Weight Loss Short-Cuts

... May lead to a bad trip down the wrong road!

I have never advocated any weight loss product or drug; “natural” or otherwise and today I found yet another case to illustrate my point.

One of my professional news alerts directed me to the following blog. The article is reflective of the FDA warning, but I want to caution readers that the blog is surrounded by bogus weight loss ads! Since I’m a blogging rookie, I’m not sure what that is about… it seems a bit contradictory to me. Perhaps the author will write me and let me know what is going on there. Anyway, if you would like to take a look at the original article that caught my attention, here it is:

“FDA Warns Consumers About Tainted Weight Loss Pills


Agency seeks recall of products that pose serious health risks


The U.S. Food and Drug Administration is alerting consumers nationwide not to purchase or consume more than 25 different products marketed for weight loss because they contain undeclared, active pharmaceutical ingredients that may put consumers’ health at risk.”

You can also check out the FDA’s website directly. Here’s an excerpt from the FDA site:

“Consumer Directed Questions and Answers about FDA’s Initiative Against Contaminated Weight Loss Products

FDA has developed these questions and answers (Q & A’s) to help consumers, health care practitioners, and the general public understand FDA’s actions regarding weight loss products contaminated with various prescription drugs and chemicals. Many of these products are marketed as dietary supplements. Unfortunately, FDA cannot test and identify all weight loss products on the market that have potentially harmful contaminants in order to assure their safety. Enforcement actions and consumer advisories for unapproved products only cover a small fraction of the potentially hazardous weight loss products marketed to consumers on the internet and at some retail establishments.


1. What undeclared drugs and/or chemicals are contained in the weight loss products associated with this action?


Laboratory tests revealed the presence of sibutramine, rimonabant, phenytoin, and phenolphthalein. A summary of our findings are below:


Product(s) Name

• 2 Day Diet 

• 3 Day Diet
• 
3x Slimming Power 

• 5x Imelda Perfect Slimming 

• 7 Diet Day/Night Formula

• 7 Day Herbal Slim 

• 8 Factor Diet 

• 24 Hours Diet
• 999 Fitness Essence

• Extrim Plus 

• Fatloss Slimming

• GMP

• Imelda Perfect Slim
• Lida DaiDaihua 

• Miaozi Slim Capsules

• Perfect Slim

• Perfect Slim 5x

• ProSlim Plus

• Royal Slimming Formula 

• Slim 3 in 1 

• Slim Express 360

• Slim Tech 

• Somotrim

• Superslim

• Triple Slim
• 
Venom Hyperdrive 3.0 

• Zhen de Shou
• Phyto Shape
• 3x Slimming Power
Extrim Plus
• 8 Factor Diet

• 24 Hours Diet
• 
Fatloss Slimming

• Imelda Perfect Slim

• Perfect Slim 5x

• Royal Slimming Formula

• Superslim
• 
Zhen de Shou

2. What action is FDA taking regarding these tainted weight loss products?


FDA is taking action to help ensure that these products and other products containing undeclared prescription ingredients are removed from the marketplace. FDA has inspected a number of firms associated with the sale of these products and is currently seeking recalls of the products. Based on these inspections and the firms’ responses to recall requests, FDA may take additional enforcement steps to include warning letters, seizure, injunction, or criminal charges.”

And on a final note, as I read this list of tainted weight loss products, it makes me sad. Sad that consumers are in danger and sad that we are willing to spend so much money on unproven products when eating less and moving more are readily available to all. In the meantime I will continue my quest for the truth and continue to try to find a way to make sensible eating and increased activity more exciting so maybe people will learn once and for all that this is the only road to effective weight loss.

Firming up the Flab

The truth about fat loss and exercise -

“The fabulous flab-o-later 5000 can firm your thighs, flatten your abdominals and have you feeling fit in no time flat. This limited time offer is not available in stores so act NOW!”

Ah, the info-mercial! It’s hard to go anywhere these days without seeing the latest and greatest wonder-gadget to help us get a “better” body. Whether it is saggy saddlebags, flabby abs, or a drooping derrière – those pesky “problem areas” are clearly the root of all evil. The promise is that you can: tone it, tighten it, lift it, firm it, shape it, or sculpt it with this machine or that exercise… But, these are promises that no single exercise can deliver. To find out why, we need to take a look at what “it” is and how “it” works.

What is it? We name it, specifically love handles or beer belly and in general terms flab. Is it a muscle issue? No, it is a fat issue. Adipose tissue. Fat, not muscle is the problem. Physiologically, fat and muscle are two totally separate systems in the body. They have different jobs. Muscle, helps us move around or even just sit upright. Muscle is like the engine in a car, it works to get from one place to another. Fat is an essential part of our bodies, some is located just under the skin and helps to insulate our bodies and some helps to cushion our vital organs. When we repeatedly consume more calories than our bodies can burn, we store those excess calories as - you guessed it – FAT. The distribution of that excess fat around our bodies is genetically predetermined. We don’t get to decide where to store it or where to lose it. Bummer!

How does it work? Fat doesn’t work like muscle does, it just hangs out. Using the car analogy, if muscle is the engine – then fat is the baggage in the trunk. Generally speaking, fat is a storage unit. Muscle can contract to help us run, jump or lift a weight – fat can’t. Muscle can be trained (through exercise) and get bigger and stronger – fat can’t. In essence, fat is lazy – it will not work no matter how hard your try. There is no “target” exercise for fat so it cannot be toned, tightened, lifted, firmed, shaped or sculpted. Fat is not a muscle group. You can’t train fat – it refuses to do work. Fat is totally, utterly and completely disobedient!

The brutal truth is you can’t firm up the flab. You can train the muscle under the flab, but the flab will remain flab. To get rid of flab we need to burn the excess calories that we have stored in the trunk. Calories are burned in the greatest amounts when we do whole body, cardiovascular exercise. Reducing the amount of calories we consume will also help us lose the excess body fat. We don’t lose fat from pieces and parts of our bodies; we lose it from the whole system. And when we train our muscles, we should train the whole system (all major muscle groups) not just pieces and parts. Reduced calorie consumption + increased calorie burning (whole body exercise) = body fat reduction - aka flab loss. So, step away from the flab-o-later 5000 and back on the bike, the treadmill or whatever gets your heart rate up and makes you sweat for about 30 minutes, 5 or more days a week.

Social Wellness

Several months ago my hair stylist, Bonnie, witnessed an accident. She was stopped at a light waiting to make a right hand turn. She noticed a little girl walking along the sidewalk parallel to her vehicle. It was one of those brisk mornings we long for as memories of the summer heat fade away into fall. Bonnie was mesmerized by this little girl in her brightly colored jacket with her little backpack on her way to school. But, the tranquility of the moment was shattered as an SUV came seemingly out of nowhere and struck the little girl in the crosswalk. I’ll spare you the details of this horrifying event but tell you that Bonnie rushed to the aid of this little girl and quite possibly saved her fragile little life. The driver of the SUV had come to a stop several feet away from where the girl lay unconscious in the road. The driver never hit the brakes and admittedly didn’t know what had just happened. When Bonnie told the driver she had hit the girl, the driver was clearly upset, as anyone would be. After the ambulance rushed the girl away and all the witnesses had given their statements, Bonnie was left to wonder about the fate of this little girl who had captivated her imagination for those few seconds in what now seemed like a lifetime ago.

Fast forward to yesterday. As I sat in her chair, Bonnie was excited as she told me that she had recently heard that the little girl was ok – just cuts and bruises, truly a miracle! The other stylist and patron joined in the conversation as Bonnie continued to tell me that she was asked to give her statement to an attorney a few days earlier. It seems that the driver of the SUV was placing blame on the child in the crosswalk.

Here’s where my opinion comes in and you have the right to agree or disagree. I wasn’t there on that morning so I don’t know what really happened. But I have a vivid memory of Bonnie’s telling of the story and of Bonnie’s emotion and how the images haunted her so perhaps that’s why my opinion is so wholly, completely, and admittedly one sided. Honestly, I was and am appalled at the thought of an adult with a driver’s license placing blame on an eight-year-old child in a marked crosswalk. An adult who asked Bonnie “what just happened” after she struck the child. An adult who never applied the brakes – there were no skid marks at the scene. An adult who never saw the child, but knew that she hit something is the very person claiming she did see that the light was green. She saw a green light about the size of a volleyball – but couldn’t see an eight year old child. Bonnie believed that the driver ran the red light because as she watched the accident she recalled the sound of the drivers behind her honking their horns and wondered if she was the only one who had just seen what happened. Bonnie’s light was green as she pulled her vehicle across the lane of traffic to protect the little girl; that she knows. But she doesn’t know when her light turned green as she was so focused on the little girl.

Equally appalling to me was the reaction of the other patron who agreed that the eight-year-old girl was responsible for the accident because she didn’t see the SUV. When I politely objected to the statement and questioned how the adult driving the SUV could miss seeing the girl entirely the patron stated very matter of factly that “..people are distracted when they drive and can’t be expected to see everything… the child should have been paying attention…” My next response was less polite because I don’t understand how it is acceptable in our society today to be distracted as we speed down the road in a 3,000-pound missile. How is it acceptable make an eight-year-old child accountable and not an adult? I felt myself getting emotional and had to stop talking, as I’m not one to pick a fight in a hair salon – or anywhere for that matter! But I did want to fight for the right of a child to be the kid and an adult to the grown-up. Has the world indeed gone mad? Have we no social conscious? Is where we are going and what we are doing in our vehicles more important than the life of a child or any other living thing? And again I must repeat that we are talking about a child walking in a marked crosswalk in broad daylight – not a crack head stumbling across the middle of the expressway at midnight!

I was compelled to write this story not because I want people to debate the color of the light and who’s truly at fault – but because I want us to wake up! We adults need to take responsibility for our actions. The well being of our society depends on it. Our social wellness depends on it. Our relationships with all of those around us should matter. Even if the child did step into the intersection before the sign said, “walk”, the driver should have been able to see her and apply the breaks. The driver should have been paying attention enough to know she just hit a child. We, as human beings should have compassion for the child and yes, the driver too. Once the driver realized what she had done she was truly sorry, and for that I do have compassion. I’m trying not to judge the driver and I’m trying not to judge the patron and I ask that you do the same. What I would like you to do is pay attention to our social norms and fight to keep the human element in humanity.

And finally, please put down your blackberry, your cell phone, or your hamburger and pay attention when you drive. Value our social wellness.

Burn Baby Burn!

The Truth About Fat Burning and Weight Loss...

Anyone who has ever used a treadmill, bike, elliptical or other cardiovascular training machine has probably noticed the “Fat Burning” workout or “Fat Burning Zone” designated on the machine. For those of you who don’t know, the theory is that the lower end of your target heart rate training zone is the “fat burning zone,” if you train at these low levels you will burn more body fat and lose weight faster. Well I have good news and bad news about this assumption.

First the bad news – the “Fat Burning Zone” is myth, a timeless urban legend much like big-foot or the loch-ness monster. I know what you’re thinking, “if it’s not true why is it written on every cardio machine?” I had the opportunity to speak with James Peterson, Ph.D., FACSM, sports medicine consultant and former director of sports medicine for StairMaster Sports/Medical Products Inc. (now owned by Nautilus) and ask that very question. He answered with one word, “marketing”. Despite what the researchers know and advise, marketing gets the final word on selling equipment. After all, every equipment manufacturer is in business to sell machines and to do so they need to convince consumers that their product is the best and burns the most fat and calories. The concept of “fat burning” is a popular trend and therefore a must have for advertising purposes. The truth about the “fat burning zone” is not part of the equation.

Now, the truth - weight loss is all about burning enough calories to help us lose body fat. To lose a pound of body fat through exercise you need to burn approximately 3500 calories. A calorie is a calorie is a calorie: one calorie of fat is equal to one calorie of carbohydrate, which is equal to one calorie of protein. Think about it, which weighs more a pound of lead or a pound of feathers? A pound is a pound and a calorie is a calorie – both are units of measure. There is no magical “fat burning zone” because the energy units being utilized as you exercise are equivalent.

The good news - no more worries about having your heart rate “too high” to burn fat! If you are burning calories you are on the right track for weight and fat loss. Strive to burn as many calories as possible in whatever amount of time you have available to exercise. Choose an exercise intensity level that is challenging, but not exhausting, and work at that level for as long as you can. The other half of the equation is your calorie consumption. Reducing your calorie intake and increasing the amount of calories you burn will get you to your weight loss goals even faster.

Good News for “Losers” in the Weight Loss Game

Making healthy food choices and lifestyle changes are beneficial to your health whether you lose weight or not!

According to a 2003 study done by the U.S. Centers for Disease Control and Prevention, simply attempting to lose weight can lengthen your life and help prevent disease. This study tracked 6,391 overweight or obese participants for 9 years. The study concluded that, "Attempted weight loss is associated with lower all-cause mortality, independent of weight change." (Edward W. Gregg, PhD, et. al.)

On the average, Americans are gaining 2 pounds each year - that’s 20 pounds of fat each decade! According to Dr. James Hill of the University of Colorado, long-term weight loss can be as basic as "cutting back on a cookie or taking three fewer bites of a fast-food hamburger" (USA TODAY, 2003). These two simple examples shave off 100 calories a day from your diet and can lead to a 10 pound weight loss in a year rather than the typical 2 pound gain.

I know what your thinking, “only ten-pounds in a year?” At first it may not sound like much, especially when the hot new “PDQ Diet” is promising ‘10 pounds in 10 days’ (I just made that up, please don’t Google it - as of this writing it does not exist!). But consider how long it took you to put the extra weight on - it takes months and years to gain weight, not days. Don’t lose sight of the point here, which is your health and your quality of life.

Ralph Waldo Emerson said, "Our greatest glory is not in never failing, but in rising up every time we fail." I think it is safe to say that everyone who has dieted has failed in one way or another. If you believe it is worth trying again, you win. Typically we define success as lost pounds when we get on the scale, but as we see here, this is not always the case. Making a commitment to a healthier lifestyle is a positive step on the road to improved health. Keep up the good work of making healthy food choices - someday your children and your grandchildren will be glad you did!

Defining Wellness

Today I’m writing from the heart. My purpose is not as much educational as it is inspirational, so if you choose to embark on this journey with me, I hope that you will take some time to reflect at the end of our time together.

April is my favorite month in Arizona, the weather is ideal, the sky is bright blue and the desert is bursting with color. Today is an incredible day! I’m so fortunate to be working from home because it’s just wrong to be trapped inside on such a day. I’m sitting on the back patio feeling the wind in my hair, hearing the birds sing and enjoying the vibrant colors of the spring flowers blooming in our yard. This is my own personal paradise. I feel peaceful, I feel happy, I feel alive and I feel connected to the universe. This is my vision of wellness today.

The word “wellness” is so overused in our society that I think it has lost meaning for a lot of people. When I entered the workforce after my undergrad degree I had to explain the word wellness on a regular basis, the words “health promotion” were easier for folks to grasp, so I often avoided the term wellness with those outside the profession. My, how times have changed! Although we see it, hear it and use it all the time, do we really understand what it is we are talking about when we say wellness?

Here’s a definition from my website:
“Wellness can be simply stated as the opposite of illness, but it is really so much more than that. Whether we realize it or not our own personal wellness, or sometimes the lack there of, affects everything we do on a daily basis. Think about it, how productive are you when you have a cold, a headache, are hungry or haven’t slept?

Our wellness is not only affected by physical needs but also by our self image, our relationships, our environment, our careers, our ability to learn, share, grow and connect with others. Most of us take our wellness for granted until something affects it, and then we choose to take action. Remember the words of Benjamin Franklin, ‘An ounce of prevention is worth a pound of cure.’ Wellness is a balanced approach to life.”

The seven dimensions of wellness include: social, emotional spiritual, environmental, occupational, intellectual and physical. If you want a definition of each component, you can visit the AW Brooks site.

This definition works for me; I understand it and seem to have success when explaining it my audiences. But there is more to wellness than what I think. Wellness for you needs to be about what you think and how you feel both physically and emotionally. What does wellness mean for you in your own unique life at this unique moment in time? Who cares what I say, what the newspapers, magazines or infomercials say? Your voice is the one that matters. It’s all about you. There, I said it – haven’t you been longing for someone to tell you that?

In the professional world, away from the sales pitches, products and promotions wellness is often about behavior change. During the early part of my career, I wanted to help people change. Now I see things differently. Now I have a clearer mission: to inspire people to make informed decisions. Maybe you don’t need to change, don’t want to change or aren’t ready to change. Fine with me. When you do make a decision about your wellness, I hope it is your decision, based on sound information and free from commercial, media or even family bias. Free from guilt or fear. If you are feeling guilty about all of the things you “should be” doing for your health then how can you ever be well? When you’re perfect and you magically have the time and resources to do everything right? Wellness is not about perfection.

If you are in this profession, remember that wellness is not about programs, processes or policy – it’s about people. All too often we (as professionals) get too caught up in finding the ideal intervention. There are a myriad of cookie-cutter programs out there and the message is “your company can get results just like Company XYZ”. But you’re not Company XYZ, and people are not cookie dough. You can still follow industry best practice, but follow it in a way that makes sense for your people. What does wellness mean to your company? What does wellness mean to you. Perhaps the most important question. You won’t find the answer in a blog, a book or a binder so stop looking outside and start looking in. I found it years ago on a bike ride one glorious desert morning. I can see it right now in the soft petals of a cactus flower. It blooms for just a few hours, just one day - today. What a precious gift! Where will you find it?

CBS News Casts a Dark Shadow on the Fitness World

Yesterday, the CBS Early Show aired a story called “Certified Trainers Ungoverned” which made some blanket statements questioning the validity of the entire fitness industry. The “certified” trainers responsible for the injuries reported in this piece should be questioned, but casting a shadow over the entire industry is uncalled for. Interestingly, not once did the story mention the facilities that hired these “certified” trainers. In fact, one of the trainers mentioned did not have any certification at all. Shame on the facility for not hiring qualified staff – and kudos to the many, many fitness centers, clubs, gyms and personal training studios who do hire real, certified, educated, qualified trainers and instructors.

What does certified really mean? As investigative reporter Susan Koeppen proved, anyone can get a “certification” as a personal trainer. She got one on the Internet in 45 minutes for less than $50 – scary!

When I entered the industry after completion of my undergraduate degree in health promotion/wellness, I obtained a certification from the American College of Sports Medicine (ACSM) as a Health Fitness Instructor (HFI), a fitness degree (BA/BS) is required to sit for the test. When my professional career shifted more towards sports conditioning and I was working with more athletes, I obtained a certification from the National Strength and Conditioning Association (NSCA) as a Certified Strength and Conditioning Specialist (CSCS). This certification also requires a degree. Both of these organizations require regular continuing education credits, publish professional research journals and are highly respected in the industry. There are other respected certifying bodies in the industry that also have rigorous standards for certification (and continuing education), but since I’m not a member of any other organization, I’ll stick to what I know to be true.

The word “certified” is not meaningless to me or to anyone who has worked hard to acquire and maintain this level of professionalism. I agree that the industry does need to be licensed. But even licensing does not guarantee the safety or the sanctity of the profession. Case in point, a Registered Dietitian (RD) is the only professional licensed to write a diet – but yet, the market is flooded with diet books written by people without the letters “RD” behind their name. I have seen people call themselves “nutritionist” without being an RD, DTR or even having a degree in nutrition and I think it stinks! In the CBS story, Marc Rabinoff, Ed.D., Chair of the Department of Human Performance And Sport at Metro State College said that the fitness industry is the “wild, wild west” and at the extremes, I guess he’s right. But there is something we can do!

A Call to Action! Business owners, club managers, hiring managers and anyone involved in the fitness industry – please consider industry best practice. Following the ACSM Health/Fitness Facility Standards and Guidelines is a must. Hiring degreed, certified (ACSM, NSCA or other large, known certifying agency) fitness staff is best practice, and should be the only practice. Contact your local college or university and find out what training programs and degree programs are available for would-be personal trainers in your area. In remote or rural areas, finding trainers with college degrees may not be realistic, but certified and qualified is still possible.

How to find qualified trainers. Please do your homework – don’t just hire someone because they look good or can talk a good game. Here’s a great place to look for highly qualified staff – your local YMCA or community college. In the Phoenix area, the Maricopa Community College District fitness centers are open to the public and all of the fitness instructors have a bachelor’s degree and many have a master’s in a fitness related field. I know other community colleges across the nation have similar programs. YMCA’s and community colleges are also affordable and don’t require long-term contracts. As far as clubs and gyms are concerned, find out if they are a member of the International Health and Racquet Sportsclub Association (IHRSA). IHRSA’s mission is to grow, protect and promote the health and fitness industry. If the club is not an IHRSA member, ask if they follow the ACSM facility guidelines – if the answer is no, walk out the door and don’t go back.

Shopping Made Simple

Supermarket savvy could be coming soon to a grocery store near you…

Can it be – is it possible that there may soon be a tool available at grocery stores to help us understand the REAL health benefits of food? For most of us in the health education world, this seems like a far off dream. Whenever I start a weight management group I begin by asking participants if they understand food labels and how to make healthy choices. Most think they have pretty good label skills, but in reality they don’t because it is HARD to find the truth on the nutrition label.

Test your skills with this quiz:

1. Rank the following foods from highest to lowest based on SODIUM content:
   
• YooHoo Chocolate Drink
  
• Cape Cod Potato Chips
  
• Chex Cereal
  
• Fritos Corn Chips
2. Which has more sugar: Ragu Pasta Sauce or Smucker’s Ice Cream Topping?
3. What is “unbleached enriched flour”?

How did you score?
Sodium makes food taste good and when it tastes good we eat more and when we eat more we need to buy more, which makes the food manufacturers happy. Do you really think they care about our health? Here’s the real ranking from least to most sodium: Cape Cod Potato Chips (73 mg per 100 calories), Fritos Corn Chips, YooHoo Chocolate Drink and saving the worst for last – Chex Cereal, with 233 mg sodium in a 100 calorie serving!

Added sugar can also enhance taste and add to the total calories of a seemingly “healthy” food. Yes, it’s true - Ragu Pasta Sauce has MORE sugar than the Smucker’s Ice Cream Topping, with 12 and 11 grams per serving respectively. There are 4 grams of sugar in a teaspoon, so that 100 calorie serving of pasta sauce has 3 teaspoons of sugar!

“Whole Wheat” or “Faux Wheat”? If a product is really made from whole grain “whole wheat flour” will be the first ingredient. “Unbleached enriched flour” is white flour in a fancy dress. Most breads with names like “multi grain, stone ground or wheat” are not made from whole-wheat flour. Read the ingredient list to be sure you are getting the real deal.

Help is on the way!
On Sunday, March 16, the Chicago Tribune ran an article “Food retailers hope to inspire loyalty, increase sales with their own nutritional labels…” about a nutrition score card system that will be appearing soon in Hy-Vee grocery stores across the Midwest. The scoring system is called the Overall Nutritional Quality Index (ONQI) and was developed by a team of experts led by Dr. David Katz of Yale University.

The ONQI will help shoppers choose foods based on overall nutritional quality and free from label claims made by the manufacturer. Personally, I’m really excited about this and professionally this could have a profound effect on public health. Eating the right foods could result in an “80% reduction in heart disease, a 90% reduction in diabetes, and a 60% reduction in cancer” according to Dr. Katz.

Currently the ONQI team is working with Topco, which provides procurement, quality assurance, packaging and other services to supermarket retailers, wholesalers, and food service companies. Hy-Vee is one of Topco’s 61 members, and so is Bashas’ which is located in the Southwest (where I live). Topco members serve over 60 million consumers and have over $100 billion in annual sales.

Other grocery stores are making attempts too. Safeway has a tool on their website called foodflex™ to help consumers determine the nutritional value of foods they have purchased.

I hope to see other grocery stores take an interest in consumer health too. It would be great to see the ONQI become a mainstream tool for us to evaluate food choices. Whether we realize it or not, most of our health decisions are made in the grocery store – not in the doctors office!

Weight Loss Success

NEWS FLASH: Losing as little as 10 pounds can reduce your risk for heart disease, stroke, and diabetes!

Recently, the American College of Sports Medicine (ACSM) hosted a learning event featuring Dr. John Foreyt, Ph.D. of Baylor College. The following is a summary of tips for long-term weight loss success. These tips are based on data from weight loss studies done all over the world as well as research from the National Weight Control Registry (a database of over 5,000 people who have lost at least 30 pounds and kept it off for long periods of time).

Successful “losers” have the following behaviors in common:
1. Eat a low fat diet consisting of 24% fat, 56% carbohydrate and 20% protein
2. Are physically active 60-90 minutes per day at a moderate intensity, walking is the most common activity
3. Use frequent self-monitoring techniques like weigh-ins, food records, calorie or fat gram counting
4. Eat breakfast, 78% report eating breakfast daily and 95% eat breakfast 5 days a week

In addition to the 4 common behaviors mentioned above, here are the other secrets to success from the long-term “losers”:
• Sleep 8 hours each night
• Write down everything you eat
• Find support in a weight loss class, group or with family & friends
• Never give up!

If every American would eat 3 fewer bites of a fast food hamburger (eat 100 less calories) and walk for an additional 20 minutes (burn 100 more calories) each day, our current trend of weight gain would be halted - obesity rates, disease rates and health care costs would all begin to drop. Imagine that!

The Great American Diet Dilemma

It’s early in the New Year, ‘tis the season to contemplate our ever expanding waistlines. As you may know, 65% of Americans are considered over fat and a third are obese. The current obesity epidemic is on the minds of health care and health promotion experts everywhere. It’s also on the minds of the self proclaimed diet guru’s looking to cash in on this growing (no pun intended) market.

Who’s to blame?
Honestly, who cares? Is blaming genetics (aka the fat gene), the fast food industry, fad diets (see the debate in Business Week) or even the food guidelines (I’m not kidding, check out this debate from MedPage Today, be sure to read it all see both sides) going to help us solve the problem? Which came first, the chicken or the egg? It’s a futile argument and it doesn’t change the fact that we are fat and getting fatter. Every diet, even the most bizarre, has worked for somebody at one time or another. And that one person will defend the merits of that diet forever, while the other 99 people blame themselves and go look for something else that will “work”.

The food industry spends over $25 billion a year on advertising; “Five-a-Day” for fruits and vegetables spent $1 million; which message are consumers getting? Each year something like 80 million Americans go on a diet and spend about $40 billion dollars. The long-term success rate of the average diet is poor and most dieters regain some or all of the weight back in 3-5 years.

We eat too much, move too little and then try to buy a miracle. Then we repeat the cycle over and over. Benjamin Franklin said, “The definition of insanity is doing the same thing over and over and expecting different results.” I agree!

Wake up America!
It’s time to stop letting the food industry tell you what to eat, stop letting the restaurants tell you how much to eat and stop to letting the diet industry lure you into buying the latest fad. I know that even if I wear a Nike golf apparel and use Nike golf equipment, I am not going to golf like Tiger Woods. It’s that simple. Why can’t we draw the same logical conclusions when it comes to food?

Because behavior change is hard, really hard and we want it to be easy. There is no easy button when it comes to weight loss and behavior change. I wish there was. Believe me, I will tell you if I ever find it – so will every health care and health promotion professional – we’re the one’s on your side.

What’s Next?
Trust a professional – a real one, with a degree and credentials. If you want to change your diet, talk to a Registered Dietician. If you want to exercise, talk to an exercise physiologist (ACSM or NSCA are good places to start). If you want to change your behavior, talk to an Intrinsic Coach®. If you want to learn more, research a site that’s not selling anything (web sites ending in .org or .gov). Here are a few of my favorites:
• FDA Facts About Weight Loss Products & Programs
• American Dietetics Association 2007 diet review
• ADA Good Nutrition Reading List
• My Pyramid Eating Plan
• Shape Up America
• For more links you can also visit my web site

Remember, it’s not about the product, the professional or the program – it’s about you. Here’s to your health!

Arizona’s “Health Pulse” – Unanswered Questions, Part 2

Welcome to Part 2, the second unanswered question from Tuesday’s “Arizona Health Pulse Breakfast” sponsored by the Phoenix Business Journal and Blue Cross Blue Shield of Arizona.

Question 2: In essence, why don’t health care agencies pay for necessary preventive care or cover prescription drug costs when it comes to treating chronic conditions like diabetes or hypertension? Another excellent, but complex question. I’d like to address this question in two parts, first preventive care services and then the prescription drug costs.

First I’ll cover the question of preventive care. Dr. Smethers did answer this part of the question and I applaud BCBSAZ for their coverage of preventive services. Since leaving BCBSAZ I can confirm that other large insurance carriers do not cover prevention as a core part of the plan. Wise benefit managers can include a prevention option as part of their company’s plan, if this is something the company leadership supports (I will cover the importance of leadership support in future articles). Companies need to realize that they can either pay for prevention services up front or pay for the cost of disease later on. Clearly, the former is more cost effective.

The second part of this question asks about prescription drug coverage for certain chronic conditions. Dr. Smethers stated that charging reasonable co-pays for maintenance medications helps members realize the value of the service they are receiving. We have seen this demonstrated in health care and know that when services are offered at no or very low cost they are often taken for granted and sometimes abused (which opened the door for HMOs to reign in the system several years back). Although true, this is only half of the story. As a seasoned Health Promotion professional, I can shed some light on the other half, which is all about disease management.

Disease Management (DM) programs are growing in popularity and are put in place by companies to help employees with certain chronic conditions effectively manage their condition. Some of the more popular DM programs are offered for conditions like asthma, heart disease, diabetes, hypertension and chronic pain. DM programs offer educational materials and often health coaching. An important and often overlooked component of an effective DM program is incentives. Companies use many types of incentives like apparel items, event tickets an even earned days off. Cash happens to be one of the best incentives out there. Most companies can’t give employees cold hard cash due to gift limitations and tax laws, but there are other creative ways to save employees some cash. One of those ways is to encourage them to participate in their DM program by offering lowered or even waived prescription drug co-pays (for condition specific drugs). I wish I could take credit for this brilliant idea, but I know pharmacy benefit management companies like Express Scripts are working to promote these types of programs. If you are going to offer an incentive, why not offer something that connects back to the program, a real win-win.

In closing I’d like to say, keep up the good work Dr. Smethers and the health promotion team at BCBSAZ. Keep fighting the good fight against our sworn enemy, preventable chronic disease!

For more information on Health and Productivity Management, please visit my website: www.awbrooks.com.

Arizona’s “Health Pulse” – Unanswered Questions, Part 1

Welcome to my very first blog entry! I'd like to thank my good friend Kevin Hillstrom, President of MineThatData and author of the world's top ranked blog on Multichannel Forensics, for getting me started on this endeavor.

On Tuesday, I attended the "Arizona HealthPulse Breakfast" sponsored by the Phoenix Business Journal and Blue Cross Blue Shield of Arizona. As a former member of the wellness team at BCBSAZ, I was excited to see the latest data and hear keynote speaker Richard H. Carmona, M.D, M.P.H, FACS, 17th Surgeon General of the United States.

Dr. Carmona’s address was inspiring and depressing all at the same time. Dr. Carmona is an outstanding speaker who’s passion for public health comes across loud and clear. It was inspiring to hear his dedication to serving people and his message about both the need for and the power of prevention. The depressing part, although not a surprise, is how difficult it is to do something good in Washington because of partisan politics. For the record, I have no desire to debate politics nor the pro’s and con’s of Democracy. I just wish we could all get along and unite against the common enemy of chronic disease.

Anyone who is interested can get a free copy of the report, so I won’t take the time to re-hash the findings. One comment I will add is that I hope to see the sample size grow from year to year to increase the validity of this data.

I would like to address two audience questions that were (in my mind) left unanswered:

Question 1: How much of the health care budget should be allocated to wellness and prevention programs? Excellent question! The answer given was about incentives and participation- although interesting, did not answer the question. And, with all due respect the EVP of External Operations is not a health promotion professional and shouldn’t be expected to know what I know on the subject.

The answer is complex and depends on your organization. There are some important questions you need to ask your company leadership that have to do with your business goals, health care spending trend, age of your workforce, turnover, injury rates, absenteeism rates, productivity, etc. There is not one simple answer that will work for every business. In general, if you want your program to have an impact you need to budget about $100-150 per employee per year. A small price tag considering that in 2005 total U.S. health care spending was $2 TRILLION (about $6,700 per person). In 2006, the annual premium for an employer health plan was $4,200 for a single employee. This number seems low to me, as I have one client who’s medical cost PEPY were over $6,000 and when you factor in prescription drug costs, workman’s compensation and disability it brings the number to over $10,000. So, if you were this client, I would recommend spending at least 1-1.5% of the total per employee cost. What a bargain, especially when you consider the documented $3 to $1 ROI of a comprehensive HPM program!

I’ll address the second question, which had to do with insurance coverage for prevention in my next article. For more information on Health and Productivity Management, please visit my website: www.awbrooks.com.