Reuters, Bill Berkrot, Novemner 23, 2010
More than half of Americans will have diabetes or be prediabetic by 2020 at a cost to the U.S. health care system of $3.35 trillion if current trends go on unabated, according to analysis of a new report released on Tuesday by health insurer UnitedHealth Group Inc.
Diabetes and prediabetes will account for an estimated 10 percent of total health care spending by the end of the decade at an annual cost of almost $500 billion — up from an estimated $194 billion this year, according to the report titled “The United States of Diabetes: Challenges and Opportunities in the Decade Ahead.”
The average annual health care costs in 2009 for a person with known diabetes were about $11,700 compared with about $4,400 for the non-diabetic public, according to new data in the report drawn from 10 million UnitedHealthcare members.
The average annual cost nearly doubles to $20,700 for a person with complications related to diabetes, the report said. Complications related to diabetes can include heart and kidney disease, nerve damage, blindness and circulatory problems that can lead to wounds that will not heal and limb amputations.
Diabetes, which is reaching epidemic proportions and is one of the fastest-growing diseases in the United States, currently affects about 26 million Americans.
Another 67 million Americans are estimated to have prediabetes, which may not have any obvious symptoms. More than 60 million Americans are unaware that they have the condition, according to UnitedHealth.
People with prediabetes have higher than normal blood sugar levels, but not yet high enough to be diagnosed as diabetes. Prediabetics often have other risk factors, such as overweight, high blood pressure and high cholesterol.
The 52-page UnitedHealth report also focuses on the growing obesity epidemic as that condition is a leading cause of diabetes.
The authors of the report contend the skyrocketing cost forecasts are not inevitable, however, if the crisis is tackled aggressively, including early intervention to prevent prediabetes from becoming diabetes.
“Because diabetes follows a progressive course, often starting with obesity and then moving to prediabetes, there are multiple opportunities to intervene early on and prevent this devastating disease before it’s too late,” Deneen Vojta, senior vice president of the UnitedHealth Center for Health Reform & Modernization, said in a statement.
“What is now needed is concerted, national, multi-stakeholder action,” Simon Stevens, chairman of the UnitedHealth Center for Health Reform & Modernization, said in a statement.
“Making a major impact on the prediabetes and diabetes epidemic will require health plans to engage consumers in new ways, while working to scale nationally some of the most promising preventive care models.” Stevens added.
If solutions for tackling the epidemic offered in the report were adopted broadly and scaled nationally it could lead to cost savings of up to $250 billion over the next 10 years, according to the UnitedHealth analysis.
via Half of Americans facing diabetes by 2020: report | Reuters.
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Bloomberg News, Pat Wechsler, August 3, 2010
The U.S. is losing the battle of the bulge, and Mississippi is the state reporting the largest percentage of fat people.
The number of states with an adult obesity rate of 30 percent or more has tripled, to nine, since 2007, the Centers for Disease Control and Prevention said in a report today. Mississippi had the highest rate, 34 percent. About 75 million Americans are considered obese, the Atlanta-based CDC said.
Being fat is costing Americans as much as $150 billion a year from ills such as diabetes, heart disease and cancer, as obese people carry almost $1,500 more in yearly medical expenses, the CDC said in the report. The Obama administration and public-health officials have made fighting flab a priority, organizing campaigns to get people to eat less, consume more fruits and vegetables, and get more physical activity.
“This is a call to action for the nation,” Heidi Blanck, the CDC’s branch chief for obesity prevention and control, said in an interview. “It took over a decade for smoking prevention efforts to take effect. We’re still in our infancy on diet and exercise.”
Besides Mississippi, the states with 30 percent or higher obesity are Alabama, Arkansas, Kentucky, Louisiana, Missouri, Oklahoma, Tennessee and West Virginia, the CDC said. Thirty-nine states showed increases in their rates. In 2000 no state had a rate of 30 percent or more, according to the public health agency.
High Altitude
Only Colorado and the District of Columbia had obesity rates of less than 20 percent. Colorado’s relative thinness may relate to the fact that two-thirds of the population lives in the mile-high city of Denver. The high altitude, which requires more exertion from people, is keeping weight off, said William Dietz, director of the CDC’s division of nutrition, physical activity and obesity. Colorado also has a “culture of physical activity,” he said.
“The District of Columbia is more of a mystery,” Dietz said. “It may have to do with the city’s higher rates of breast feeding and consumption of fruits and vegetables.”
To determine whether someone is obese, researchers calculate the BMI, or body mass index, which is weight in kilograms divided by the square of the person’s height in meters. “Normal” index numbers are 18.5 to 24.9. Doctors deem patients to be “overweight” at an index figure of 25 to 29.9, and “obese” at 30 or higher.
‘Sick And Die’
A 5-foot, 5-inch (1.65 meters) woman is considered overweight at 150 pounds (68 kilograms) and obese at 180. A 6- foot man is overweight at 184 pounds and obese at 221.
“Obesity continues to be a major public health problem,” CDC Director Thomas Frieden said in a statement today. “We need intensive, comprehensive and ongoing efforts to address obesity. If we don’t more people will get sick and die from obesity-related conditions such as heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of death.”
States and the federal government have been creating programs to influence people’s food choices, including removing sweet beverages such as soda and fruit drinks from schools. New York City has required chain restaurants to list calorie counts for meals.
Calorie Count
The Food and Drug Administration is working on a national standard for listing calories in chain restaurants, based on a requirement set in the health-care overhaul passed in March, Blanck said. Those rules may be issued next year, she said.
“We sort of have to grit our teeth and not be discouraged if this thing doesn’t turn around immediately,” said Sally Findley, a professor of population and family health at Columbia University’s Mailman School of Public Health, in New York.
Findley said focusing on a reduction in the consumption of sweetened drinks would be one campaign that might “make a big difference,” as it would cut across demographic groups. Placing a tax on soda or certain fruit drinks, as has been proposed in New York State, might be one approach, while prohibiting the use of food stamps to buy those beverages is another, she said.
Michelle Obama
Responding to First Lady Michelle Obama’s campaign against childhood obesity, PepsiCo Inc.,Kraft Foods Inc., Kellogg Co. and 77 other food and beverage companies pledged to cut 1 trillion calories from their products by 2012 and 1.5 trillion by 2015.
The CDC report is based on Behavioral Risk Factor Surveillance, which collects state public health data. The statistics on obesity are collected through phone surveys and are likely to produce underestimates since both men and women tend to overestimate their height and underestimate their weight, according to the CDC.
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Americans are fat, but at least theyre not getting fatter.
Sixty-eight percent of Americans are overweight or obese, but that number hasnt changed much in the last decade, according to a team of doctors Wednesday in two studies in the Journal of the American Medical Association.
Doctors feared that the trend of ever-increasing rates of obesity that started in the 1980s had no end.
But the new findings reveal that from 1999 to 2008, the percent of obese women hovered between 33.2 and 35.5 percent, and the percent of obese men ranged between 27.5 percent to 32.2 percent — small changes for the National Health and Nutrition Examination Survey which measures the Body Mass Index BMI for over fivethousand men and women every two years.
Still, doctors are hesitant to give high-fives and pop champagne.
“It’s really good news if this is a real change,” said Thomas Robinson, a professor of pediatrics and the director for the Center for Healthy Weight at Stanford University and Lucile Packard Children’s Hospital. “But we’re still stuck with a large percent of the population that is obese.”
For years, health professionals have been warning that obesity — and the diseases like diabetes it engenders — are all poised to become public health problems as deadly and costly as cigarette smoking.
Robinson tersely warns that if obesity trends don’t take a dramatic reversal, “we’re going to have a disaster.”
Also found in one of the studies: Childhood obesity may be slowing too, with one exception—the heaviest boys are getting heavier.
Fifteen percent of all boys between 6 to 19 now fit into the 97th percentile weight category, a group beyond obesity that researchers gingerly term “highest BMI.” Though Latino boys and African-American boys are more likely to be in this highest obesity class than white boys (19.6 percent and 15.7 percent in 2008, respectively), the only significant upward trend toward high BMI was seen in white boys.
Childhood obesity is alarming, says Robinson, because it strongly predicts obesity into adulthood, when chronic diseases are more likely.
Overall, for children 2 to 19, 31.7 percent were overweight (above the 85 percentile), 16.9 were obese (above the 95th percentile) and 11.9 were above the 97th percentile.
Does the improved data mean Americans are absorbing public health messages about eating healthy and exercising regularly?
“We don’t know,” said Cynthia Ogden, a CDC epidemiologist and author in both studies.
More public awareness is one explanation for the apparent slowdown, say doctors. But maybe American obesity has reached a saturation point based on genetics and the environment, suggests Robinson.
In Santa Clara County, obesity levels also appeared to plateau, hovering around 18 percent for adults between 2004 and 2009, according to county health spokeswoman Joy Alexiou.
“We think more schools and parents are emphasizing better eating habits and exercise,” said Alexiou. “We’ve raised a lot of attention to this issue.” Vending machines have healthier snacks not only in schools, she says, but also in the workplace.
Nearly two-thirds of Santa Clara County schools participate in Fit for Learning, a nutrition and wellness program that teaches kindergarten through sixth-grade students about the food pyramid, exercise and making healthy food choices. In the past four years, Michelle Mount, the program’s coordinator, says she’s seen a steady increase in students and staff talking about fitness. And she noted that scores on the Fitnessgram, a physical test that includes a mile run, have improved recently in some districts.
“There have been some gains, but we have a lot more work to do,” said Mount. “As a society, we’ve become very sedentary. Students sit in the classroom all day.”
Fighting obesity, says Mount, “is like trying to turn around a large ship.”
Still, a few San Jose residents say the message must be getting through.
“My high school son doesn’t drink soda,” said Matthew Fleming, a business owner on his way out of the San Jose Athletic Club after a lunchtime basketball game. He said he’s seen public schools emphasize health and fitness more over the last 10 years.
“People are more aware that to live a longer life, you’ve got to be healthy,” said Fleming.
The new data is a surprise to others.
“I don’t see what the impetus will be for people to dramatically change their eating habits,” said Tim Hodgson, a sales rep for a high-tech company in San Jose. If parents aren’t drastically changing their habits, neither will their children, he said.
Undoing the damage, he predicts, “is going to take some generations.”
via Americans are fat, study says, but not getting fatter – San Jose Mercury News.
]]>A review of two studies stretching back to 1988 found the proportion of obese adults has crept up to over a third.
Levels of exercise also fell, as did consumption of fruit and vegetables.
The American Journal of Medicine study found those with health problems were no more likely to follow a healthy lifestyle than their fitter peers.
Researchers at the Medical University of South Carolina compared two large-scale studies covering the period 1988 to 2006.
During those 18 years, the percentage of adults aged 40-74 years with a body mass index (BMI) greater than 30 rose from 28% to 36%.
The number of people exercising three times a week or more fell from 53% to 43%, while the number of people eating five portions of fruit and vegetables a day fell by nearly 40%.
At the same time, smoking levels remained the same and moderate drinking slightly increased.
Overall, researchers found, the number of people adhering to all five “healthy habits” – including maintaining a healthy weight and stopping smoking – decreased from 15% to 8%.
What now
This drop “demonstrates that the amount of emphasis by the current health system on prevention and healthy lifestyles may be insufficient,” wrote lead author Dana King.
“The implications of the decreasing rates of healthy lifestyle habits include the possibility of an upswing in cardiovascular morbidity and mortality, and increase in the number of aging persons with disability and decreased quality of life due to the burden of chronic disease.”
But he added that research showed individuals could be persuaded to adopt healthy behaviour in middle age, and more effort should be focused on this.
Dr Steven Galson, the acting US surgeon general, said: “There is clearly a lot of work that needs to be done.
“If we want all Americans to achieve the health benefits of a healthy lifestyle, then all members of society must take action including parents, educators, community leaders, government as well as the individual.
“Together we can help Americans understand the severity of obesity, the efforts being made to address it, and how to maintain a healthy weight and live a healthy lifestyle.”
Professor Alan Maryon-Davis, president of the UK Faculty of Public Health commented: “This is a wake-up call for the UK. What happens in America often happens over here a few years later.”
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