The Lifestyle Chronicles - Limousines And Stockcars

Many studies of lifestyle and public health use self-reporting to gain needed information about personal habits and activities. This has been an unreliable tool for many reasons. A Danish research team at The National Institute of Public Research in Copenhagen chose to analyse 3.5 million supermarket transactions instead of asking people what they consumed.

The study was reported in the British Medical Journal and followed-up on previous data showing that drinking wine is linked to lower mortality rates than drinking beers and spirits. They found that wine buyers bought more olives, vegetables, fruits, poultry, cooking oil and low-fat cheese than buyers of beer. The beer buyers bought more cold cuts, chips, pork, butter, margarine, sausages, lamb and soft drinks.

The team suggested the food factor as a possible explanation of why drinking wine appears to be beneficial for health. No doubt they have a point but the more interesting question may be why these linkages exist. Could wine and beer create the tastes, or is it some deeper environmental or genetic programing?

Nevertheless, analyzing supermarket transactions is an interesting tool that provides a way to circumvent the lack of reliability for self-reporting.

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The Lifestyle Chronicles - Seeking Answers

A $5 million grant from the Starr Foundation ("Hank" Greenberg) to the Academic Medicine Development Company will fund a 5-year study to test interventions designed to delay or prevent the onset of Type-2 diabetes in children. The study involves 1,000 students to be recruited from public schools in Manhattan, Brooklyn and Nassau County.

The Academic Medicine Development Company is a consortium of 33 of New York State's medical schools, academic health centers and major medical research institutions.

A worthy study by an impressive group. This is a complex issue that needs more facts about what works in order to design effective interventions. The North Karelia Project, CardioVision 2020 and the health trainers (coaches) in the UK are related projects. Lessons learned from these projects will require special attention.

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The Lifestyle Chronicles - Chronic Problems And Acute Solutions

A recent article in the NY Times reported that schools are increasing time spent on reading and math, especially for low-proficiency students. Those subjects require annual exams and schools that fall short of rising benchmarks are penalized. Since the passage of No Child Left Behind, seventy-one percent of the nation's 15,000 school districts have reduced instructional time for history, music, art and social studies.

Sounds strange and very narrow. Lots of attention to preparation for a test. It may be years before we know if the powers-that-be in Washington know what they are talking about. Let's pray they do know what they are doing. Meanwhile, a lot of kids will be herded down the same path and God help them if this path is a deadend.

Requiring discipline and performance is good. Proficiency in fundamental knowledge is good. Using these as a basis for analyzing and solving problems is better. The health of future generations needs broad understanding of lifestyle that is currently lacking. What is the basis of that failure and how can it be addressed? It is an educational issue that is inadequately treated by medical care.

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The Lifestyle Chronicles - Up And At 'Em

Twice as many children and almost three times as many teens are overweight today as compared to 20 years ago. Overweight young people are more likely to be overweight or obese as adults.and excess body weight is a risk for diseases such as diabetes and heart disease.

The search for causes of excess body weight in children has established linkage between watching more television and increased risk for overweight. This has been attributed to the children being more sedentary. A recent study from the Harvard School of Public Health and Children's Hospital in Boston shows that children spending more time watching television also eat more of the calorie-dense and low nutrient food advertised on the shows they are watching (April 2006 issue of the Archives of Pediatrics and Adolescent Medicine).

Food marketing that targets children and physical inactivity are two social issues that need grassroots public attention. After-school programs that keep kids active and away from television could work. An active response that is positive more likely would be successful with kids than negative preaching or bullying.

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The Lifestyle Chronicles - Health Trainers (Coaches) in England

The NHS Health Trainers Program will deploy health trainers to work with local communities to help residents develop healthier lifestyles. This will include development of personal health plans, cessation of smoking, increasing physical activity, improving diet and assisting with access to needed services for achievement of health goals.

The program will start in the most health deprived areas in England with the highest levels of health inequities. The plan includes expansion to the entire country in 2007.

This is an ambitious program that bears watching. Undoubtedly, there will be lessons to learn from the experience.

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The Lifestyle Chronicles - "How Easy?" Versus "How Effective?"

Punam Keller from Dartmouth University has an interesting and potentially useful report in the June 2006 issue of the Journal of Consumer Research. He believes that some people are eager to try new things but base decisions about health behavior on whether they can actually do it, rather than if it is effective. Another group is more concerned about safety and security than accomplishment and growth. "A person who is more prevention-focused centers on preserving an absence of unwanted occurrences and maintenance of the status quo, and is more vigilant toward the decision to limit the chances of mistakes."

The implications concern how information about healthy practices and disease prevention would be best distributed to each group.

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The Lifestyle Chronicles - Mood Swings

There never could be any doubt that a public mood exists. In all probability there is a worldwide and national mood with local nuances. The aggragate mood must be the result of individual moods but the prevailing mood also has to influence individuals. Moods are derived from circumstances but the specific nature of these circumstances are not always apparant.

One readily available tool for assessing public moods is financial markets. Another method related to markets is shopping and consumer activity. The utilization of antidepressants also would be a selective barometer of mood except for the fact that once started they are continued. If the mood improves, it is believed to be the result of the medication.

Dutch researcher Maarten de Rijke and co-workers have developed a program to detect and explain mood patterns on the Internet. The opinions and experiences of tens of millions of people can be followed every day. Their project is called MoodViews and it follows the mood of 2 million bloggers from around the world. Each day the programs pick up about 150,000 blog messages. The reliability of the tool is assessed by determining if independently measured responses to worldwide events can be linked to global mood detected by MoodViews.

MoodViews has three components. One monitors the global mood of bloggers. Another uses language technology to predict mood on the Web. The third component records unusual peaks in mood levels and uses search engine technology to find an explanation for mood swings.

Of course, market researchers and psychologists are interested in these tools and the results. The linkage of mood and health, or at least the perception of health, present an opportunity to use these tools to search for ways to improve public health.

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The Lifestyle Chronicles - Oh, The Things You Will See

Two interesting examples of adaptation to change might be instructive for addressing problems that confront medical care today. One is the adaptation of automobile manufacturing to a shift in market conditions (Wall Street Journal, April 11, 2006) and the other is the development of container shipping.

For many years the automobile industry sold car models in large volume and assembly plants dedicated to one model operated at full capacity. However, when sales volume dropped expensive plants and equipment became idle because car models were not engineered for compatability of assembly. This has become a severe problem as market conditions for automobiles has changed resulting in rare mega-selling models.

The Japanese were first to develop flexible assembly plants to produce more than one car model. This required engineering the cars for compatibility of assemby and organization of the plant for rapid change-over from one model to another. The Japanese companies have reaped the rewards of this foresight. Now, Chrysler has moved in this direction and is gaining an edge on GM and Ford who have been slow to adapt.

The Box is a book by Marc Levinson that describes another example of adaptation. The history of cargo shipping is the slow and expensive moving of a wide variety of packages by the the muscle of stevedores and other heavy lifters. That changed with the standardized shipping container (the box) that could be moved from one means of transportation to another by machine or crane. Malcom McLean introduced the lifting of trailer bodies directly on ships at portside. An example is given of a 94% drop in costs shipping beer from Newark, N.J. to Miami.

For ten years McLean's innovation languished until the Vietnam War required rapid transport of huge amounts of material halfway around the world, and Japan's export boom of the mid-1960s. Ports that were willing to adapt prospered due to supercranes, reshaped docks, flexible labor contracts and connecting highways and railways. Newark, N.J. and Port Elizabeth would hasten the demise of antiquated and corrupt docks in Manhattan and Brooklyn. Boston and Phildelphia declined while Charleston, S.C., Savannah, GA and Los Angeles-Long Beach thrived.

These are examples of how market change, disruptive technology and innovative organization can produce success and cause failure. Medical care is involved in similar types of issues and searching for answers, e.g. application and dissemination of technology has been a constant struggle for medical care.

When change comes, some of it will be in the form of adjustments to the existing system, such as universal insurance coverage, different mechanisms for financing and application of information technology. But, the responses also will include actions and plans that redefine health care and change perspective as to its application.

These might be Humana using consumer oriented market research to develop programs that attract new business, a hospital in Portland, Oregon giving care to acutely ill patients at home or a risk-based health record vs a problem-based medical record.

Some are trying to create working models for community health care that emphasize health over sickness and create mechanisms for maintaining optimum health of populations. Finland is an example, Olmsted County in Minnesota has a model and Greenville County in S.C. has started to develop one. Steve Bellar has a model that addresses health and wellness for the individual.

There are other examples out there and more will come. Keep your eye on the development of innovative practices of public health that are oriented to primary and secondary prevention of illness and disease. I think communities all across America are moving in that direction.

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The Lifestyle Chronicles - Tradeoffs and Unintended Consequences

An interesting analysis of health risk comes from Joshua Cohen and colleagues at the Harvard Center for Risk Analysis (HCRA) and appeared in the American Journal of Preventive Medicine 2005;29(4):325-334. The study examined the public health tradeoffs of an advisory about the risks of methylmercury in fish and shellfish issued by the FDA and EPA in 2004.

Methylmercury is a neurotoxin that can cause developmental delays when young and unborn children are exposed. Fish are an excellent source of lean protein associated with better health and some are rich in omega-3 essential fatty acids. The omega-3 fatty acids are thought to reduce the risk of coronary disease and stroke, as well as promote the neurodevelopment of the fetus and infant.

The advisory was as follows: 1) avoid those types of fish with high mercury concentrations (shark, swordfish, king mackerel and tile fish); 2) eat no more than one meal a week of fish with moderate mercury levels, such as albacore tuna; 3) eat no more than two meals a week of fish with low mercury concentrations (e.g. shrimp, canned light tuna, salmon, pollack and catfish); and 4) check local advisories about the safety of non-commercially caught fish.

Evaluating the tradeoffs of the advisory depends upon the impact on fish consumption patterns, estimating the extent to which the resulting changes in consumption affect nutrient intake and contamination exposure and establishing the relationship between the dietary changes and the resulting health effects. The different types of health effects are aggregated to determine the net impact. One previous study following a similar fish advisory in 2001 found that pregnat women in eastern Massachusettes decreased fish consumption bt 17%. No study reports the impact of advisories on consumption in the broader population.

The HCRA group considered three scenarios for estimating changes in fish consumption resulting from the 2004 advisory. The optimistic scenario assumes that only women of childbearing age chage their intake of fish by shifting consumption from the typical mix of fish for US consumers to a mix that replaces fish high in mercury with fish low in mercury. This assumes the women reduce mercury exposure while essentially preserving the omega-3 fatty acid benefits and it was the response intended by the FDA and EPA. In the middle scenario only women of childbearing age react to the advisory by reducing their consumption of fish by 17% without changing to other fish. This assumes a loss of some neurological development benefits to unborn children due to decreased maternal intake of omega-3 fatty acids. The pessimistic scenario assumes that all adults reduce fish consumption by 17%, losing some protection against coronary heart disease and stroke.

The analysis includes four health effects: 1) the impact of mercury exposure during pregnancy on cognitive development as measured by IQ; 2) the impact of omega-3 fatty acids on cognitive development measured by IQ; 3) the net impact of fish consumption (i.e., the effect of both omega-3 fatty acids and mercury) on coronary heart disease mortality; and 4) the net impact of fish consumption on stroke-incidence and mortality.

Integrating the fish comsumption scenarios with the estimated impact on health outcomes and aggregating these impacts was done by use of the quality-adjusted life year (QALY). One QALY is defined as a year of life in perfect health, and death is a value of zero QALY. A year of less than perfect health has a value between zero and one QALY.

The impact of the 2004 advisory depends heavily on how it affects fish consumption.

The optimistic scenario resulted in a gain of more than 400,000 IQ points among the four million babies born annually in the America. There are slight increases in mortality and non-fatal strokes. The cognitive development benefit averages 0.1 IQ points per newborn baby and the increase in individual annual mortality risk is less than one in a million for women between the ages of 35 and 44 years.

Under the middle scenario the positive effects of omega-3 fatty acids on cognitive development are reduced and the net gain in IQ drops to 92,000 points per year for all newborn babies in the America (approximately 0.02 points per child). The mortality and non-fatal stroke risk remain small.

The pessimistic scenario results in the same cognitive development benefits to newborn babies because the conditions are identical to the middle scenario for women of childbearing age. The decrease in fish consumption among the adult population results in approximately 8,000 additional deaths and 1,500 non-fatal strokes each year. The risks differ by age group because of the differences in baseline risks. The estimate for a 17% decrease in fish consumption would increase annual mortality risk by approximately 3 per 100,000 for males between 55 and 64 years, by 8 per 100,000 for males between 65 and 74 years and by 28 per 100,000 for males between 75 and 84 years.

Converting IQ points, fatalities and non-fatal strokes into QALY aggregates outcomes and shows whether the overall impact is positive or negative. Under the optimistic scenario, cognitive development gains among newborns are the dominant factor and population well-being improves. Under the middle scenario, cognitive development remains the dominant factor, but the countervailing loss due to lower omega-3 intake contributes to reducung the gain by a factor of five. Under the pessimistic scenario, the cognitive impact for newborns remains beneficial but is dominated by the increased cardiovascular impact among adults.

The analysis found that an increase in fish consumption would decrease both stroke and coronary heart disease risk. Evaluation of epidemiologic data suggests substantial benefits are associated with consumption of at least some fish (e.g., one meal per week) rather than no fish.

The basis of the study and the reason for three scenarios is that the understanding and response to a public health advisory by the population is not uniform, nor does it take the intended course in all cases. Some responses may actually result in greater harm to health. It is an example of the many things that can go wrong and often do.

The questions arise then as to where best to place the emphasis in health and healthcare, how best to educate the public about health, how best to keep the public informed and how best to follow-up on important issues and problems. It begs the question as to the organization and delivery of healthcare in America. The recent posts about projects in Finland, Olmsted county in Minnesota and Greenville county in SC are a beginning. Subsequent posts will continue to address this issue of the organization and operation of healthcare in America.

This information comes from Risk in Perspective, January 2006, Volume 14, Issue 1.

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The Lifestyle Chronicles - Community Health Challenge

A healthy lifestyle consists of a few key behaviors that yield a large and growing list of benefits. Finland, first through the North Karelia Project and then through a nation-wide initiative, demonstrated that public health intervention prevents chronic disease and extends life expectancy. World Health Organization programs have made it possible for other countries to benefit from Finland's experience. In 1999 a community of interested parties that includes Mayo Clinic in Olmsted County, MN adapted Finland's experience and launched CardioVision 2020. CardioVision 2020 advocates personal commitment and community action as the most effective and least costly means to optimize health.

Subsequently, a consortium of Greenville, SC community organizations issued a challenge to CardioVision 2020 and Olmsted County on behalf of Greenville County to determine who can produce the most improvement in community health status by the year 2020. The challenge was accepted and CardioVision 2020 versus Healthy Greenville formally began in January 2004. The contrasts and commonalities will generate learning opportunities for any community that wishes to join the challenge. The members of the consortium are:

City of Greenville
Furman University
Greater Greenville Chamber of Commerce
Greenville Technical Education College
School District of Greenville County
The Greenville News

Healthy Greenville is a public health intervention project with the purpose of improving the health status of Greenville County citizens by altering health behavior. There are many broad and complex factors contributing to health status of populations but the message of Healthy Greenville is not complex. Everyone can grasp the message and it can be mastered to varying degree but only with personal commitment and community action. Motivation, inspiration and innovation will determine the degree to which the community masters the message but the message is constant. Practicing the message in everyday life will improve health. The message is:

1. Cease exposure to cigarette smoke.
2. Eat a balanced diet that includes five servings of vegetables and fruit daily, lean meat or
vegetable protein and low fat dairy, drink water, tea and lemonade and avoid sodas, and no
highly processed food.
3. Daily physical activity with a goal of walking 10,000 steps.

The objectives of the planning process are:

1. To stimulate and promote ideas that relate to the issue of health promotion and disease prevention.
2. To recruit the interest of all existing resources in the county.
3. To link and coordinate existing resources for the purpose of health promotion and disease prevention.
4. To establish and maintain a horizontal and decentralized functionality.
5. To avoid the development of unnecessary overhead and expenses.
6. To establish a seamless transition between planning and implementation.
7. To create a free flow of information so that all may learn from every effort.
8. To create momentum for a process that will never end.

Initial programs are designed to establish a base with children and young adults and link that base to health promotion initiated within corporations and other community organizations.

Healthy Greenville is a component of Healthy SC, a health challenge initiative with the mission to improve health status throughout the state - www.healthysc.gov

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The Lifestyle Chronicles - Time Warp

Is it my imagination or does time seem to slow down around Easter? It helps to have a little time warp every once in a while. The problem is that most of the time it seems to speed up.

The Lifestyle Chronicles - Why, Oh Why

Motivation is the ignition for a biological machine. Whether it is to improve health, lose weight, achieve better physical condition, look better, feel better or reward yourself, motivation, focus and commitment are the most important aspects of a healthy lifestyle. Do not be judgemental when it comes to inspiration and motivation. Vanity is good, and you have to look out for yourself if you want to be helpful to others. To be a good example can be of service to everyone, including you.

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The Lifestyle Chronicles - You Can If You Try

Health promotion, healthy lifestyles and disease prevention are frequently discussed and often written about in the medical literature, as well as the press. Be that as it may, the practice of preventive health care has yet to gain widespread acceptance and consistent application.

The predominant activity of health care practitioners continues to be providing service to people already suffering from illness and disease. Very few practices are organized for prevention and reimbursement is not clearly defined. Those practitioners who do consider prevention are largely addressing early detection (mammogram, PSA, biopsies) and secondary prevention such as drug therapy for elevated cholesterol.

I am confident that in time preventive health care will be a common practice. The public, community institutions and health care practitioners will need to be more systematic about prevention, and changes will be required in the financing mechanisms for health. There is good reason to believe the practice of preventive medicine may not be dominated by physicians. Nurses and other practitioners such as nutritionists and fitness instructors can serve well in this capacity. It is conceivable that lifestyle health coaches could be attached to a team trained and organized for primary health care where prevention and risk management are the predominant focus.

Primary prevention at the level of the community offers leverage for the most effective and efficient improvement in health status. The Framingham Project and the North Karelia Project in Finland provide evidence for lifestyle as the origin of chronic heart disease. The North Karelia Project demonstrates how public health intervention at the community level can effectively reverse this process and reduce the incidence of heart disease.

In the 1960s Finnish men had the highest rate for heart disease in the world and the Province of North Karelia had the highest rate in the Finland. The North Karelia Project was originated in 1972 to address this situation. It was a public health intervention to reduce smoking; improve diet by reducing fat and salt, and increasing vegetables and fruit; reduce weight; detect and treat systemic hypertension and elevated cholesterol.

The project demonstrated that a determined and well-conceived public health intervention would change health related lifestyle and population risk factors, and this leads to reducing disease rates and improved health status. By 1995 the incidence of heart attacks had decreased 75% and the incidence of cancer also decreased. Over a span of 20 years the project prevented 3,800 premature deaths in the North Karelia Province.

Some recent comments on this and other health related blogs have voiced skepticism about the effectiveness of preventive health care. Immunizations, smoking cessation, and the Framingham and North Karelia projects provide evidence that prevention and healthy lifestyle are effective. However, there is concern as to how this information might best be implemented in the US. The orientation of the US public and the US health care system is medical intervention with application of technology, drugs and surgery. This diverts resources from public health interventions that would be more effective. Of greater consequence is the distortion and distraction of attention from how best to achieve optimum health.

Medical care treats but does not cure chronic disease. Healthy lifestyles and primary prevention will not avoid all chronic disease but enough to improve health status and quality of life for the population. In turn, this provides high probability to change basic equations and outcomes for society.

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The Lifestyle Chronicles - Glad To Be Alive

Many years ago I made a presentation to the AOA Chapter at the University of Louisville medical school. During the discussion period someone asked me about the Medical University of South Carolina. My response included the fact that the College of Medicine at MUSC was founded in 1824 and is the first (oldest) medical school in the South. Exception was taken by a member of the audience in that the University of Louisville medical school can trace its ancestory back to the University of Transylvania, which would make it the oldest medical school in the South. I responded that even if their medical school was older, Louisville is not in "The South".

All of us are proud of where we come from and where we are. It is a part of who we are. That and our associations with those around us create our lifestyles. It is a beautiful time of the year. A time of growth and renewal and appreciation and gratitude.

Thanks to everyone for what you teach me everyday.

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The Lifestyle Chronicles - Reality TV

There is a new Reality TV show on the TLC cable network entitled "Honey, We're Killing The Kids". The show involves getting members of 13 families across the country to eat right and exercise.

Well, it certainly is worth a try. Until the answer is found, everything is open to exploration and it appears that Reality TV is part of today's lifestyle.

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The Lifestyle Chronicles - Promoting Disease(s)

David Henry and Ray Moynihan at Newcastle University in Australia have issued a report stating that pharmaceutical companies are exaggerating and inventing diseases to sell more drugs. They present the term "disease-mongering", which is defined as selling of sickness to widen the boundaries of illness and grow the markets for those who sell and deliver treatments.

Can you imagine that? I'm shocked!

Surely, our government would stop this, what with health care costs being so high and all.

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The Lifestyle Chronicles - Understanding Health

All medicine is health, but all health is not medicine.

It is a lesson that deserves considerable thought. The American public needs to be taught this lesson from early childhood through old age Those who understand it improve their chances for a more healthy life.

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The Lifestyle Chronicles - Healthy Lifestyles

Over the years as faculty members would retire, I would seek for them to return and participate on a part-time (paid) basis but doing what they enjoyed most. Usually, what they enjoyed most was what they did best. Many of them accepted and they enriched our institution once again.

One such faculty member was well-known and beloved in the university and in our state. His life was full and busy before, as well as after retirement but in different ways. He and I visited from time to time and we speculated as to how there could ever be enough time to do all the things of interest or worth. Our conclusion was that it helped to start early, gain wisdom fast (an oxymoron), live long, stay active and never lose enthusiasm.

It was this experience that taught me to question my parents' concept of retirement. That generation did more physical labor and considered retirement a reprieve. On the other hand, my father was in apparant good health and did not last two years after retirement. He was not as happy during those two years.

People need to remain active and productive to be happy and healthy. And, society needs the benefit of the experience and wisdom of these people. All organizations, especially non-profit enterprises, should re-think how to achieve a mutually beneficial balance with this valuable resource.

To lead a purposeful and productive life is to be healthy. The life of Sargent Shriver is a fine example and it should not be forgotten. He created and led the Peace Corps, founded Head Start, created the Job Corps and Legal Services for the poor, started Volunteers in Service to America and was president and chairman of the Special Olympics.

Mr. Shriver told the 1994 graduating class at Yale to shatter their mirrors. “In our society that is so self-absorbed, begin to look less at yourself and more at each other. Learn more about the face of your neighbor, and less about your own.”

His is a life of service that promoted healthy lives for others. It is a life young people should know about.

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The Lifestyle Chronicles - True, True And Unrelated

"Carrots are sweet".

Did you get heavy eating carrots?

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The Lifestyle Chronicles - A Little Discipline Will Help

Today's issue of the journal Science contains a study from the University of Erfurt in Germany involving 84 students in an investment game. Each player was given 20 tokens that at completion could be redeemed for real money. The players could join one of two groups and any player could change groups before each round.

One group could impose penalties within its membership and the other group could not. The players in the penalty group had the option to pay one token to dock another player three tokens. Otherwise, the two groups functioned under identical rules and conditions. Each round offered players the option to invest in a fund that returned guaranteed profit as a multiple of the tokens invested. The profit from an investment were distributed equally among all members of a group, including those who did not invest.

Initially, about one-third of the players chose to join the group that imposed penalties. Two-thirds of the players joined the no penalty group. Within each group everyone was aware of the contribution of each player, the profit generated by the group and their own return.

By the fifth round, about half of the no-penalty group had changed to the penalty group. A smaller number of players moved in the opposite direction. Round twenty found most of the players had joined the penalty group and the no-penalty group was deserted.

The conclusion drawn from the study is that a group (society) manages successfully when people with shared standards have the moral courage to informally sanction others to promote cooperation. Also, the results demonstrate how self-interest can over-ride aversion to punitive norms. Perhaps someone should introduce the investigators to the Survivor series on television.

There might be some lessons that pertain to community health. The self-interest of a community and its individual members dictates reduction of known health risk. How is the best way to do it? Penalties should not be excluded from consideration. An example is the current trend of communities to tax tobacco, prohibit smoking and restrict advertising by tobacco companies. Also, there is serious question about the need to limit advertising of junk food to children and advertising by pharmaceutical companies.

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The Lifestyle Chronicles - Rabbits Beware

Shining Wire Warren (Cowslip's Warren) from Watership Down is a warren built by humans. The rabbits are ignorant of the fact that humans harvest them. The humans give them an abundant food supply and set snares around the warren. Everything in the warren seems to be free, but the ultimate price is very high.

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The Lifestyle Chronicles - Courage To Do The Right Thing

Bill Strikes at Low-Nutrition Foods in School - New York Times

It will be very interesting to see what happens during consideration of this bill. An old saying goes that there are two things you do not want to see during production. One is sausage and the other is legislation.

With the Jack Abramoff Affair fresh in everyones mind, it is time to recognize that lobbying does not have to be illegal to be corrupt.

Wake up and smell the flowers! What our children and grandchildren eat plus physical activity does make a huge difference in their health and future lives. No amount of lobbying or high tech medicine will change that.

A study in Oregon revealed that vending is more profitable for the companies than it is for the schools (http://communityhealthpartnership.org). The attraction is revenue with more flexibility on how it may be spent. Administrators will go to extremes for small amounts of such revenue.

This legislation will do more to improve health status in the US than Medicare Part D or HSAs. A thorough analysis would reveal that Medicare Part D is detrimental to health status of the nation when compared to pursuing healthy lifestyle. Unfortunately, medications often are utilized in lieu of healthy lifestyle.

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The Lifestyle Chronicles - The 80/20 Rule

Eighty percent of medical cost is incurred by 20% of patients. It is a rule that is unsustainable if all people are patients. Modifying the conditions changes the population to which the 80/20 rule applies. When 100% of people practice preventive health care, then 20% are patients.

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The Lifestyle Chronicles - What's In A Name?

A diagnosis is the label associated with a health problem or a group of symptoms. Diagnoses do not have to be officially condoned or linked to a disease to be widely accepted by patients and health professionals. Diagnoses can create constituencies and fields of activity. It is common for a diagnosis to be misunderstood and there are more than a few examples of incorrect diagnosis.

Depression is a diagnosis that is frequently misunderstood. People responding to a life situation may be depressed and in America they are often treated with medications. The medications may or may not bring relief and the life situation may pass but the patient remains on the medication. The health care system is not oriented to resolution of life situations. Life situations need not be medical problems but the American culture pushes in that direction.

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The Lifestyle Chronicles - Get Out, Get Moving, Don't Stop

It is widely recognized and generally assumed that aging is associated with decreased exercise capacity. However, some athletes who maintain training have performed in masters competition at near their peak of an earlier age. Research at the University of Washington demonstrated that six months of physical training for two groups of men and women, one at ages mid-60s to late 70s and the other in their 20s and eartly 30s, abolished the disparity in exercise capacity between the groups (J. Susie Woo, M.D., Journal of the American College of Cardiology, 7 March 2006).

The older group increased peak work output by 29%, due to increased oxygen delivery and exercise efficiency. The younger group improved exercise efficiency only 2% but they boosted their peak oxygen consumption. These observations indicate that some of the decline in exercise capacity with aging may not be inevitable but results from decreased fitness that can be changed with training. So much for assumptions!

These were some of my thoughts while transversing the 10K course over the Cooper River Bridge. It was a great weekend with a Childrens' Fitness Festival and Runs on Friday, and the Bridge Run on Saturday. Don't ask me how or why over 47,000 people registered and 33,742 finished the course. The 14,000 prodigal runners/walkers will be welcome next year with everyone better trained.

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