WHEN I stock up on ibuprofen (my painkiller of choice), I typically buy a 500-count bottle of a store brand like Kirkland or Rite Aid. After all, ibuprofen is ibuprofen. Each pill costs me about 3 cents — or only one-third the cost of 9-cent Advil.

Yet, when it comes to vitamins — which I take only when I feel run down — I turn to name brands like Centrum or Nature Made. My thinking has been: Why mess around with quality when it comes to the essential ABCs?

But now that I’ve done some research, I might soon change my vitamin-buying ways. Read on to find out why.

Americans love vitamins. About half of adults take a daily multivitamin, according to industry data. And according to some theories, the economic downturn has inspired them to fortify themselves by swallowing more.

Sales over the last decade had been growing by about 4 percent annually. But this year, as more people are taking their health into their own hands, perhaps hoping to stave off doctor bills, vitamin sales are expected to grow by 8 percent to a total of $9.2 billion, according to Nutrition Business Journal, a market researcher and publisher.

About 42 percent of shoppers purchase their vitamins at natural and specialty retail outlets, like GNC and Whole Foods, according to the journal, while only 23 percent take the discount approach and buy their bottles at supermarkets and club stores. The other 35 percent buy through mail order or from a health care provider.

Of course, it’s controversial whether we should be taking vitamins at all. Recent studies have indicated that taking a multivitamin won’t protect you from heart disease or cancer. And experts maintain that if you eat well, you don’t need vitamin supplements.

“The evidence shows that a healthy diet and exercise are the best way to ward off disease; a vitamin cannot replace those benefits,” says Eric Rimm, associate professor of epidemiology and nutrition at the Harvard School of Public Health.

But what if you don’t eat well or are chronically stressed out? Then, Professor Rimm says, there may be some benefit from taking a multivitamin. “Certain subgroups, including women of child-bearing age attempting to get pregnant, may need specific supplements, like folic acid and omega-3,” he added.

As for the matter of cost: If you take only a daily multivitamin mainly as a medicalinsurance policy, it certainly won’t hurt your health — as long as you do not already eat a lot of fortified food. And it could help. But it will require spending some money. And if you take a multivitamin and a few individual vitamins and minerals, it’s even more worth your while to make sure you’re not paying more than you need to.

Here’s how to get the most vitamin for the least money.

USE ONLY WHAT YOU NEED Popping too many vitamin pills is not only a waste of money but can be bad for your health. Talk to your doctor about what added vitamins or minerals you might require; you can ask for a blood test to learn what you might be lacking.

For example, if you don’t get enough vitamin D — many people who live in the northern states or who wear sunscreen everyday are low on this crucial vitamin — then buy just a D supplement. Standard multivitamins will probably not have the levels of D you require (many doctors suggest taking 1,000 to 2,000 international units a day).

If your doctor recommends a specific supplement, like omega-3, ask in what form you should be taking it.

FIND A REPUTABLE SOURCE Vitamins and minerals are commodity items, and every manufacturer has access to the same ingredients. For that reason, researchers and scientists say paying more for a name brand won’t necessarily buy you better vitamins.

“When we measure levels of vitamins in the blood, we find the levels are the same whether the person was taking a generic brand or a name brand,” says Dr. Rimm, who has been studying the effects of vitamins for 20 years.

That said, don’t be too cheap. Purchase your vitamins from well-known retailers that do a brisk business and restock frequently, whether that’s Costco or Drugstore.com. Vitamins lose their potency over time and must be stored at, or below, room temperature. If bottles are sitting on a shelf in warm room or in direct sunlight, they may degrade even before their expiration date.

PRICE MAY NOT MEAN QUALITY While the Food and Drug Administrationregulates vitamins as part of the nutritional supplement industry, it does not test them before they are put on the shelves. The F.D.A. places the responsibility on the manufacturer to ensure that its dietary supplement products are safe before they are marketed. All of which means that no matter what the price, quality is not assured.

ConsumerLab.com, a company based in White Plains that tests hundreds of vitamins each year, finds that 30 percent of multivitamins have a quality problem: the pills might have more or less of a stated ingredient, or they might not dissolve properly.

“We haven’t found any brand with a broad product line that makes every product well,” says Dr. Tod Cooperman, president of the company.

Taking exception to such assertions is the vitamin industry’s trade group, the Council for Responsible Nutrition. In response to questions, the council released a statement from Andrew Shao, a vice president for scientific and regulatory affairs.

Mr. Shao said that the F.D.A. allowed for “a reasonable amount of variation” — which he characterized as up to 15 percent more of an ingredient than the label might indicate. Mr. Shao said that manufacturers frequently add slightly more of an ingredient to ensure that the amount is at least at the level claimed on the label as the product nears the end of its shelf life.

In any case, ConsumerLab.com says it has found a few patterns that consumers may find helpful. Products sold by vitamin chains tend to be more reliable than drugstore brands, and Wal-Mart and Costco’s vitamin lines are usually worth considering. In a recent test of multivitamins, ConsumerLab.com found that Equate-Mature Multivitamin 50+ sold by Wal-Mart was just as good as the name brand Centrum Silver, but at less than a nickel a day is half the price.

Puritan’s Pride, a catalog and online retailer, also has very good prices, and Dr. Cooperman says that its products are generally good.

Curious consumers can subscribe to ConsumerLab.com for $30 a year and learn how other supplement brands fare in the lab’s tests.

CERTIFICATION SYMBOLS One quality check you can make, although it is not a perfect screening, is to see whether a product is certified by one of several nonprofit organizations that check supplements for purity and quality.

The two most commonly used groups are the United States Pharmacopeia (www.usp.org) and NSF International (www.nsf.org), according to Mr. Shao. Manufacturers voluntarily submit a product for review and, if it passes, the product can bear an approval seal, such as USP or NSF. Because the process is voluntary, Mr. Shao points out, the absence of the seal does not necessarily mean the product is of poor quality.

But at least the seal should mean you know what you’re getting. And with vitamins, anything beyond that simple assurance may not be worth paying for.

Patient Money – When Buying Vitamins, Know What’s Worth Paying For – NYTimes.com.

Nearly a decade ago, Dr. David Satcher, 16th surgeon general of the United States, declared that overweight and obesity “have reached epidemic proportions” in the 2001 Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity. The evidence base has steadily improved about how to prevent overweight and obesity, as well as how to help people successfully lose weight. Health system reform can and should be based on this evidence of best practices.

Today, by working together in a nonpartisan way we can better inform our political leaders, our communities, our families and ourselves on the critically important need to end the obesity epidemic and how we can accomplish that goal.

We are deeply concerned about the fact that for far too long our nation has turned a blind eye or, worse yet, taken the wrong path in trying to end the epidemic of obesity.

Many of us supersized our meals when we should have downsized them. We often drove our cars to purchase processed food when we could have been getting exercise by taking daily walks or growing our own fresh food.

The nation has begged, educated, scolded and stigmatized people who are obese or overweight — but those countless messages, programs, guidelines and warnings have not ended the epidemic or changed the sedentary lifestyles of the American people.

The burdens caused by the obesity epidemic are unsustainable. Unless we do something now, the cost burden of obesity — currently nearly $150 billion each year — will be an ever-tightening yoke around the neck of future generations of Americans. The emotional burden from stigma bears down on our neighbors and friends every day in the form of an inability to be successful at school, work and in numerous other unseen ways.

In addition to these costs, the actual health burden of obesity is threatening to crush our already tenuous “sick care” system. Obesity accelerates heart disease, type 2 diabetes, some types of cancer, stroke, high blood pressure, breathing issues, sleeping problems and psychological disorders. These are the types of chronic diseases — largely preventable — that cost us 75 cents of every dollar spent on health care today.

Despite the clear harm being done to our nation, current discussions on health system reform are informed more by partisan politics than by evidence and accurate information. Mixing political agendas and public health is counterproductive for the nation and for the individuals who are struggling with weight issues and the associated chronic diseases. Our leaders need to set political aspirations aside and act in the best interest of our nation’s physical, mental, economic and spiritual health.

Health system reform must address the obesity epidemic by incorporating the many practices known to be effective in preventing and reducing the burden obesity places on the nation. We need to promote standardized health and medical treatments that produce effective outcomes. We need to focus on incentives for prevention and reverse the all-too-common progression from being overweight to becoming obese. We need to engage with communities in order to bring what we know from research to what we do in our everyday lives. We also need to make sure researchers continue to find solutions to the many inequities in health related to being overweight or obese.

A lack of clear understanding of this complex health issue, exacerbated by poor health literacy, is a challenge to successfully addressing the obesity epidemic.

For example, we all need to understand that obesity is not a simple matter of personal lifestyle choice. People do not become overweight or obese all on their own. The reality is that their communities may not include safe places to exercise. Their incomes may not allow them to purchase healthy food. Their workplaces may not offer a wellness program. Genetics can also be a reason why some people become overweight or obese more easily than others and struggle unsuccessfully to lose pounds.

A healthy future for America is in peril. Children as young as 10 are now being diagnosed with chronic conditions often related to weight that previously only affected adults, including type 2 diabetes and high blood pressure.

We are at a critical point. At the recent Weight of the Nation Conference in Washington, D.C., our friend and colleague Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, explained that “the average American is now 23 pounds overweight and collectively we are 4.6 billion pounds overweight.”

Dr. Frieden is correct. The data is in and the truth is that we cannot wait any longer. Helping Americans make healthier choices and enjoy a better quality of life can no longer be compromised by political bickering or continued inaction. Instead it must be a national priority.

Dr. David Satcher, director of The Satcher Health Leadership Institute and Center of Excellence on Health Disparities and Poussaint-Satcher-Cosby Chair in Mental Health Morehouse School of Medicine, was U.S. surgeon general from 1998 to 2002. Dr. Richard H. Carmona, president of the Canyon Ranch Institute and distinguished professor at the University of Arizona, was U.S. surgeon general from 2002 to 2006.

via U.S. turns blind eye to obesity as health costs soar  | ajc.com.

JULIE STEENHUYSEN, REUTERS

Obesity-related diseases account for nearly 10 percent of all U.S. medical spending or an estimated $147 billion a year, researchers said on Monday.

They said U.S. obesity rates rose 37 percent between 1998 and 2006, driving an 89 percent increase in spending on treatments for obesity-related diseases such as diabetes, heart disease, arthritis and other conditions.

Obese people spent an extra $1,429 per year or 42 percent more for medical care in 2006 than did normal weight people, with most of that spent on prescription drugs, the researchers said.

The study, published in the journal Health Affairs, was released at the U.S. Centers for Disease Control and Prevention’s Weight of the Nation conference in Washington, where the CDC issued 24 new recommendations on how communities can fight back.

“It is critical that we take effective steps to contain and reduce the enormous burden of obesity on our nation,” CDC Director Dr. Thomas Frieden said in a statement.

For the study, Eric Finkelstein of the non-profit research institute RTI International and researchers at the CDC and the Agency for Healthcare Research and Quality analyzed national medical cost data from 1998 and 2006.

More than 26 percent of Americans are obese, which means they have a body mass index of 30 or higher. BMI is equal to weight in kilograms divided by height in meters squared. A person 5 feet 5 inches tall becomes obese at 180 pounds (82 kg).

Finkelstein’s team found obesity accounts for 9.1 percent of all medical spending in the United States, up from 6.5 percent in 1998.

“What we found was the total cost of obesity increased from $74 billion to maybe as high as $147 billion today, so roughly double over that time period,” Finkelstein said in a telephone interview.

Obesity accounts for 8.5 percent of health costs among people on Medicare, the federal program for the elderly and disabled, and 11.8 percent of costs from Medicaid, the joint state-federal program for the poor.

An obese Medicare beneficiary spends an $600 more per year on drug costs than a normal weight person on Medicare, the team found.

“One of the big drivers is diabetes, which has been estimated to cost as much as $180 billion per year. There is evidence that most of the diabetes in the U.S. is caused by excess weight,” Finkelstein said.

To address these issues, the CDC has devised 24 obesity prevention strategies being tested in Minnesota and Massachusetts.

They aim to address issues in the environment — lack of access to healthy food in poor neighborhoods and sedentary lifestyles — that contribute to the nation’s weight problem.

“All of these factors just make it easier to be overweight and harder to be thin,” Finkelstein said.

via Obesity costs US health system $147 billion: Study .

(The Pittsburgh Post-Gazette, August 2, 2009)

Obesity and its impact on health care costs have taken center stage in the debate about national health care reform.

And it seems there may be as many ideas about how to address the problem as there are people who are obese.

The issues converged last week when a national study estimated the cost of obesity at $147 billion annually, nearly double what it was 10 years ago; the Centers for Disease Control and Prevention held its first Weight of the Nation conference in Washington, D.C., and Congress debated how to account for wellness programs in the health care reform package.

“If obesity was an infectious disease, it would be an epidemic,” said Dr. Daniel Bessesen, professor of medicine at the University of Colorado at Denver and chief of endocrinology at the Denver Health Medical Center.

“To ignore the problem, you’re keeping your head in the sand. If you could fix the obesity problem … you would make a huge impact on the nation’s health care costs.”

But obesity is not just a health problem. It’s a national economic problem that will become more prominent as the country debates the cost of health care reform.

“These results reveal that obesity continues to impose an economic burden on both public and private payers,” writes Dr. Eric Finkelstein, director of the Public Health Economics Program at the North Carolina-based RTI International, which produced the national study.

“The connection between rising obesity rates and rising medical spending is undeniable.”

The CDC estimates nearly 40 percent of American adults are considered obese based on their body mass index, a mathematical formula that considers a person’s height and weight. That extra weight frequently leads to additional health problems such as heart disease, diabetes, high blood pressure and pulmonary difficulties.

A RTI study estimates $1,429 a year is added to the nation’s health care costs for each obese patient. The overall cost is about 42 percent more annually for obese people and even higher for obese patients on Medicare. Obesity adds 9.1 percent to the annual cost of health care.

The study was published in the magazine “Health Affairs” as a followup to a similar study 10 years ago and includes data through 2006.

Allegheny County hasn’t analyzed the cost of obesity, but a 2002 survey found about 59 percent of adults either overweight (a lower category) or obese, comparable to the national average of 59.2 percent and the state average of 59.5 percent. The county will begin a new telephone health survey tomorrow in which 5,000 randomly chosen people will answer 185 questions about their health and lifestyle.

“People will see tangible results if they eat better and exercise more,” said Dr. Bruce Dixon, director of the Allegheny County Health Department. “But it’s a very difficult issue that involves a lifestyle change. I think people have to ingrain it in their daily lives.”

Most experts agree that is the solution, but the debate centers on how to get there. That was one of the key topics at the inaugural Weight of the Nation conference.

Kathleen Sebelius, U.S. Health & Human Services secretary, told the conference she’s particularly concerned about obese children. Statistics compiled by the CDC show that 25 percent of obese children stay obese as adults and have a raft of serious health problems.

“If there was an epidemic of little kids getting cancer, it would be a national crisis,” Ms. Sebelius said. “But because it’s obesity and the damage doesn’t come until later in life, we’ve been slow to act. We can’t ignore this problem any longer.”

Obesity among children is a major focus of the Robert Wood Johnson Foundation, a Princeton, N.J., organization that helps to fund health care initiatives. It has committed $500 million to help reduce childhood obesity by 2015.

The call for health care reform is causing greater emphasis on the cost of obesity, but there seems to be no consensus on the best approach to dealing with it.

Dr. William Dietz, a co-author of the RTI study, said he believes the key is offering people healthy options such as healthy snacks and drinks in schools, supermarkets with fresh fruits and vegetables in poor neighborhoods and neighborhoods with sidewalks to encourage walking.

He cited Pennsylvania’s Fresh Food Initiative, which provides grant money to help build grocery stores in underserved areas, as a positive approach. The program provided $1 million to help build a new Kuhn’s grocery in the Hill District.

“You can’t expect people to make good choices where they don’t have choices to make,” said Dr. Dietz, who also is director of the CDC’s division of nutrition and physical activity. “Just looking at communities with a different eye would help, allowing supermarkets and movie theaters to be close enough to housing so people could walk to them.”

He cited Shelby County, Ala., as a community that has taken such an approach over the last decade and seen positive results. Alabama has the nation’s highest percentage of obese people.

Dr. Bessesen said it will take a different approach that involves better teaching for doctors and almost individual programs to change the lifestyle of each patient on a trial-and-error basis to find which approach works best for each one. He called obesity “a symptom of a lifestyle that really has gotten out of control.”

“People don’t like to be heavy,” he said, pointing to widespread dieting and other efforts at weight control.

“Our bodies are really engineered for physical activity, but our lifestyle has evolved into spending a lot of time working at a desk or sitting in front of a television or a computer. It’s going to take long-term treatment to change that.”

Locally, insurance provider Highmark offers a raft of programs aimed at improving customer health. Its wellness program offers employers the opportunity to provide workers with programs to lose weight, quit smoking and exercise, among others, while its Health High 5 program has committed $100 million over five years to improving the health of children.

Highmark tries out programs on its employees first, said Dr. Mary Goessler, medical director of quality and medical permanent management. For example, the agency saw the number of employees who get annual physicals increase from about 10 percent to just under 70 percent when it offered a financial incentive.

She acknowledges the numbers on obesity nationwide continue to grow.

“The progress is slow because there isn’t one thing that works for everybody,” she said. “Everybody has to take personal account for the changes they need to make.”

Calls for a focus on preventative health care are rising as Congress grapples with the hard financial realities of how to pay for the health care of a population of more than 300 million.

Ms. Sebelius told the CDC conference a significant amount of the $1 billion Congress appropriated in stimulus money for prevention and wellness will go “to help states and communities attack obesity.”

“Reducing obesity — especially for children — would be one of the biggest steps we could take toward this country’s health future,” said Ms. Sebelius.

In Congress, legislators are having a hard time determining how to include preventive programs in the health care package because the Congressional Budget Office has had a difficult time assessing the savings they could generate, said Rep. Jason Altmire, R-McCandless. He’s a former UMPC executive and a member of the House Education and Labor Committee.
Read more:http://www.postgazette.com/pg/09214/988131-114.stm#ixzz0N3vyU3Ui

Obesitys costs emerge as major concern.

Medical spending on obesity-related conditions is estimated to have reached $147 billion a year in 2008, according to the new study, published online on Monday in the journal Health Affairs. That figure represents almost 10 percent of all medical spending, the study found.

Obese Americans spend about $1,429 more on health care each year than the roughly $3,400 spent by normal-weight Americans.

Most of the excess spending is for prescription drugs needed to manage obesity-related conditions, said Eric A. Finkelstein, one of the study’s authors and the director of the public health economics program at the Research Triangle Institute, a nonprofit research organization.

The results were presented on Monday at the first Weight of the Nation conference, which was held in Washington by officials at the Centers for Disease Control and Prevention.

“Obesity, and with it diabetes, are the only major health problems that are getting worse in this country, and they’re getting worse rapidly,” Dr. Thomas R. Frieden, director of the C.D.C., said.

The average American consumes 250 more calories per day than just two decades ago, Dr. Frieden noted, and the rising obesity rate is the single greatest contributor to a national epidemic of diabetes.

via Obese Americans Spend Far More on Health Care – NYTimes.com.

Fast-food strategy: free, or practically free – Los Angeles Times.