Where are we going?

You’ve seen it all—you can’t miss it—the wave of talking points, articles and arguments regarding waste, change, need and health care reform. It brings to mind, “The Good, The Bad, and The Ugly.” We all tend to view our individual realities (and the wants and needs that accompany them) through our own lenses, and this only adds to the complexity of what is already a difficult and frustrating health care reform discussion.

We’ve reached a point where we simply can’t hold on to a past that no longer works—and for all practical purposes, no longer exists. To try to do so is, as the saying goes, “like trying to nail jello to a tree.”

Today, we have almost instant access to greater resources. Information on just about anything is readily available. Now that we have it, what do we do with it? How do we use it? And where are we going with it? How in the world does this tie-in to health care reform? It ties in because we all have a responsibility to be informed—and we have a responsibility to make our voices heard.

The challenges facing institutions, health care and health care systems confront tradition—and this is part of what makes change difficult. The outcomes of this discussion are still uncertain, vague and indefinite. What does seem clear however is the need for continued dialogue that respects our voices and opinions. We’re still at the beginning, yet we already know the ending will bring change in “some” form. Will it make sense? Will it be enough? Will it be too much? I don’t know about Washington, but I wish I was smart enough to know exactly what this—and the related ramifications will ultimately mean in real terms and real results—for real people.

What do you think?

It’s Independence Day

It’s Independence Day, and your country is counting on you. We've got a big problem and it's only getting bigger. America's fighting a "Battle of the Bulge" and right now, we're losing the fight. This is one battle we simply can't afford to lose. We can't afford it individually, our employers can't afford it, and our country can't afford it. And, we’re running out of time. Health care reform is on everyone’s agenda, but we don’t yet know what form it will ultimately take. In the meantime . . .

Each one of us pays an additional $175 annually through Medicare and Medicaid to cover obesity-related illnesses. The epidemic of obesity is costing us all in less obvious ways as well. According to analysis by researchers at Cornell University, the extra poundage packed on by the average American in the last decade required airplanes to use an extra 350 million gallons of fuel at a cost of more than $275 million a year (and that figure is based on prices in 2000 when jet fuel was 79 cents a gallon). On a more personal level, an overweight family may lose 10 percent of every gallon of gas they buy, and at today’s prices that adds up fast. If we want to be "green" we've got to get lean.

The Centers for Disease Control and Prevention says obesity has roughly the same association with chronic health conditions as 20 years of aging. It contributes to 53 diseases including heart disease, diabetes, arthritis and some types of cancer. Almost one-half of all Americans report having a chronic illness—and those illnesses account for 75 percent of our national spending on health care (Robert Wood Johnson Foundation). Furthermore, almost 80 percent of all chronic disease is caused by three preventable health behaviors—physical inactivity, poor nutrition and overeating, and smoking.

How about this? What if this Independence Day we declare our independence from junk and fast food? What if we look for healthy substitutions? What if we work in a little more physical activity? What if we make just one modest yet meaningful change in our nutritional behaviors? If we as a nation of individuals can each make the effort to independently create a positive change for ourselves, we will collectively do great things for our country—and our own long-term health and wellness. “We the people” can take control of our wellness behaviors—and outcomes. “We the people” can become the solution rather than part of the problem. We are all stakeholders in this effort, and together we can turn the epidemic of overweight, obesity, and inactivity around and reduce our risk factors for preventable chronic illnesses. Yes, it's a mouthful, but something well-worth chewing on.

Are You a Food Citizen?

LoneStart Wellness talks a lot about nutritional content and making positive food choices. We talk about making modest yet meaningful changes in our daily “food and activity behaviors.” We talk about “spreading Viral Wellness™” and creating the mind-set that turns burdens into opportunities.” We don’t usually talk about pesticides. But . . .

Do you ever think about what’s on (or in) your food—or drinking water? You’ll probably be surprised, and disturbed, and maybe even disgusted. The Pesticide Action Network points out that the most recent figures from the Environmental Protection Agency (2001) indicate that nearly 900 million pounds of pesticides are used in the U.S. each year. This is about three pounds per person.

What do the 900 million pounds of pesticides do? For starters, they make your apples, tomatoes, corn and other produce look nice. People who have organic vegetable gardens know that their vegetables don’t look like those in the bins at the grocery store. They aren’t full of chemicals either. The problem is, toxic pesticides are absorbed into the food—meaning they don’t wash off. They accumulate in our bodies. They accumulate in our soil and water.

According to the Pesticide Action Network, an average American child gets more than five “servings” of pesticide residue each day. Atrazine (a hormone disrupter) is a pesticide that has been banned in Europe, yet is found in 71 percent of U.S. drinking water. An analysis made by the Environmental Working Group (EWG) of more than 110,000 government-tested food samples, and detailed government data on children’s food consumption, found that multiple pesticides known or suspected to cause brain and nervous system damage, cancer, or hormone interference are common in foods many children consume. Take apples as an example: The EWG found the average apple has residues of four pesticides after it is washed and cored. Some have residues of as many as ten. More than half of the children exposed to an unsafe dose of organophosphate insecticides get it from apples, apple sauce, or apple juice.

And it’s not just about the food we put on the table—widespread use of toxic agricultural chemicals threatens the health of farm workers, wildlife and delicate ecosystems.

We have a controversial food production system. If we think about it, this is a concern we might all be hungry to change.

An open letter to President Obama from LoneStart Wellness

Dear President Obama:

You’ve made health care reform a priority, and rightly so. It’s been said, “the devil is in the details,” and maybe that’s why some important details seem to be missing in the ongoing national discussion on health care reform.

It’s true that our health care system is collapsing under its own weight. And, it’s true our nation needs health care reform. It’s also true that an ounce of prevention can be worth (in this case) many pounds of cure.

We’re not talking only about health care and health care reform. Americans don’t want to just talk about reforming health care. They want to know that whatever solution emerges will improve their access to affordable, high-quality health care and that it will be sustainable. That means we must shine a bright light on all aspects of our current health care delivery system. We must look for every opportunity to eliminate waste, redundancy and practices that exist more for the enrichment of the provider than the health care of the consumer. We’re dealing with an issue that is complex, has deeply entrenched private and public interests and threatens some of our fundamental assumptions about rights, privileges, profits and entitlements. While we do not yet know what shape comprehensive health care reform will take or what it will cost, we do expect that we will all bear some of that burden. That makes it “our” issue and our responsibility as well as our burden.

Let’s turn some of that burden into an opportunity to engage our citizens to become more proactive in their own vital wellness behaviors. For the past three years, we’ve proven that those most at risk for preventable chronic illness can and will change even satisfying and deeply-entrenched behaviors so long as they can believe that they have a reasonable expectation of success.

Almost one-half of all Americans report having a chronic illness, and about 80 percent of all chronic disease is caused by three preventable health behaviors—poor nutrition and overeating, physical inactivity, and smoking. Obesity is a major contributor to and accelerator of chronic disease, which accounts for 75 percent of the $2.2 trillion spent on health care in the United States each year.

We’ve seen those who at one time have been viewed as part of our health care problem, become part of the solution as a result of their success through LoneStart’s individual and workplace wellness programs. This is how what we call Viral Wellness™ spreads, from person to person, organization to organization, and then to families and social networks. It’s how we can turn wellness itself into a pandemic, and it’s how we can proactively reduce health care costs and utilization. Over time we have the ability to create a true Culture of Wellness in our families, our organizations, our communities and our country.

LoneStart Wellness asks you to expand the conversation and let all of us have a chance to address those “pesky details.” As the debate continues it’s time to bring each individual’s responsibility for our collective wellness into focus—devilish details and all.

Why Do We Make The Choices We Make?

In our last post we talked about Burger King and their new “healthier” Kids’ Meal options. We asked if even these healthier choices could be considered “healthy?” Well, here’s a question for all of us adults, one that asks why we make the choices we make? Interesting question in many ways, but we’ll just focus on one area—food. Is it taste, habit, comfort, convenience, price, or maybe, nutrition? Or maybe, none of the above? Or maybe, all of the above?

We have to believe that most of us know by now which food choices are healthier than others. But do we care? A recent study in the Journal of Consumer Research might answer this question with, “maybe not.” The study goes further to say that the presence of healthy items on restaurant menus may actually encourage consumers to select less healthy food items.

So, here’s food for thought. “Just because consumers say they want to see healthier options on menus, doesn’t mean they are going to choose them.” The study points out that the presence of healthy options can actually call the consumer’s attention to the “unhealthy” choices.

Researchers from Duke University, Loyola College and City University of New York asked a group of college students to choose a side from a menu that offered chicken nuggets, french fries or a baked potato. Another group of students was asked to select from the same menu but with an additional choice—a side salad. All items were the same price. When the salad was not offered, 10 percent of the students chose french fries, the least healthy choice. When the side salad was offered, 33 percent chose french fries.

And, this is really interesting. The study found that just the presence of a healthy item on the menu vicariously fulfilled “healthy eating goals,” and drove the diners attention to the least-healthy food choices, providing them with the “license to indulge in tempting foods.”

Our question(s)? Do we see all the choices as “sides” (so all are incidental)? Do we see that all are the same price, and think, “all the same?” Do we “know,” what we should choose, but think, “next time?” Or do we know, but don’t care?

But, Does It Go Far Enough?

Last month Burger King announced it has added new “kids’ meal options” as part of its commitment to the BK Positive Steps program and to meet the company’s nutrition criteria for advertised kids’ meals. The new meals include:

• A two-pack of BK Burger Shots (bite-sized burgers topped with mustard, ketchup and two crunchy pickles, Fresh Apple Fries, caramel dipping sauce and Minute Maid apple juice).
• A hamburger served with Fresh Apple Fries, caramel dipping sauce and Minute Maid apple juice.
• A four-piece Chicken Tenders meal with reduced sodium, Fresh Apple Fries, caramel dipping sauce and Hershey’s fat free milk.

The company has identified more than 350 Burger King meal combinations that provide 650 calories or less. The company has eliminated all trans fat cooking oils and ingredients in the U.S., Europe, Latin America, Puerto Rico and Canada. It has instituted a “sodium commitment” of 600 milligrams or less for BK Kids’ Meals.

So these are positive steps—and as far as they go, should be applauded. But do they go far enough? Questions I would ask?

• Does the ketchup list high fructose corn syrup as an ingredient?
• Are fresh apple fries really fresh apples? Why are they fried? Why is caramel dipping sauce considered a “healthy choice?”
• Does Minute Maid apple juice have added sugar? Does it have high fructose corn syrup?
• Are the Chicken Tenders skinless? Are they fried or grilled? Are they highly processed chopped and formed pieces of chicken with added binders?
• Is a sodium commitment of 600 milligrams or less enough of a commitment when the FDA and USDA state that an individual food that has the claim “healthy” must not exceed 480 mg sodium per reference amount? The Food and Nutrition Board recommends only 400 mg per day for children between 6 and 9 years of age.

When we consider the epidemic of childhood obesity, and that this generation of children may be the first in America to have shorter life expectancies than their parents, the new Kids’ Meals may still not be such a good choice even if they are labeled, “healthy.” Let’s define what healthy really means. What do you think?

To Tax or Not to Tax—That’s a Big Question

Actually, it’s a lot of questions. Liquids make up about 22 percent of our daily calories. A 12-ounce can of sweetened soda contains 150 calories and 10 teaspoons of sugar. Is this tax-worthy? It’s a question we may be looking at. Here’s a question to go with it—Is soda a sin? Do we impose a “sin” tax on regular soda but not diet soda? It seems the Center for Science in the Public Interest plans to propose a federal excise tax on soda, certain fruit drinks, energy drinks, sport drinks and bottled / canned teas. It would not include diet beverages.

There is money to be made with such a tax. The Congressional Budget Office estimates that adding a tax of three cents per 12-ounce serving would generate $24 billion over the next four years.

Now, if this tax is based on sugar or health issues associated with these beverages, we know there are risks associated with diet drinks as well. Should the proposed tax include diet sodas and drinks?

A study published in “Circulation: Journal of the American Heart Association,” found those who drank just one soft drink a day—diet or regular—showed increased risk factors for heart disease.

Here’s more: Women who drink two or more cans of diet or regular soda a day are nearly twice as likely to show signs of early kidney disease. The acid in soda can erode tooth enamel. And, any soda may increase your risk of metabolic syndrome. People who consumed just one diet soda daily had a 34 percent higher risk.

So, maybe the question we should ask might be something along the lines of: As with smoking and alcohol, should those who consume any soda help pay for the cost of health care associated with that choice?

What do you think?