Reversing Chronic Disease Through Lifestyle Change

More Than 9 In 10 Primary Care Physicians Say U.S. Health Care System Should Place Greater Emphasis On Nutrition To Manage Chronic Disease

Main Category: Nutrition / Diet
Also Included In: Preventive Medicine
Article Date: 11 Jun 2009 – 5:00 PDT

Ninety-six percent of primary care physicians believe the nation’s health care system should place more emphasis on nutrition to treat and manage chronic disease, according to a new survey released today. However, only 12 percent believe physicians currently pay significant attention to nutrition in the context of chronic disease.

“The good news is physicians know nutrition therapy can improve health outcomes,” said registered dietitian Jane V. White, PhD, LDN, RD, FADA, with the Department of Family Medicine at the University of Tennessee Graduate School of Medicine, who partnered with the American Dietetic Association on the survey. “Now, it’s time to move nutrition services to the forefront in prevention and management of chronic disease.”

In the survey, nutrition services were defined as referral to a registered dietitian or recommendation of specific nutrition products.

“Nutrition is more than just eating a healthy diet; for patients with chronic disease nutrition acts as therapy to help them heal faster, respond better to medical care and control their disease,” White said.

“Registered dietitians and doctors have long known the intrinsic value of nutrition services for their patients,” said registered dietitian Martin Yadrick, MS, MBA, RD, FADA, immediate past-president of the American Dietetic Association. “It is now important for lawmakers to recognize the benefits as well and include them as covered benefits in health care reform.”

The national online survey of 400 primary care physicians was conducted by Hart Research Associates in association with the American Dietetic Association and the University of Tennessee Graduate School of Medicine, Department of Family Medicine. The results were presented June 10 at a briefing on Capitol Hill attended by nutrition advocates, physicians, researchers and chronic disease organizations.

The findings are especially significant as Congress addresses health care reform and increases the focus on preventive care. According to the Centers for Disease Control and Prevention (CDC), chronic disease accounts for 75 percent of the $2 trillion the U.S. spends annually on health care. Nutrition has been shown to be highly cost-effective in preventing and managing chronic disease, but nutrition services are not a routinely covered health care benefit. In the survey, almost half (46 percent) of physicians agreed the provision of routine nutrition services definitely would be cost effective, while another 44 percent said it would probably be cost effective.

Nearly half of all adults in the U.S. have at least one chronic disease. Primary care physicians are nearly unanimous in their belief that nutrition is a key element in chronic disease: An overwhelming 94 percent of the doctors surveyed believe that nutrition plays a major role in prevention, and 95 percent say nutrition plays a major role in chronic disease management and treatment. On average, they estimate that two in three of their adult patients who have chronic disease would benefit from nutrition services. If the costs were reimbursed by a third-party payer, almost all of the physicians (94 percent) say they would refer more of their patients with chronic ailments for nutrition services than they do now.

Former Senator George McGovern, who has been a prominent advocate for improving nutrition worldwide, encouraged policymakers to take the benefits of nutrition into account in health care reform.

“As Congress takes up health care reform, it is important that the benefits of nutrition therapy be fully recognized. Investments in nutrition research, nutrition programs and nutrition therapy would provide dividends to the taxpayer. Nutrition services should be included in the Medicare program, and in any basic benefit package developed as a result of health care reform,” said Sen. McGovern.

The abstract of a new study conducted by researchers at the Ohio State University Center for Health Outcomes, Policy and Evaluation Studies (HOPES) was also released at the briefing. The study, which has been submitted for publication, examined the cost effectiveness of therapeutic nutritional supplements (TNS) in the treatment of pressure ulcers, wounds, and burns. The researchers conducted economic modeling comparing the costs of TNS treatment to the savings from forgoing treatments that would be necessary if TNS was not used. Preliminary results indicate savings from the use of TNS for these conditions could be nearly $1 billion annually in the U.S.

Both studies were conducted with support from Abbott Nutrition, a division of Abbott, the global health care company.

About the American Dietetic Association

The American Dietetic Association is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy.

Source: American Dietetic Association

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Weight Loss and Vitamin D Levels

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Nutrition / Diet
Article Date: 13 Jun 2009 – 1:00 PDT

Vitamin D levels in the body at the start of a low-calorie diet predict weight loss success, a new study found. The results, which suggest a possible role for vitamin D in weight loss, were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.

“Vitamin D deficiency is associated with obesity, but it is not clear if inadequate vitamin D causes obesity or the other way around,” said the study’s lead author, Shalamar Sibley, MD, MPH, an assistant professor of medicine at the University of Minnesota.

In this study, the authors attempted to determine whether baseline vitamin D levels before calorie restriction affect subsequent weight loss. They measured circulating blood levels of vitamin D in 38 overweight men and women before and after the subjects followed a diet plan for 11 weeks consisting of 750 calories a day fewer than their estimated total needs. Subjects also had their fat distribution measured with DXA (bone densitometry) scans.

On average, subjects had vitamin D levels that many experts would consider to be in the insufficient range, according to Sibley. However, the authors found that baseline, or pre-diet, vitamin D levels predicted weight loss in a linear relationship. For every increase of 1 ng/mL in level of 25-hydroxycholecalciferol – the precursor form of vitamin D and a commonly used indicator of vitamin D status – subjects ended up losing almost a half pound (0.196 kg) more on their calorie-restricted diet. For each 1-ng/mL increase in the active or “hormonal” form of vitamin D (1,25-dihydroxycholecalciferol), subjects lost nearly one-quarter pound (0.107 kg) more.

Additionally, higher baseline vitamin D levels (both the precursor and active forms) predicted greater loss of abdominal fat.

“Our results suggest the possibility that the addition of vitamin D to a reduced-calorie diet will lead to better weight loss,” Sibley said.

She cautioned, however, that more research is needed. “Our findings,” she said, “need to be followed up by the right kind of controlled clinical trial to determine if there is a role for vitamin D supplementation in helping people lose weight when they attempt to cut back on what they eat.”

The National Institutes of Health, the University of Minnesota, and the Pennock Family Endowment at the University of Minnesota funded this study.

Source:
Aaron Lohr
The Endocrine Society

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Weight Loss and Vitamin D Levels

Link Between Successful Weight Loss And Vitamin D Levels

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Nutrition / Diet
Article Date: 13 Jun 2009 – 1:00 PDT

Vitamin D levels in the body at the start of a low-calorie diet predict weight loss success, a new study found. The results, which suggest a possible role for vitamin D in weight loss, were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.

“Vitamin D deficiency is associated with obesity, but it is not clear if inadequate vitamin D causes obesity or the other way around,” said the study’s lead author, Shalamar Sibley, MD, MPH, an assistant professor of medicine at the University of Minnesota.

In this study, the authors attempted to determine whether baseline vitamin D levels before calorie restriction affect subsequent weight loss. They measured circulating blood levels of vitamin D in 38 overweight men and women before and after the subjects followed a diet plan for 11 weeks consisting of 750 calories a day fewer than their estimated total needs. Subjects also had their fat distribution measured with DXA (bone densitometry) scans.

On average, subjects had vitamin D levels that many experts would consider to be in the insufficient range, according to Sibley. However, the authors found that baseline, or pre-diet, vitamin D levels predicted weight loss in a linear relationship. For every increase of 1 ng/mL in level of 25-hydroxycholecalciferol – the precursor form of vitamin D and a commonly used indicator of vitamin D status – subjects ended up losing almost a half pound (0.196 kg) more on their calorie-restricted diet. For each 1-ng/mL increase in the active or “hormonal” form of vitamin D (1,25-dihydroxycholecalciferol), subjects lost nearly one-quarter pound (0.107 kg) more.

Additionally, higher baseline vitamin D levels (both the precursor and active forms) predicted greater loss of abdominal fat.

“Our results suggest the possibility that the addition of vitamin D to a reduced-calorie diet will lead to better weight loss,” Sibley said.

She cautioned, however, that more research is needed. “Our findings,” she said, “need to be followed up by the right kind of controlled clinical trial to determine if there is a role for vitamin D supplementation in helping people lose weight when they attempt to cut back on what they eat.”

The National Institutes of Health, the University of Minnesota, and the Pennock Family Endowment at the University of Minnesota funded this study.

Source:
Aaron Lohr
The Endocrine Society

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Many Children Need More Vitamin D

27 Oct 2009

Many U.S. children, especially minorities, are in need of more Vitamin D, according to the new study: “Serum 25-hydroxyvitamin D Levels Among US Children Ages 1 to 11 Years: Do Children Need More Vitamin D?” The study authors reviewed data from the 2001-2006 National Health and Nutrition Examination Survey, and specifically the serum 25-hydroxyvitamin D levels in children, age 11 and younger.

Currently, the American Academy of Pediatrics recommends that children should have vitamin D levels of at least 50 nmol/L (20 ng/ml) and the authors found over 6 million children below this level. Other studies in adults suggest that vitamin D levels should be at least 75 nmol/L (30 ng/ml). There were 24 million children below this level, including 92 percent of non-Hispanic blacks and 80 percent of Hispanics.

Source
American Academy of Pediatrics

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Chemical Pollutants Increase Fat

Greenwire –  January 15, 2010

By Sara Goodman

Researchers have for the first time found a connection between exposure to certain chemicals and insulin resistance, according to a study published in the online edition of Environmental Health Perspectives.

A group of European scientists examined whether exposure to persistent organic pollutants (POPs) contributed to insulin resistance, which has been increasing around the world. More than 25 percent of U.S. adults suffer from metabolic conditions stemming from insulin resistance that include fatigue, obesity and difficulty regulating blood levels of fat and sugar.

Researchers fed rats a high-fat diet of either crude or refined fish oil from farmed Atlantic salmon over 28 days. The crude fish oil contained average levels of POPs that people are exposed to through fish consumption, while the refined oil contained none. Both had equal fat levels.

They found that rats exposed to the crude fish oil developed belly fat and could not regulate fat properly. They had higher levels of cholesterol and several fatty acids in their livers. Those exposed to the refined fish oil experienced none of those symptoms.

Researchers said the findings provide “compelling evidence” of a causal relationship between POP exposure common in the food chain and insulin resistance, and highlight the need to understand the interactions of POPs and fat-containing foods such as fish, dairy products and meat.

How to deal with POPs is particularly challenging because they persist in the environment for long periods and can build up in animals’ tissues.

The 2001 Stockholm Convention, which the United States has ratified but not signed, lists and bans numerous POPs from manufacture and use. The researchers say their evidence reinforces the need to have international agreements aimed at limiting the release of POPs into the environment in an effort to protect public health.

Reprinted from Greenwire with permission from Environment & Energy Publishing, LLC. www.eenews.net, 202-628-6500

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