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  • Mar1

    Diabetes Doubles! Food Can Help. Should It Be Reimbursed?

    Posted in: Aging and Costs of Aging, Diabetes, Wellness and Health

    Americans treated for diabetes doubled to about 19 million (8.5% of the population) in 2007 compared with 9.1 million (4.6% of the population) in 1996, according to the AHRQ, a federal agency.

    That doesn’t count the undiagnosed (7 million) and those with prediabetes (79 million).

    Health care spending on diabetes more than doubled to $40.8 billion (the ADA says this figure is low: total diabetes costs are $174 billion, they say, in 2007). U.S. Diabetes expenses 1996-2007

    But something odd happened: what it was spent on changed.

    The amount spent on on prescription medication in 2007 doubled vs 1996: 46.7% compared with 23%.  The amount spent on home health actually fell by nearly two-thirds: 9.5% vs 27.1%.

    Individuals with diabetes paid double too: $1048 in 2007 versus $495 in 1996.

    What do all these numbers mean? They mean diabetes is doubling, fast. They mean that payers are paying for medication–not home care, by a mile.  Actually, by billions of dollars.

    But I wonder if these same payers know the data about lifestyle program cost and prevention of diabetes.Diabetes Prevention Program

    This slide summarizes the results of the Diabetes Prevention Program. It tested metformin (a good, inexpensive medication)  versus diet and lifestyle in reducing diabetes, for a year.  Metformin reduced diabetes by 31%.

    Lifestyle did better. It reduced diabetes by 58%. Without any complications.

    They lost just 7 percent of body weight and exercised only 2.5 hours weekly, on average.

    It was an expensive program–about as expensive as medication, not including diabetes costs prevented–but the researchers brought the costs down: United Health is testing a version with the YMCA and pharmacists.

    More innovation! That’s the spirit! Should the right food be reimbursed?

     

  • Sep28

    Is Food the New Pharma or Woo-Woo?

    Posted in: Cancer, Common Conditions, Environmental Health, High Cholesterol, Uncategorized, Wellness and Health

    New exciting food is the new pharma initiatives seem to be fighting with an equally new governmental crack-down on food with pharma claims.

    Who should you believe?

    On the one hand, Nestle is about to invest $500m in a new company to create food-based solutions to diabetes, obesity, Alzheimers and more.

    I think this is brilliant–Kit-Kats aside–and will bring much of the global interest in the health effects of foods front and center.  And it’s about time.

    On the other hand, the FDA doesn’t like Walgreen’s/CVS/Johnson and Johnson claiming that their mouthwash improves oral health because it contains flouride.  The FTC doesn’t like POM Wonderful’s claims that it improves prostate cancer (or its CEO’s claims that it is “40 percent as effective as Viagra“)…or a dozen other issues in the warning letter.  Cheerios don’t lower cholesterol, Mini-Wheats don’t improve kids attention, and there is more to come.

    How does a consumer make sense of this?  Does food work like medicine, or is it just food?

    I’m going to talk about this, and our way out, at TEDx American Riviera in Santa Barbara next month: the NYTimes covered TEDx talks this weekend. Expect 12 intense and hopefully entertaining minutes.

     

  • Aug24

    Short Trip to Sacto: Obesity Testimony

    Posted in: Child Obesity, Obesity and Weight Loss, Wellness and Health

    Jamie Oliver illustrating policy change in West Virginia...next stop SacramentoTomorrow I’m testifying at a Legislative Informational Hearing on Diabetes and Obesity at the California State Capitol in Sacramento on what works in practice.

    It’s not unfamiliar, but still a challenge. I did testify before the U.S. Senate Subcommittee on Aging about the care near the end of life in the 1990s.

    Now the time seems right to be part of change about obesity and public policy.

    You can read the press release about my appearance, and sneak a quick look at my prepared statement.

    I think this will be fun, and hope you’ll find ways to advocate for change not just in school lunches (which California is leading in, within the U.S.), but also in “seat-belt-equivalents” (my term).

    Seat belts save more lives than any doctor ever will. We need something like them in obesity and diabetes prevention. What would it be?

    Here’s a 90 second viewer success story in diabetes: a viewer of my Chef MD segment on Lifetime TV followed my plan, wrote to me, I encouraged her, and she transformed her life. Gotta love how powerful Susan is.

     

  • Jun7

    Personal Food Revolution #7: Reverse Diabetes with What You Eat…Out

    Posted in: Common Conditions, Wellness and Health

    One of the best ways to help people transform their lives and create their own food revolution is to write my patients’ stories: this is #7 of 7.*

    Carol has diabetes. She is 48 years old, the mother of two and a successful Washington litigator. She does not know what to eat at the dinner she must attend tonight.

    She eats out ten times weekly, usually orders chicken Caesar salad, and snacks on cheese, chocolate and energy bars. She often eats the last of her Taco Bell in the front seat of her car before going in for the night.

    I tell her that she can beat insulin resistance, which is causing her out of control diabetes. But she has to treat her disease like her best client–conscientiously.

    She is to avoid red and processed meat for 12 weeks: the heme iron increases diabetes risk. Ditto, any food with the words High Fructose or Enriched Flour or Sugar or Rice or Corn Syrup on the package.

    Tonight, like every night out, she should have two dinner salads with good vinaigrette over 20 minutes with good fish or lean poultry, and drink hot cinnamon tea afterwards. She should pack almonds, high protein cereal, tea bags and string cheese when she travels.

    Carol liked knowing what to eat, and practiced it, a lot, with coaching. She now teaches water aerobics in Virginia.

    *adapted from ChefMD’s Big Book of Culinary Medicine.

     

  • Dec15

    "Drinks with Benefits" for Diabetes Prevention

    Posted in: Common Conditions, Environmental Health

    “Drinking 4 cups of coffee, decaf, or tea daily can reduce the chances of getting type 2 diabetes by about 25 percent to 35 percent.”

    That’s usually 6 ounce cups, that’s Harvard University data, and that’s almost 500,000 people…though a “small study.” Nonsense.

    Chalk another one up for the convergence of food-is-medicine, the medical literature, and real food. The green movement and the local food movements are close behind.

    And conventional medicine is finally catching up to patients. This week alone we’ve seen:

    1. a glowing review of “an up-to-date nutrition reference text that physicians, particularly family practice physicians, should have on their bookshelves” …about food that can help prevent and control disease (more books on culinary medicine).

    2. a JAMA caution about artificial sweeteners (saccharin, acesulfame, aspartame, neotame, sucralose). A pediatrician calls them an “inadvertent public health experiment”, citing 2009 adult data showing a 67% greater risk for type 2 diabetes with daily diet soda. Just one daily.

    3. Chefs beginning to think about the flavors of street food and their own health in the same taco.

    Of course, a low carb, low glycemic load, higher monounsaturated fat, plant-based diet with fewer calories and directed, guided, sustained muscle cell build up to amass insulin receptors is best for most people trying to prevent and control type II diabetes.

    Maybe it’s the magnesium, lignans, and chlorogenic acids in coffee; maybe it’s tea catechins which lower sugar production; maybe caffeine has something to do with it.

    But the take-out point? Food works. Get the right stuff.

    If coffee or tea were FDA improved, there would be a run on doctors’ offices and pharmacies. Caution if you’re addicted, have a heart arrhythmia, or have an anxiety disorder. Otherwise, enjoy.

     
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