Obesity And Knee Osteoarthritis Shorten Healthy Years Of Life

An estimated 10 million Americans suffer from knee osteoarthritis (OA), making it one of the most common causes of disability in the US. Due to obesity and symptomatic knee OA, Americans over the age of 50 will together lose the equivalent of 86 million healthy years of life, concluded researchers at Brigham and Women's Hospital (BWH), who investigated the potential gains in quality and quantity of life that could be achieved averting losses due to obesity and knee OA. These findings are published in theAnnals of Internal Medicine.

"Reducing obesity to levels observed in 2000 would prevent 172,792 cases of coronary heart disease, 710,942 cases of diabetes, and 269,934 total knee replacements," said Elena Losina, PhD lead author of the study and co-director of Orthopedics and Arthritis Center for Outcomes Research in the Dept of Orthopedic Surgery at BWH. "All told, it would save roughly 19.5 million years of life among US adults aged 50-84."

Experts have long known that knee osteoarthritis is on the rise among Americans, due in part to the growing obesity epidemic and longer life expectancy. Obesity and knee OA are among the most frequent chronic conditions in older Americans. However, how that translates into years of healthy life lost has not been accurately estimated. Dr. Losina and colleagues used a mathematical simulation model to assemble national data on the occurrence of knee OA, obesity and other important conditions such as coronary heart disease, diabetes, cancer and chronic lung disease. Their analysis examines the contribution of both obesity and knee OA to losses in quantity and quality of life. It also evaluates how those losses are distributed among racial and ethnic subpopulations in the United States.

"There are 86 million healthy years of life at stake, a disproportionate number of them being lost by Black and Hispanic women," said Jeffrey N. Katz, MD, Director of the Orthopedics and Arthritis Center for Outcomes Research at the BWH and a senior author of the study. "These staggering numbers may help patients and physicians to better grasp the scale of the problem and the potential benefits of behavior change."

This study was funded by grants from National Institute of Arthritis, Musculoskeletal and Skin Disease and the Arthritis Foundation. Contributing authors include Rochelle P. Walensky, MD, MPH, Massachusetts General Hospital, William M. Reichmann, MA, Holly L. Holt, Hanna Gerlovin, Daniel H. Solomon, MD, MPH and Jeffrey N. Katz, from Brigham and Women's Hospital, David Hunter MD from University of Sydney, Australia, Joanne M. Jordan, MD from University of North Carolina, Chapel Hill, Drs. Lisa Suter and A. David Paltiel, from Yale University School of Medicine.

Healthy Habits For New Hampshire Children

As part of an ongoing effort to instill healthy habits for New Hampshire children, Anthem Blue Cross and Blue Shield in New Hampshire is pleased to announce a multi-year grant to the Albert Schweitzer Fellowship (ASF). The grant of $167,446 will be used to support New Hampshire Fellows from Dartmouth College who will implement ASF's 5-2-1-0 Healthy Kids Countdown, a childhood obesity prevention program, in the granite state.

ASF was selected for the grant because its Schweitzer Fellows exceptional graduate and professional school students who dedicate themselves to addressing health disparities have served youth and families in underserved communities for nearly two decades. Specifically, ASF's New Hampshire-Vermont Schweitzer Fellows Program will use the Anthem Blue Cross and Blue Shield Foundation grant to support stipends for New Hampshire Fellows and participating community-based organizations, 5-2-1-0 Healthy Kids Countdown initiative training, leadership development training, and the purchase of equipment and other materials needed to support the Schweitzer Fellows' 5-2-1-0 Healthy Kids Countdown programming in community-based organizations.

The Fellows will address childhood obesity in underserved communities head-on and will work to help make the 5-2-1-0 Healthy Kids Countdown habits a part of children's lives through a comprehensive approach, including:

-- Integrating 5-2-1-0 Healthy Kids Countdown activities into community health fairs;

-- Featuring 5-2-1-0 messaging and programming in individual Schweitzer projects; and

-- Providing children and their families with 5-2-1-0 resources, such as weekly log sheets and colorful posters that reinforce healthy lifestyle messages

A total of $167,446 in grant funds will be directed to ASF for the New Hampshire program over the course of three years, beginning with $47,446 in 2010. Subsequent grants of $60,000 will be disbursed in 2011 and 2012, provided each year's grant terms are successfully met.

The 5-2-1-0 Healthy Kids Countdown program seeks to help kids live a healthy lifestyle by asking them to do four simple things:

-- Eat five fruits or vegetables per day

-- Limit screen time (TVs, computers) to two hours or less per day

-- Get one hour or more of physical activity per day, and

-- Drink zero sugar-sweetened beverages per day.

Developed in 2003, the 5-2-1-0 metric has since been recommended by the American Academy of Pediatricians and adopted by wellness programs across the country.

"Good habits at an early age can help New Hampshire's children avoid chronic health conditions such as obesity and heart disease throughout their lifetimes," said Lisa Guertin, president and general manager, Anthem Blue Cross and Blue Shield in New Hampshire. "Childhood obesity in our state and across the country has reached epidemic proportions, and it is a problem that impacts all of us in a number of ways including health care costs. This unique approach helps get at the crux of the issue."

Three years ago, Anthem launched its State Health Index, a program that incorporates public health data to identify and help address major health issues in New Hampshire. As part of the initiative, Anthem assembled a dedicated team to collaborate with local and state officials, as well as community organizations, to research the reasons behind the prevalent health deficiencies and to design policy solutions and implement or enhance programs aimed at helping to improve overall health in the state. "High up on the project list is child fitness, so this partnership is in wonderful alignment with that work," noted Guertin.

She added that Anthem also provides major support to the Foundation for Healthy Communities and its HEAL initiative (Healthy Eating, Active Living); both programs also champion the 5-2-1-0 movement in New Hampshire.

Obesity is a serious health issue for America's families and their children. Nearly one in three children are overweight or obese, and it is estimated that one-third of all children born in or after the year 2000 will suffer from diabetes. Additionally, research indicates that obesity and the resulting chronic health conditions associated with being overweight disproportionately impact people living in underserved communities, where fresh food sources are scarce and social factors make healthy lifestyles difficult to attain.

"Our hope is that through the 5-2-1-0 Healthy Kids Countdown, we will have an immediate impact on the health of underserved children and families but that also, in the long-term, we will have equipped future health professionals and community leaders with the tools to address childhood obesity in an empowering way that emphasizes individual choices," said ASF Executive Director Sylvia Stevens-Edouard, who played a key role in developing 5-2-1-0 during her time as the senior director of Children's Health Initiatives at Blue Cross Blue Shield of Massachusetts.

Since the launch of its U.S. Fellows Program in 1991, ASF has selected and supported over 2,000 Schweitzer Fellows who have delivered more than 400,000 hours of health-focused community service. From launching a Hepatitis B initiative that has since been replicated across the country, to creating a mobile legal assistance program for rural domestic abuse victims, Fellows from many disciplines partner with community agencies to create and carry out yearlong service projects that address the social determinants of health all on top of their regular academic responsibilities.

"In a given program year, around 80 percent of our Schweitzer Fellows across the country create and carry out service projects related to nutrition, physical health, and obesity," says ASF President Lachlan Forrow, MD. "Through our 5-2-1-0 Healthy Kids Countdown initiative, we're providing our Fellows and the communities they serve with an exciting variation on a proven resource for effective health promotion."

Source: Anthem Blue Cross and Blue Shield in New Hampshire

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Spanish Heart Risk Study Challenges Image Of Healthy Mediterranean Diet And Lifestyle

A Spanish study has challenged the long-held belief that people in the Mediterranean all enjoy more healthy diets and lifestyles, after discovering alarmingly high cardiovascular risk factors similar to those found in the UK and USA.

Research published in the January issue of IJCP, the International Journal of Clinical Practice, also found strong links between low levels of education and increased risk.

"Cardiovascular diseases account for 33 per cent of deaths in Spain, making it the main cause of mortality in the country" says Dr Ricardo Gómez-Huelgas from the Internal Medicine Department at Hospital Carlos Haya, Malaga.

The study was carried out on a random selection of 2,270 adults attending a healthcare centre in Malaga, Andalucia, a region with one of the highest rates of cardiovascular disease in Spain. The participants ranged from 18 to 80, with an average of just under 44 years, 50.3 per cent were female and 58 per cent had low educational levels.

More than 60 per cent were overweight or obese and 77 per cent did not get enough exercise. The researchers also found that 28 per cent smoked, 33 per cent had high blood pressure, seven per cent had diabetes and 65 per cent had high cholesterol levels.

Just under 30 per cent of the patients had three or more cardiovascular risk factors that could be modified by changes to their lifestyle or diet.

"Most of the cardiovascular risk factors increased with age, with the exception of smoking and low levels of 'good' cholestererol, and we noted some differences between the sexes" says Dr Gómez-Huelgas.

"We also found that a low education level was associated with a high prevalence of cardiovascular risk factors and this association was significant when it came to smoking, obesity, abdominal obesity and high levels of fatty molecules.

"The prevalence of obesity, diabetes, high blood pressure and high cholesterol in Spain have all risen at an alarming rate over the last 20 years and this is likely to cause future increases in bad health and death due to cardiovascular disease."

Other key findings of the study include:

* Men had a higher prevalence of smoking, high blood pressure, high levels of fatty molecules and impaired fasting glucose - which can lead to diabetes - than women.

* Women were more likely to demonstrate a higher prevalence of physical inactivity and abdominal obesity. Young female smokers with sedentary lifestyles were a particular concern.

* Obesity increased with age - 84 per cent of people over 50 were overweight or obese and 82 per cent had abdominal obesity, compared with 61 per cent and 56 per cent for the study as a whole.

"Our findings are cause for concern" says Dr Gómez-Huelgas. "We found high rates of obesity, abnormal lipid and fat levels and hypertension in the study group. And the high rates of smoking and sedentary lifestyles in young women raises fears for a large increase in cardiovascular deaths in this group in the near future. There are also issues around public health messages for people with lower education levels who tend to have higher risk factors.

"The drive to reduce cardiovascular disease by tackling these risk factors poses a real challenge for the healthcare profession. We hope that our findings can help to reduce risk factors among the most vulnerable sections of the community."

"The study by Dr Gómez-Huelgas and colleagues challenges the belief that cardiovascular disease, one of the fastest growing diseases in the developing world, is more likely to affect the chilly north than the sunny south" says Dr Anthony Wierzbicki, a London-based Consultant in Metabolic Medicine.

"In fact, the risk levels found in this study show parallels with the USA and are worse than those reported by recent UK studies.

"The myth that the Mediterranean diet and lifestyle is so healthy is based on 40-year old data from rural areas and so much has changed during those four decades. Studies like this are invaluable because they identify those people most at risk and provide valuable information that helps us to improve both screening and prevention strategies."

Paper: Prevalence of cardiovascular risk factors in an urban adult population from southern Spain. IMAP study. IJCP, the International Journal of Clinical Practice. Gomez-Huelgas et al. 65.1, pp 35-40. (January 2011). DOI: 10.1111/j.1742-1241.2010.02543.x

Editorial: Cardiovascular screening: which populations, what measure of risk? Wierzbicki A. IJCP, the International Journal of Clinical Practice. 65.1, pp 3-5. (January 2011). DOI: 10.1111/j.1742-1241.2010.02566.x

Source: Wiley-Blackwell

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American Women Speak Out About Weight Loss And Their Thoughts On Healthy Eating

On average, more than a third of American women think about their weight at least three times per day, and many think that achieving their weight loss goals or maintaining an 'ideal' weight requires overly strict and drastic lifestyle changes, according to a recent survey conducted by McNeil Nutritionals, LLC, the marketer of SPLENDA® Sweetener Products, with the support of SHAPE Magazine. Eighty-one percent of women surveyed do not think they are at their ideal weight; still, almost half are optimistic they will achieve their ideal weight in 2011. The survey, which polled women across the country ages 25-54, returned thoughtful feedback on the state of weight loss in America today and the things women are doing to stay healthy.

The survey revealed that when it comes to achieving or maintaining their ideal weight, most women are ill-informed on the most effective and/or healthy ways to do so. For example, 91 percent of women were unaware of the amount of calories one needs to burn in order to lose a pound of fat (3,500 calories). Women surveyed cited stresses, demands on their time, family obligations and financial problems as the reasons their weight loss efforts have been difficult. With so many other factors on their minds, the survey also found that women tend to overlook nutritional value in their food purchases, ranking price, taste and quality higher. Only 17 percent of women ranked nutritional value as the most important factor when purchasing food.

"We found that many women are implementing major lifestyle changes to lose weight. Oftentimes it's small, simple changes that are not only crucial to the weight loss process, but are also healthy and effective in the long run," said SHAPE magazine senior health and nutrition editor Sharon Liao. "We want to spread the message that it doesn't need to be really difficult to make a difference and get on the right track."

The survey went on to reveal some detailed information on the steps women believe are necessary to achieve or maintain a healthy weight. Many women surveyed believe that in order for an average woman to lose 20 pounds in one year, she would need to cut something like sweets or snacks out of her diet entirely (35 percent) or reduce her caloric intake to fewer than 1,000 calories per day (39 percent). In reality, an average woman can successfully lose weight if she follows a calorically-appropriate diet and stays active. The survey revealed that 70 percent of women currently add sugar to foods and beverages, most often adding it to their coffee (48 percent). By making smart substitutions with their food choices and by watching their portion sizes, women can continue to enjoy the foods they love with fewer calories from added sugars.

"If women have unrealistic ideas of what it takes to reduce calories and eat healthfully, they are more likely to become derailed in their weight loss efforts," said Fred Tewell, group product director for SPLENDA® Sweetener Products. "We want to educate women who are trying to manage their weight and let them know that a good place to start is by simply incorporating healthier habits into their daily routines, such as using SPLENDA® No Calorie Sweetener in place of sugar. If you replace 3 tablespoons of sugar each day with SPLENDA® No Calorie Sweetener, you'll save 100 calories. It's important for women to know that they can carry out their goals in simple, delicious ways that won't disrupt their daily lives."

Source:
McNeil Nutritionals, LLC

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