Tag Archive for: healthy diet

What Would You Invest in a Healthier Diet?

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Would you eat more vegetables and fruit if your health insurance paid for it? How about an overall healthier diet that also included whole grains, nuts and seeds, fish, and healthy oils? Would you eat healthier if it didn’t cost you more?

Researchers from Tufts and Harvard examined the potential cost and benefits of subsidizing 30% of the costs of both approaches in Medicare and Medicaid programs. This was a computer simulation using data from NHANES on dietary intake and the relationship to cardiovascular disease and type 2 diabetes. They used the CVD events and mortality data and the current costs of treatment. Then they created models, one with increasing vegetable and fruit intake and another increasing all the aforementioned food, to find out if a healthier diet would affect disease events, deaths, and costs associated with the treatments.

Their estimates found that over a lifetime, the vegetable and fruits model would prevent 1.93 million CVD events and 350,000 CVD deaths while saving $40 billion in healthcare costs. The healthy food model would prevent 3.28 million CVD cases and 620,000 CVD deaths, prevent 120,000 diabetes cases, and save $100 billion in healthcare costs.

However, the net cost of the first model—subsidies minus healthcare savings—would be $84 billion while the second would cost $111 billon. It would improve the quality of life, but at a price. It’s easy to get lost in big numbers so let’s bring it down to the individual. After deducting healthcare savings, it would cost $110 per person per year for the fruit and vegetable subsidy and $185 per person per year for the healthy foods model. Does that seem like a reasonable investment for a healthier life for everyone?

The unknowns are whether physicians would actually write the prescriptions for foods; they’re not known for their nutrition knowledge and have a tendency to look for a pharmaceutical solution. But I think that’s minor; the real unknown is whether people will actually buy healthier foods and eat them.

We’ll find out: $25 million has been set aside in the 2018 Farm Bill to run pilot programs. It will be years before we know the results, but it’s a start to see if the theoretical will meet the actual.


The Bottom Line

Using food to improve health and quality of life makes sense. Whether having insurance companies or government pay 30% for healthier foods will work, I’m not convinced. I get the reduction of CVD events and deaths that could potentially be saved and the reduction in healthcare costs, but I question the $100 billion price tag without a public health education program to go along with it. Maybe a better approach would be to invest in the public health education program to teach people and physicians how they can use food to be healthier.

But now you know how a healthier diet could affect your life. What are you prepared to do today?

        Dr. Chet

Reference: PLoS Med 16(3): e1002761. https://doi.org/10.1371/journal.pmed.1002761.

2018’s Worst Most-Read Paper

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In March of last year, the Journal of the American Medical Association published a viewpoint written by two experts in public health titled “Vitamin and Mineral Supplements. What Clinicians Need to Know”; it was one of the nutrition papers most read and most shared last year. The only problem is that clinicians really won’t find out much by reading it.

I’m going to pick one recommendation because everything after it won’t matter. The authors recommend that all clinicians recommend that patients get their nutrients from food. I absolutely agree with that. They go on to advise clinicians to tell their patients there’s no need to take any dietary supplements if they eat a healthy diet. That’s plain wrong.

We already know that over 90% of all adults do not get enough servings of vegetables, fruit, and whole grains every day—and it’s proven that food contains less nutrition than in the past—yet the authors did not recommend doing a nutrition analysis for the patient. With little to no information about the patient’s diet, clinicians are to tell their patients to eat a healthy diet, don’t take any supplements, and go on their way.

These are exceptional researchers; they know how poor the American diet is because they’ve done much of that research. To publish this opinion was incomplete in my opinion and thus it ranks as one of the worst papers of 2018. With almost a quarter million reads and shares passed along through social media and news feeds, millions read what they wrote, and it will influence millions. My opinion is that millions will be less healthy because they accepted these recommendations and dropped their nutrition insurance: their multivitamin and omega 3s and so on.

That doesn’t mean you take every dietary supplement that comes along. The rule is simple: know what supplements you take and more important, exactly why you’re taking them. And work on eating a healthier diet in 2019 as well.

What are you prepared to do today?

        Dr. Chet

Health Habits: Just Do Better

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Let’s finish up our look at the recent paper that concluded we’re doing poorly when it comes to our health habits (1). If you thought smoking and exercise were underwhelming, today we’ll look at diet and body fat.

When it comes to following the U.S. Department of Agriculture Dietary Guidelines, just under 38% hit that goal. I’ve talked about this a lot over the years, and this isn’t a debate over what constitutes a good diet. While we are doing somewhat better, adults do not eat enough vegetables, fruits, or beans, and we still . . .

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Death by Donut

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There are times when the topics I write about seem to align like astronomical events; it’s as if I’m compelled because of a series of apparently unrelated actions. This time, emails from two people prompted me to write about heart disease. Yes, it’s American Heart Month and I generally write about it every year. But what would get your attention? What might drive you to take action? Let’s see if the messages this week will do it.

Thanks to S.B., a longtime reader, for sending me a link to a story about a man who . . .

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Do You Have Orthorexia Nervosa?

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Based on the prior memos, the question has to be: Is obsession with healthy foods really such a bad thing, worthy of an actual medical term? After all, it’s really healthy eating, isn’t it?

I can’t argue with that. However, any time people transition from freedom of choice to being compelled to do something that seems beyond their control, that’s a problem. Maybe not the worst problem, but a problem nevertheless.

I’ve observed first-hand anorexia nervosa when I was a college professor; college students seem to be prone to it, especially the female students . . .

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Extreme Food Choices

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People have always fixated on the perfect diet. From the food combiners of the early 20th Century to the current focus on the Paleolithic diet, there’s always someone touting the best and healthiest way to eat. A lecturer from Australia, Rebecca Charlotte Reynolds, recently wrote an article on food fixations and raised the question of whether the food obsessions might fall into the category of psychological disorders such as anorexia nervosa (1).

She cites three current ways of eating that can take over someone’s life in an unhealthy way: raw foods, clean foods, and the Paleolithic diet. I . . .

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Disordered Eating?

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You may have noticed that when it comes to weight loss, I’ve expanded my recommendations. It used to be eat less and move more; I’ve now added “eat better” between those two recommendations. That can mean a lot of things, but the simplest explanation is to eat more vegetables and fewer refined carbohydrates. But eating better can mean a whole lot more: grass-fed beef, free-range chickens, organic foods, and non-GMO foods.

Grocery stores are being developed to cater to this market. Whole Foods Market has decided to introduce a smaller scale store that offers organic . . .

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School Lunch Study Results

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Today we finish our look at a recent study designed to see if kids will eat more vegetables and fruits in school lunches (1). Over the seven-month study, there were four scenarios:

  • Schools with chef-assisted meals
  • Smart café approaches
  • Chef-assisted meals with smart café
  • Control schools that did not change their approach to school lunches

If you want to guess the results just based on logic, you would have been correct that the chef-assisted meals, with and without the smart café approach worked best. The schools . . .

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Keeping Track of Life’s Simple 7

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To complete American Heart Month, here’s an easy way to track your heart health called Life’s Simple 7 (LS7), developed by the American Heart Association. LS7 has been around since 2010 but it escaped my attention until recently. For those of you who like to track your progress to see how you’re doing, this is a great tool; you may remember I mentioned it last month, but I think you need the details to really understand how LS7 can work for you.

There are seven different categories of variables to track, hence the name Life’s Simple . . .

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How to Reverse Heart Disease

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In this final message of the week on reversing heart disease, I’m going to tell you why I think the program was successful, a couple of problems that I have with it, and the bottom line.
 
The Training
The key to this program in my opinion was education. The program began with a five-hour seminar with limited participation: no more than 12 participants. Here’s what they did in the training:

  • Explained the relationship between diet and heart disease in other cultures throughout the world.
  • Showed the damage to arteries in very young . . .

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