Lifestyle Underwriting

Diabetes Prevention: Lifestyle Change – amednews.com

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The national YMCA of the USA was awarded a three-year, $12 million grant from the federal Center for Medicare and Medicaid Innovation to make its diabetes-prevention program available to about 10,000 Medicare patients in 17 communities. Medicare fee-for-service patients pay no additional out-of-pocket cost for the YMCA class and 27 private health plans cover it. For other patients, the fee is charged on an income-based sliding scale that varies by facility and can reach $400, says Matt Longjohn, MD, MPH, the national health officer at YMCA of the USA.

26 million Americans have diabetes, more than 8% of the U.S. population. Researchers estimate that one in three U.S. patients — about 80 million — can be classified as prediabetic either because of their scores on diagnostic blood tests or a combination of age, family history of diabetes and other factors. Patients with prediabetes are two to five times likelier than patients with normal blood glucose to develop type 2 diabetes. Ten percent of prediabetics will become diabetics within seven years, says Ronald T. Ackermann, MD, MPH, associate professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.

A randomized controlled trial of more than 3,000 patients with prediabetes found that patients exposed to an intensive lifestyle-modification program that aimed for 7% weight loss and 150 minutes in weekly physical activity were 58% less likely to develop diabetes than those who received standard lifestyle recommendations and took a placebo pill. During the study’s three-year period, the patients who got the comprehensive lifestyle support in the form of 16 lessons covering diet, exercise and behavior modification avoided diabetes at a rate nearly double that of patients who got the standard advice and took the diabetes drug metformin.

For every seven prediabetics who participated in the lifestyle-modification program, one case of diabetes was avoided, said the study in the Feb. 7, 2002 issue of The New England Journal of Medicine.

via Diabetes prevention: Set on a course for lifestyle change – amednews.com.

Fruit Tied to Fewer Aortic Aneurysms

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Through 13 years of follow-up, men and women who said they ate more than two servings of fruit a day had a 25% lower risk of developing AAA (HR 0.75, 95% CI 0.62-0.91) compared with those who ate less than 0.7 servings a day, according to Otto Stackelberg, MD, of the Karolinska Institute in Stockholm, and colleagues.

And those who ate the most fruit had a 43% lower risk of developing a ruptured AAA (HR 0.57, 95% 0.36-0.89), the researchers reported in the Aug. 20 issue of Circulation: Journal of the American Heart Association. There were no such associations with vegetable intake.

via Fruit Tied to Fewer Aortic Aneurysms.

Red Meat Hikes Diabetes Risk

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Individuals who added more than half a serving a day of red meat to their diet saw a 48% increase in their risk of type 2 diabetes onset over the next 4 years compared with those who stayed at that level, An Pan, PhD, of the Harvard School of Public Health and National University of Singapore, and colleagues found.

 

Cutting intake by the same amount during the first 4 years of follow-up lowered that risk by 14% during the following 12 to 16 years, the researchers reported online in JAMA Internal Medicine.

via Red Meat Hikes Diabetes Risk.

Walk or Run? Think Distance, Not Speed

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Researchers evaluated 33,060 runners in the National Runners’ Health Study and 15,045 walkers in the National Walkers’ Health Study. Dr. Thompson said there will be more results coming from the data. The study found:

  • Running reduced the risk for first-time hypertension 4.2%, and walking reduced it by 7.2%.
  • Running cut the risk for first-time high cholesterol 4.3%, and walking reduced it by 7.0%.
  • Running cut the risk for first-time diabetes 12.1%, and walking decreased it by 12.3%.
  • Running reduced coronary heart disease 4.5% compared with 9.3% for walking.

via Walk or run? Think distance, not speed, for health benefits – amednews.com.

GREAT NEWS for this aging tortoise who no longer runs 10-k’s due to bilateral knee osteoarthritis.

Is Running Bad for Your Heart? – NewsOK.com

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A study published in the December issue of the British medical journal Heart looked at 52,600 people over three decades, and it found that those who ran more than 20 to 25 miles per week lived no longer than those who didn’t exercise at all. Another recent study also found that people who ran faster than 7 minutes and 30 seconds per mile when they exercised enjoyed no mortality advantage over couch potatoes. But in both studies, people who ran regularly, but at shorter distances and slower paces, lived longest.

via Is running bad for your heart? | NewsOK.com.

Yet another study that adds to the conflicting data we already have.  For the record, I no longer run for exercise.  But my excuse is OA.

When the Patient Is ‘Noncompliant’ – NYTimes.com

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Despite efforts to change the term to the slightly more accurate “nonadherent,” the word “noncompliant” remains firmly entrenched in the medical lexicon. No matter what it’s called, however, it’s an enormous problem. Experts estimate that some 50 percent of patients do not take their medicines as prescribed or follow doctors’ recommendations.

via When the Patient Is ‘Noncompliant’ – NYTimes.com.

Underwriting and mortality issue?  I think so.