Crisis in Our Disease Management System, Part II.

By Radhia Gleis PhD, C.C.N.

In part I of Crisis in Our Disease Management System we talked about overweight and obesity being the major contributing factor to problem. But how bad could a few extra pounds and eating a poor diet really be? Let’s take a closer look at this disease crisis and how it affects everyone, regardless of whether you are over weight now or not! Over eating, eating over cooked, highly refined and processed food, and eating foods lacking in nutrients will invariably cause excessive weight (fat), and degenerative disease. Did you know that statistics from the Center for Disease Control state that the life time risk of developing cancer is 2 in 5. Risk of dying from heart disease/strokes is 2 in 5. And according to the CDC 50% of everyone born today in the US will be diabetic in their lifetime.

A study published last year in the New England Journal of Medicine stated that weight gain was the second leading cause of all cancers. The American Cancer Society (ACS), estimates weight contributes to between one-third and one-half of breast cancer in older women. According to new research recently released by the ACS: older women who gained 20 – 30 pounds after high school were 40% more likely to get breast cancer. Heather Spencer Feigelson, senior epidemiologist states that “the risk doubles if the woman gains more than 70 pounds”.

Studies have now proven that inflammation underlies all phases of heart disease. So the question is what promotes inflammation? The major causes of inflammation are: smoking, insulin resistance, excessive weight (fat), and infection (which may be caused by inadequate nutrition). Three out of four of these causes are diet related; all include poor lifestyle choices. Smoking causes oxidants to form and hastens the oxidation of LDL cholesterol, thereby fostering arterial inflammation. Homocysteine is an amino acid in the blood that is related to increased risk for heart disease, stroke, and vascular disease. Homocysteine levels are strongly influenced by diet. Excessive weight leads to insulin resistance and diabetes elevates glucose levels in the blood; this sugar enhances the inflammatory properties of the body. Infections may also trigger a similar response. This is because when the body fights an infection its inflammatory mediators can escape into the blood and travel to distant sites. Eating a diet rich in sugars and mucus forming foods is an invitation to infection.

The best way to beat diabetes is to prevent it, and research suggests that the disease can be prevented by a lifetime of weight control, regular exercise and a diet that avoids excessive amounts of carbohydrates which the body turns into sugar. Obviously, providing the basic nutrients needed for life is essential not only for proper cellular function but to help avoid any imbalance that may promote the growth of diabetes.
Besides a poor diet, the top three causes of death in this country are environmental pollutants, unhealthy lifestyle and stress. But disease is not the only consequence of these conditions; a study published in the September 2002 issue of the Journal of Health Economics reported that regardless of a person's career, being obese limited their advancement and salary. On average, obese people earned 2.5% less than did their thinner colleagues performing the same job. For the typical American this amounts to roughly $100,000 less over the life of their career. The wage penalty is more severe for overweight women. They averaged up to 6.2% less pay. Being as little as 30 pounds over weight could hamper a woman's job prospects, whereas men's careers typically were not affected until they were very overweight.

While the overall health of the population is declining rapidly, consider the tremendous impact this crisis will have on the American economy as a whole. Even if you are one of the few that prides themselves on a healthy diet and lifestyle, it is a mistake to think that you and your family won’t be directly affected by other peoples poor lifestyle choices. Have you seen the headlines? Barbara Martinez of the Wall Street Journal writes: “Shifting the Burden; With Medical Costs Climbing, Workers are Asked to Pay More; Faced with Rising Expenses, Companies Boost Copay Premiums for Employees”. In “Health Insurance Costs Surge”, Don Lee of the Los Angeles Times writes “Study shows that employer’s premiums increase an average of 13%, while double-digit increases in workers’ out of pocket expenses.” Thomas Aeppel, from the Los Angeles Times writes: “Skyrocketing Health Costs Start to Pit Worker vs. Worker; Employees Gripe That Those with Bad Habits Drive-Up Insurance Charges for All”.

Insurance providers, state and local governments, small businesses and large corporations throughout the country are slowly waking up to the fact that if they do not take a proactive stance on health education and disease prevention this crisis will break the back of our already strained economy. There are many benefits to a transition from disease management to a health care system that includes priorities in prediction, prevention, and health education. Ironically the workplace has become an environment that both contributes to employee ill health, while simultaneously offering the most potential for improving overall employee health and well-being. Considering the average full-time employee spends 260 out of 365 days a year at their job, it seems elementary that employers would want to provide a vehicle to help improve their employees’ physical and mental health. The benefits of improving employee health will reduced absenteeism; increased employee morale; reduced turnover; provide better recruitment leverage; and lower healthcare costs.

Employers and employees alike will find it far more cost effective to implement a comprehensive wellness program and nutrition education as a part of their company benefits package than be faced with the financial burden of this disease care paradigm.

To find out about a Corporate Wellness Program or Brown Bag Lunch Nutrition Education Series for you or your company, please contact our office.