Posts Tagged ‘Public Health’

Public Health, a Leading Indicator of National Wealth

February 26th, 2014 at 11:36 am by timigustafson

A country’s gross domestic product (GDP) has long been the predominant measure for its wealth and standard of living of its citizens. But that’s a relatively small element of the entire picture, according to Paul Bulcke, CEO of Nestlé, a multinational food and beverage company, the world’s largest of its kind. What remains largely neglected are additional important aspects, including the state of public health.

More than any other indicator, the health and well-being of the population should be of interest to us when we talk about the wealth of nations, he writes in a recent article published in the German edition of the Huffington Post.

Amounts of healthcare spending alone do not tell us how healthy people are in any given part of the world. It is well known that the United States has by far the highest expenditure per capita worldwide, yet falls dramatically behind in terms of access to healthcare, infant mortality, and longevity. Canada, for example, spends about 40 percent less but has a slightly higher average life expectancy. Leading European nations like Germany, France and Switzerland do much better as well – at about half the cost. And even notoriously welfare-oriented Scandinavian countries like Norway, Denmark and Sweden all seem to offer much more bang for the buck.

There can be countless speculations about these discrepancies, but in the end, everyone has to look at the same situation: Despite of record-high spending on medical services, people get sicker everywhere in greater numbers. According to the World Health Organization (WHO), more people die every year from so-called non-communicable diseases (NCDs) like obesity, diabetes, heart disease and cancer than ever before, and the trends are worsening. Even more tragic is that most of this could be prevented with better diet and lifestyle choices.

One of the reasons why we seem unable to address these issues more effectively is our culture and the policies we have put in place to deal with illnesses as they occur, rather then finding better ways to prevent them from taking hold in the first place, says Bulcke.

“We need to focus on a culture of healthful living and disease prevention,” he urges.
“Unfortunately, we have a tendency to value our health only after we’ve lost it. This position has to change. We have to protect and improve our public health. […] That means that healthcare systems must be developed further in terms of prevention and improvement of health standards. This is what we must concentrate on.”

As the CEO of a leading food manufacturing company, Bulcke sees a clear mandate for his industry to contribute more forcefully to the creation of health-promoting environments through education and, if necessary, sensible regulation.

Consumers must also take responsibility to lead healthy lives as best as they can. But industry and government should support those efforts and not hinder or inhibit them by remaining on the sidelines.

“There cannot be any healthy industry within an unhealthy society,” he writes. Both are interdependent, and progress will only be made if all parties work together for the common good.

Amen to that.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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More Attention Must Be Paid to Obesity Prevention, Report Finds

August 10th, 2013 at 5:48 pm by timigustafson

The United States government does not enough to prevent obesity and obesity-related illnesses, according to a report by the Institute of Medicine (IOM), a non-profit organization that advises policy makers on issues of science, medicine and health.

Obesity continues to pose one of the greatest public health challenges of the 21st century, creating serious health, economic, and social consequences, despite of the numerous efforts that are being made to better understand the causes of the epidemic and to implement preventive interventions, says the report.

35.7 percent of adults and 17 percent of children and adolescents are currently diagnosed as obese in America, according to the Centers for Disease Control and Prevention (CDC).

In a prior report, the IOM laid out its plans for solving the nation’s obesity crisis through decisive measures in terms of policies and incentives for individuals and communities to speed up progress in treatment and prevention.

Besides the staggering human toll caused by obesity and related chronic diseases and disabilities, the IOM warns that the growing medical costs are unsustainable, even in the foreseeable future. Today, treating obesity amounts to nearly $200 billion annually.

Preventive measures put in place so far, however, are insufficient, sporadic, and underfunded, the IOM report warns. The organization recommends the creation of a task force to guide and oversee a comprehensive national anti-obesity plan.

The concept of prevention also plays an important role in the Affordable Care Act (a.k.a. Obamacare). The Prevention and Public Health Fund (PPHF) was created as a national investment to reduce the occurrence of preventable chronic diseases, including obesity, diabetes, heart disease and cancer. Unfortunately, funding for the program was substantially reduced by Congress in 2012 and again in 2013.

A good example for how preventive health policies could be developed was set by the New York State Department of Health (NYDH). In a “Strategic Plan for Overweight and Obesity Prevention”, the department listed a set of important markers to help more New Yorkers achieve and maintain a healthy weight range.

Among them are the goals to increase public awareness of obesity as a major health threat; identify environmental, socio-economic and personal factors that contribute to obesity; recognize early tendencies toward excessive weight gain; improve management of obesity-related diseases; reduce food insecurity and hunger; set guidelines for healthier eating habits; promote lifelong physical activity; encourage employer-sponsored physical activity and fitness programs in the workplace; require daily physical education (PE) classes for all public and private schools; recommend limiting television viewing time for children; decrease exposure of children and adolescents to advertisements for products associated with overeating; work toward greater availability and affordability of healthy foods and beverages in low-income neighborhoods.

The NYDH also acknowledges that government cannot do all, if any, of this alone and needs the public to support initiatives, policies and legislative measures to implement at least some of its recommendations.

Granted, these are highly complex issues that require concerted action by all of society, whether it’s on the federal, state or local level. That in itself makes it a daunting task. But, considering the dismal track we are on, what choice do we have other than doing our best to turn this crisis around.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Diabetes Can Be Caused by High Sugar Intake Alone, New Study Finds

March 3rd, 2013 at 2:43 pm by timigustafson

Diabetes affects over 25 million Americans today, more than 8 percent of the population. One in four seniors suffers from the disease, and the numbers among young people, including teenagers, are dramatically on the rise. Over a third of all diabetics in the United States remain undiagnosed and are not treated, according to the latest statistics of the Centers for Disease Control and Prevention (CDC).

In most cases, type 2 diabetes (traditionally known as adult onset diabetes) develops in connection with overweight and obesity. A new study, however, found that consuming large amounts of sugar may cause the disease independently from weight problems.

For the study, researchers from Stanford University School of Medicine, the University of California, Berkeley (UCB) and the University of California, San Francisco (UCSF) compared the availability of sugar and diabetes rates in 175 countries. The underlying data came from the Food and Agricultural Organization of the United Nations and the International Diabetes Federation.

The scientists believe they have clearly identified a correlation between rising sugar consumption and the growing diabetes epidemic. Specifically, they found that an additional 150 calories from sugar per person per day – the equivalent of just one 12-ounce soda drink – increased the prevalence of diabetes by one percent in that population. The longer the exposure to the higher amount of sugar lasted, the more pronounced the diabetes risk became. Conversely, whenever sugar consumption was reduced, diabetes rates diminished as well. These variations still registered when other potentially contributing factors like weight, age, gender and race were taken into account.

While the research cannot prove direct causation, the evidence is compelling, said Dr. Robert Lustig, a pediatric endocrinologist at UCSF and senior author of the study. “This study is proof enough that sugar is toxic. Now it’s time to do something about it,” he was quoted saying by the New York Times.

Many of his colleagues in the science community agree. “The results make clear that sugar consumption is fueling the global epidemic of diabetes and that reducing that consumption is an essential step in controlling the rise of the disorder,” said Dr. Walter Willett, professor of epidemiology at the Harvard School of Public Health, to the Los Angeles Times.

Based on his findings, Dr. Lustig said, manufacturers of sugary sodas can no longer claim that calories from their products don’t differ from those of other sources.

In an op-ed article written in response to the study, Mark Bittman, a food writer for the New York Times, called for immediate action by the Food and Drug Administration (FDA) that should include re-evaluating the toxicity of sugar and removing fructose (the molecule that gives sugar its sweet taste) from the list of products the government considers safe to use.

The Center for Science in the Public Interest (CSPI), a consumer advocacy group, has reportedly petitioned the FDA to revise safety limits for sugar consumption.

By contrast, the American Beverage Association (ABA) has rejected the conclusions drawn from the study. “This study does not show – or even attempt to show – that consuming sugar causes diabetes,” the trade group says in a statement on its website.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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Obesity Must Be Addressed on Multiple Levels

February 24th, 2013 at 2:36 pm by timigustafson

Obesity has grown into an alarming public health crisis, and there is no telling when or even whether we will be able to get this epidemic under control. Over two thirds of Americans now struggle with weight problems, and there is no consensus among the experts over the precise causes. Recommendations for countermeasures range from calls for more government involvement to greater responses from food manufacturers and restaurant operators to better health education of the public.

Recent legislation for the improvement of nutrition standards of school lunches and initiatives like “Let’s Move” to reduce childhood obesity have gotten some traction, but progress remains slow and uncertain, according to the latest report by the Centers for Disease Control and Prevention (CDC). Overall, there is no significant change in the current trends, and so the battle for America’s health continues unabated. There is general agreement that more, much more needs to be done.

Demands for tougher regulation of industry and policies to influence the behavior of consumers have become louder in recent years, but we have not seen the results we had hoped for. In a recent op-ed articleNew York Times columnist Mark Bittman has faulted the current Surgeon General, Dr. Regina Benjamin, for being “missing in action” in the fight against obesity, especially childhood obesity. On this issue, he writes, “Benjamin, like most of her predecessors, is virtually invisible.” Even with regards to seemingly straight forward measures like curbing children’s exposure to junk food via advertisements on TV or banning soda sales from school campuses, the government remains inexplicably passive. Instead, it still lays most of the blame at the feet of the victims by overemphasizing personal accountability.

Voluntary commitments by food manufacturers and restaurant operators have not produced much success either, despite of ample promises to show more cooperation by making food labels less confusing, offering healthier alternatives on fast food menus, or limiting exposure of kids to food advertisements.

But there is another aspect to this discussion that is often neglected. It is people’s real life experience that is not taken enough into account. By this I don’t mean to lend credence to oversimplifying statements that people are responsible for their own actions and should not blame others for their demise. Those who read my columns and blog posts know very well that I am a strong supporter of many of the measures Mr. Bittman and others are proposing.

Asking folks to make better nutritional choices makes no sense if they live miles and miles away from food outlets that carry fresh produce or in neighborhoods where getting physical exercise is difficult because of safety concerns and lack of public facilities like bike paths and parks. It is also futile to make dietary recommendations that completely ignore financial limits or access to health education.

But still, no matter what we will try from here on in terms of legislation and policy making, changing individual behavior will always play a predominant role. Eating habits are rarely just about food. They are also about stress, anxiety, loneliness, boredom, addiction, past traumatic experiences, and more. By exclusively focusing on the quality and quantity of our food supply, we will not be able to really understand these concerns and make them part of the equation, as they need to be. As they say, all politics are local. And all health issues are personal.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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