• Archives
  • Jul12

    Recently I’ve seen several patients with terrible looking numbers: 260 LDL cholesterol, 35 HDL cholesterol, 375 triglycerides, 180/85 blood pressures, 222 blood sugars, 9% glycohemoglobin.

    The standard treatment for such numbers is clear: prescribe the right medicine in the right amount, and recheck in a few days or weeks.

    People with metabolic syndrome are up to 2.5 times more likely to die of heart-related causes and to have heart disease, a heart attack or stroke, compared to people without the syndrome.

    But these data don’t move people to action, even though they have Abnormal Lab Test Syndrome. I think it’s because they don’t know how good they can feel…and they usually feel ok.

    In my office, having one or two numbers as goal posts is very helpful for people who like to measure.  It gives us something to shoot for.  I usually gather my own numbers too: pedometer counts, body fat percentage, waist:hip ratio ( your waist should be half your height, as well).

    But people come to see me for a healthy direction and, usually, nonpharmaceutical approaches to their problems.  So writing recipes and exercises on prescription slips, recommending websites and books, and culling useless supplements are part of my job.

    The real challenge, now especially seen in companies that aim to create a culture of wellness, is how to motivate people to create real lifestyle change.

    For me, the key is finding out what people love to do–dance, build kites, plant trees, read–and then driving their individual program so that they have more energy for what they love, not less of a number they don’t.

    Getting to know patients as people instead of numbers is its own reward–and usually rewarded with less body fat, lower blood pressure and blood sugar, and less prescription medication.

     
  • Feb2

    To build a culture of health, develop policy, engage stakeholders, focus on healthy lifestyle changes, recognize success and measure impact is a long, worthwhile, profitable journey. So, it’s best tackled in bite sized portions.

    There are several great places to look.

    • The National Business Group on Health makes a business case for prevention and provides resources to members.
    • HERO has assembled a large, retrospective multi-employer health promotion research database.
    • PeopleMetrics has broadened corporate wellness (a poor sister, underfunded idea) to Employee Engagement, a robust notion of passion, retention, effort and advocacy.
    • The 3rd Corporate Health, Wellness & Benefits Summit just concluded.
    • The American Psychological Association (APA) celebrates psychological health in the workplace with annual awards and honorees. And #cohealth has a terrific monthly tweetchat.

    Among the 2010 APA honorees are Leaders Bank, which has amazingly kept people on course with a “comprehensive Adapting to Change and Effective Stress Management program, motivated from the ground up and endorsed by senior management.”

    I’m going to help Lincoln Financial later this month and next with starter-tips, and a unique How Job-Stressed Are You? Now quiz now in beta. It’s bite-sized, tasty and I hope really fun. Try it.

     
  • Jan10

    No one writes down on my medical practice questionnaires that they eat because they are stressed.

    People say that they eat for a reward, or are lonely or bored, or are happy or angry or frustrated, or because they want to.

    Scientists who study workplace health group say those feelings can mean “chronic stress.”

    But senior management see those feelings as something else: as overtime pay, temporary help, quality lapses, and higher health care, drug and health plan costs.

    Inside companies, health-related lost work time is barely noticed, because it is camouflaged as wanting to eat.

    When you drill down and look at the science, you find that some (acute) stress is helpful in the workplace.  And that learning to manage chronic stress boosts productivity and saves money.

    The place between acute and chronic stress is the razor’s edge. The science of job stress tells us that individualizing help at work is part of a successful program, with evidence-based interventions.

    Medical science now studies what works in stress management: behavioral therapy, exercise, relaxation and nutrition.  A few examples:

    Relaxation: a controlled trial of one 45 minute Swedish massage versus light touch measurably reduced cortisol levels and inflammatory markers (these levels and markers which are high in obese people too).

    Exercise: a randomized controlled trial of yoga postures measurably improved mood, increased GABA levels and decreased anxiety more than calorie-equivalent walking.

    Simple behavioral changes (breathing exercises) and dietary changes (chewing gum) also have scientific theory and data.

    There are many excellent resources online for individuals and companies that want to manage stress well. I’ve just taped an instructional DVD on the subject, and it’s fascinating!

     
  • Aug27

    Get ready for a boom in prevention. Many benefits will be covered. But which?

    Health plans established on or after Sept. 23, 2010 will need to cover preventive services rated “A” or “B” by the U.S. Preventive Services Task Force. Ditto Medicare/Medicaid by January 1, 2011.

    Which services are those for You? Fill in the quick blanks below: it shows “A” and “B”.

    No copays, deductibles and coinsurance amounts will be due. That’s for

    • Mammograms, colonoscopies and other cancer screenings.
    • Blood pressure, diabetes and cholesterol screening.
    • Lifestyle counseling (quitting smoking, losing weight, eating better, treating depression and reducing alcohol use).
    • Counseling and screening for healthy pregnancies.
    • Flu and pneumonia vaccines
    • Regular well baby and well child visits

    Older private employer plans are exempt or grandfathered, if they don’t change their plans. But most will. 70 percent will probably lose their exemption or grandfather status by 2013.

    Next: grants for employee wellness.

     
  • Aug1

    We rated 10 of the top online diet programs.

    We used the National Weight Control Registry’s core finding that people who keep weight off use personalized programs that teach and achieve four principles: accountability, self-monitoring, individualization of diet and adequate exercise.

    We assigned each program a total possible of 100 points, with each of the four areas representing 25 points.

    We included only paid programs, because other research has shown that people are more likely to adhere to a program they paid for, even if a free program is of higher quality.

    Here are the rankings, and links to the top six.

    Jillian Michaels (94 points)

    Joy Bauer (94 points)

    Denise Austin (91 points)

    Sonoma Diet (90 points)

    South Beach Diet (88 points)

    The Duke Diet (87 points)

    Weight Watchers (82 points)

    e-diets (76 points)

    Diet.com (66 points)

    Nutrisystem (56 points)