Category Archives: policy

entrepreneurship, healthcare, healthy habits, nutrition, policy

New Jamie Oliver ministry to open in Sydney

Good to see this, aligned with Riot Health mission… potential partnering opportunity?

Source: http://www.goodfood.com.au/good-food/food-news/new-jamie-oliver-ministry-to-open-in-sydney-20131022-2vz6i.html

New Jamie Oliver ministry to open in Sydney

  • October 22, 2013
Passionate about encouraging people to eat more healthily: Jamie Oliver.

On a mission … Jamie Oliver is opening a Ministry of Food in western Sydney.

For many years Jamie Oliver has been on a crusade to fight obesity and bad eating habits, with the aim to equip people the world over with cooking skills and a greater appreciation of fresh food.

Sydneysiders have witnessed his mission through numerous television shows, campaigns and cookbooks. Now it’s closer to home, with the announcement of the first Ministry of Food centre in NSW.

The British chef will open a cooking school in August to teach basic kitchen skills. It will be at the Stockland Shopping Centre at Wetherill Park in western Sydney, which is undergoing a $222 million redevelopment. It will be Oliver’s fifth Ministry of Food kitchen in Australia.

“Obesity is not just a diet-related disease. It’s the biggest killer in Australia and what the Ministry of Food is, it’s a fix and response that really does transform people’s confidence in the kitchens,” Oliver said.

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The cooking classes, funded by the not-for-profit arm of electrical goods retailer The Good Guys, will focus on basic cooking skills, nutrition, budgeting, meal planning and shopping tips.

Oliver said recipes would be healthy and tasty and would include desserts.

“We all love ice-cream. Life is about ice-cream and sometimes people get confused with some of my messaging,” he said.

“Of course we want to be as healthy as possible but we don’t want to edit out things in life. Life is about having beautiful treats and cakes and things like that.”

He said the problems began when parents gave in to their child’s requests for more soft drinks and desserts. “That’s the sort of repetition that gets us into trouble. Absolutely I give my kids ice-cream but my wife is fairly strict about when and how much.”

This year, the Australian Diabetes Council revealed that a diabetes epidemic had gripped the western suburbs of Sydney, with Liverpool in the south labelled as the suburb with the highest number of people with the disease.

Of the 10 suburbs with the highest incidence of diabetes, seven were in Sydney’s west, said head researcher, Alan Barclay. This includes Liverpool, Mount Druitt, Campbelltown, Westmead and Blacktown.

The high rates could be drastically reduced with a combination of improved primary healthcare and better knowledge of healthy cooking, he said in July.

“People need to know more about food and how to prepare it,” Barclay said. “We have to start doing more in schools and in the local community.”

The co-host of Channel Nine’s Today show, Lisa Wilkinson, will be the ambassador of the Ministry of Food centre.

healthcare, policy, politics

Diabetes set to become the largest epidemic in human history…

  • 600 million will suffer diabetes in 20 years, 2.3 million in Australia
  • Will kill one person every 6 seocnds (5.1 million people this year)
  • Affects developing economies just as much as developed economies
  • The US spends USD263 billion annually on diabetes
  • In 2013, AU will spend AUD11.4 billion, with 1 in 10 adults afflicted and 9500 deaths attributed.
  • Indigenous Australians have prevalence around 30%
  •  Western Pacific Islands have prevalence over 35%
  • Middle East (Saudi, Qatar, Kuwait) has a diabetes prevalence of 24%

 

Source: http://www.medicalobserver.com.au/news/largest-epidemic-in-human-history

‘Largest epidemic in human history’

DIABETES is likely to be “the largest epidemic in human history” with the number of people with diabetes predicted to surge to nearly 600 million in 20 years, including 2.3 million in Australia, experts say.

The latest edition of the International Diabetes Federation’s Diabetes Atlas, published today on World Diabetes Day, estimated that diabetes kills one person every six seconds and it will cause the deaths of 5.1 million people this year.

Professor Paul Zimmet, director emeritus of the Baker IDI Heart and Diabetes Institute, said the Diabetes Atlas group predicted 20 years ago that there would be 200 million people in the world with diabetes, but the predicted numbers for 2035 are almost double.

“Diabetes is likely to be the biggest health problem, the largest epidemic in human history,” he said.

The data showed that the majority of the 382 million people with diabetes today are aged between 40 and 59 and 80% of them live in low- and middle-income countries.

Professor Jonathan Shaw, associate director of Baker IDI Heart and Diabetes Institute, said the data debunked the historical idea that diabetes was a rich man’s disease.

“It really is not, when we look at the distributions across the world because the largest numbers of people with it are clearly in the developing world, particularly in our region with 138 million [in the Western Pacific] and 72 million in South Asia,” he said.

In contrast, around 37 million have diabetes in North America and 56 million in Europe.

However, health expenditure on diabetes in North American was 263 billion, higher than any other region in the world.

Australia spent $11.4 billion on diabetes care in 2013, with one in 10 adults now having diabetes, and more than 9500 people died from diabetes in Australia in 2013.

Comparative prevalence rates were highest in the Western Pacific Islands, where 37% of the population in Tokelau had diabetes, 35% in the Marshall Islands and 35% in Micronesia.

However, comparative prevalence rates had also surged in the Middle East where around 24% of the population in Kuwait, Saudi Arabia and Qatar have diabetes.

These prevalence rates were similar to that seen in Aboriginal and Torres Strait Islanders, where more than 30% of the population had diabetes, and high prevalence rates were common in indigenous people around the world.

complex adaptive systems, healthcare, healthy habits, nutrition, policy, rapid learning health systems, research methodology

NYT: The Challenge of Diabetes for Doctor and Patient

..or why managing diabetes doesn’t fit with how doctors have been taught, and therefore generally like, to treat patients >>> we need a radically new approach not involving doctors, busy doing other things – see Iora Health post re. health coaches.

The good news: lifestyle change for the obese or those with prediabetes may have lower progression to diabetes
http://archinte.jamanetwork.com/article.aspx?articleid=1485081

The average news: childhood obesity is plateauing [PN: ??from a scandalously high base]
http://www.nytimes.com/2012/12/11/health/childhood-obesity-drops-in-new-york-and-philadelphia.html?_r=0

The bad news: Intensive lifestyle change for diabetics did not reduce the risk of stroke or heart attack, even though these patients were able to lose weight, improve their overall quality of life, take fewer medications and even decrease costs.

Lifestyle changes — diet and exercise — require huge and ongoing investment efforts for patients; we’d like to think it pays off for the big-ticket clinical outcomes. Hopefully future studies will show benefits.

 

OCTOBER 17, 2013, 3:43 PM

The Challenge of Diabetes for Doctor and Patient

By DANIELLE OFRI, M.D.

My patient was miserable — parched with thirst, exhausted and jumping up to go to the bathroom every few minutes. His vision was blurry and he’d been losing weight the last few weeks, despite eating voraciously. I’d only just met him, but I was able to diagnose diabetes in about a minute. What was unusual was that this was a scheduled office visit; usually, patients with such overwhelming symptoms are the provenance of emergency departments and urgent care centers.

A quick shot of insulin and five glasses of water and my patient felt like a new man, with no need to go to the E.R. But now, of course, the hard work would begin. A new diagnosis of diabetes is an enormous undertaking — lots to explain, major life changes to contemplate, myths to dispel, consultations with a nutritionist and a diabetes nurse.

Two days later I had another new patient for a scheduled visit — thirsty, tired, losing weight, eating and drinking like mad, eyes so blurred he could hardly see. We’d barely gotten past the introductions before I’d made another new diagnosis of diabetes. Another shot of insulin, another five glasses of water, and then the plunge into the thicket of diabetes education.

Most of my regular office visits with diabetic patients — even newly diagnosed patients — don’t involve such dramatic presentations. More often the disease is found when we screen patients who have risk factors like obesity or a family history of the disease, or who have commonly co-occurring illnesses like hypertension, heart disease or elevated cholesterol.

These two patients highlighted the outsized role that diabetes plays in the primary care setting. The tidal wave of diabetes over the last two decades has made it one of the most common diseases that internists and family doctors treat. Right now feels like a good-news-bad-news time on the diabetes front, which in a general medical clinic can sometimes feel like the only front there is.

The good news is that childhood obesity rates have begun to inch downward in some cities, including among poor children, the first positive sign in the obesity epidemic in years. Obese children are potential future diabetic patients, so even incremental progress is a public health victory to celebrate.

Also good news is a study in which adults with obesity and pre-diabetes were able to lose weight with sensible lifestyle changes and coaching. This took place in a primary care setting, not a research setting, so this also suggests that we might be able to bend the curve of new diagnoses of diabetes.

But there’s also bad news. Intensive lifestyle changes for patients with diabetes, disappointingly, did not reduce the risk of stroke or heart attack, even though these patients were able to lose weight, improve their overall quality of life, take fewer medications and even decrease costs. Lifestyle changes — diet and exercise — require huge and ongoing investment efforts for patients; we’d like to think it pays off for the big-ticket clinical outcomes. Hopefully future studies will show benefits.

Even with all the research and new treatments available, combating diabetes can feel like a Sisyphean task. The bizarre contradiction of junk food being cheaper than healthy food, combined with a bombardment of advertising — especially toward children — make it a challenge even for motivated people to eat healthfully. Sugary drinks in monster-size containers abound. And our fixation with screens large and small keeps us increasingly sedentary.

But even with all the uphill challenges, there are successes, even if not perfect ones. Both of my patients who came to my office with florid diabetes that week have improved. Perhaps it was the concreteness of their symptoms that motivated them, but they have both made steady progress getting their diabetes under control.

Over the past few months they’ve been eating more moderately, and exercising more regularly. We’ve been calibrating their medications so that their blood sugars have left the stratospheric levels and are now only moderately elevated. Medication side effects, cost of glucose meter supplies, real-life logistics, and concomitant issues of blood pressure and cholesterol control have made it a challenge to get to normal. We’d still be dinged as “failures” in the quality-measures department for not achieving the recommended clinical goals, but both patients feel vastly better and are much healthier now.

So there’s bad news and good news. But the real news for these two patients – and for many, many more like them — is that diabetes is a marathon, not a sprint. Although there have been a flurry of life changes right now, diabetes is something they will live with for the rest of their lives. They will always have to be cognizant of what they eat. They will have to keep track of medications, glucose levels, carbohydrate intake, doctors’ appointments, exercise, and weight.  They will have to be on the lookout for the many complications that diabetes can bring. This of course is not news to anyone who has diabetes or treats diabetes, but for these two patients this was news.

Now, we gear up for the long haul, the messy, complicated, occasionally gratifying business of living with a lifelong chronic illness.

Dr. Danielle Ofri’s newest book is “What Doctors Feel: How Emotions Affect the Practice of Medicine.” She is an associate professor of medicine at NYU School of Medicine and editor in chief of the Bellevue Literary Review.

http://well.blogs.nytimes.com/2013/10/17/the-challenge-of-diabetes-for-doctor-and-patient

entrepreneurship, meaning, policy, politics

Bill Gates: Here’s My Plan to Improve Our World — And How You Can Help

From: http://www.wired.com/business/2013/11/bill-gates-wired-essay/all/

Bill Gates: Here’s My Plan to Improve Our World —
And How You Can Help

  • BY BILL GATES
  • 11.12.13
  • 6:30 AM

I am a little obsessed with fertilizer. I mean I’m fascinated with its role, not with using it. I go to meetings where it’s a serious topic of conversation. I read books about its benefits and the problems with overusing it. It’s the kind of topic I have to remind myself not to talk about too much at cocktail parties, since most people don’t find it as interesting as I do.

But like anyone with a mild obsession, I think mine is entirely justified. Two out of every five people on Earth today owe their lives to the higher crop outputs that fertilizer has made possible. It helped fuel the Green Revolution, an explosion of agricultural productivity that lifted hundreds of millions of people around the world out of poverty.

These days I get to spend a lot of time trying to advance innovation that improves people’s lives in the same way that fertilizer did. Let me reiterate this: A full 40 percent of Earth’s population is alive today because, in 1909, a German chemist named Fritz Haber figured out how to make synthetic ammonia. Another example: Polio cases are down more than 99 percent in the past 25 years, not because the disease is going away on its own but because Albert Sabin and Jonas Salk invented polio vaccines and the world rolled out a massive effort to deliver them.

Thanks to inventions like these, life has steadily gotten better. It can be easy to conclude otherwise—as I write this essay, more than 100,000 people have died in a civil war in Syria, and big problems like climate change are bearing down on us with no simple solution in sight. But if you take the long view, by almost any measure of progress we are living in history’s greatest era. Wars are becoming less frequent. Life expectancy has more than doubled in the past century. More children than ever are going to primary school. The world is better than it has ever been.

But it is still not as good as we wish. If we want to accelerate progress, we need to actively pursue the same kind of breakthroughs achieved by Haber, Sabin, and Salk. It’s a simple fact: Innovation makes the world better—and more innovation equals faster progress. That belief drives the work my wife, Melinda, and I are doing through our foundation.

WE WENT ON A SAFARI TO SEE WILD ANIMALS BUT ENDED UP GETTING OUR FIRST SUSTAINED LOOK AT EXTREME POVERTY. WE WERE SHOCKED.

Of course, not all innovation is the same. We want to give our wealth back to society in a way that has the most impact, and so we look for opportunities to invest for the largest returns. That means tackling the world’s biggest problems and funding the most likely solutions. That’s an even greater challenge than it sounds. I don’t have a magic formula for prioritizing the world’s problems. You could make a good case for poverty, disease, hunger, war, poor education, bad governance, political instability, weak trade, or mistreatment of women. Melinda and I have focused on poverty and disease globally, and on education in the US. We picked those issues by starting with an idea we learned from our parents: Everyone’s life has equal value. If you begin with that premise, you quickly see where the world acts as though some lives aren’t worth as much as others. That’s where you can make the greatest difference, where every dollar you spend is liable to have the greatest impact.

I have known since my early thirties that I was going to give my wealth back to society. The success of Microsoft provided me with an enormous fortune, and I felt responsible for using it in a thoughtful way. I had read a lot about how governments underinvest in basic scientific research. I thought, that’s a big mistake. If we don’t give scientists the room to deepen our fundamental understanding of the world, we won’t provide a basis for the next generation of innovations. I figured, therefore, that I could help the most by creating an institute where the best minds would come to do research.

There’s no single lightbulb moment when I changed my mind about that, but I tend to trace it back to a trip Melinda and I took to Africa in 1993. We went on a safari to see wild animals but ended up getting our first sustained look at extreme poverty. I remember peering out a car window at a long line of women walking down the road with big jerricans of water on their heads. How far away do these women live? we wondered. Who’s watching their children while they’re away?

That was the beginning of our education in the problems of the world’s poorest people. In 1996 my father sent us a New York Times article about the million children who were dying every year from rotavirus, a disease that doesn’t kill kids in rich countries. A friend gave me a copy of a World Development Report from the World Bank that spelled out in detail the problems with childhood diseases.

Melinda and I were shocked that more wasn’t being done. Although rich-world governments were quietly giving aid, few foundations were doing much. Corporations weren’t working on vaccines or drugs for diseases that affected primarily the poor. Newspapers didn’t write a lot about these children’s deaths.

This realization led me to rethink some of my assumptions about how the world improves. I am a devout fan of capitalism. It is the best system ever devised for making self-interest serve the wider interest. This system is responsible for many of the great advances that have improved the lives of billions—from airplanes to air-conditioning to computers.

But capitalism alone can’t address the needs of the very poor. This means market-driven innovation can actually widen the gap between rich and poor. I saw firsthand just how wide that gap was when I visited a slum in Durban, South Africa, in 2009. Seeing the open-pit latrine there was a humbling reminder of just how much I take modern plumbing for granted. Meanwhile, 2.5 billion people worldwide don’t have access to proper sanitation, a problem that contributes to the deaths of 1.5 million children a year.

Governments don’t do enough to drive innovation either. Although aid from the rich world saves a lot of lives, governments habitually underinvest in research and development, especially for the poor. For one thing, they’re averse to risk, given the eagerness of political opponents to exploit failures, so they have a hard time giving money to a bunch of innovators with the knowledge that many of them will fail.

By the late 1990s, I had dropped the idea of starting an institute for basic research. Instead I began seeking out other areas where business and government underinvest. Together Melinda and I found a few areas that cried out for philanthropy—in particular for what I have called catalytic philanthropy.

I have been sharing my idea of catalytic philanthropy for a while now. It works a lot like the private markets: You invest for big returns. But there’s a big difference. In philanthropy, the investor doesn’t need to get any of the benefit. We take a double-pronged approach: (1) Narrow the gap so that advances for the rich world reach the poor world faster, and (2) turn more of the world’s IQ toward devising solutions to problems that only people in the poor world face. Of course, this comes with its own challenges. You’re working in a global economy worth tens of trillions of dollars, so any philanthropic effort is relatively small. If you want to have a big impact, you need a leverage point—a way to put in a dollar of funding or an hour of effort and benefit society by a hundred or a thousand times as much.

One way you can find that leverage point is to look for a problem that markets and governments aren’t paying much attention to. That’s what Melinda and I did when we saw how little notice global health got in the mid-1990s. Children were dying of measles for lack of a vaccine that cost less than 25 cents, which meant there was a big opportunity to save a lot of lives relatively cheaply. The same was true of malaria. When we made our first big grant for malaria research, it nearly doubled the amount of money spent on the disease worldwide—not because our grant was so big, but because malaria research was so underfunded.

But you don’t necessarily need to find a problem that’s been missed. You can also discover a strategy that has been overlooked. Take our foundation’s work in education. Government spends huge sums on schools. The state of California alone budgets roughly $68 billion annually for K-12, more than 100 times what our foundation spends in the entire United States. How could we have an impact on an area where the government spends so much?

We looked for a new approach. To me one of the great tragedies of our education system is that teachers get so little help identifying and learning from those who are most effective. As we talked with instructors about what they needed, it became clear that a smart application of technology could make a big difference. Teachers should be able to watch videos of the best educators in action. And if they want, they should be able to record themselves in the classroom and then review the video with a coach. This was an approach that others had missed. So now we’re working with teachers and several school districts around the country to set up systems that give teachers the feedback and support they deserve.

The goal in much of what we do is to provide seed funding for various ideas. Some will fail. We fill a function that government cannot—making a lot of risky bets with the expectation that at least a few of them will succeed. At that point, governments and other backers can help scale up the successful ones, a much more comfortable role for them.

We work to draw in not just governments but also businesses, because that’s where most innovation comes from. I’ve heard some people describe the economy of the future as “post-corporatist and post-capitalist”—one in which large corporations crumble and all innovation happens from the bottom up. What nonsense. People who say things like that never have a convincing explanation for who will make drugs or low-cost carbon-free energy. Catalytic philanthropy doesn’t replace businesses. It helps more of their innovations benefit the poor.

Look at what happened to agriculture in the 20th century. For decades, scientists worked to develop hardier crops. But those advances mostly benefited the rich world, leaving the poor behind. Then in the middle of the century, the Rockefeller and Ford foundations stepped in. They funded Norman Borlaug’s research on new strains of high-yielding wheat, which sparked the Green Revolution. (As Borlaug said, fertilizer was the fuel that powered the forward thrust of the Green Revolution, but these new crops were the catalysts that sparked it.) No private company had any interest in funding Borlaug. There was no profit in it. But today all the people who have escaped poverty represent a huge market opportunity—and now companies are flocking to serve them.

Or take a more recent example: the advent of Big Data. It’s indisputable that the availability of massive amounts of information will revolutionize US health care, manufac­turing, retail, and more. But it can also benefit the poorest 2 billion. Right now researchers are using satellite images to study soil health and help poor farmers plan their harvests more efficiently. We need a lot more of this kind of innovation. Otherwise, Big Data will be a big wasted opportunity to reduce inequity.

People often ask me, “What can I do? How can I help?”

Rich-world governments need to maintain or even increase foreign aid, which has saved millions of lives and helped many more people lift themselves out of poverty. It helps when policymakers hear from voters, especially in tough economic times, when they’re looking for ways to cut budgets. I hope people let their representatives know that aid works and that they care about saving lives. Bono’s group ONE.org is a great channel for getting your voice heard.

Companies—especially those in the technology sector—can dedicate a percentage of their top innovators’ time to issues that could help people who’ve been left out of the global economy or deprived of opportunity here in the US. If you write great code or are an expert in genomics or know how to develop new seeds, I’d encourage you to learn more about the problems of the poorest and see how you can help.

At heart I’m an optimist. Technology is helping us overcome our biggest challenges. Just as important, it’s also bringing the world closer together. Today we can sit at our desks and see people thousands of miles away in real time. I think this helps explain the growing interest young people today have in global health and poverty. It’s getting harder and harder for those of us in the rich world to ignore poverty and suffering, even if it’s happening half a planet away.

Technology is unlocking the innate compassion we have for our fellow human beings. In the end, that combination—the advances of science together with our emerging global conscience—may be the most powerful tool we have for improving the world.

complex adaptive systems, data saving lives, healthcare, meaning, musings, policy, politics, rapid learning health systems

The gist of my concerns…

Post-change makers festival closing event, here’s a first go at capturing my main beefs with the health system – a little rough around the edges but captures the gist:

 

  Appearance Reality Vision
Mission Brittle health system Bankrupt sickness market Sustainable learning wellness market
Universality Universal healthcare Safety net + PHI Universal
Payment Fee for care Fee for activity Fee for outcomes
Leadership Run by experts Run by amateurs Run by the finest minds
Levers Doctors in hospitals prescribing pharmaceuticals and performing procedures Unmanaged social determinants with doctors spruiking pills and procedures Actively managed social determinants featuring broccoli magnates

That said, and given the issues and concerns we discussed, I suspect some (if not all) of what needs to happen, has to happen alongside or entirely outside the existing system. Hmm.

I just returned from the closing event for this: http://changemakersfestival.org/

I didn’t have a chance to properly speak with Jenny about our discussion, but got the impression that there simply wasn’t the kind of support for think tanks here that existed overseas.

That said, I did have a reasonable chat with Nicholas Gruen – an very interesting economist and thinker – and suspect there may be an alternate angle to pursue… will keep you posted.

musings, nutrition, policy

What REALLY Kills Us

Terrific Daniel Katz piece on LinkedIn on the actual causes of death.

Heart disease, cancer, stroke and diabetes are not causes, they are diseases.

The 1993 JAMA article “Actual Causes of Death” lays it out, and the top three causes of premature death, which account for 80% of the risk, are:

  1. tobacco
  2. diet
  3. exercise

Population-based research published in 2009 showed that people who ate well, exercise routinely, avoided tobacco, and controlled their weight had an 80% lower probability across their entire life span of developing ANY major chronic disease- heart disease, cancer, stroke, diabetes, dementia, etc.- than those who smoked, ate badly, didn’t exercise, and lost control of their weight

 http://www.linkedin.com/today/post/article/20131110133420-23027997-what-really-kills-us

What REALLY Kills Us

Heart disease is not the leading cause of death among men and women in the United States. Cancer, stroke, pulmonary disease, diabetes, and dementia are not the other leading causes of early mortality and/or chronic malady either.

Don’t get me wrong- these are the very diseases immediately responsible for an enormous loss of years from life, and an even greater loss of life from years. In that context, heart disease is indeed the most common immediate precipitant of early death among women and men alike. Cancer, stroke, and diabetes do indeed follow close behind. It’s just that these diseases aren’t really causes. They are effects.

We got this message loud, clear, and first- at least in the modern era- in what really should have been a culture-changing research paper published in JAMA in 1993 entitled ‘Actual Causes of Death in the United States.’ In that analysis, two leading epidemiologists, Drs. William Foege and J. Michael McGinnis, looked into the factors that accounted for the chronic diseases and other insults that immediately preceded premature deaths. When they were done crunching numbers, they had a list of ten factors that accounted for almost all of the premature deaths in our country every year.

Let’s digress to note we cannot ‘prevent’ death. But what makes death tragic is not that it happens- we are all mortal- but that it happens too soon. And even worse, that it happens after a long period of illness drains away vitality, capacity, and the pleasure of living. Chronic disease can produce a long, lingering twilight of quasi-living, before adding to that injury the insult of a premature death. And that, we can prevent. We can preserve vitality, and we can postpone death to its rightful time, at the end of our full life expectancy.

Now back to our regularly scheduled program. There were two astounding things about McGinnis and Foege’s list of ten factors*. First, we as individuals have substantial control over everything on the list, and virtually complete control over most of the entries. Second, just the first three factors on the list – tobacco, diet, and physical activity – accounted for fully 80% of the action. In other words, the actual, underlying “cause” of premature death in our country fully 8 times in 10 comes down to bad use of our feet (lack of physical activity), our forks (poor dietary choices), and/or our fingers (holding cigarettes).

I trust you immediately see the up-side to this. If bad use of feet, forks, and fingers accounts for 80% of premature deaths (and a bounty of chronic disease), it stands to reason that optimal use of feet, forks, and fingers could eliminate up to 80% of all premature mortality and chronic illness. This proves to be exactly true. Feet, forks, and fingers are the master levers of medical destiny.

We know this not just from McGinnis and Foege’s seminal paper, but from a steady drumbeat of corroborating research spanning the two decades since. Scientists at the CDC replicated the findings in the original paper in an update a decade later. Population-based research published in 2009 showed that people who ate well, exercise routinely, avoided tobacco, and controlled their weight had an 80% lower probability across their entire life span of developing ANY major chronic disease- heart disease, cancer, stroke, diabetes, dementia, etc.- than those who smoked, ate badly, didn’t exercise, and lost control of their weight. Flip the switch on any of these factors from bad to good, and the lifetime risk of serious chronic disease was reduced by nearly 50%. But firing on all four cylinders produced a greater net benefit than perhaps any advance in the history of medicine. These very findings have been replicated again, and again– and have been shown to extend that same influence over the expression of our very genes. DNA is not destiny, and to a substantial extent- dinner is. By changing what we eat and how we live, we can alter the expression of our very genes in a way that immunizes us against chronic disease occurrence, recurrence, or progression.

And so it is we have the knowledge to eliminate fully 80% of all chronic disease and premature death. The contention isn’t even controversial.

But knowledge, alas, isn’t power unless it is put to use. And for the most part, we have not leveraged the astounding memo we first got in 1993. Not only have we failed to slash rates of chronic disease, we are actually seeing them rise- with onset at ever-younger ages. We could bequeath to our children a world in which 8 times in 10, heart attacks and strokes and cancer simply don’t happen. Instead, should current trends persist, we will bequeath to them a world in which they and their peers succumb to just such preventable calamities more often and earlier than we.

So current trends cannot persist- and that, bluntly, is why I wrote Disease Proof. As a society, we clearly know the ‘what,’ but as individuals and families; spouses and siblings; parents and grandparents- most of us, just as clearly, don’t know how. How, despite the challenges of modern living, do we adopt, maintain, and enjoy a healthful diet? How, despite those same challenges, do we fit fitness in? How do we navigate around other challenges, from sleep deprivation and lack of energy, to overwhelming stress, to chronic pain?

These questions have answers, and I know them. I know them not because I’m special, but because it’s my job to know them. Pilots know how to fly planes; nuclear physicists know how to split atoms. I am a health expert, and I know how to get to health and weight control from here. Like any worthwhile thing, it requires a skill set- but we are used to that. We had to learn how to read and ride our bikes. We had to learn how to drive our cars and use our smart phones. Every worthwhile undertaking in our lives has involved someone who already knew how teaching us. Our job was to learn, and apply.

Health and weight control are exactly the same. In Disease Proof, I share the full skill set I apply myself.

We could, as a culture, eliminate 80% of all chronic disease. But my family and yours cannot afford to keep on waitin’ on the world to change. By taking matters into our own hands, we can lose weight and find health right now. We can reduce our personal risk of chronic disease, and that of the people we love, by that very same 80%. We can make our lives not just longer, but better.

What really kills us prematurely, and all too often imposes years of misery before hand, isn’t a list of chronic diseases, but the factors that cause those diseases. What really takes years from life and life from years is a willingness to know WHAT, yet neglect the opportunity to know HOW. What really kills us is the failure to turn what we know and have long known, into what we do. We can change that, and substantially disease-proof ourselves and those we love, any time we’re ready. I hope that’s now, because waiting- is really killing us.

-fin

DISEASE PROOF is available in bookstores nationwide and at:

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org

http://www.facebook.com/pages/Dr-David-L-Katz/114690721876253
http://twitter.com/DrDavidKatz
http://www.linkedin.com/pub/david-l-katz-md-mph/7/866/479/

 

*the list is: tobacco, diet and activity patterns, alcohol, microbial agents, toxic agents, firearms, sexual behavior, motor vehicles, and illicit use of drugs

healthy habits, nutrition, policy

AdShame saying stop, or we’ll say stop again?

A commendable element of a multi-prong approach… every bit helps.

adShame showcases the ways the alcohol and food industry regularly flout the rules when it comes to responsible advertising.

Our aim is to show that self-regulation is not working, and changes are needed to ensure that regulation protects children and young people from the harmful effects of alcohol and unhealthy food advertising. 

http://www.adshame.org.au/