How To Be A Successful Patient: Young Doctors Offer Some Advice

Article Source: Health And Fitness Journal

I am proud to be a part of the American Resident Project, an initiative that promotes the writing of medical students, residents, and new physicians as they explore ideas for transforming American health care delivery.  I recently had the opportunity to interview three of the writing fellows about how to help patients take control of their health. Dr. Marissa Camilon (MC) is an emergency medicine resident at LA County USC Medical Center, Dr. Craig Chen (CC) is an anesthesiology resident at Stanford Hospitals and Clinics, and Dr. Elaine Khoong (EK) is a resident in internal medicine at San Francisco General Hospital. Here’s what they had to say:

1. How would you characterize the patients who are most successful at “taking charge of their health?”

MC: They are usually the the patients who aren’t afraid to ask questions about everything- possible treatments, pathology, risk factors.

EK: I think there are several traits that make patients successful at modifying their health: 1) Understanding of their disease: patients need to understand how their actions impact their health and be able to clearly identify the steps they need to take to achieve their desired health. 2) Possessing an internal locus of control: patients need to feel that their health is actually in their control. Oftentimes, patients who come from families that have a history of chronic diseases simply assume certain diseases may be their fate. But in reality, there are things that can be done to manage their disease. 3) Living in a supportive, nurturing environment: behavior changes are difficult. It is often not easy to the right thing for your health. Patients that take control of their health have a support system that helps ensure they take the steps they need. 4) Having realistic expectations: improving your health takes time and thus it requires patience. Individuals must be able to identify the baby steps that they’ve taken towards improving their health.

CC: Patients must collaborate with their physician – the best patients come in motivated, knowledgeable, and educated so they can have a meaningful dialogue with their doctor. Medical decision making is a conversation; patients who are invested in their health but also open to their doctor’s suggestions often have the best experiences.

2. What do you see as the main causes of non-adherence to medical advice/plans?

MC: Not fully understanding his or her own disease process, denial/shock, inability to pay for appointments/rides/medications.

EK: I think there are several reasons that patients may be non-adherent. These reasons can largely be grouped into three main categories — knowledge, attitude, and environmental factors. Some patients simply don’t understand the instructions provided to them. Providers haven’t made it clear the steps that need to be taken for patients to adhere. In other cases, patients may simply not believe that the advice provided will make an impact on their health. Probably most frequently, there are environmental factors that prevent patients from adhering to plans. Following medical advice often requires daily vigilance and strong will power. The challenges of daily life can make adherence difficulty.

CC: In my mind, non-adherence is not a problem with a patient, but instead a problem with the system. Modern medicine is a complex endeavor, and patients can be on a dozen different medications for as many medical problems. It’s unreasonable to expect someone to keep up with that kind of regimen. Socioeconomic factors also play a big role with adherence. Patients who are poor struggle to maintain housing, feed their children, hold a job; how can we expect them to be perfectly medically compliant? Tackling the issue of non-adherence requires engagement into the medical and social factors that pose challenges for patients.

3. Could mobile health apps help your patients? Do you think “there’s an app for that” could revolutionize patient engagement or your interaction with your patients now or in the future?

MC: Apps, not necessarily. Most of patient population has limited knowledge of their mobile phones (if they even have mobile phones). If they do have a phone, its usually an older model that doesn’t allow apps.

EK: I absolutely think that mobile health apps could help my patients. I work at a clinic for an urban underserved population. For patients that work multiple part-time jobs to make ends meet, it is difficult to ask them to come into see a healthcare provider (particularly if the commute to see us requires 2+ bus rides). Unfortunately the patients who are working multiple jobs are often patients in their 40′s and 50′s when they start manifesting the early signs and symptoms of our most common chronic diseases (hypertension, diabetes, and cardiovascular disease). Mobile applications have great potential to simplify the way through which patients can receive medical guidance especially helping the patients who don’t have the luxury to seek medical advice during normal work hours.

CC: I think there is a role for technology in the delivery of modern medical care. However, we have to keep in mind that not everyone has access to smartphones, and often the most medically disadvantaged populations are those who need support the most. Although initially, technology seemed to put a barrier between the clinician and the patient, I think as devices become more prevalent and we become better at using them, we’ll be able to use these collaboratively. The main advantage of an “app” or device is giving the patient more control over their health; they can track their sleep, diet, exercise, medication adherence, and other aspects of their health and work with their doctor to optimize it.

4. Do you know of any programs to improve health literacy that have been particularly successful or innovative? If so, describe. If not, what kind of initiative do you think could make a difference for your patients?

MC: I know that some of the primary care clinics in the county have started using texting for appointments reminders. Texting seems to be more accessible to our county population.

EK: Unfortunately, off the top of my head, I cannot think of any great programs that have increased health literacy. Part of the reason for this is that we really don’t have a great sense of what levers increase literacy. Any initiative that will work best honestly depends on the individual patient — each patient has different barriers that limit their health literacy. For some patients, their limited English proficiency is the greatest barrier. For other patients, there are cultural beliefs that must be considered in delivering health content. And for some patients, numeracy or general literacy is an issue. Unfortunately, I think there is no one size fits all solution for addressing health literacy.

CC: I don’t think there’s any magic bullet for health literacy. Different communities, patient populations, and clinical settings merit different interventions. For example, tackling child obesity in a neighborhood with lots of fast food requires a different program than ensuring prenatal health in an immigrant community.

5. Are there generational differences in how your patients interact with the healthcare system? Describe.

MC: I tend to see older patients since they usually have more medical problems. They are more likely to have a primary care doctor; whereas younger patients don’t come in as often, but don’t usually have access to primary care.

EK: I think more than a generational difference there is actually a cultural and socioeconomic difference. Traditionally, we are taught or somehow led to believe that older patients are more likely to simply adhere to medical advice whereas younger patients question. But in my limited experience, I have seen affluent patients more engaged with providers (bringing in their own resources, asking about health advice they’ve heard or read about). Some of my less wealthy patients seem more passive about their health and during visits. Furthermore, patients from certain cultural backgrounds are more or less likely to view healthcare providers as an authoritative figure rather than a partner in shared decision making.

6. Do you use digital systems (EMR/Social Media/Mobile) to interact with your patients in any way? Do you think you should do more of that, or that there is a desire for more on the part of your patients?

MC: We do have an EMR but don’t really use it to interact with patients. As I mentioned before, mobile texting may encourage patient interaction.

EK: The main way that I currently use digital systems to interact with patients is via email. Our clinic has a somewhat difficult-to-navigate telephone prompt system, so some patients email me directly re: changing their appointments, medical advice, or medication refills. Unfortunately our EMR doesn’t currently have a patient portal (although it will be rolling this out soon). I think a patient portal is a great tool for helping patients stay more engaged in their healthcare.

I think there is a role for SMS messaging to remind patients about appointments, important medications, or other healthcare related notices. For the right patient population, I think this could make a big difference.

In general, I am a big proponent of technology. I don’t think it’s going to be a panacea for our many problems in the healthcare system, but I think there are very specific shortcomings that technology can help us address.

7. What would your patients say they needed in order to be better educated about their health and have more successful healthcare experiences?

MC: More time with their physicians, mainly.

EK: Almost certainly simply more time with healthcare providers to better explain their health issues as well as more time to explore shared decision making.

CC: There is a lot of information out there about common illnesses and diseases, but not all of it is accurate or up-to-date. One challenge for patients is identifying appropriate resources written in a manner that can be easily read and understood with content that has been reviewed by a physician or other health care expert.

8. If you could pick only 1 intervention that could improve the compliance of your patients with their care/meds, what would it be?

MC: Increase the amount of time physicians have to answer questions with patients and discuss medical treatment options with them.

EK: Wow, that’s a hard one. I struggle to answer questions like this because I strongly believe that each patient is so different. Any non-adherent patient has his or her own barrier to adherence. But I suppose if I had to pick something, it might be some form of weekly check-in with a health coach / community health worker / health group class that intimately knew what the most important steps would be to helping that one patient ensure better health.

CC: I think that social interventions make the most difference in the health of underserved populations. For example, stable housing, healthy meals, job security, and reduction in violent crime will improve health including medical compliance far more than any medicine- or technology-based intervention.

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The Fight Against Water Fluoridation Continues

Article Source: Health And Fitness Journal

By Stuart Cooper, Campaign Manager, Fluoride Action Network

The fluoride-free movement has continued to grow throughout the world at a staggering pace. We have had more than 400 communities around the world end existing fluoridation programs or reject new efforts to fluoridate either by council vote or citizen referendum since 1990.

In 2014 alone, we’ve confirmed that at least 30 communities providing water to more than 9,961,111 residents rejected or ended fluoridation. Some of 2014’s victories include:

See the full list of victories.

Israel Bans Fluoridation

Nearly eight million residents in Israel will no longer have fluoride added to their drinking water.

On July 29, 2013, the Supreme Court of Israel ruled1 that new regulations approved by the current Health Minister, Yael German, required the country to reverse its 14-year-old nationwide fluoridation mandate and stop adding fluoride chemicals into public water supplies in 2014.

These regulations ended the national mandate, but it was thought that individual communities could choose to fluoridate. However, the Health Minister stated in August 2014 that fluoridation would be outlawed throughout the country as of August 26.2

Minister German was aggressively attacked in the media for her new regulations. In response to the intense bullying of German by the pro-fluoridation lobby in Israel, FAN sent an open letter3 to the Minister supporting her opposition to the practice and had it signed by over 100 international professionals.

With the fluoridation ban in Israel, the victory numbers jumped up substantially, adding countless more communities throughout the nation without fluoridation.

This brings the number of people freed from the practice in 2014 to nearly 10 million, making 2014 the best year yet for the fluoride-free movement! In comparison, last year we saw about 1 million freed from the practice.

When we add Israel to the number of residents freed from fluoridation since 1990, we are talking about a whopping 14.8 million people. This also brings the official number of countries in the world with 50 percent of their population drinking fluoridated water down to 10, and leaves Ireland as the only country with mandatory fluoridation.

Ireland Will Likely Be Next

Ireland is the last remaining country in the world with mandatory fluoridation, and perhaps the most likely to follow Israel’s example. In recent years, the fluoride-free momentum has been building in Ireland, and we believe the tipping point has been reached.

In 2013, legislation to end the nationwide mandate4 in Ireland was introduced, which would not only reverse the mandate, but would make fluoridation a criminal act. This bill got a significant boost when a major Irish magazine5  began investigating fluoridation.

They found a parliamentary report6 calling for an end to fluoridation that was suppressed by the government for seven years, and the Labour party’s chief whip, Emmet Stagg, called for an end to the practice,7 saying that time had run out for “mass medication” by fluoridation.

In the spring of 2014, the Agriculture Minister announced that the Irish government would appoint an international group of experts to review public water fluoridation8 in response to the growing public pressure in opposition to fluoridation.

The next day, on March 10th, the Cork County Council, the largest county council in Ireland voted by a huge majority9 in favor of a motion calling on the federal government to ban fluoridation throughout the country. The vote had cross-party support and was expected to have a domino effect with other county councils.

A domino effect is exactly what it had, when on October 6th, Dublin’s City Council passed a motion10 by a vote of 22-20 calling for the immediate cessation of water fluoridation in Ireland. Dublin is the capital and largest city in Ireland, and home to more than 500,000 residents.

Also in October, fluoridation was also being debated in the House of the Oireachtas11 (Irish Legislature).

Senator Mary Ann O’Brien made a motion to end fluoridation because of the “fundamental human right of every Irish citizen to choose whether or not they have their water medicated with fluoride given that they are now paying for it.”

Senator O’Brien wrote a powerful op-ed for the Irish Independent on October 1st explaining in detail why she was bringing the motion.12

And, on November 10th, the Kerry County Council unanimously passed the motion13 opposing public water fluoridation. The vote received cross party support and was passed without any disagreement amongst the councilors, making it the fifth major Council to adopt a similar resolution in 2014, representing approximately 1.5 million Irish residents.

These votes are the result of a national effort that is gaining significant momentum due to campaigners like the West Cork Fluoride Free Campaign,14 scientist Declan Waugh,15 The Girl Against Fluoride,16 and the hard-working fluoridation fighters Robert Pocock and Gladys Ryan who preceded them.

You can learn more about the campaign in Ireland, and hear directly from many of these key players and organizers by downloading November’s International Fluoride Free Teleconference.

Fluoride Litigation

Ireland isn’t the only country possibly on the verge of ending fluoridation. In Canada, a resident of Peel, Ontario, Liesa Cianchino (chairperson of Concerned Residents of Peel to End Water Fluoridation), launched a lawsuit17 against the Peel Region and the Province of Ontario, Canada.

The lawsuit challenges the constitutionality of adding fluoride to municipal drinking water in Canada and points out that the practice is also a violation of the Ontario Safe Drinking Water Act.

If successful, the lawsuit could end fluoridation throughout Canada, and could establish that councilors in fluoridated communities are personally liable for the damages caused by fluoridation. The action will be heard in Ontario Superior Court in Brampton.

Infant Warnings

2014 saw infant fluoride warnings18 published in the annual water quality reports for San Francisco and East Bay, California (population 7.4 million), thanks to members of Clean Water California.19

These two communities now join Sunnyvale, California, Austin, Texas, Milwaukee, Wisconsin, and the state of New Hampshire in adding these warnings to their annual water quality reports, bringing the number of residents these warnings are sent to approximately 10 million.

There is also infant warning legislation20 currently being considered by the Massachusetts legislature, where the bill was recently sent to study committee and will receive an executive committee vote this winter. If passed, the warning would help reduce fluorosis rates and bring awareness to an additional 6.6 million people.

Click here to start your own Infant Warning Campaign.

Fluoride Classified as Dangerous to Developing Brains

While this isn’t good news for the health of our children, it is a victory that fluoride’s toxicity is becoming more apparent to the scientific community. An article was published in the March 2014 journal The Lancet Neurology21 in which medical authorities classified fluoride as a developmental neurotoxin. The prominent peer-reviewed medical journal published the article entitled “Neurobehavioral effects of developmental toxicity.” The authors point out that 27 studies of children exposed to fluoride in drinking water found an average lowering of IQ by seven points; twice that of the effects of secondhand smoke on children. This confirmed what FAN has been saying for years.

See FAN’s press release on the Lancet article.

At present, a total of 42 human studies22 have linked moderately high fluoride exposures with reduced intelligence, and over 100 animal studies have shown that fluoride exposure can cause brain damage. Most striking among these are 30 (out of a total of 32 investigations) that have shown that fluoride lowered the ability of animals to learn and remember. Studies have also demonstrated that fluoride toxicity, caused by overexposure, can lead to a wide variety of health problems, including:

Increased lead absorption Disrupts synthesis of collagen Hyperactivity and/or lethargy Muscle disorders
Thyroid disease Arthritis Brain damage, lowered IQ, and dementia Skeletal fluorosis and bone fractures
Lowered thyroid function Bone cancer (osteosarcoma) Inactivates 62 enzymes and inhibits more than 100 Inhibited formation of antibodies
Genetic damage and cell death Increased tumor and cancer rate Disrupted immune system Damaged sperm and increased infertility

Journal Article Calls for Prohibition of Fluoridation

Also this year, The Scientific World Journal published a review article23 by Dr. Stephen Peckham and Dr. Niyi Awofeso entitled, “Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention.” According to the authors:

Available evidence suggests that fluoride has a potential to cause major adverse human health problems, while having only a modest dental caries prevention effect. As part of efforts to reduce hazardous fluoride ingestion, the practice of artificial water fluoridation should be reconsidered globally, while industrial safety measures need to be tightened in order to reduce unethical discharge of fluoride compounds into the environmentcoordinated global efforts to reduce adverse human health effects on fluoride need to start with ensuring that its introduction into water supplies is prohibited.

Increasing Our Momentum

Overall, 2014 has been a good year for the fluoride-free movement. FAN has seen a significant increase over the past year in the number of campaigns to end fluoridation worldwide, which is why this year we launched a new coalition called the Worldwide Alliance to End Fluoridation.24 This was open to any group of citizens organized to end fluoridation.25 There was an overwhelming response, with over 120 founding member groups representing 12 countries, 28 U.S. States, and 6 Canadian Provinces. And we fully expect the campaign momentum from 2014 to carry over into the new year to make 2015 an unprecedented year for the fluoride-free movement.

Most of 2014′s victories were the result of citizens who organized local opposition and voiced their concerns to council members, either working in coordination with FAN, or using our materials and arguments to educate their neighbors and decision-makers about the serious health risks associated it the practice. Our hats are off to these citizen campaigners and their professional allies. Without dedicated campaigners around the world our goal of a future without fluoridation couldn’t be possible. To start your own campaign, please visit our Take Action section, and to join an existing campaign please visit the Worldwide Alliance directory.

Again, thank you for your continued support for FAN and your efforts to end fluoridation. Please help us make 2015 even more successful by making a tax-deductible donation today. Thank you.

Donate Today!

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Global Obesity Now Worse Than Smoking

Article Source: Health And Fitness Journal

By Dr. Mercola

More than 2.1 billion people, or close to 30 percent of the global population, are overweight or obese. This is more than double the number of adults and children who are undernourished.1

Further, according to a report by The McKinsey Global Institute, the global cost of obesity is now $2 trillion annually, which is nearly as much as the global cost of smoking ($2.1 trillion) and armed violence (including war and terrorism, which also has a global cost of $2.1 trillion).

For comparison, alcoholism costs are $1.4 trillion annually, road accidents cost $700 billion, and unsafe sex costs $300 billion. What’s more, if current trends continue, the McKinsey report estimates that nearly half of the world’s adult population will be overweight or obese by 2030.

The costs stemming from obesity are varied. The condition is associated with lost work days and lower productivity, and higher health care costs due to a myriad of related diseases. Worldwide, obesity is responsible for about 5 percent of all deaths each year.2 But while the global burden of obesity is clear, what’s less so is what to do about it.

‘Systemic, Sustained Portfolio of Initiatives’ Needed to Reduce Obesity Health Burden

The McKinsey report leaves more questions than answers, but that’s to be expected because obesity, and its causes, is complex. As they wrote, “existing evidence indicates that no single intervention is likely to have a significant overall impact.” Instead, they recommended a “systemic, sustained portfolio of initiatives,” which include such options as:

  • Reducing default portion sizes
  • Changing marketing practices
  • Restructuring urban and education environments to facilitate physical activities
  • Reformulating food products
  • Workplace wellness

Rather than wait for the “perfect proof” of what works, the report urges experimenting with solutions immediately, especially when the interventions are low cost and low risk.

The changes, according to their findings, should “rely less on conscious choices by individuals and more on changes to the environment and societal norms.” This, they say, is important because education and personal responsibility are not sufficient on their own to reduce obesity – a stance I can’t completely agree with.

Societal changes are indeed important, but so is personal choice and, absolutely, education — spreading the truth about what really works to maintain a healthy body weight.

The Big Lie from Monsanto and the GMA

The 300+ members of the pro-GMO Grocery Manufacturers Association (GMA) include chemical/pesticide (i.e. Monsanto), GE (genetically engineered) seed, and processed junk-food companies.

Between 2012 and mid-2014, GMA (by way of dues from their members) successfully blocked GMO labeling legislation in over 30 states, at a price tag of more than $100 million. The claim that GE crops are “necessary” to feed a growing population is a popular mantra among those who do not have an understanding of the whole picture.

Contrary to claims, genetic engineering has not increased crop yields,3 which isn’t surprising as what we really need is to focus on strategies that will promote soil health — and GE crops decimate soil fertility.

Also, besides killing critical soil microbes needed for plant health and nutrition, what many fail to take into account is that GE plants typically require more water, not less.

And while many varieties are designed to produce their own internal pesticides, which was meant to reduce pesticide requirements, these plants actually require more pesticides too—just to keep up with the proliferation of resistant pests and weeds!

So the big lie that Monsanto and the GMA junk food purveyors continue to promote is how they aim to feed the world… but they fail to show their products are actually FATTENING the world.

They make no progress with starvation due to distribution issues, and instead look for profitable ways to get more people eating the GMO diet staples of corn syrup, trans fats from soybean oil, and sugar, which together fuel the rising obesity rates around the globe. The safety of the entire GMO “food” production is a boldfaced lie when you look at these primary food crops sickening Americans:

  • High fructose corn syrup—one of the primary sources of calories in the American diet—is made from GMO corn (Bt corn), registered with the EPA for producing its own internal pesticide
  • Hydrogenated vegetable oils (trans fats) known to cause heart and cardiovascular disease are made from GMO soy that is resistant to pesticide. This allows it to soak up much more of it than non-GMO soy
  • Sugar beets are also genetically engineered, ensuring that even foods sweetened with “regular sugar” fall into a more toxic category, courtesy of elevated pesticide contamination

Corn syrup, trans fats, and sugar – what a “safe and healthy” food system these companies have created… The continued argument that GMOs are safe is a horrible joke. These ingredients are now foundational in the US diet, and there is virtually no doubt that they are primary contributors to many Americans’ failing health and rising rates of obesity.

Soda Companies Increase Marketing to Black and Latino Kids

GMA members also include leading beverage companies, who have recently done just the opposite of what the McKinsey report advises to counter rising obesity rates… they’ve ramped up marketing to black and Latino youth, a population who already has higher rates of obesity than white children and teens.4

In a report released by the Rudd Center for Food Policy & Obesity at Yale University,5 it was revealed that, in 2013:6

  • Black youth saw more than twice as many TV ads for sugary drinks and energy drinks than white youth
  • Advertising for sugary drinks and energy drinks on Spanish-language TV increased by 44 percent
  • Beverage companies spent $866 million to advertise unhealthy drinks, which is more than four times the amount spent to advertise water and 100% juice
  • Many beverage companies developed child-friendly mobile “advergame” apps

Jennifer Harris, director of marketing initiatives at the Yale Rudd Center and lead author of the report, told The Salt:7

“[Black and Latino] populations suffer more from diabetes, obesity and other negative health consequences from the consumption of sugary beverages; it’s a huge problem in those communities.

…These companies all say they have practices for responsible marketing to children in black and Latino communities, but it’s not very responsible to be marketing products that are so detrimental to them.

We are really hoping to get companies to pay attention not just to the market opportunities, but also the public health consequences of what they’re doing.”

Food and beverage advertisers are far from innocent when it comes to creating a global obesity pandemic. According to recent research into food addiction, “highly processed foods can lead to classic signs of addiction like loss of control, tolerance, and withdrawal.”8 What other industry is infamous for aggressively marketing a highly addictive product to kids?

Big Tobacco… And just like the tobacco industry, the processed-food industry is fighting tooth and nail to divert responsibility away from their products when questions are raised about the root causes of obesity and food addiction. Is it any coincidence now that the products of these two powerful industries – smoking and obesity – top the list for global health costs?

8 Million Americans Have Diabetes But Don’t Know It

When discussing obesity, it’s not only obesity that’s the problem. As the McKinsey report noted, the rising rates of obesity are driving the increases in heart and lung disease, lifestyle-related cancer, and… diabetes.9 In 2012, more than 28 million (11.8%) US adults had diabetes, but about 8 million of didn’t know it, according to a study published in the Annals of Internal Medicine.10 This amounts to about three in 10 Americans with diabetes being unaware that they’re suffering from this serious condition.

Worse, about two-thirds of those with undiagnosed diabetes had seen a doctor at least twice in the past year. Even among those diagnosed, the report found much room for improvement of care. Only 64 percent of people with diagnosed diabetes were meeting their blood sugar goals and only 66 percent had their blood pressure under control.11 Said Dr. Robert Ratner, chief scientific and medical officer for the American Diabetes Association:12

“We need to be making the diabetes diagnosis. If you miss the diagnosis, there really are adverse consequences. A disease like diabetes is treatable, but it’s only treatable if you’ve been diagnosed.”

Unfortunately, what many US physicians fail to recognize is that proper diet and exercise are the keys for resolving diabetes – not insulin and not drugs. Type 2 diabetes is a disease rooted in insulin resistance and perhaps more importantly, a malfunction of leptin signaling, caused by chronically elevated insulin and leptin levels. One of the driving forces behind type 2 diabetes is excessive dietary fructose, which has adverse effects on insulin and leptin – and also plays a role in driving up rates of obesity. According to the International Diabetes Federation, over 70 percent of type 2 diabetes cases can be prevented or delayed with a healthier lifestyle.13

Rising Diabetes Rates May Fuel Tuberculosis Epidemic

Diabetes can lead to blindness, kidney failure, limb amputations, and many other health problems, including reduced immunity. This has major implications, because diabetes isn’t a condition isolated to the US. Eighty percent of diabetics live in low- and middle-income countries, 14 where infectious disease like tuberculosis (TB) is common. Diabetes triples your risk of tuberculosis, which infected 9 million people in 2013 (1.5 million died from the disease). According to a report published by the International Union Against Tuberculosis and Lung Diseases and the World Diabetes Foundation, the world is facing a “looming co-epidemic of TB-diabetes.”15

As CNN reported:16

“Changes in diets and lifestyles are taking place across emerging economies, particularly as more people move to urban settings to earn a living. The changes are resulting in higher rates of diseases such as type-2 diabetes… Worryingly, diabetes also triples the risk a person will develop TB… The number of people with diabetes is predicted to be 592 million by 2035, with the majority living in countries with high rates of TB, such as India, China, Brazil, Indonesia, Pakistan and Russia.”

Obesity May Overtake Hunger as the World’s Number One Health Problem

In 1950, the number of starving individuals on Earth was estimated to be around 700 million; 100 million people, primarily in rich countries, were obese. By 2010, the world’s hungry had marginally grown to 800 million, while the number of obese citizens of the world had exploded to 500 million. Estimates suggest that by 2030, more than one billion people, worldwide, will fall into the obese category.17 Along with excess body weight comes a wide range of other health problems. In the US, eight obesity-related diseases account for a staggering 75 percent of healthcare costs. These diseases include:

Type 2 diabetes Non-alcoholic fatty liver disease (NAFLD)
Hypertension Polycystic ovarian syndrome
Lipid problems Cancer (especially breast, endometrial, colon, gallbladder, prostate, and kidney18)
Heart disease Dementia

The four diseases in the left column are associated with metabolic syndrome, which is a common factor in obesity. However, several other diseases fall within this category as well, which are listed on the right. And many more could be added to that list. According to the Surgeon General, in addition to the diseases mentioned above, obesity increases your risk for asthma, sleep disorders (including sleep apnea), depression, pregnancy complications, and poor surgical outcomes.19

Again, it’s easy to think of obesity as a problem affecting only the wealthiest of nations, but even developing countries are increasingly plagued by expanding waistlines. One analysis discovered that more than half of the world’s obese people congregate in 10 countries: United States, China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, and Indonesia.20 The analysis also revealed:

  • One-third of the global population (about 2.1 billion people) is now overweight or obese, 671 million of which fall into the obese category
  • Worldwide, rates of obesity among children have risen by 50 percent between 1980 and 2013
  • In Tonga, more than half of all adults, both men and women, are obese
  • In Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, and Samoa, more than half of all women are obese
  • Of the more than 180 countries analyzed, the US carries the heaviest obesity burden, followed by China and India. Obese Americans account for about 13 percent of the world’s obese people, while China and India together account for 15 percent of the total

Non-starchy, carb-rich, highly processed (and typically genetically engineered) foods, along with being in continuous feast mode, are primary drivers of these statistics. Wherever a highly processed food diet becomes the norm, obesity inevitably follows.

How to Lose Weight and Get Healthy

Most overweight Americans have some degree of insulin and leptin resistance. Generally, in order for you to significantly gain weight, you must first become leptin resistant. Leptin is a hormone that helps you regulate your appetite. When your leptin levels rise, it signals your body that you’re full, so you’ll stop eating. However, as you become increasingly resistant to the effects of leptin, you end up eating more. Many people who are overweight also have an impairment in their body’s ability to oxidize fat, which leads to a low-energy state.

Dr. Richard Johnson’s research clearly shows that refined sugar (in particular fructose) is exceptionally effective at causing leptin resistance in animals, and it’s very effective at blocking the burning of fat. If you are insulin or leptin resistant, as long as you keep eating fructose and grains, you’re programming your body to create and store fat… This is one of the key reasons why, if you are overweight (which means you are also likely insulin or leptin resistant), it would be prudent for you to restrict your fructose consumption to about 15 to 25 grams of fructose per day from all sources. Not only will this help you to avoid additional weight gain, but it will also help you to avoid further metabolic dysfunction.

You may find this fructose chart helpful in estimating how many grams of fructose you are consuming each day. Dietary sugar, especially fructose, is a significant “tripper of your fat switch.” However, if you are serious about losing weight, you’ll need a comprehensive plan that includes the following. This plan will help most people lose weight but, also, it will help you to gain metabolic health. So even if your weight is normal, you can follow this plan to ensure that you’re metabolically healthy as well.

  • Eliminate or strictly limit fructose in your diet, and follow the healthy eating program in my comprehensive nutrition plan.
  • You can also use intermittent fasting strategically with this program to greatly boost your body’s fat-burning potential. Intermittent fasting helps reset your body to use fat as its primary fuel, and mounting evidence confirms that when your body becomes adapted to burning FAT instead of sugar as its primary fuel, you dramatically reduce your risk of chronic disease. Exercising in a fasted state (such as first thing in the morning) will bring it up yet another notch. A simple way to get started with intermittent fasting is to simply omit breakfast, making lunch the first meal of your day. It is a useful strategy to follow until your insulin resistance resolves.
  • Engage in high-intensity Peak Fitness exercise to burn fat and increase muscle mass (a natural fat burner). Also, strive to sit less (much less, such as only three hours a day) and walk 7,000 to 10,000 steps a day in addition to your regular exercise program.
  • Address the emotional component of eating. For this I highly recommend the Emotional Freedom Technique (EFT), which helps eliminate your food cravings naturally.

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Article Source: Health And Fitness Journal
If you like all this stuff here then you can buy me a pack of cigarettes.

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