasting episodes and likely came from fat cells, this leads us to believe fasting may be an effective diabetes intervention."

The removal of LDL cholesterol from the fat cells for energy use should help stop insulin resistance, which happens when the pancreas keeps producing more and more insulin until it can't make enough for the body, and the blood sugar rises. "The fat cells themselves are a major contributor to insulin resistance, which can lead to diabetes," he said. "Because fasting may help to eliminate and break down fat cells, insulin resistance may be frustrated by fasting."

Home noted that although fasting might be effective for protecting against diabetes, the results were not immediate. "How long and how often people should fast for health benefits are additional questions we're just beginning to examine." (Read more)

Princess Health and Princess Health andStudy: Banning sugary drinks from SNAP would reduce obesity and Type 2 diabetes; subsidy would boost fruit consumption.Princessiccia

Princess Health and Princess Health andStudy: Banning sugary drinks from SNAP would reduce obesity and Type 2 diabetes; subsidy would boost fruit consumption.Princessiccia

diabetes food stamps fruit nutrition obesity research sugar vegetables

Gusty 08:43 Add Comment

A measure preventing people from purchasing sugar-sweetened beverages through the Supplemental Nutrition Assistance Program, or food stamps, would significantly reduce obesity and Type 2 diabetes in adults under 65, and adding a subsidy for fruits and vegetables would more than double the number of SNAP participants who meet federal vegetable and fruit consumption guidelines, says a new study published in Health Affairs.

Research has shown that people on food stamps suffer diabetes, heart disease and obesity at higher rates than people who are in the same tax bracket but not on food stamps, Diane Jeanty reports for PBS Newshour. In 2013, these findings prompted 18 mayors from major U.S. cities to write to Congress with a push to ban the use of food stamps to purchase sugar sweetened beverages.

The American Beverage Association pushed back, saying "sugared beverages were being targeted and were not the only causes for obesity," Jeanty writes.

A research team led by Dr. Sanjay Basu, an assistant professor of medicine at the Stanford University School of Medicine, conducted the study to determine how banning sugared beverages could affect the SNAP population�s level of risk for these diseases, Jeanty reports. They used a survey by the federal Centers for Disease Control, which assesses the nutritional status of adults and children, and combined it with current information on SNAP.

The study had two models, one that banned sugary beverages�excluding 100 percent fruit juice�and another that offered an incentive for SNAP participants to receive a 30 cent credit for each dollar spent on fruit and vegetable purchases. The study factored in metabolism rates and demographics such as race, age, gender and income to test the effects of the proposed measures, Jeanty reports.

They found that with a simulated ban, a person would reduce his or her calorie intake by 24 per day. They also found that obesity rates decreased 2.4 percent and type 2 Diabetes rates dropped 1.7 percent�or 240,000 people�Jeanty reports. The simulated subsidy, did not, however, have a significant impact on overall diabetes and obesity.

The study also found that by adding a simulated subsidy on fruits and vegetables, SNAP participants increased their consumption from 1/4 cup to 3 cups per day. However, increasing the amount of fruits and vegetables consumed is not enough to influence the reduction of diabetes and obesity on a national scale, according to Basu. �There would also have to be further reforms to also reduce the consumption of sugary beverages,� Basu told Jeanty.

The Illinois Public Health Institute, addressing a proposed ban in Illinois, found that SNAP participants would still purchase sugared beverages with their own money, even if they were banned, Jeanty reports. But Basu says that his study accounted for this consideration. Basu said it is time to perform a controlled study instead of a simulation model, Jeanty writes.

Princess Health and Princess Health andGroup overseeing effort to make state healthier hears of 'dire need,' tools for improvement.Princessiccia

Princess Health and Princess Health andGroup overseeing effort to make state healthier hears of 'dire need,' tools for improvement.Princessiccia

cancer cardiovascular disease dental care dental health diabetes drug abuse drugs health rankings mental health obesity oral health state government

Gusty 20:23 Add Comment

Kentucky's health is "in dire need of improvement," but the state has some tools to do that, including health-care reform and the insurance program for its own employees, the group of officials charged with improving the state's health heard at its first meeting Thursday.

Mayfield

Dr. Stephanie Mayfield, commissioner of the Department of Public Health, told the group overseeing "Kyhealthnow" that the state is near the bottom of national rankings on nearly every goal set for the effort, but "is poised to make strong progress through school-based programs and the fact that federal health reform has made preventive services free," a state press release said.

The goals are that by 2019, Kentucky will reduce its smoking, obesity and uninsured rates by 10 percent; cut its death rates from cancer and cardiovascular disease by 10 percent; reduce deaths from drug overdoses and the average number of poor mental health days by 25 percent; reduce the percentage of children with untreated dental decay by 25 percent, and increase adult dental visits by 10 percent.

The effort is overseen by state cabinet secretaries, other key state officials, Mayfield as co-chair and Lt. Gov. Jerry Abramson as chair, by appointment from Gov. Steve Beshear. They are to meet quarterly.

The oversight group also heard from Department of Employee Insurance Commissioner Joe Cowles, whose agency provides health insurance coverage for 266,000 members, including employees of state agencies, school boards and local government, as well as retirees under age 65 and their dependents.

Cowles talked about the two insurance plans that contain a wellness component designed to encourage plan members to lead healthier lifestyles. "These plans provide lower coinsurance, deductibles and out-of-pocket maximums," Cowles said. "But more importantly, those who choose a LivingWell plan are required to complete an online health assessment. This helps them become more aware of their current well-being and understand their health risks. And, they get a personalized plan of action so they can get or stay healthy."

The department also offers a diabetes prevention program at no cost, and it has shown encouraging results, as participants are improving their physical activity and overall health, Cowles said. And it has anti-fraud measures that track the distance members drive to fill prescriptions, what drugs they are buying, how often, and so on.

The officials also heard from Dave Adkisson, president and CEO of the Kentucky Chamber of Commerce, which has made the health and wellness of Kentuckians one of its top three priorities because health-insurance costs have increased and an increasing share of companies� tax dollars go to pay for health care. He said the state's health problems have reached �epidemic proportions.�

�We commend Governor Beshear for engaging his entire administration in a comprehensive effort to improve Kentucky�s health problems,� Adkisson told Kentucky Health News. �Health costs are a major issue among Kentucky businesses. But containing those costs can be like turning an aircraft carrier around in open water. We are glad state government as a huge employer has stepped up its efforts to encourage wellness among state employees and their family members who are covered by the state�s health insurance program. By being aggressive on wellness, prevention and disease management, tens of thousands of lives will be improved and health care costs paid by taxpayers will be contained.�

Princess Health and Does "Metabolically Healthy Obesity" Exist?. Princessiccia

Princess Health and Does "Metabolically Healthy Obesity" Exist?. Princessiccia

cancer cardiovascular disease diabetes disease metabolic syndrome overweight

Gusty 05:00 Add Comment

Obesity is strongly associated with metabolic alterations and negative health outcomes including diabetes, cardiovascular disease, and some types of cancer (1, 2, 3, 4). Excess body fat is one of the primary causes of preventable health problems and mortality in the United States and many other affluent nations, ranking in importance with cigarette smoking and physical inactivity. Obesity is thought to contribute to disease via the metabolic disturbances it causes, including excess glucose and lipids in the circulation, dysregulated hormone activity including insulin and leptin, and inflammatory effects. This immediately raises two questions:

1. Does metabolically healthy obesity exist?
2. If so, are metabolically healthy obese people at an elevated risk of disease and death?

Does metabolically healthy obesity exist?

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Princess Health and Floyd County newspaper editor calls on readers to make lifestyle changes to address area's diabetes health crisis.Princessiccia

Princess Health and Floyd County newspaper editor calls on readers to make lifestyle changes to address area's diabetes health crisis.Princessiccia

diabetes exercise health journalism heart disease nutrition obesity rural health rural journalism rural-urban disparities

Gusty 10:40 Add Comment

The editor of an Eastern Kentucky newspaper has joined an advocacy group's call for residents in his county to make simple, healthy lifestyle changes, serving as an example of how local newspapers and community members can engage the public to confront poor health status of the area, which is often put on the back-burner despite alarming warning signs.

Recently, the Tri-County Diabetes Partnership declared the rate of diabetes in Floyd, Johnson and Magoffin counties (map) "a crisis of epidemic proportions." The rate in 2002-10, the latest available, was 14 percent.

If the federal Centers for Disease Control and Prevention "saw a similar increase in any other illness, they would probably declare a national emergency,� said J.D. Miller, vice president of medical affairs for Appalachian Regional Healthcare, who chaired the meeting.

The group's statement was an appropriate response to direct public's attention to the imperative of addressing the area's skyrocketing rate of the disease, Ralph Davis of The Floyd County Times wrote in an editorial.

Diabetes will remain a crisis unless we do something about it, said Davis, and "if you have been waiting for a crisis before making healthy lifestyle changes, we�ve got one for you. In fact, we have several," Davis said.

The Central Appalachian region suffers from disproportionate rates of diabetes, cancer and heart disease, and Floyd, Magoffin and Johnson counties have much higher rates of obesity than state and national averages, Davis notes. Floyd County ranks last among the state�s 120 counties in overall health measures, and Johnson and Magoffin counties are ranked 108th and 104th, respectively.

To do something about this problem, Davis calls for concentrated attention by health care providers and government officials, but the problem won't be solved without action from the community and individuals, he says. Simple, healthy lifestyle changes are needed.

"It�s going to require the conscious decision by everyone in the region to do what they can to improve their diet and exercise habits, and to encourage their friends and family to do the same," said Davis.

Calls like Davis's are needed even more in most of the counties that surround the three counties, based on data from the CDC's Behavioral Risk Surveillance System. The counties in dark blue had rates above 14 percent; the highest was Greenup, at 17 percent.

Princess Health and State Health Department gets diabetes prevention funding; will focus on prediabetes detection and lifestyle changes.Princessiccia

Princess Health and State Health Department gets diabetes prevention funding; will focus on prediabetes detection and lifestyle changes.Princessiccia

diabetes federal grants grants health departments obesity prevention public health

Gusty 19:08 Add Comment

The state Department for Public Health has been awarded a $134,380 federal grant to help reduce high rates of prediabetes and Type 2 diabetes in Kentucky.

�Diabetes is a tremendous public health concern that is both horrific for the individual, if unmanaged, and costly in terms of medications, various complications and long-term hospitalizations that are so often associated with the disease,� Audrey Haynes, secretary of the Cabinet for Health and Family Services, said in a press release.

In 2009, Kentucky's rate for diagnosed diabetes was the fourth highest in the nation at 11.4 percent of the population, compared to a national median of 8.3 percent. The rate means an estimated 366,000 adults in Kentucky have diabetes. An additional 266,000 Kentuckians are estimated to have prediabetes, according to the CFHS website.

Prediabetes often leads to Type 2 diabetes, the most common type, within a few years, but lifestyle changes promoted by the federal Diabetes Prevention Program can decrease the risk of developing diabetes by almost 60 percent, according to a recent study published in the Journal of Preventive Medicine.

�We must act now to begin reversing the devastating impact of diabetes on our state,� Haynes said. �We are excited to continue our work with the Diabetes Prevention Program to help more Kentuckians start making healthier lifestyle choices so they can avoid developing diabetes and lead longer, healthier lives.�

The DPP specifically targets individuals with prediabetes and works with them to reduce their risk of developing Type 2 diabetes. The risk factors for both are: being older than 45, being overweight or obese, physical inactivity, having a family history of diabetes, ever having gestational diabetes, high blood pressure, abnormal cholesterol, having a history of cardiovascular disease and being African-American, Hispanic/Latino, Native American, Asian American or Pacific Islander. Click here to take the diabetes risk test.

The federal Centers for Disease Control estimates that national efforts to prevent Type 2 diabetes could save $5.7 billion in health care costs by preventing 885,000 cases in the next 25 years. Kentucky will focus on three diabetes prevention strategies that involve raising awareness among health care providers to improve detection and treatment of prediabetes and encouraging both state/local government and business to add lifestyle change programs to the list of covered services under health plans, says the news release. (Read more about diabetes and prevention in Kentucky).