Health Care Cost Trends

Health care costs continue to rise at twice the rate of inflation. The  total amount spent on health care rose 7.4% in 2003, less than the 9.5% in 2002. Health care spending is down last year for several reasons. Patients used doctors, drugs, and hospitals less than the previous year, possibly because insured workers are now paying larger deductibles and co-payments.

Average health insurance premiums increased for employers at the rate of 12% in 2004, down from the 2003 rate of 15%. This is the first year premiums have gone down since 1996. According to a survey of health insurers for 2005, health plans say they intend to raise prices an average of 13.7% but analysts say this may be reduced closer to 10% by the year's end.

What can we do to keep health care costs down?

• As you might expect from this newsletter, choosing a healthier lifestyle can cut costs significantly (see following story of one company who started a wellness program).
• The trend to shift a greater portion of the health care expense in deductibles and co-pays to patients may encourage people to be more interested in their health.
• As health leaders in our communities we can help people know how to live more healthfully and prevent serious illness. Health fairs, health classes such as the Eight Weeks to Wellness, web based educational initiatives as featured in our web links, and other community wellness programs can make a difference.
• The bottom line is that health is a personal responsibility. It will only be solved as we all take responsibility in our own lives, in our homes, in our work places, in our churches, and in our communities to promote healthy living, make it a priority, and teach by example.

Source: Health care spending rises at slower rate, USA Today, June 9, 2004

Worksite Wellness - Cutting Healthcare Costs

St. John Health initiated a wellness program for it's hospital employees to help curb health care expenses. After doing a health assessment on 435 of its employees to identify health needs, it focused on six of the most common health concerns identified:

• high blood pressure
• diabetes
• overweight
• high cholesterol
• smoking
• lack of physical activity

By the end of the first year they saw these kinds of changes in their pilot group:

• 76% of the group exercised more than when they joined the wellness program
• 58% lost weight
• 84% made changes to their eating habits  to eat healthier
• 71% were more productive

These healthier lifestyles translated into over $200,000 cost saving in the first year according to Darlene Ephraim, corporate director of St. John Health Occupational Health Partners. Their goal next year is to include more of their 15,000 employees in the program.

They also compiled statistics from 13 other companies who also have comprehensive wellness programs in place for at least 3 years. Their wellness programs reduced health care costs an average of $3.72 for each dollar invested. In addition they saved another $5.06 in reduced absenteeism cost for each dollar invested in the program.

The St. John Health Care wellness program cost about $150 per enrollee for a comprehensive assessment and wellness program for the whole year. Not all companies may want to spend that much to start with but they can start and grow into a larger program. When the program saves money, it really isn't an expense but an investment in the lives and productivity of their employees.

St. John Health conducted a survey among other corporate executives to see what they were thinking. Here is what they found:

• 76% of the company executives agreed that it is the responsibility of the employer to promote wellness and healthy living to its employees
• 74% of the companies surveyed had already adopted a formal wellness program to some degree
• 45% of the executives with employee wellness programs indicated that they have observed an increase in productivity as a result of their program
• 58% of executives who did not have an employee wellness program think their companies should adopt one

A proactive wellness program identifies health risk factors and helps workers manage them before they become more costly and devastating to the person's health. This is an effective way to reduce health care costs, improve productivity, and enhance quality of health enjoyed by a company's employees.

Source: Kim Norris, Preventive Care: Wellness Program Works at St. John, Detroit Free Press, June 8, 2004

Exercise More Important in Bone Health than Calcium

A 10 year study of young women (12-22) called the Penn State Young Women's Health Study looked at the contribution of dietary calcium and physical activity in developing strong bones. Researchers collected dietary calcium intake data yearly as well as physical activity records. They found only a small positive association between calcium intake and bone health (not reaching statistical significance) but a strong significant relationship between physical activity and bone health. They concluded:

• "Overall, data from the Penn State Yong Women's Health Study indicates that daily calcium intake greater than 500 mg/day during adolescence does not result in clinically appreciable increased body bone accrual or increased adult bone mass."
• "Our study suggests that exercise is really the predominant lifestyle determinant of bone strength in young women."

It is still important for young women to get adequate calcium, as least two servings of high calcium foods daily, but just taking calcium, without the exercise, if of little value, it appears, for strong bones. It's vital for young women to be active, especially in the years between 13-15 (the most important years for building bone mass in women) to insure healthy, strong bones for a lifetime.

Source: Role of calcium in bone building less than exercise, Journal of Pediatrics, June 2004

Family History - A Major Risk Factor for Cardiovascular Disease

If you had a parent who died early from heart disease are you at increased risk? Is this because you inherited high cholesterol or some other risk or is it an independent risk factor? These are questions that have been unclear in the past. Data from the Framingham Heart Study offspring sheds light on the importance of family history in predicting risk of heart attack. The study included 2302 men and women, children (now middle-aged) of the famous Framingham heart study.

Here is what they found. Men whose fathers died prematurely (before age 55) from cardiovascular disease (CVD) were 2.2 times more likely to develop cardiovascular disease as well. If both parents died early from CVD (mothers before age 65) the risk increased to 2.4 times. This increased risk was independent of other major risks including age, cholesterol levels, blood pressure, body mass index, diabetes, and smoking.

Women who had a family history of early CVD were also at increased risk; 1.7 times higher for one parent, and 2.8 times more likely to have a heart attack or stroke if both parents died early. These are large increases in risk and the increased risk is independent of other risk factors. If you have a family history of CVD be sure to take preventive steps to lower all of your other risks: avoid smoking, get weight in a healthy range, eat well to keep blood pressure and cholesterol levels low, and get regular physical activity. Family history is an important risk indicator.

Reference: Parental Cardiovascular Disease and Offspring Risk, JAMA 291:2204-2211, May 12, 2004

Stress, Sleep Loss, and Depression

What causes depression? This is a good question. We know factors that contribute to depression, but the causes are not fully understood. The University of Michigan's Mental Health Research Institute is studying college students and depression. Here are some of the factors they are finding that contribute to the likelihood of developing depression.

• Stress is certainly a contributor. Social stress, the stress of staying up late, an irregular lifestyle, the pressures of studying and worrying about getting good grades all contribute to the stress load. Excessive stress can lead to anxiety, poor sleep, alcohol and other drugs. Then the stress cycle deepens.
• Drinking and drug use. Many students experiment with drugs and alcohol. When used at a young age, drugs and alcohol can have profound effects on the brain. These substances make the individual feel good (for the moment) and often become addictive. Drugs release dopamine in the brain's pleasure center, as do other pleasurable experiences. For example, the pleasure of delectable foods boosts dopamine release by 50%. Sex doubles the dopamine released. But the effect on the brain of these natural pleasures is small compared to illegal drugs. Cocaine increases dopamine release by 4-5 times, and amphetamines provide a 10 fold boost in dopamine! You can see how these drugs when used often can fry the brain. Depression usually follows these extreme "highs".
• Lack of sleep also contributes to depression. Studies show that up to 40% of adults suffer from lack of sleep. Up to 71% of college students report sleep complaints. Lack of sleep fosters a lack of coherence in brain waves which often precedes depression. Staying up late and sleeping during the day also interferes with getting adequate sunlight and this also upsets the body's natural rhythms.

If you want to prevent depression, here are some common sense suggestions.

• Keep your life balanced with adequate rest daily.
• Try to keep some semblance of regularity in your life.
• Keep stress within limits. Don't sacrifice your health by pushing yourself to the limit.
• Be active in the sunlight daily when you can. Both sunlight and exercise help the brain to function better.
• Stay away from alcohol and drugs. They can cause real havoc in a student's life.
• Take time to eat well. Have at least one warm meal daily.
• Take time for some simple, natural pleasures daily. Fun social activities, sports, taking a little time for yourself can keep a busy life balanced and is healing to a busy mind.

Source: Stress, sleep loss, and substance abuse create potent recipe for college depression, JAMA 291:2177-79, May 12, 2004

More on Low Carb Diets

Two new studies appeared in the Annals of Internal Medicine this last month (May 18, 2004). The first study was for 6 months. One group followed a low fat/calorie diet, the other a low carbohydrate diet. Those on the low carb diet lost the most weight in 6 months.

The second study lasted for 1 year. The low carb dieters lost the most in the first 6 months again, but by one year there was no significant difference between the two groups. Those on the low carb diet ate 300-400 calories less per day than those on the traditional diet plan. This explained why they lost weight the fastest. (See MS PP slides.)

The authors conclude the review of these two studies by saying, "Never-the-less, every diet should emphasize physical activity and healthy sources of proteins, fat, and carbohydrates, such as poultry, fish, nuts, legumes, and vegetables". 

Source: More on Low-Carb Diets, HealthNews, July, 2004

Role of Irradiation in Food Safety

Each year in the United States 76 million cases of foodborne illness occur resulting in 325,000 hospitalizations and over 5,000 deaths. This is caused by contamination of food with pathogens, primarily from fecal contamination in poultry and meat, and improper handling, storage, preparation, and cooking of these contaminated foods.

For example, currently only about 0.32% (1/3 of 1 percent) of ground beef is contaminated with E. coli 0157:H7, the strain that causes serious illness if the meat is not cooked properly. However, because the nation eats so much ground beef, about 8 billion pounds annually, some 25.6 million pounds of beef is sold annually that is contaminated with E. coli (it's not possible to eliminate all contamination). This contributes to the 5000 plus deaths annually from contaminated food.

This problem could be largely prevented by irradiating the beef before it goes to market. Many people are afraid of eating irradiated beef or poultry because they don't understand the process. The Centers for Disease Control and Prevention (CDC) estimate that some 900,000 cases of foodborne illness would be prevented if only 50% of the nation's meats were irradiated. This would save about 350 lives yearly (about the same number of soldiers that are dying yearly in Iraq (about 700 soldiers died in the last 2 years).

Here are some facts about irradiated food:

• Irradiating food kills pathogenic bacteria but does not make the food radioactive in any way
• Irradiation does not lower the nutritional value appreciably, any more than moderate cooking or other food preservation methods would.
• Animal and human studies have been done for years looking at eating irradiated food and the possible development of any health problems. None occur.
• The military and astronauts have been eating irradiated food for many years with no health consequences other than less foodborne illness.
• Irradiation has minimal change on texture or taste of food.
• Irradiating high risk foods for contamination (meat and poultry) could save hundreds of thousands of cases of illness each year.
• Irradiation of foods is endorsed by the US Department of Health and Humane Services, the FDA, CDC, American Dietetic Association, AMA, World Health Organization, and many other government and scientific organizations.

If we want to decrease the large number of illnesses and deaths from food-borne illness, irradiation of food is an available and economic means of doing so. Health organizations are encouraging this technology to save lives. Whether it happens or not is dependant upon the public's reaction. You should look at irradiation of meats as a life saving process similar to the pasteurization of raw milk initiated in the 1940s that has saved many lives from raw milk borne pathogens. Don't be afraid of irradiated foods. Be afraid of the real threat; foodborne illness caused by contaminated foods.

Source: The role of irradiation in food safety, The New England Journal of Medicine, 350:1898-1901, April 29, 2004

Changes in the US Diet and Risk of Type 2 Diabetes

From 1935 to 1966 the prevalence of diagnosed diabetes increased by 8.6 times. It's now estimated that about 50 million people in the U.S. have metabolic syndrome, a condition linked to high risk for developing both diabetes and heart disease. Obesity increased 57% in just the last 10 years. Currently, 2 out of 3 American adults are overweight. What has caused this remarkable change in such a short time period?

An article in the May issue of American Journal of Clinical Nutrition looks at changes in the diet over the past 100 years and has come up with some interesting observations.

• Dietary carbohydrate intake decreased steadily in America from 1909 to 1963 (from 500 g/day to 374 g/day), primarily from a decrease in consumption of whole grains.
• Simultaneously, dietary fiber decreased at even a greater rate -- by nearly 40%.
• Since 1963, the intake of carbohydrate increased again back up to the 500 grams per day, but dietary fiber has continued to fall. This means that the increase in carbohydrates was from refined sources such as sugars, white bread, snack foods, etc.
• During this time total fat increased nearly 30%, protein increased 8%, and total calories increased by 9%.
• Significant correlations with type 2 diabetes were found during these years with the increased intake of fat, the decrease in fiber, an increased consumption of corn syrup, and the total increase in energy.
• When all of these factors were adjusted in multivariate analysis to see which factors were most likely the causative agent, only two factors remained significant predictors of increased risk of type 2 diabetes: a positive link to corn syrup intake and a negative association with dietary fiber. Dietary fat and protein showed no association in this model.
• From 1980 to 1997, total energy intake increased nearly 500 cal/day. Most of this increase (428 calories or over 80%) came from an increase in highly refined carbohydrates. A switch to corn syrup for sweeteners was a major change during these years. Currently, more than 20% of all carbohydrate intake comes from corn syrup sweetener which now surpasses sucrose as the leading sweetener in the US food supply (56% of all sweeteners).
• High fructose corn syrup is the primary sweetener used in ice cream, soft drinks, and in most "light" foods.

• Our analysis shows that during the past century and especially the last 20 years, the American diet has undergone a dramatic change.
• The increased intake of refined carbohydrate increases the risk of obesity, glucose intolerance, high blood fat levels, and type 2 diabetes.
• The rapid increase in type 2 diabetes in the US may likely be linked to the rapid increase in the intake of refined carbohydrates.
• Type 2 diabetes may be reduced by replacing refined carbohydrates (sweeteners, white bread and white flour products, white rice, pastry, sweets, snack foods) with low glycemic index carbohydrates, whole grains, and other high fiber foods (whole wheat bread, oatmeal, vegetables, most fresh fruits, legumes, soy, soy milk, nuts, etc.).

Source: Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the US, American Journal of Clinical Nutrition, 79:774-9, May 2004

Reverse Cholesterol Transport

Atherosclerosis, the accumulation of cholesterol in the arteries clogging the circulation and resulting in heart attacks and strokes, is the leading cause of death in the US and most other countries in the World. Prevention and treatment efforts have centered primarily on slowing down this process by lowering LDL cholesterol, the main lipoprotein causing accumulation of cholesterol in the arteries. Lowering LDL cholesterol is accomplished primarily by reducing saturated fat and cholesterol in the diet, keeping blood pressure down, avoiding smoking, keeping blood sugar levels under control, and losing excess weight. All of these methods slow the development of atherosclerosis by slowing the accumulation of cholesterol in the arteries.

Another strategy for preventing heart disease and stroke is to clear out the clogged arteries, restoring circulation. This might be called reverse cholesterol transport, opening up the arteries. This process is accomplished by the high density lipoproteins (HDL) in the blood. The HDL particles facilitate a reverse cholesterol transport pathway. They remove excess cholesterol from the artery wall macrophages and transport it to the liver where it is excreted in the form of bile salts (such as cholic acid) and cholesterol. This pathway is the only way to get rid of excess cholesterol from the body.

HDL also decreases atherosclerosis by protecting LDL cholesterol from becoming oxidized. Oxidized cholesterol is much more likely to be deposited in the artery walls than non-oxidized cholesterol. Research shows that if you increase HDL cholesterol in your blood by only 1 mg/dL, the risk for cardiovascular disease decreases by 2-3%.

In the April issue of the New England Journal of Medicine, Tufts University and others have been researching ways to raise HDL cholesterol levels with the hope they can reverse atherosclerosis, cleaning up plugged arteries. They reported exciting news of a new medication called Torcetrapib that raised HDL levels in test subjects from an average of 29 to 47 mg/dL (up 61%) in one group, and if taken twice daily from 34 to 70 mg/dL (up 106%) in another group. These are amazing increases and may prove revolutionary in treating cardiovascular disease. The next step in research is to actually demonstrate by clinical trials that taking this new drug will actually decrease heart attacks and strokes.

Meanwhile, you can still use this new strategy of raising HDL cholesterol and increasing reverse transport of cholesterol out of the arteries by making certain lifestyle changes. Research shows that the following changes help raise HDL levels:

• Losing excess body weight, especially intra-abdominal fat. A 10-15 pound weight loss can help improve HDL levels considerably.
• Getting regular aerobic physical activity, 30-60 minutes daily. Fitness research shows that you need to get at least the equivalent of 12-15 aerobic miles of activity to get good improvements in HDL levels. Higher levels of activity increase HDL levels even further. For example, a friend of mine is a world class runner currently training for the Olympics in Athens. I tested his blood recently and from all of his running and lean weight his HDL levels are even higher than his LDL levels. It's considered healthy if your HDL levels are 1/4 of your total cholesterol level. His ratio is more than  1 to 1. His reverse transport system is so high it is essentially impossible for him to have any excess cholesterol in his arteries.
• Avoid a high carbohydrate intake, especially refined carbohydrates, and eat more calories from healthy fats and healthy proteins. A low fat, high carbohydrate diet will always suppress HDL levels. Healthy fats (nuts, nut butters, olives or olive oil, and other pure unhydrogenated vegetable oils) when used regularly help keep HDL levels high. The newest guidelines by NCEP recommend up to 35% of calories from fat is OK if they are healthy fats.
• Avoid all trans fats. Hydrogenated fats such as hard stick margarine, shortening, and deep fried foods, lower HDL levels. Foods commonly high in trans fats include most baked goodies (pastry, doughnuts, cookies, cake, pie crust) chips, French fries and other deep fried foods, most margarines, and most packaged foods such as microwave popcorn or packaged noodle or rice dishes. You can make your own cookies using unhydrogenated vegetable oils and eliminate the trans fat.

If you follow these guidelines, your HDL levels will increase and so will your reverse cholesterol transport. When the cholesterol and bile salts are excreted into the gut you need to know that most of them will be absorbed again and recycled unless you also have a high intake of fiber, especially water soluble fiber. The NCEP guidelines recommend 10-25 g of soluble fiber daily for best results in trapping this cholesterol and excreting it from the body. The best sources of soluble fiber include: oats and oat bran, peas, beans, lentils, and other legumes, fresh fruits, vegetables, and the richest source known is psyllium seed. Lowering your intake of refined carbohydrates and increasing the intake of high fiber foods can be just as effective in reducing cholesterol as decreasing saturated fat and cholesterol in the diet.

Now you have two major strategies for protecting the arteries. First, reduce cholesterol levels to decrease accumulation of cholesterol in the arteries. And second, increasing HDL levels to promote reverse cholesterol transport, to clean out the arteries.

Source: Increasing HDL Cholesterol Levels, New England Journal of Medicine 350:1491-1494, April 8, 2004

Cancer Prevention Needs more Emphasis

The cost of cancer is staggering. Last year the US bill for medical costs and lost work totaled $190 billion. While many other diseases have been droping, there hasn't been much change in most cancers, and some are still increasing. In a recent report some feel cancer may become the leading cause of death in the next 10 years. Because of the great cost and the great potential for prevention, many cancer centers are shifting budgets to give greater emphasis on prevention.

One-third of cancers are caused by smoking. Another third are caused by poor nutrition. Physical inactivity, heavy drinking, and obesity are other modifiable causes. "The best possible way to deal with cancer is not to have it in the first place, so prevention makes great sense," says Dr Robert Young in a recent interview. Dr Young is a past president of the American Cancer Society.

The World Health Organization recently made the following recommendations for preventing cancer:

• Maintain a healthy weight (overweight is responsible for as much as 15-20% of cancers)
• Perform physical activity on most days of the week; 60 minutes per day of moderate-intensity activity such as walking. Fast walking and other vigorous activities may give further benefits for cancer prevention.
• Consumption of alcoholic beverages is not recommended; if consumed, do not exceed two drinks per day.
• Overall consumption of salt-preserved foods and salt should be moderate.
• Have a diet which includes at least 400 g per day of total fruits and vegetables (5-9 servings).
• Those who are not vegetarian are advised to moderate consumption of preserved meats (e.g. sausages, salami, bacon, ham)
• Do not consume foods or drinks when they are at a very hot temperature.

WHO, "Cancer Prevention Recommendations", Diet, Nutrition and the Prevention of Chronic Disease, 2003.

QuickFacts Important health facts you need to know and share.

New risk factor for fractures. High homocysteine levels increase the risk for heart disease. New studies show that high homocysteine levels also increase the risk for bone fractures, doubling the risk for women and increasing risk 4-fold in men. To keep homocysteine levels low, be sure you get adequate levels of vitamin B12 and folic acid. HealthNews, July 2004

Diabetes linked to Alzheimer's disease. Here is another reason to keep your weight down and your exercise up. Based on a 5.5 year study of 823 older persons, those who develop diabetes had a 65% increased risk of getting Alzheimer's disease. This risk remained even after adjusting for age, gender, education level, and stroke. (See MS PP slides.) HealthNews, July 2004

Automobile safety. This year over 50 million people will be injured in motor vehicle accidents world wide, 1.2 million will die. This is a high price to pay for transportation. Automobile safety is a world wide problem that is getting worse. We can all improve safety by driving sober (this could eliminate 40% of all motor vehicle deaths or 16,650 lives per year in the U.S.), driving defensively (allow a margin of safety), driving with courtesy, and  buckling up. It is a matter of personal responsibility. JAMA June 2, 2004

Heart disease rising in developing nations. World health experts are seeing an alarming rise in heart disease in developing countries. Deaths from heart disease are expected to more than double (increase 137% for men and 120% for women) in the next 20 years. Now is a window of opportunity to help people in developing countries take preventive steps by adopting healthier lifestyles such as not smoking, not overeating, getting more exercise, and controlling high blood pressure and high cholesterol levels.  JAMA June 2, 2004

Fitness reduces healthcare costs. General Motors offered a wellness program for 23,500 of their employees. They found that employees who had a regular exercise program had lower healthcare costs of $250 per year compared to employees who did not exercise regularly. Obese and sedentary workers cost $800 more per year. If obese, sedentary workers would exercise regularly, GM estimated a savings of $400-500 per worker per year, even when they didn't lose weight. (See MS PP slides.) Amer College of Occupational & Environmental Med., News Release, May 2004

Hand washing saves lives. In countries where diarrhea is a leading cause of child death, instruction in hand washing with plain soap saves lives. A study in a poor section of Karachi Pakistan taught households with small children the importance of washing hands with soap after using the bathroom, before fixing meals, and before eating. Within one year the study communities reduced the incidence of diarrhea by 53% compared to control communities that made no change. Washing hands makes a difference! JAMA June 2, 2004`

Good nutrition slows the development of AIDS. A 1078 pregnant women in Tanzania infected with HIV were assigned to receive vitamin supplements or a placebo to see if it would make a difference in outcomes. After 6 years of follow up, those women taking the vitamins had a 29% lower rate of progression on to AIDS and a 27% lower death rate compared to those taking the placebo. Multivitamins assist the body's immune system and delay the development of HIV disease. This is a low-cost means of treating HIV positive women in poor African countries and delaying the more costly antiretroviral therapy.  N Eng J Med, July1, 2004

Taking estrogen may increase risk of dementia. More data from the Women's Health Initiative study shows that women who take estrogen therapy are at increased risk of developing dementia. At one time doctors thought estrogen would help prevent cognitive decline but careful studies now show the opposite. The researchers concluded, "These studies further support last year's recommendations that menopausal hormone therapy should not be used to prevent cognitive decline or dementia in older postmenopausal women".  NIH News release June 22, 2004

Smokers who quit early in life regain health. Studies at Duke University show that smokers who quit smoking by age 35 and who stay stopped have a life span nearly the same as non-smokers. It takes about 15 years after stopping to reverse most of the risks, but then, ex-smokers can expect health as good as non-smokers. This is good news for smokers! The sooner you stop, the less irreversible damage occurs to your body.  Health Services Research, June 2004

High intake of vitamin C in supplements may increase knee osteoarthritis. Animal experiments at Duke University indicate that high intakes of vitamin C may increase osteoarthritis of the knee. Experiments were made using guinea pigs which develop knee arthritis similar to humans. They were given low, medium, and high doses of vitamin C in supplements for 8 months and then studied their knees for osteoarthritis. Those receiving the low and medium dose saw no problems, but those receiving the high dose of vitamin C (equivalent in humans to 1500 to 2500 mg/day) developed more cartilage damage of the knee, bone spurs, and greater severity of the disease. Getting enough vitamin C is important, large doses may be damaging to the heath.  Arthritis and Rheumatism, June 2004

A high intake of fruits and vegetables reduces stroke risk. Data continues to show that fruits and vegetables are protective against strokes. New results from the Physicians' Health Study showed that men with the lowest (bottom 20%) blood levels of carotenoids (carotene, lycopene etc.), a marker for intake of colorful fruits and vegetables, had a 40% increased risk of ischemic stroke compared to all other men in the study. Eating brightly colored vegetables and fruits, at least 5 or more servings daily, is good preventive medicine for avoiding a stroke.  Stroke, June 2004

Fruits help prevent eye disease. Fresh fruits are also good for the eyes. New data from the Nurses Health Study and Health Professionals follow-up Study (12-18 year study of over 100,000 people) found that those who ate at least 3 servings of fruit daily had a 36% decreased risk of a degenerative eye disease called age related macular degeneration, the leading cause of blindness in people over 65. This impairment affects over 25-35 million people in the world. For good eye health, and good eating, aim for 3 or more servings of fresh fruits daily. Archives of Ophthalmology, June 2004

Alcohol abuse increases in the US. A survey by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) shows an increase in abuse of alcohol over the past ten years. Rates have increased from 13.8 million people in 1992 to 17.6 million people in 2002. Alcohol abuse rates are highest among young adults. The NIAAA defines alcohol abuse as, "a condition that is characterized by failure to fulfill major role obligation at work, school, or home, interpersonal social and legal problems, and/or drinking in hazardous situations."   NIH, NIAAA, Alcohol Abuse Increases, News Release, June 10, 2004

What's New? 

Eight Weeks to Wellness™ in DVD. Health outreach is becoming simpler! The revised version of Eight Weeks to Wellness™ will soon be available in DVD format. The full set should be finished by September. Don Hall, DrPH, CHES makes each presentation and answers questions. You have no notes to learn! They can be used in group education settings (projected from a laptop computer and a video projector) or in a home setting playing them on your home TV. Each presentation is about 50 minutes.

The price is the same as Eight Weeks to Wellness ™ in PowerPoint® format: $275.00. Accompanying materials (other than speaker notes) are the same for both formats. You can order either LifeLong Health community outreach program through Wellsource at 800.862.4395 or 503.557.9545.

HealthSummit/West, September 22-27, 2004.  If you want the Health Summit experience this fall, “Go west”! North American Division certification will be available for both health training sessions near Portland, Oregon, September 22-27, 2004. Most meals are included with registration since courses will be held at the lovely Gladstone Campmeeting facilities. Sabbath speakers and free time in the beautiful Portland, Oregon area are scheduled. Full information is downloadable from www.healthsummitwest.com. Tell your friends! Post a notice on your church or agency bulletin board!

Health Ministry Courses and Presenters - Session 1
Thursday and Friday, September 23-24:
Plant-based Nutrition Instructor (Part A), Marcella Lynch, Linda Sloop, RD, Fred Hardinge, DrPH
Stress Management, DeWitt Williams, EdD
Lifelong Weight Management, Don Hall, DrPH, CHES
Community Health Assessments & Follow-up, Steve J. Veres, MDiv
Forgiving from the Heart, David White, DMin

Health Ministry Courses and Presenters - Session 2
Sunday and Monday, September 26-27
Plant-based Nutrition Instructor (Part B), Marcella Lynch, Linda Sloop, RD, Fred Hardinge, DrPH
Eight Weeks to Wellness, Don Hall, DrPH, CHES
Regeneration, Hal Gates, JD
Healing Grief, Jose Agosto, PhD
CHIP, Harold Burden, MPH

Healthy Recipes

Summer is a great time for picnics. Here are a couple ideas for your next picnic. Check out the avocado-sprout salad, the garbanzo sandwich spread, and the apple cake with lemon sauce. They are healthy and they are fun to eat!

Featured Health Links 

Alcohol and Health, Special Report to the Congress.  A 24-page pdf on the effects of drinking on health.

Surgeon General Calls on Americans to Face Facts about Drinking.  A recent news release by NIAAA that briefly covers the health concerns of alcohol facing our nation today.

American Indian Health. A new web site for information dealing with native American health. An excellent resource for native Americans and those working with native Americans.

The Health Consequences of Smoking. A new report by the Surgeon General. Read about the latest information on smoking and health. Review the executive summary for a quick overview. Explore the interactive animation of the health consequences of smoking on the body. It's a fun learning experience, especially for teens.

Diabetes and Cardiovascular Disease Toolkit.  A series of 24 downloadable PDFs you can copy and hand to your patients/friends with diabetes. Excellent materials.

Taking Steps to Lower the Risk of Getting Diabetes. A 17-page pdf prepared by the government to help people take steps to prevent diabetes. Good for someone who is high risk or who has prediabetes.

Featured Power Point Slides

You can download these slides and use them in your health presentations.

• Weight, fitness, and health care costs - Data from the GM study (3 slides).
• HbA1c and coronary heart disease - HBA1c is a blood test you can take that predicts heart risk as well as blood sugar levels (1 slide).
• Low carb diets - Research is finally being published. Here are results from two different studies, one 6 month and the other 1 year (6 slides).
• Diabetes and Alzheimer's disease - Diabetes is a risk factor for AD (1 slide).