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Wednesday, 4 June 2014

Princess Health and Princess Health andKentucky gets $1.75 million in national settlement with big drug maker; marketing and promotional practices reined in.Princessiccia

Princess Health and Princess Health andKentucky gets $1.75 million in national settlement with big drug maker; marketing and promotional practices reined in.Princessiccia

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Kentucky will receive approximately $1.75 million from a $105 million national settlement with GlaxoSmithKline to resolve allegations that the pharmaceutical manufacturer unlawfully promoted its asthma drug, Advair, and its antidepressant drugs, Paxil and Wellbutrin, according to a press release from Attorney General Jack Conway's office.

The complaint and consent judgment alleges that GSK violated state consumer-protection laws by misrepresenting the uses and qualities of these drugs. Conway said in the release that this settlement will change the way pharmaceutical sales teams are motivated and paid.

The consent judgement requires GSK to reform its marketing and promotional practices, stating the company shall not: make any false, misleading or deceptive claim about its products; make claims not approved by the U.S. Food and Drug Administration; present information or conclusions from inadequate clinical studies; provide samples to health care professionals if they know it is being prescribed for non-approved use; or provide information describing any off-label use of a GSK product, unless consistent with applicable Food and Drug Administration regulations.

They must also continue a program through March 2019 that decreases financial incentives for sales representatives who use deceptive marketing practices, says the release.  In addition, scientifically trained personnel will be responsible for providing unbiased and non-promotional information to health care providers.

Kentucky joined 43 other states and the District of Columbia in reaching the national settlement with GSK.

Princess Health and Princess Health andLexington preschool becomes Kentucky's first with a farm-to-school food program.Princessiccia

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About 20 years from now, today's preschoolers will be purchasing and preparing their own food. What if they spent 13 years in an educational setting that taught farm-to-school practices? Children who represent the next generation would learn not only to eat healthy food but also to support local food systems, state Farm to School Program coordinator Tina Garland told Cerise Bouchard of Lexington Family Magazine.

This year, Growing Together Preschool in Lexington became the first Farm to Preschool program facilitated by the state Department of Agriculture. Bouchard returned to GTP in July 2013 as the executive director with the goal of improving the menu by working with a farm to provide community-supported agriculture.

When Bouchard told Garland about her idea, Garland connected her with Lazy Eight Stock Farm and Carla Bauman, who told the magazine, "I am excited about being part of a project that encourages young children to like eating fresh fruits and vegetables while their food preferences are still forming." Bauman said the the GTP project also will give the students' families weekly access to fresh, local, organic produce.

Childhood obesity rates in Kentucky are very high, and many children eat most of their meals in school, Bouchard writes. Instead of exacerbating the problem, schools have an opportunity to improve the health of children. GTP's focus has always been on quality improvement initiatives, and "Implementation of the Farm to School program is simply the next step to ensuring that we are making the best decisions to improve and support the development of the whole child," Bouchard writes.
Princess Health and Princess Health andWhat you eat, such as refined and easily digestible carbohydrates, may be more important that how much you eat.Princessiccia

Princess Health and Princess Health andWhat you eat, such as refined and easily digestible carbohydrates, may be more important that how much you eat.Princessiccia

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By Melissa Patrick
Kentucky Health News

Our weight is determined by the number of calories we take in compared to the number of calories we expend. So, if you over-eat and don't exercise, all those extra calories will be stored as fat, and the solution to losing the fat is to eat less and exercise more, right? What if this isn't true?

For most people, over the long term, eating less doesn't work, nutritionists David S. Ludwig and Mark I. Friedman write in an opinion piece for The New York Times. They suggest it is time to look at another idea, one that says overeating is not causing us to get fat, but that the process of getting fat is causing us to overeat.

This hypothesis suggests that when fat cells take in too many calories, those calories increase the amount of fat tissue instead of providing the energy our bodies need to function. When this happens our bodies still think we need food, so they continue to tell us we are hungry. Thus, we eat more and subsequently gain weight, Ludwig and Friedman write in The Journal of the American Medical Association.

Studies have shown our bodies have a "set point" for weight largely determined by our genes, Ludwig and Friedman note. If this is true, they then pose the question: Why has obesity almost tripled since 1960, and what can we do about it?

Ludwig and Friedman write that among the many biological factors that affect the storage of calories in fat cells, one has an indisputably dominant role: the hormone insulin. We know that excess insulin causes weight gain, and insulin deficiency causes weight loss. We also know that highly refined and rapidly digestible carbohydrates, like sugar or potatoes, produce the most insulin.

The authors suggest that the increasing amount of refined carbohydrates in Americans' diets has "increased insulin levels, put fat cells into storage overdrive and elicited obesity-promoting biological responses in a large number of people."

The authors suggest that one reason we consume so many refined carbohydrates is because they have been added to processed foods in place of fats, especially since low-fat diets are the most recommended diet. However, several studies cited in the article show that low-fat diets are the least effective way to lose weight.

The authors recognize that existing research cannot provide a definitive test of their hypothesis and the existing trials have exhibited major limitations, but it is time to "invest much more in this research." The cost savings for treating diabetes alone�predicted to approach half a trillion dollars by 2020�would make it a good investment.

If this hypothesis turns out to be correct, the authors say obesity treatment would more appropriately focus on diet quality rather than calorie quantity.

"With reduced consumption of refined grains, concentrated sugar and potato products and a few other sensible lifestyle choices, our internal body weight control system should be able to do the rest," they write. "Eventually, we could bring the body weight set point back to pre-epidemic levels. Addressing the underlying biological drive to overeat may make for a far more practical and effective solution to obesity than counting calories."

David S. Ludwig directs the New Balance Foundation Obesity Prevention Center at Boston Children�s Hospital and is a professor of pediatrics at Harvard Medical School. Mark I. Friedman is vice president of research at the Nutrition Science Initiative. (Read more)
Princess Health and Calorie Intake and Body Fatness on Unrestricted High-fat vs. High-carbohydrate Diets. Princessiccia

Princess Health and Calorie Intake and Body Fatness on Unrestricted High-fat vs. High-carbohydrate Diets. Princessiccia

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In recent posts, we've explored the association between calorie intake and the US obesity epidemic, and the reasons why this association almost certainly represents a cause-and-effect relationship. I also reviewed the evidence suggesting that carbohydrate and fat are equally fattening in humans, calorie for calorie.

One valid objection that came up in the comments is that calorie-controlled diets in a research setting may not reflect what happens in real life. For example, in a context where calorie intake isn't tightly controlled, diet composition can impact calorie intake, in turn affecting body fatness. This, of course, is true, and it forms one of the central pillars of our fat loss program the Ideal Weight Program.

Some low-carbohydrate diet advocates argue that the obesity epidemic was caused by US dietary guidelines that emphasize a carbohydrate-rich diet*. The idea here is that the increase in calorie intake was due to the diet shifting in a more carbohydrate-heavy direction. In other words, they're hypothesizing that a carbohydrate-rich eating style increases food intake, which increases body fatness**. According to this hypothesis, if we had received advice to eat a fat-rich diet instead, we wouldn't be in the midst of an obesity epidemic.

Fortunately for us, this hypothesis has been tested-- many times! Which eating style leads to higher calorie intake and body fatness when calories aren't controlled: a carbohydrate-rich diet, or a fat-rich diet?

Short-term Studies

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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

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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.
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