In the Spotlight

3 Ways to Reduce Cancer Risk

2013-01-02T16:54:07Z

By Margaret I. Cuomo, MD

What can we do to reduce our risk of getting cancer? WebMD asked Margaret I. Cuomo, MD, author of A World Without Cancer, to share some insights with us on this topic. Cuomo is a board certified radiologist who served as an attending physician in diagnostic radiology at North Shore University Hospital in Manhasset, New York, for many years. Specializing in body imaging, involving CT, ultrasound, MRI, and interventional procedures, much of her practice was dedicated to the diagnosis of cancer and AIDS. She is the daughter of former New York Governor Mario Cuomo and Mrs. Matilda Cuomo, and sister to Governor Andrew Cuomo and ABC’s Chris Cuomo, and wife of Howard S. Maier. She resides in New York.

What is the one most important step people can take to reduce cancer risk?

Maintain a healthy weight.

Obesity is a national epidemic, and is a risk factor for cancer, as well as heart disease and diabetes. A study published in the New England Journal of Medicine reported higher death rates from at least 14 different kinds of cancer among overweight populations, and noted that the heaviest people were 50 percent more likely to die from cancer than people of normal weight.

What are some of the most troublesome chemicals we are exposed to that may cause cancer?

At least 80,000 chemicals are manufactured in the United States, and we are exposed to many of them on a daily basis. We know with alarming certainty that some of them cause cancer. In fact, the International Agency for Research on Cancer states flatly that 100 agents in use today are “carcinogenic to humans,” and several hundred others are “probably” or “possibly” carcinogenic to humans. Yet, most of them remain unexamined and unregulated.

There are three chemicals in our daily lives that are of particular concern: Bisphenol A (BPA), perchloroethylene and parabens.

BPA has been associated with breast and prostate cancer in mice, and an increased risk of miscarriage and polycystic ovary disease in humans. BPA is ubiquitous in consumer products, from plastic bottles containing water and other beverages, to canned food to cashier receipts. To reduce BPA exposure, avoid plastics with a 3 or 7 recycle code on the bottom, or look for products labeled “BPA-free”.. In 2012, the FDA banned BPA from baby bottles and children’s drinking cups.

Perchloroethylene, or “perc,”, a chemical used in dry-cleaning, has been called a “likely human carcinogen” by the Environmental Protection Agency, or EPA. Workers in the dry cleaning industry have a higher incidence of several cancers, including non-Hodgkin lymphoma, multiple myeloma and bladder cancer. The Natural Resources Defense Council advises that consumers seek out alternate methods of dry-cleaning.

Parabens are chemicals that mimic estrogens, and have been found within breast tumors. Parabens are found in moisturizers, hair care products, shaving products, processed meats, snacks, candy, and some liquid dietary supplements. The FDA has not banned parabens from consumer products, but says that it will consider new research as it becomes available. I recommend that you avoid ingredients with the word “paraben” in them, such as methylparaben.

Can vitamins and supplements help prevent cancer?

Research on taking multivitamins for cancer prevention has shown some promise in recent studies, and taking a daily multivitamin makes good sense for both men and women.

In October, 2012, an article published in the Journal of the American Medical Association reported that daily use of a common multivitamin reduced the risk for cancer in a long-term study of about 15,000 male doctors. Those men taking the daily multivitamin had an 8% reduction in risk of developing cancer compared with those taking a placebo. The multivitamin use had no effect on the incidence of prostate cancer among the men studied, however. In addition, this study did not include men younger than 50 years old, nor women.

The vitamin with the best evidence for cancer prevention is vitamin D. Everyone, including children and adults, should have their vitamin D blood levels measured and then supplements should be discussed with their doctors. Many vitamin D experts internationally recommend a vitamin D blood level between 40 and 60 ng/ml, or 100 and 150 nmol/l, for cancer prevention. The daily dose of vitamin D supplementation will depend on each person’s blood level.

The most important way to get vitamins is through your diet. In A World Without Cancer, I explain that most experts recommend a plant-based diet, rich in vegetables, fruits, beans, and whole-grains as the best way to reduce cancer risk.

It’s also important to follow other cancer-preventing measures including exercising, ending smoking, limiting alcohol, and protecting our skin from the sun.

Navigating Romance with HIV

2012-11-30T14:41:30Z

By Jamie Gentille

Jamie Gentille earned a BS in Biobehavioral Health from Penn State University, a Masters in Public Health from Walden University, and completed her child life internship at Children’s Hospital at Dartmouth. She lives in Northern Virginia with her husband of six years and works as Director of Child Life Services. Jamie has been living with HIV for 30 years and is an experienced public speaker on the topic. She is currently penning a memoir about her life as an HIV advocate and survivor.

Relationships aren’t easy. Anyone who has ever listened to a Taylor Swift song knows that. Even on the best of days, meeting new people is complicated. Throw a chronic disease into the mix, and it can be downright nerve-wracking. I spent much of my adolescence and young adulthood trying to figure out how to navigate the social scene, while secretly being HIV positive.

I was born with a serious cardiac defect called Tetrology of Fallot, and underwent open-heart surgery at age three to repair it. During this surgery, I received a blood transfusion that was unknowingly infected with HIV. We didn’t find out that I was infected until years later, when I was eight. At that time, it was a death sentence. Doctors gave me two years to live, and my family prepared for the worst. Thankfully, phase I drug protocols came to my rescue and I was able to begin an HIV medication regimen at age ten. These medications have kept me amazingly healthy and allowed me to grow into the thriving thirty-three year old that I am today.

When I was a kid, no one ever thought that I would live long enough to have to worry about dating, and what to tell people. But lo and behold, I was surviving, entering college, and facing the dating scene. Now what do I do?

While I had a million “what ifs” floating in my head, of one thing I was certain: I needed to be up front with people before it got too physical. I had to have “the talk” before I had “the sex.” I also knew that I had to tell prospective dating partners before we got too attached. Let’s face it — this kind of news could send someone running for the hills, and I didn’t want to be already in love with that guy who was running in the other direction.

One thing that I’ve learned is that there was never a perfect moment to tell someone that I was HIV positive. It’s not the kind of subject matter that I could slip in somewhere between political beliefs and favorite movies. So I just had to bite the bullet and put it out there. It was a leap I had to take early on, because it haunted me until I could get it out.

After the “there’s something I need to tell you” conversation, came the waiting game. For a brief moment, I was in charge – in charge of telling my story, answering questions, setting the facts straight. But when that was over, I had to let go, and let him react. This was where the paranoia set in. Is he going to freak out? Is he going to tell our friends? Is he going to shun me? Only time would tell, and this emotional purgatory was torture.

What I discovered was that most guys took it surprisingly well. After processing it, all but one guy decided that they could deal with it. It was heartbreaking to see this guy walk away after admitting that he couldn’t deal, but I didn’t hold it against him. I wasn’t in his shoes, and it would do no one any good to judge him for his decision.

While having a chronic condition like HIV presents many challenges, it also offers silver linings where you least expect them. These nerve-wracking conversations, for example, were fantastic litmus tests for a relationship. When I just knew that a guy would not be able to handle this kind of information and I was able to make a graceful “it’s not you, it’s me” kind of exit, without wasting too much of our time. On the flip side, when a relationship did pass this test, it was that much stronger, and the feeling of relief is intoxicating.

When I told my now-husband, Paul, seven years ago that I was HIV positive, I knew he was a keeper and that I would never have to have this conversation again. He took it in stride and knew that it was something that we could deal with together. And we’ve been doing that ever since.

What got me through the tough stuff and to my happy ending was the support of my loving family and friends. It also required a very conscious effort to realize that I am not flawed or broken. There is nothing wrong with who I am. I am someone living with a chronic illness. Yes, my life is different, but different works

Would You Rather Lose a Limb or Your Eyesight?

2012-07-20T21:07:53Z

By: Michael W. Smith, MD

When I first read that question, I had to think about it a bit.

In a new survey, almost 70% of people around the world said they’d rather lose a limb or give up 10 years of their life rather than lose their eyesight. I think I agree. This question, among others, was asked to over 11,000 people across 11 countries in a survey performed by eye care company Bausch + Lomb.

Of course, the thought of losing a limb or eyesight is almost unbearable to those of us who don’t currently face those daily struggles. Having to choose sounds like the latest version of a Saw movie. But here’s how I decided.

If I lost a limb, there are medical treatments – prosthetics — that can help me become mobile again. I’d unlikely be able to move quite the same, but I could, at a minimum, get some function back. But there’s no prosthetic eye that gives you your vision back (unless you’re the Bionic Man, for those of us who can remember back that far). Maybe not a deep, thoughtful reason, but there you go.

So if our vision is so important to us, why do we ignore our eye health? In the survey only 21% had an eye exam in the last 5 years. I like to think many of us have become much more aware of our health in recent years, but that doesn’t seem to apply to our eyes. In the survey less than one third said they do what they should to preserve their eye sight. That includes getting regular eye exams, eating right to protect your vision, keeping a healthy weight, and wearing sunglasses to block damaging UV rays.

Here are two great reasons to get your eyes checked. First, your eye doctor can find vision problems early before they affect your vision and can often stop them in their tracks. In fact, most vision loss is preventable if found early.

Second, heard the saying that your eyes are the window to your soul? I’m not philosophically inclined enough to speak to that. But your eyes are definitely the window to your health – and not just your eye health. Your eye doctor can find certain conditions, such as diabetes, high cholesterol, and high blood pressure, years before you develop symptoms (actually, these conditions often don’t have any symptoms until a lot of damage is already done).

By keeping this in mind, hopefully none of us will ever have to face such a serious question about our eyesight.

Photo: Thinkstock

Inside America’s Dental Care Crisis

2012-10-24T19:06:39Z

On June 26, FRONTLINE (PBS) aired an investigation about the nation’s dental care system. WebMD readers were invited to view the show and join a chat with the reporters on the story the following day. Below is a transcript of the Q&A.

Watch Dollars and Dentists on PBS. See more from FRONTLINE.

Dental care can be a matter of life and death. Yet millions of Americans can’t afford a visit to the dentist, resulting in preventable diseases, bankruptcy, and sometimes even death.

Why is dental care out of reach for so many?

In the new film “Dollars and Dentists,” FRONTLINE and the Center for Public Integrity reveal the shocking consequences of a ruptured dental care system, and explore some solutions to fix it.

Poor children are especially at risk — most dentists won’t see children on medicaid because there’s no profit margin. One in four children have untreated tooth decay, now the most common chronic illness among school-aged children.

Correspondent Miles O’Brien investigates how privately backed pediatric dental chains are popping up to treat these kids at Medicaid rates. But there’s suspicion some of these chains could be taking advantage of their young patients.

For adults with dental disease, the situation can be as dire — and bankrupting. While millions of Americans use emergency rooms for dental care, at a cost of more than half a billion dollars, corporate dental chains are filling the gaps in care, in some cases allegedly overcharging patients or loading them with high priced credit card debt.

On June 27, reporters Miles O’Brien, David Heath, and Jill Rosenbaum took your questions about “Dollars and Dentists” and American’s dental care crisis during a live chat.

You can read the chat transcript below.

Dollars and Dentists Live Chat

Almost Alcoholic: Is Your Drinking Becoming a Problem?

2012-06-15T20:27:35Z

Joseph Nowinski, PhD is the coauthor of Almost Alcoholic: Is My (or My Loved One’s) Drinking a Problem? (Hazelden, April 2012). Dr. Nowinski is a clinical psychologist who is currently Supervising Psychologist at the University of Connecticut Health Center, in addition to running his own private practice in Tolland, CT. He is internationally recognized for his work in substance abuse treatment. He has a private practice in Tolland, Connecticut. Learn more at http://www.thealmosteffect.com/.

Think about these scenarios:

A father who falls asleep on the couch after having several drinks three or four days a week, thereby missing out on time with his kids and wife.
A sales executive who likes to “sip” scotch on the rocks from the time he finishes his dinner to the time he goes to bed.
A college student who repeatedly has trouble making it to class because he was drunk the night before.
A mother who looks forward to her daily double glass of wine to help her get through the day.
An assisted living resident who finds that two or three brandies every day helps to relieve her boredom.

What do all of the above people have in common? They are almost alcoholics. And there are many more almost alcoholics like them than there are true alcoholics in the world.

A New Look at an Old Problem

For many years health care professionals like myself have been accustomed to thinking about drinking in terms of just two diagnostic categories: alcohol abuse and alcohol dependence. In order to qualify for one of these diagnoses an individual has to suffer some fairly severe and obvious consequences directly related to drinking: a major health crisis, an arrest, loss of a job, etc. And to be diagnosed as alcohol dependent a person also has to experience physical symptoms of withdrawal if he or she stops drinking.

But what about all those men and women whose drinking does not qualify them for a diagnosis? Until now, because of this black-and-white way we’ve looked at drinking (either you’re an alcoholic, or you’re not), we’ve essentially considered all these people “normal.” But is that accurate? Might there be people who are suffering consequences because of their drinking, even though they are not alcoholics? The answer, in my opinion, is a resounding yes.

Could You (or a Loved One) be an Almost Alcoholic?

Rather than thinking in terms of just three categories (Normal, Alcohol Abuse, Alcoholism), it is probably more productive to look at drinking in terms of a spectrum like that depicted below:

I believe this illustration more accurately reflects the real “drinking world.” What it suggests is that an individual’s drinking can range anywhere from normal social drinking at one end of the spectrum, to almost alcoholic in the mid-range, to alcohol abuse or dependence. Moreover, these different areas are not separated by sharp lines; rather, they blend into one another. Of the three “problem” zones, the almost alcoholic zone is by far the largest.

Normal social drinking is the person who has a beer or two, or a glass of wine or two, not more than a few times a month, and almost always in a social context. This is the man or woman who meets friends for happy hour after work on Friday, who joins friends to watch a game on television, or who is invited to a party. Millions of people are normal social drinkers, and many of them never go on to be more than normal social drinkers.

As the illustration suggests, there is a large “gray area” that lies beyond normal social drinking but falls short of alcohol abuse and dependence. Many people slip into this gray zone. Some go only a short distance; others venture much deeper over time and may stay there, yet still are not alcoholics. Many men and women whose drinking patterns lie in the almost alcoholic zone are likely to be suffering, though, as are their loved ones. For example, they may be experiencing one or more of the following:

Trouble sleeping soundly
Mild depression
Marital or family conflict
Health problems that aren’t recognized as related to drinking
Declining performance at work

Connecting the Dots

One thing that has become very clear—and a major motivation for writing the book—is that most almost alcoholics (as well as health care professionals) often fail to see the link between drinking and any problems these people may complain of. Being able to “connect the dots” and see the relationship between drinking and such problems allows the almost alcoholic to make a decision: to remain in the almost alcoholic zone (and risk venturing further toward alcoholism), or to choose to move back toward normal social drinking.

WebMD Joins White House Town Hall on Senior Health

2012-06-13T20:35:19Z

Senior Medical Editor Louise Chang, MD, (right), participates at a White House Town Hall on senior health.

Photo: HHS photo Chris Smith

By Louise Chang, MD

Earlier this week, the White House invited WebMD to a live town hall event focused on seniors’ health. I was excited to represent WebMD alongside HHS Secretary Kathleen Sebelius, Kathy Greenlee, Assistant Secretary for Aging, HHS, and others.

There were many great questions from WebMD users, the audience, Facebook, and Twitter. Senior health is clearly a priority issue. The latest figures show 49 million people rely on Medicare already, and that number is expected to grow.

Topics of concern brought up during the town hall included cost, access to care, elder abuse, fraud, patient-doctor relationship, advanced directives, long term care, variability in quality of services, safer transition of care when patients are discharged from the hospital. I was able to ask four questions that came from WebMD readers, and provide patient insight into concerns about hospital discharge. See how the panelists responded to questions here http://www.youtube.com/watch?v=_IsoZL7KSSg&feature=plcp

Both Medicare and the health care reform law have many provisions and benefits, particularly cost-free preventive health services. Whether or not the law survives its challenge in the Supreme Court, preventive health is important. Currently, the law covers a yearly wellness visit with your doctor in addition to screenings for important medical conditions. Still, most people aren’t taking advantage of the services. See the current list here: http://www.medicare.gov/navigation/manage-your-health/preventive-services/preventive-service-overview.aspx

Groups like the National Council on Aging and the National Association of Area Agencies on Aging offer resources to help inform and educate people about benefits and services that they qualify for, but that often still requires the initial step of seeking out the information. This website is a great tool to find benefit programs to help you pay for medical care, medicines, food, utilities and more www.benefitscheckup.org.

Remember that many conditions, including high blood pressure, high cholesterol, diabetes, cancer, heart disease can be “silent.” By the time you feel the effect of the condition or suffer a complication like heart attack or kidney disease, your body has already suffered damage. Being proactive earlier is key, and preventive health measures are the means to catch potential problems early to help avoid or minimize complications later.

A Sisterhood of Support

2012-06-08T10:58:51Z

WebMD talks to TV personality Star Jones about her heart disease and her work as a National Volunteer for the American Heart Association. Jones was diagnosed in March 2010 and underwent open heart surgery.

What do women need to know about heart disease?

Did you know that more women die of heart disease than all forms of cancer combined? Heart disease is the No. 1 killer of women and affects more than 42 million women in the US. Talk about a sisterhood. It’s not like I planned to be a heart sister. But Lord knows I didn’t do anything to avoid it. My genetic history screamed heart disease (I’m a 5^th generation heart sister) and my lack of discipline and sedentary lifestyle (remember I used to weigh over 300 pounds!) exacerbated it. Thank God I made the decision to get my mind and body in shape (I lost over 150 pounds after weight loss surgery…and have kept it off through a real commitment to diet and exercise!) and began a laser-like commitment to heart health. You see, this particular sisterhood is made up of strong, courageous women who are not only the face of heart disease…they are the voice of compassion, comfort, and care.

How do you reach out to women through the American Heart Association?

For more than two years now, I’ve served as the National Volunteer for the American Heart Association (AHA). I’m thankful for the voice I have when it comes to fighting what I once thought was an old white man’s disease. During this time, I’ve seen, first hand, how passionate women involved in the Go Red For Women movement are about fighting their No. 1 killer. I’ve also experienced a zealous spirit of sisterhood among this group.

As with any inspiring group of women, they can move mountains when they harness their energy, passion, and encouragement for the greater good. The AHA’s Go Red For Women movement has done just that through a new peer-to-peer support program called the Go Red Heart Match. This program is made up of a community of female heart disease survivors who’ve experienced similar situations – from the shock of a diagnosis, to treatment and rehab, to recovery, and finally to survivorship. They can relate to one another’s fears, share their own courageous stories, offer around-the-clock encouragement, and truly be a voice of strength and survival.

I want women to know they don’t have to fight heart disease alone. I want women to know they have heart sisters – no matter where they live or what their diagnosis – who can be the voice of encouragement. And I want women to know they can find support through the Go Red Heart Match.

What was your rehab process like?

Six days after my open heart surgery, I walked out of the hospital and began a new journey – cardiac rehabilitation. I elected to do a full round of Cardiac Rehab and it was the second best decision of my life. The discipline necessary to strengthen your heart after open heart surgery is relentless and exhausting, but oh so worth it. Who cares that I was the youngest one in my rehab sessions? I arrived every day ready to conquer a new obstacle. Twenty-four sessions over 3 months and I got my paper graduation hat and celebrated by walking the 12 blocks home!

Cardiac rehab provided me with the medical care I needed, but just as important, it introduced me to a significant support group during my recovery process. So, not only do I encourage women fighting heart disease to seek support in their heart sisters, I encourage them to join – and complete – cardiac rehab. It gave me the confidence I needed to move forward as a heart disease survivor.

Sheryl Crow’s “Benign” Brain Tumor – What It Means to Me

2012-06-08T13:47:11Z

By Kiersten Aschauer

When I woke up in the hospital in 2002 – not knowing where I was or how I got there – the last thing I was thinking was “brain tumor.” Migraines, yes. Memory problems, definitely. But brain tumor? The doctors had no idea yet whether it was benign or cancerous (though they had a good idea that if it was cancerous, I was looking at a five-year lifespan).

I only knew I had one thought: Get this thing out of my head.

Perhaps I wasn’t as graceful as Sheryl Crow, who revealed she has a benign meningioma. “Please don’t worry about my ‘brain tumor,’ it’s a non-cancerous growth,” she wrote on her Facebook page. “Really appreciate everyone’s love and concern, I feel so blessed to have the support of all my fans, but I’m good – really!”

Knowing what I do now about brain tumors, my hope is that Crow doesn’t have to undergo brain surgery or radiation. I hope her condition doesn’t result in seizures, or vision and memory problems, as some meningiomas do. Of course, many symptoms have to do with where the tumor resides; what part of the brain it applies pressure upon.

According to the American Brain Tumor Association (ABTA), meningiomas represent about one-third of all primary brain tumors, occurring most frequently in middle-aged women. They are often slow-growing — many people live a good majority of their lives not even knowing they have one.

My tumor, as it turned out, was orange-sized and cancerous. It wasn’t a meningioma, like Crow has. It was a stage II oligodendraglioma. But before I even knew that – before I went in for my surgery — I had a decision to make. I could go one of two ways:

I could let my surgeon remove the tumor. The negative? I might lose my speech or other functions.
I could elect for an awake craniotomy. In this case, the neurosurgeon uses brain mapping techniques to avoid cutting away parts of the brain that would affect my speech or motor skills.

I went with the latter. If I was going to live, I was going to I choose quality vs. quantity of life.

Unfortunately, my cancer only stayed quiet for two years after surgery, then returned again in 2004, resulting in many months of radiation and chemotherapy. Is it still stage II? I don’t even know, because my doctors haven’t had to go back into my noggin to see.

For now, I simply celebrate 8 years of “no change” MRIs. It’s the best I can ask for and I’ll take it.

Like so many women before me – and much like Sheryl Crow did with her breast cancer six years ago – cancer definitely changed the fabric of who I am. I’m stronger for it. I’m more empathetic. I’m just a completely different person. And I’ll take that, too.

Talking to First Lady Michelle Obama About the White House Garden

2012-06-06T16:44:07Z

First Lady Michelle Obama participates in a roundtable with online women’s outlets to discuss her book “American Grown: The Story of the White House Kitchen Garden and Gardens Across America,” in the White House Kitchen Garden, June 5, 2012.

Photo: Official White House Photo by Lawrence Jackson

By Kristin Hammam
Vice President of Content, WebMD

First Lady Michelle Obama sat down with WebMD and a small group of online reporters at the White House Tuesday to talk about her new book, “American Grown: The Story of the White House Kitchen Garden and Gardens Across America.”

The conversation took place on the South Lawn, at a picnic table next to the garden, which was in full bloom with rows of green, leafy vegetables including broccoli, herbs, and peppers. “We had a lot of peas and snap peas, which Malia hates snap peas. So she was very happy to see all those vines gone,” the First Lady told us, laughing.

“American Grown” chronicles four seasons of the White House garden and includes tips for starting your own, even if it’s just a pot on a windowsill. Mrs. Obama also writes about her own personal history as well as the history of gardens at the White House. (Thomas Jefferson was apparently obsessed with growing four-foot long cucumbers).

Mrs. Obama says that planting a garden is a way to start a national conversation about the health of our children. She wants the book to be just that – a conversation starter – and doesn’t want gardening to be one more worrisome thing to pressure overworked moms. If “it’s not fun, then it’s a headache and if it’s a headache for you, then your kids are going to feel that and vegetables will be a horrible concept in your household. And that’s what we don’t want,” she says.

What about parents who don’t have time tend to a garden? Think about Farmer’s Markets as your garden, she says, or “maybe you don’t start your own garden, but you start working with your school and their garden; or your community center, and you do it that way.”

The First Lady and “Mom-in-Chief” also shared some of her healthy eating tips:

• Start healthy eating early. Your homemade mac & cheese with whole wheat pasta and cauliflower tastes different from the store-bought kind. Kids get used to sodium in processed food so when they have your healthier version their first reaction will be “this isn’t mac & cheese.”

• Wean them off of store bought juices. “Juices are fresh juices. And they have trouble going back to the store-bought juice because it’s too sweet, so they have to water it down,” says Mrs. Obama. “And that kind of transition can happen in a matter of weeks, but you’ve got to go through that period of, I hate this, I can’t eat, I won’t eat, I hate you mom, you’re horrible.”

• Treats are ok, as long as they’re in the minority. Her philosophy is to eat what you’re supposed to eat 80 or 90% of the time. “I don’t want my kids to have to worry about food,” she says. “If we have a birthday party, if we’re going out or if they’re going out with friends, I don’t want them counting calories and looking at anything. But I do encourage them — they’re going to camp this summer — and I do say, think about how you should feed yourself. “

Author proceeds from “American Grown” will go to the National Park Foundation.

Tax Fatty Foods, Stop Junk Food Marketing

2012-05-17T15:55:38Z

By David Grotto, RD, LDN

I just finished watching the four-part HBO series called The Weight of the Nation and found it so compelling and frightening that I sat for four consecutive hours to watch it. My conclusion? Watching The Weight of the Nation can cause obesity!

Sounds silly, but one of the points made in this fairly well-balanced documentary about the plague of obesity in this country is that just about anything we do as Americans can be linked to our current obesity epidemic. Regardless of where we live, how educated we are, or how much money we have, obesity is an equal opportunity offender. The documentary shares many alarming facts, such as the cost of obesity, which is bankrupting our nation to the tune of $150 billion a year and that watching television or more “screen” time (of any type) has been linked to obesity.

Thinking about putting a television in the kid’s room? Think again. Children are much more likely to become obese by having a TV in their room than not having one. And it’s not just the mere act of watching a “screen” that blocks us from healthy behaviors, like moving more and engaging in physical activity, but that this low-calorie-burning “activity” is also compounded with titillating messages enticing us to eat more of the type of foods that fuel obesity. I think that’s what they call a “vicious cycle.”

Though there were inspiring stories of how individuals, companies, and entire communities made positive changes to improve health, the documentary in general was a little short on solutions, especially on the home front. So I thought it might be helpful to discuss two major themes of obesity and start a conversation about possible solutions. Sound good? Oh yeah, I’m expecting you to add your own ideas of what has worked for you, your community, or workplace!

Calories in. Problem?

Access to food. Not only are we bombarded with thousands of food choices every day, but we don’t have to travel far to fulfill any choice we want to act on. We have changed from hunter-gatherers to sloth-like seeker-orderers. We seek out food and place our order and the only hunting we do is for an open table. Thomas Farley, MD, MPH, Commissioner of the New York City Department of Health and Mental Hygiene points out in the documentary that we are not genetically programmed to turn down calories when they are presented to us. Apparently, part of our existing hard wiring that dates back from the early days of man has programmed us to seek out high-calorie foods that we could gorge ourselves on to tide us over until we bagged another unfortunate beast.

Possible Solutions?

Sin Tax. Make foods that are associated with obesity have a higher price tag for the consumer while making nutrient-rich, lower-calorie foods more affordable. Ironically, in poorer neighborhoods, you can purchase more calorie-rich and nutrient-poor type foods for the dollar than you can healthy foods. And regardless of neighborhood, it costs more to buy a healthy salad and bottled water at a fast food restaurant than it does to purchase a burger and fries. This “sin tax” was instrumental in reducing cigarette smoking – it might be worth a try.

Make junk food harder to find. Redesign the layouts of grocery stores and cafeterias. Make good-for-you-foods easier to find and make sugar-sweetened beverages and fatty packaged pastries something you have to go on a treasure hunt for. Relegate obesity-promoting foods to bottom shelves and do not give them prime real estate.

Problem? Advertising of unhealthy foods, especially to children.

In part three of the series, called “Children in Crisis,” William Dietz, MD, PhD, Director of the Division of Nutrition, Physical activity and Obesity for the Center for Disease Control and Prevention stated that 1.5 billion dollars a year is spent on the marketing of food products to children. Seventeen leading food companies have formed the Children’s Food and Beverage Advertising Initiative (CFBA), which pledged to advertise only “better for you” foods to kids. In 2010, First Lady Michelle Obama encouraged not just a limit on advertising unhealthy foods but a simultaneous increase in the marketing of healthy foods to children. However, though improved, marketing of unhealthy foods to children remains a problem and warrants industry-adopted standards of what constitutes “healthy”. These industry-wide standards should also include stricter guidelines on label claims with hopes of eliminating confusion for the consumer.

Possible solutions?

No marketing of unhealthy foods, period! This sounds great at first glance, but what makes a food healthy or unhealthy? Do sugary sweetened cereals contribute to obesity? If so, how much do you have to eat to be concerned? What constitutes “sugary”? Many companies have already reduced sugar and increased whole grain in several of the cereals kids love and we need to encourage companies to continue to make products that are healthier for kids that they will still eat. Besides, cereal also brings along with it all the nutrition you get from milk. I would agree that sugar-sweetened beverages and treats with no redeeming health attributes should be banned from advertising.

Ban unhealthy portion size advertising. I think anything with the word “monster,” “jumbo,” “enormous,” “gut-buster,” or any such verbiage that describes huge portion sizes should not appear in advertising. I do think calorie, saturated fat, and sodium levels should be proudly displayed in all food and beverage advertisements. You want to promote a big gulp? Great. Also post what the cost of gastric bypass surgery is these days. You want to promote overeating on a food show? Great. Also post a Surgeon General’s warning that this type of behavior may also cause diabetes, contribute to heart disease, lead to erectile disorder…you get the idea.

Calories out: Problem?

Physical activity is not required in all schools! I was shocked to learn in the documentary that state and local governments, NOT federal government, mandates whether physical activity is offered in schools. What?

Solutions?

Make physical activity mandatory for all grade levels and provide adequate funding for equipment, organized sports, and facilities. Sounds simple here too, but this requires money and also a change in thinking. I was elated to see that one of the experts in the series made the connection between physical activity and improved learning. State of Texas Comptroller Susan Combs looks at the investment in physical activity in schools and the workplace as a method of controlling health care costs.

Problem? Many communities do not provide safe locations and facilities for physical activity.

Solutions?

Make federal funding of healthy communities a priority. The CDC gave 17 million dollars to the 2nd fattest city in America (Nashville) to improve city bike and walk ways among other projects to get citizens to move. They have also implemented exercise programs for their police and fire departments to help them get and stay in shape. Many communities do not have adequate sidewalks, ample lighting, or parks and recreational facilities to encourage their citizens to get moving. What wasn’t discussed was the cost of park district or health club memberships. Financial barriers need to be knocked down between those who want to be physically fit and the facilities that can help make that happen.

What was abundantly clear after watching this series is that obesity exists for many reasons, and there isn’t one solution. It will take the collective minds and souls of industry to put the health needs of consumers first as a vehicle for driving creative product development that is still profitable; policy makers, to do what’s best for its citizens instead of special interest groups; and adults, to model for their children by making healthier choices and choosing to move. I’d love to talk to you more but I think it’s about time to get up and move. Who’s with me?

Photo: Hemera