Carole Carson

Will the Recession Make Us Fatter or Thinner?

Researchers reported that during the latest round of hikes in the cost of gas, the number of fatal car accidents declined dramatically. Each 10 percent rise in the price of gasoline correlated with a 2.3 percent decrease in fatalities. As a result, the number of fatalities last year (41,059) was the lowest number in more than a decade.

 

Although part of the decline might be attributed to safer car designs and increased restrictions on young drivers, a significant portion can be attributed to higher gas prices. When gasoline became more expensive, fewer drivers took to the road, and those who did drove slower than they did previously.

 

Similarly, New York health officials discovered that the most effective tool to reduce smoking is increasing the cost of cigarettes. Initially, legislators increased taxes on cigarettes to fill their empty coffers; however, an unexpected side benefit occurred—smoking declined.

 

In both cases, what might have been considered a negative condition produced a positive result. But how will the recession affect the epidemic of people who are overweight or obese? A mixed bag of outcomes is the answer.

 

On the downside, the recession has reduced the number of food choices for lower-income families. Calorie-laden foods, such as potatoes, have slightly declined in price (2 percent), while the price of low-calorie and nutritious foods, such as fresh raspberries, has gone up nearly 20 percent. With a limited food budget, some families are forced to purchase cheaper foods. These cheaper foods fill empty stomachs, but they also pack on pounds. Purchasing more expensive, nutritious and lower-calorie food simply isn’t an option for lower-income families.

 

The upside, however, is not insignificant. Four out of ten individuals surveyed said they were eating at home more. About a third are packing their lunch for work and eating more leftovers. These statistics are positive trends since individuals tend to consume more food when eating out than when eating at home. Portions are larger in restaurants, and people tend to eat more when served more. In addition, restaurant food is generally higher in fat and calories than food prepared at home. Consider, for example, the calories in a huge slice of cheese-stuffed, double-layer pizza. Plus, individuals tend to indulge when dining out.

 

About a third of those surveyed also said they were ordering less food when they do go out to eat, and one in five replaced soda and noncarbonated drinks with plain tap water. These additional trends—ordering less food and replacing caloric drinks with water—could significantly reduce an individual’s daily caloric intake.

 

Even during these hard times, food is still a relative bargain in the United States when compared to food expenditures in other countries. The average American spends less than 10 percent of the family budget on food. This number looks good when compared to 11 percent in the United Kingdom, 17 percent in Japan, 27 percent in South Africa and 53 percent in India.

 

Thanks to warehouse clubs and technological advances in food distribution in the United States, the cost of delivery to and stocking of stores has kept food prices reasonable.

 

Of course, we have to be smart shoppers to keep our food budget in check—clipping coupons is back in style. We need to keep nutrition and health at the top of our shopping list because we don’t want simply to survive the recession. We want to come out on the other side of this economically challenging time with trim, fit, healthy and well-nourished bodies.

"The simple solution for disappointment depression: Get up and get moving. Physically move. Do. Act. Get going."                    Peter McWilliams, Life 101

 

Survival of the Fittest?

Medical care costs continue to rise. This fact has implications for all of us, but especially for persons of retirement age.

Financial experts at Fidelity Investments advise retirees to set aside nearly $250,000 to cover medical expenses during their senior years. According to Fidelity’s analysis, projected medical costs have risen 50 percent over the past seven years. Equally troubling is the observation that the trend upward shows no sign of abating, and the Medicare trust fund is expected to be insolvent by 2019.

Will these worrisome costs trigger changes in lifestyle? Will we decide to become fit to reduce medical expenses? Or will only the fittest survive?

A significant percent (some experts place the estimate at 80 percent) of the medical expenses we incur are a function of lifestyle choices such as eating too much, smoking, not exercising consistently and abusing drugs and alcohol. The implication is clear: we can prevent the majority of medical illnesses and associated costs by adopting healthful lifestyles.

If we can no longer afford expensive care or prescription drugs to deal with our medical conditions, we certainly will have a strong incentive to stay as fit as possible.

Before I decided to lose weight and get fit, my medical insurer had a file on me that was at least five inches thick. Much of what I was treated for, whether it was gallbladder surgery or chest pain, was a function of lifestyle. I ate too much, so I weighed too much. I seldom exercised, and I enjoyed nightly cocktails. One overnight stay in the hospital for chest pain cost several thousand dollars.

Today, I keep my weight in the normal range, I exercise each day and I limit alcohol to an occasional glass of wine. As a consequence, except for an occasional sinus infection, my medical expenses are minimal. I want to keep them this way, partly to preserve my good health but also to preserve my nest egg. As medical care costs continue to rise, survival of the fittest may take on a new meaning.

"A man who dares to waste one hour of time has not discovered the value of life."                    Charles Darwin

Five Steps to Avoid a Broken Heart

The heart is a muscle that some of us forget to appreciate until it is broken. In 1963, Congress instructed the president to declare each February American Heart Month to encourage citizens to join in the battle to reduce the devastating impact of cardiovascular disease. Even though cancer threatens to overtake the lead in 2010, cardiovascular disease, including stroke, remains the leading cause of death in the United States.

Putting it in human terms makes the statistics more real. According to the American Heart Association, 2 out of 3 men and 1 out of 2 women who reach the age of 40 can expect to develop cardiovascular disease.

In light of these statistics, I asked Dr. David Sabgir, a board-certified cardiologist who created the Walk with a Doc Program, how to avoid a broken heart.

Here are the five steps he recommended:

1. Walk more. Exercise is essential for good heart health. Walking benefits the heart in many ways. It raises HDL (good cholesterol), lowers blood pressure, regulates glucose levels and decreases stress.

2. Laugh more. Mental stress damages the endothelium, which is the inside of our blood vessels. This damage can lead to inflammation that can cause fat and cholesterol buildup in the coronary arteries and ultimately lead to a heart attack.

3. Cut back on fattening foods and add more fruits and vegetables to your plate. Loaded with nutrients, low in fat and high in fiber, fruits and vegetables are an essential part of a healthy-heart diet.

4. Monitor your health measurements and test results. Control your blood pressure through changes in lifestyle and/or medicine. Manage your weight and get rid of surplus pounds. Compare the results of periodic cholesterol tests to make sure your numbers are headed in the right direction.

5. Moderate alcohol consumption. If you do not drink, do not start. If you do drink alcohol, drink in moderation. Alcohol in moderation lowers the risk of heart attack and stroke.

The best part of Dr. Sabgir’s advice is that his suggestions are easily implemented. None of them cost a lot of money, require expensive equipment or take a lot of time. Yet once adopted, the five steps will protect your most valuable asset—a healthy, happy heart.

Join me in celebrating American Heart Month by taking your own steps to avoid a broken heart.

Three Ways to Avoid a Broken Heart

Our heart—that quiet, understated partner—will beat 36,500,000 times in 2009. To avoid a broken heart, we need to listen to its message before it’s too late.

Why do we need to listen? Because one out of every three Americans (nearly 81 million), suffers from some form of cardiovascular disease, a condition that encompasses not only heart attacks, but also strokes, aneurysms and atherosclerosis.

Over the past seven years, we’ve witnessed significant progress in the treatment of heart disease. This progress has resulted in a lowered death rate, so much so that cancer is projected to overtake heart disease in 2010 as the number one cause of death in the United States.

But cancer’s promotion to the spot of #1 killer is hardly cause for celebration since the toll from heart disease remains high. Approximately half a million individuals die each year from cardiovascular diseases. Seniors, parents, spouses and even children are its victims.

If our hearts could speak, they’d tell us to take good care of our health not only during American Heart Month, but throughout the year. If you’re ready to listen, consider these three tips (FIT):

F: Focus on maintaining a positive outlook, a grateful attitude, enriching relationships and satisfying work. Attaining and sustaining good mental health protects your physical health.

I: Invest 30-60 minutes a day in exercise. Researchers report that exercise, even for those who are only slightly overweight, can reduce the risk of heart disease. For those who are overweight or obese, exercise becomes even more essential to reduce the risk of heart disease.

T: Take off the extra weight. Even a few extra pounds increase the risk of heart disease. In one study of 21,000 men, researchers found that every pound of extra weight increased risk. The chubbier participants faced a 180 percent increase in the odds of developing the heart disease.

According to Dr. David Sabgir, Ohio-based board certified cardiologist and founder of the Walk With a Doc program, “Notwithstanding the wonderful advances in treatment, prevention remains the safest, most reliable and least expensive way to avoid cardiovascular disease. Plus, patients who adopt healthful habits to protect their heart (such as exercising regularly and losing weight) are simultaneously protecting themselves from other health problems.

As part of your prevention program, consider heart-friendly ways to celebrate Valentine’s Day. Instead of devouring a box of chocolates sitting in front of the television, take the hand of your loved one and go for a walk. If you give gifts, consider a pedometer or heart monitor. These are gifts that truly show how much you care.

And while you’re at it, get a one for yourself. When we take care of our health, we reduce our chances for a broken heart. Not only do we set a positive example for others, we also improve the odds that we’ll have many more future Februarys to enjoy with family and friends.

"You can create more opportunities by asking for them"                Patty Hansen

Escalating Medical Care Costs: Who Will Be Our Brother’s Keeper?

Medical care costs reached $ 2.3 trillion in 2008 and are expected to rise indefinitely at an annual rate of 9 to 10 percent.

 

In addition to the uninsured, middle-class Americans with insurance are feeling the pinch as the costs outstrip increases in income. In response to the growing financial burden, President-Elect Obama has made accessible and affordable medical care a top priority.

 

Yet 70 percent of medical care costs, or $ 1.61 trillion, is attributed to unhealthy lifestyle choices (smoking, poor eating habits and lack of exercise). This raises a compelling question: who will foot the bill?

 

A report by the Vitality Group, a provider of employer health and wellness programs, highlights the disconnect between personal responsibility for maintaining one’s health and financial responsibility for medical consequences. While 82 percent of those surveyed felt they were personally responsible for the state of their health, only 44 percent felt they had a financial responsibility for the cost of medical care.

 

Over half of those surveyed felt that employers and government should absorb the financial consequences of unhealthful lifestyle behaviors, rather than the individuals who engaged in the behaviors. Researchers also reported that the participants were reluctant to pay for wellness programs designed to teach healthful habits.

 

Spotlighting the disconnect between lifestyle choices and financial consequences provides useful insight for policymakers and employers seeking to reduce medical care costs. Even with the availability of sophisticated technological tools, social engineering is an imprecise mix of science and guesswork. Consequently, a variety of experiments are likely to be undertaken with the hope that one or more will be successful in reducing unhealthful lifestyle behaviors.

One approach is taxing unhealthful behaviors. Alabama’s fat tax falls in this category. Beginning in January 2009, obese state workers will risk a monthly increase of $25 in insurance costs if they fail to reduce their weight.

Equally controversial is the approach being proposed by New York Governor David Patterson—an 18 percent sales tax on sugary drinks and sodas. Governor Patterson estimates that this tax, if approved, would generate an estimated $400 million in revenue to offset rising medical care costs resulting from obesity.

 

His model is based on the success of the anti-tobacco campaign. Certainly anti-smoking advertisements have contributed to a decline in smoking; however, researchers have also found a clear correlation between the increased cost of cigarettes and a reduction in the number of smokers. According to statistics cited by Drs. Tom Farley and Deborah Cohen in their book, Prescription for a Healthy Nation, every 10 percent price increase on cigarettes reduced sales by about 3 percent.

 

Whether smokers connected the cost of their behavior with the cost of treating smoking-related ailments was irrelevant. Some quit smoking because of the expense. Those who continued were forced to offset some of the medical costs associated with smoking. (Even so, a $7 tax would be required to fully cover the additional costs of medical care associated with smoking.)

 

In Governor Patterson’s model, sugary drinks are the equivalent of cigarettes. Americans consume one-third of their calories from sugar; half of those come from sugary drinks that nutritionists consider empty calories—the drink is high in calories and low on nutrition. In addition, sugary drinks fail to satisfy hunger. Consequently, the surplus calories in the sugary drinks are added to the calories consumed in food. For these reasons, many experts consider sugary drinks to be the most significant factor in the rise of obesity.

 

If Governor Patterson’s tax initiative passes, public health officials believe they will see a correlation in reduction of the number of overweight or obese individuals, similar to the decline in the number of cigarette smokers.

 

According to Art Carlos, chief executive officer of the Vitality Group, “The increasing need for health care arises from the treatment of illnesses and medical problems that are preventable through more healthful lifestyle choices. Despite advances in medicine, physicians cannot undo the damage resulting from long term abuse of our bodies and are limited in their ability to reverse a lifetime of unhealthful habits. The solution will emerge when we are required to take personal accountability for the way we choose to live.”

 

We spend twice as much as other industrialized nations for medical care, yet we are losing ground on the health front. In the near future, rising medical costs will force us to answer the question: who will be our brother’s keeper?

"Am I my brother's keeper?"                    Bible, Genesis, chapter 4, verse 9

Looking for Ways to Save Money? Drink Tap Water

Test results of leading brands of bottled water reported in numerous newspaper articles on October 15, 2008, support the claim that bottled water is no purer than tap water.

Tests on 10 leading brands detected the presence of 38 contaminants ranging from bacteria, caffeine, fertilizer and solvents to the radioactive element strontium.

Overall, the level of contaminants wasn’t high enough to pose any threat to safety. All the brands met the federal requirements for safe drinking water, although a few brands contained levels of chlorine by-products nearly three times above California’s limit.

This information begs the question, why pay a premium (1,900 times more) for bottled water if it is essentially the same as tap water? Thomas Burke, one of the developers of the Safe Drinking Water Act and associate dean of the Johns Hopkins School of Public Health in Baltimore, says that there is little difference between the two kinds of water except the price.

Replacing bottled water with tap water might save a family of four as much as $20 per week. This choice seems to be an easy way to help make ends meet. What do you think?

"Water is the most neglected nutrient in your diet but one of the most vital."                                         Kelly

Got Soup? It’s a Souper Way to Weigh Less

Political Promises, Healthcare and Our Big Fat American Deficit

On September 11, 2008, the U.S. budget deficit reached an all-time high of $9,682,116,996,293.84. Servicing this debt requires around $500 billion annually, give or take a few billion. And like the addict who needs another fix, we continue to spend. This year, experts estimate that an additional $410 billion will be added to the big fat American deficit. Moreover, because of the rocky economy, less revenue from taxes may cause these numbers to rise.

The United States is currently spending 16 percent of its gross domestic product on healthcare. This figure will probably expand in tandem with the expanding waistlines of overweight and obese Americans, whose numbers now total two-thirds of adults and one-third of our offspring. Surplus weight results in health problems that translate into additional medical costs. Consequently, the direct and indirect economic costs of the rising numbers on the bathroom scale are sobering. Individuals, insurers, employers, government programs (including Medicaid and Medicare) and county, state and federal governments pay for direct costs. And as most individuals and employers know too well, insurance premiums are rising. The average annual premium for a family of four is over $12,000.

Indirect costs are harder to measure yet just as real. They reflect the loss of income resulting from absenteeism, sick days, restricted activity and premature death.

I wrote about this issue in an article titled "Political Promises, Healthcare And Our Big Fat American Diet" that appeared September 3, 2008 on basilandspice.com and included a summary of the solutions to the healthcare dilemma proposed by the two presidential candidates. Go here for the full article.

McCain proposes a $5,000 tax credit to help uninsured families afford coverage. He also proposes taxing employer-subsidized medical insurance. McCain believes that improved management of the healthcare system will trim costs.

In contrast, Obama’s priority is obtaining coverage for the 45 million uninsured Americans at an estimated annual cost of $65 billion. Like McCain, Obama assures voters that better management of the healthcare system and cost controls can lower the annual insurance premiums to an affordable level of $2,500 for a family of four.

Both of these candidates agree that the healthcare system needs attention. Although they disagree on the means, both want citizens to have access to affordable healthcare. Without being drawn into the merits of either candidate’s proposals, we can focus on three fixes that can help us become more fiscally and physically fit (FIT):

F: Fix the medical model. Instead of reimbursing physicians and hospitals $250,000 for a single heart surgery, fund wellness and prevention programs for 1,000 people at $250 each. That’s the perspective of Dr. Nick Yphantides, author of My Big Fat Greek Diet and the poster child for what an individual can achieve when lifestyle changes occur. Once a big man (he weighed nearly 500 pounds) with an even bigger heart, Dr. Yphantides now weighs 237 pounds. He uses his personal example with his patients and members of the community to promote healthy lifestyles even though it would be more lucrative to focus on the treatment of medical problems arising from lifestyle choices.

I: Intervene in the lives of individuals to cut through denial. Alabama is experimenting with a stick rather than a carrot. State employees will be fined $25 if they fail to make lifestyle changes that address health and weight issues. Although most of us prefer a carrot to a stick, some of us may need the sting of a stick to wake us up.

T: Tackle the issue of fitness as a community. We need to change the environmental cues that encourage us to overeat and underexercise into ones that encourage us to eat more healthfully and exercise regularly.

Communities can adopt successful group weight-loss programs such as the Nevada County Meltdown, where over 1,000 people lost nearly four tons in eight weeks. Or communities can introduce Dr. David Sabgir’s model, the Walk with a Doc program in Lewis Center, Ohio. Each Saturday at 8:30 a.m., Dr. Sabgir and other physicians and medical-care providers walk with about 175 to 200 patients, family and friends.

How I cast my ballot once inside the voting booth this November is a private matter. Publicly, however, I have no problem sharing my ideas on how we can enhance the health and well-being of friends, family and neighbors. As a by-product, we can reduce the cost of healthcare and help lower the national debt.

My own medical cost-containment program is to lead a healthful lifestyle to render expensive medical care and prescription drugs unnecessary. And my tongue-in-cheek goal is to die a natural death without the help of a doctor.

What’s Triggering Body Inflation?

The price of food throughout the world has risen at an unprecedented rate, according to a warning issued by United Nations. In 2007, the global food price index rose over 40 percent compared to 9 percent in 2006. Agency officials cite global warming, changes in farming practices, natural disasters, war and rising demand for food and fuel from growing populations as key factors.

In the United States, the price of fresh fruits and vegetables rose 74% between 1989 and 2005, and we can expect the cost to continue to rise given the damage to crops from flooding in the Midwest and a drought on the west coast. In terms of the dollar’s purchasing power, it takes $125 to buy the same goods today that $100 bought in 2000.

Given the rising cost of food, why are Americans—along with citizens of other countries—ballooning? Obesity is even becoming a problem in some parts of Africa as the pendulum for many now swings from under-nutrition to obesity without bothering to stop at normal weight. Is inflation contagious? Is it triggering inflation in body weight as well?

In an effort to address this question, a special health issue of Time magazine focused on supersized kids. The expanding problem (excuse the pun) of childhood obsesity is a concern for many but especially parents, grandparents, teachers and medical professionals.

Time’s eight lengthy, well-researched articles cover topics ranging from the economics of obesity (how limited access to fresh fruits and vegetables in inner cities and certain rural areas, referred to as food deserts, encourages calorie-laden diets) to genetic causes of obesity and medical solutins. Practical tips to help parents trim their oversized kids by helping them become more active is also included.

But is the problem of body inflation this complex? And is the solution more exercise?

Not according to biologist John Speakman at the University of Aberdeen in the U.K. He narrows it down to one simple cause: we eat too much. In a study reported in the June 4, 2008, issue of Science Now titled “The Couch Isn’t Making You Fat,” Dr. Speakman asserts that overeating rather than under-exercising is the root cause of obesity.

Dr. Speakman and a fellow biologist, Klaas Westerterp of Maastricht University in the Netherlands, studied data that measured the daily energy expenditure stretching over a twenty year period. Then they compared the data from the long term studies with results they obtained measuring the current energy expenditure of 366 individuals. Rather than rely on subjective reporting, the researchers measured the ratio of hydrogen and oxygen in the urine of subjects, a ratio that provides information on the rate of metabolism.

Their conclusion was both startling and controversial. The researchers found that the daily expenditure of energy for their subjects was about the same as it was for people measured twenty years ago. True, watching television has replaced listening to the radio, and surfing the Internet or playing video games has replaced reading books. But the effect of these changes does not significantly alter energy expenditure.

Even more impressive was their conclusion that the expenditure of energy was consistent over the entire twenty year period. Surprisingly, geography had little impact. That is, the expenditure of energy remained constant whether the data came from studies in developing or westernized countries.

His study confirms my own experience in losing over sixty pounds. How did I acquire the surplus pounds? I ate too much.

Here’s a typical day of eating before I lost weight.

Breakfast

1 fried egg 100

2 slices of bacon 80

2 slices whole wheat bread 200

2 cups of coffee with cream 90

1 8-ounce glass of orange juice 130

Total 600

Lunch

1 double cheeseburger 440

1 large order French fries 500

1 packet catsup 15

1 12-ounce McFlurry with M&Ms 620

Total 1,570

Snack

2 chocolate chip cookies 200

Dinner

2 slices cheddar cheese 210

4 whole wheat crackers 100

1 baked potato 90

2 heaping tablespoons sour cream 120

1 heaping tablespoon butter 100

1 breast of chicken 200

1 cup green salad 180

3 tablespoons salad dressing 100

1 cup green beans with butter 100

Total 1,200

Total for the day 3,570

Given my height of 5-feet 2-inches, even with an hour of exercise, my body burns around 1,500 calories a day. So what happened to the 2,080 surplus calories on my typical eating day? My body stored fat around my middle, hips and thighs.

Had I tried to burn the extra calories through exercise, I would have needed to walk 10 hours. As you can see, there weren’t enough hours in the day to burn off the surplus calories.

Although I’m not a math major, I figured out that except for the ultra-athlete engaged in intense, continuous training or the competitors on The Biggest Loser, exercise by itself would not be sufficient to lose weight. Consequently, my approach to losing weight involved eating less (reducing portion sizes) and eat differently (substituting lower-calorie foods for richer ones.

Don’t get me wrong. Exercise shapes and tones my body, lowers my blood pressure, improves my balance, sharpens my mind, strengthens my muscles and bones, reduces the risk of certain chronic diseases and lifts my spirit. Exercise also helps me sleep better, boosts my energy and burns a few incidental calories. Because exercise has these enormous benefits, I’m committed to daily exercise. At the same time, I’m realistic about the ongoing need to monitor the amount of calories I consume if I want to keep from packing on pounds.

What triggers body inflation? Genetics? Too much screen time? Or do we eat too much? Is it simply consumption inflation? If it is, can we accept such a straightforward answer? Or will we seek an answer that does not require us to alter our current way of life. And eating.

Like Brutus, will we continue to look for answers—not in ourselves—but in the stars?

"The fault, dear Brutus, lies not in our stars but in ourselves..."                            Shakespeare

Back-to-School Tips to Trim Your Budget While Splurging on Fitness

Saving money is a high priority for many parents now that the school year is beginning. The worst food inflation in nearly two decades is placing a strain on family budgets.

The supersizing of prices at the grocery store and at the gas pump is matched by the supersizing of our bodies and weight. In the United States, two-thirds of adults and one-third of children are overweight or obese—a condition that alarms medical experts. And like food prices, the numbers are rising.

Families are forced to trim their expenses back to the basics. But when it comes to getting good grades, keeping our offspring physically fit isn’t a luxury. Fitness and academic achievement go hand in hand.

Today’s assignment for parents is to promote health and fitness and stay within the family budget. I wrote about this topic in an article titled “3 Back-to-School Tips to Trim Your Budget While Splurging on Fitness” that appeared on Gabby Reece’s Web site on August 13, 2008. Go here for the full article.

Although you may need to trim your budget during these uncertain times, you can confidently splurge on your efforts to promote family fitness. The reward will be seeing good grades on your children’s report cards today and watching your children develop into healthy, active and productive adults tomorrow.

"He who will not economize will have to agonize."                   Confucius