Electronic cigarettes (e-cigs) continue to be a hot topic on news wires and health blogs. Those in support of the products argue that smokers should be offered these products as a tool to quit smoking traditional cigarettes, while those who are unconvinced argue that they should not be offered until we have good data that tells us they are both safe to use and effective in helping smokers quit. I doubt that any rational person would argue against the premise that traditional combustible cigarettes are probably the most dangerous form of nicotine delivery available. The annual death toll in the US and worldwide is enormous and growing. Counseling support plus FDA approved pharmacological treatments are effective in helping smokers quit, but the problem is that relatively few smokers use evidence-based treatments to quit. This problem is compounded by the fact that tobacco use and dependence is very difficult to treat and many have tried and failed.
The recently published article by Dr. Katrina Vickerman and colleagues has been misinterpreted by many who have written about it. It was never intended to assess the effectiveness of the e-cig as a mechanism to quit. Instead the analysis was intended to gain insight into e-cig use by those who enrolled in public tobacco quitline services and were contacted seven months later to determine whether or not they were quit. The Alere Wellbeing study shows smokers who got help through quitlines who reported using e-cigs (to quit or for other reasons) were less likely to succeed during their current quit attempt than those who did not. The data showed that 21% of e-cigarette users were tobacco-free after seven months, compared with 31% of those who didn't use e-cigs. Many are misinterpreting it as saying that e-cigs did not help those who enrolled in QL services to quit. The analysis was never intended to answer that question.
The issue continues to be whether we should turn to a device like the e-cig to reduce the disease and death caused by traditional smoking. Many advocate for a harm reduction approach that would use e-cigs as a tool in that process. In general, harm reduction is a strategy that helps to reduce death and disease from a behavior until the person engaging in that behavior is willing to cease it entirely. The question is whether the e-cig will serve this role, or whether the product might actually create more problems than it fixes. This issue always seems to play into any discussion around harm reduction strategies, whether they be condoms for teens or clean needles for heroin addicts.
I think most will agree that the e-cig is highly unlikely to cause the same amount of damage to the body as traditional cigarettes. The question is whether e-cigs will cause damage that is new and different from that caused by traditional cigarettes. To date we have no evidence that this is the case. The problem is that there is very little data that informs the safety of long-term use of e-cigs or whether they are effective in helping smokers quit traditional cigarettes. Both safety and effectiveness are standard measures that need to be demonstrated in order for a treatment, such as e-cigs, to be adopted by tobacco treatment professionals.
Currently e-cigs are being advertised as a product to use “when you can’t smoke”, or as a cheaper and safer alternative to traditional cigarettes. When used for “when you can’t smoke” the person becomes a dual user. Current scientific evidence shows that those who use two or more tobacco products (dual users) have more difficulty quitting than those who use a single tobacco product. So if we promote e-cigs as a harm reduction product do we run the risk of creating a bigger problem than we fix? The answer is that we do not know.
So, until we have good scientific evidence about the safety of long-term e-cig use or their effectiveness in helping smokers quit, it is extremely likely that the debate will go on. Those who are concerned about making the problem worse will be reticent to endorse e-cigs as a public health policy, while those who are convinced that e-cigs are safe enough will continue to advocate for wide spread adoption.
Learn more about our evidence-based and proven tobacco cessation services.
Sure, you can order an apple pecan chicken salad at Wendy’s. And McDonald’s has launched its Egg White Delight McMuffin. But don’t be fooled: Fast food as a whole isn’t getting any healthier.
A new study[i] of eight popular fast-food restaurants compared menu items from 1997-1998 and 2009-2010 and found paltry improvement in nutritional quality over the 14-year stretch. The study, published in the American Journal of Preventive Medicine, used the U.S. Department of Agriculture’s Healthy Eating Index, which ranks foods on a scale of 1 to 100.
In addition to McDonald’s and Wendy’s, the restaurants included in the study were Burger King, Wendy’s, Taco Bell, KFC, Arby’s, Jack in the Box, and Dairy Queen.
During the study period, the average score for all eight restaurants increased from 45 to 48. The new score is still well below the average American diet’s score of 55 — which itself is no high standard, given our high rates of obesity, diabetes, and other chronic conditions related to poor diet.
The study found minor improvements in meat, saturated fat, and calories from solid fats and added sugars. Scores didn’t budge at all for fruit, whole fruit, total vegetables, dark green and orange vegetables, legumes, total grains, whole grains, and oils. Scores for milk/dairy and sodium actually got worse.
The fast-food industry pays plenty of lip service to the importance of nutrition, so this study serves as a reality check. Earlier this year, McDonald’s boasted[ii] about the eight grams of whole grains in its chicken-sandwich buns and the smaller serving of fries in its Happy Meals. But fries are fries, and adding a few more whole grains to a low-fiber, chemical-laden white bun is hardly going to make a dent in the obesity epidemic.
Similarly, Taco Bell announced a campaign to make its menu items healthier — but not until 2020[iii]. For now, the restaurant promotes its “fourth meal” menu and its 970-calorie Volcano Nachos.
Fast food is a mainstay of the American diet; more than 25 percent of U.S. adults eat fast food twice a week. So until the industry dramatically improves the nutritional quality of its menu items, it will remain a major culprit in our country’s obesity epidemic.
But that doesn’t mean we need to eat what the industry is serving. Here at Alere Wellbeing, we’re passionate about helping companies usher in a new era of healthy eating. Through our Weight Talk program, we offer expert, one-on-one coaching to help employees make healthier food choices — and steer clear of those Volcano Nachos.
[i] http://www.sciencedirect.com/science/article/pii/S074937971300161X
[ii] http://www.sltrib.com/sltrib/entertainment2/56057810-223/mcdonald-nutrition-eat-calories.html.csp?page=1
In this episode of Weight Talk® with Dr. Lovejoy, we talk to Dr. Jennifer Lovejoy about the difference between healthy and unhealthy fats, and how to determine how much fat you need in your diet. Podcast host Reed Dunn talks to Jennifer Lovejoy, PhD, to learn how to look for fats at restaurants and how even one fatty meal can stiffen a person’s arteries.
Jennifer Lovejoy is a clinical expert specializing in nutrition, chronic disease, and weight loss through behavior change. She leads the clinical team who developed Alere Wellbeing’s Weight Talk program.
Listen to or download this podcast to learn the truth about fat.
Would your company benefit if more of your workforce arrived on time, in happy moods, and feeling mentally sharp? You can make it happen by inspiring them to bike to work.
Research has linked car commuting to stress, fatigue, compromised sleep, even missed work days due to sickness[i]; bike commuting, unsurprisingly, has the opposite effect[ii]. Folks who pedal to work not only are fitter and healthier than car commuters, but they also are more productive on the job, according to a survey of participants in Denver’s city-wide bike-commuting program.[iii] Bike to Work Day, sponsored by the League of American Bicyclists and held May 17th, just might get your workforce hooked. In San Diego, one out of five first-time commuters who participated in the city’s Bike-to-Work Day became regular bike commuters, according to a study by the San Diego Association of Governments[iv].
To get your company pedaling, offer incentives such as bike accessories or gift certificates donated by local shops. And when employees offer up all the reasons they “can’t” ride to work, counter with the following solutions.
The obstacle: “I don’t feel safe riding in traffic.”
The answer: Ask your local bike-advocacy organization for low-traffic, bike-friendly routes, and post links to them or maps via email or in the break room. Match novice cyclists with veteran commuters, who can show them the ropes. Remind employees that, legally, bikes are vehicles, so cyclists need to stop at stop signs and use turn signals. When cyclists project confidence and take up the space they are entitled to, they’re safer than when they hug the curb.
The obstacle: “I don’t have time.”
The answer: Cycling can actually save time, since cyclists spend less time sitting in traffic, hunting for parking, and visiting the gym. In some traffic-clogged cities, cycling to a destination is faster than driving. As a bonus, riding through town at 10 mph makes cyclists feel connected to their communities in a way that doesn’t happen when they’re surrounded by steel and glass.
The obstacle: “I don’t want arrive at work sweaty.”
The answer: Bike commuting isn’t like riding the Tour de France! In most cases, it’s similar to taking a brisk walk: showering afterward just isn’t necessary. A synthetic bike top and a fresh change of clothes will suffice.
The obstacle: “I’m not fit enough to ride.”
The answer: Novices can simply ride at an easy pace. They’ll be in great shape soon enough.
The obstacle: “I have too much stuff to carry.”
The answer: For extra clothes, a laptop, and a briefcase, all a cyclists needs is a pannier or two.
The obstacle: “I don’t want to suck vehicle exhaust.”
The answer: The health benefits of bike commuting far outweigh the risks of breathing in vehicle exhaust. A 2010 Dutch study found that commuters who switch from a car to a bike gain an estimated three to 14 months of life, compared to a lost of .8 to 40 days lost from pollution.[v]
The obstacle: “I’m no bike mechanic.”
The answer: A quick lesson — from a friend or a bike shop — on changing a tire will give a cyclist confidence, but flats are rare when riding wide tires on city streets.
For more ideas on how to get your employees moving, check out our Healthy Worksite Thought Starters.
In yet another example of how powerful an individualized approach to health care can be, a long-running Danish study recently announced that setting personal treatment goals can cut the risk of diabetes-related complications by up to 20 percent.
The study, Diabetes Care in General Practice, has been running for more than 20 years. During that time, 745 general practitioners have been working with 1,428 type 2 diabetes patients. Half of the doctors have been educated on how to leverage lifestyle changes and the patients’ own preferences in the fight against the disease. The results show that the patients treated by the general practitioners who received the specialized education significantly reduced their risk of suffering a heart attack and other diabetes-related complications.
One of the most compelling aspects of this study is the powerful impact that relatively simple changes in habit can have. The doctors involved were more inclined to treat diabetes through lifestyle changes than medication. As a result, their patients had the opportunity to experience firsthand the effectiveness of their own efforts in the areas of nutrition, exercise and weight management. Even six years after the diagnosis, almost one-third of the diabetes patients were able to manage their blood sugar simply by changing their eating habits.
These findings are applicable, of course, to the millions who currently suffer from diabetes as well as their employers, many of which struggle to meet the financial demands of rising health premiums and productivity lost to illness.
This study also has implications for those with prediabetes. That’s a term used to describe the elevated blood-sugar levels that put people squarely into the danger zone for developing diabetes. According to the Center for Disease Control and Prevention (or CDC), of the 79 million Americans with prediabetes, only 11 percent are aware of their condition.
Finally, the Danish study’s findings apply to the work we do here at Alere Wellbeing. We believe that individualized coaching is essential for empowering people to attain and sustain better health through weight management. That’s why coaching is the cornerstone of our Weight Talk program, offered in collboration with the American Diabetes Association, which has already helped thousands of employees overcome the challenges that many among your workforce face as well.
The office soda machine has taken another hit: A British study has found that drinking just one sugar-sweetened beverage a day raises the risk of developing type 2 diabetes by 22 percent.
Researchers at Imperial College London compared 12,000 people who developed diabetes with a group of 16,000 who did not. All were part of an ongoing study, the European Prospective Investigation into Cancer and Nutrition, which tracks the dietary habits of a half million adults in 10 European countries.
If the British findings sound familiar, it’s because they echo the results of a 2010 study conducted in part by the Harvard School of Public Health[i]. In that paper, which pooled the results of eight studies, participants who drank one to two sugary drinks per day — whether soda, energy drinks, or sweetened teas — had a 26 percent greater risk of developing type 2 diabetes risk than those who consumed less than one sugary drink per month.
Plenty of research has linked sugar-sweetened beverages with obesity, but these are the first large studies to connect sugary beverage consumption directly with type 2 diabetes, independent of weight.
The British and American findings may differ slightly, but the researchers’ message is the same: sugary beverages harm health.
This message doesn’t seem to be making an impact on the American public, which continues to gulp Big Gulps.
Since the late 1970s, daily consumption of sugar-sweetened drinks has jumped from 64 calories per person per day to 142 calories.[ii] On any given day, half of Americans consume sugary drinks; one in four get at least 200 calories from these drinks, and 5 percent get at least 567 calories—equivalent to four cans of soda.[iii]
Each 20-ounce bottle of soda contains 15 to 18 teaspoons of sugar and 240 empty calories. A 12-ounce can of sugar-sweetened soda contains 9 to 11 teaspoons of sugar and about 140 calories.
Researchers suspect sugary beverages promote diabetes in multiple ways. For starters, liquid calories don’t register with the brain’s appetite controls the way solid food does. As a result, soda drinkers don’t compensate for the calories they sip by eating less and are prone to weight gain. Obesity, of course, is strongly linked to diabetes.
What’s more, sugary drinks have a high glycemic load; in other words, they spike blood-sugar and insulin concentrations — and quickly. These spikes can lead to insulin resistance, inflammation and other processes linked with type 2 diabetes.
Though the British study’s findings are new, it’s not exactly news that sugary beverages expand our waistlines and damage our health. And yet, as a nation, we can’t seem to stop drinking them.
This is partly because soda is carefully engineered to be addictive, as New York Times reporter Michael Moss reveals in his must-read book Salt Sugar Fat. It’s also because of the sophisticated way that sugary beverages are marketed.
In the face of these challenges, how can soda lovers kick the habit? That’s where Alere Wellbeing’s Weight Talk program can help. Alere’s highly trained coaches know what it takes to combat the powerful forces that draw a workforce to the soda machine.
Based on two recent studies, rheumatoid arthritis has joined the list of costly and debilitating conditions strongly linked to lifestyle factors such as cigarette smoking and diabetes.
Also known as rheumatoid disease, rheumatoid arthritis is a chronic, progressive and disabling autoimmune disease that causes inflammation and pain in the joints, the tissue around the joints and other organs. According to the Johns Hopkins Arthritis Center, the condition affects 1 to 2 percent of the population worldwide, and the prevalence jumps to an estimated 5 percent for women over age 55. Rheumatoid arthritis is two to three times more common in women than in men.
One of the studies, led by Ian Bruce, M.D., a professor of rheumatology at the University of Manchester (U.K.), found that smoking, obesity and having diabetes were all independent risk factors for developing rheumatoid arthritis. The study followed more than 25,000 men and women ages 40 to 79 for a number of years, comparing the 184 participants who developed arthritis with those who did not.
The other study, conducted by researchers at Sweden’s Karolinska Institute and Karolinska University Hospital, found that smoking just one to seven cigarettes a day can double a woman’s risk of developing rheumatoid arthritis. Based on data from the Swedish Mammography Cohort, the study included 34,000 women ages 54 to 89, 219 of whom developed RA.
Comparing women who had never smoked with those who had smoked for up to 25 years, researchers found that the longer the women smoked, the more likely they were to develop rheumatoid arthritis. The good news: Quitting smoking lowered their risk of developing RA by one-third over 15 years.
Health care costs related to rheumatoid arthritis –a portion borne by employers – are staggering, reaching $19.3 billion annually in the U.S. alone. This estimate includes $8.4 million in direct costs to treat RA and $10.9 billion to treat consequences of the disease, according to the National Institutes of Health.
Helping employees reduce their risk factors for rheumatoid arthritis could save your organization considerable costs. Learning more about Alere Wellbeing’s Quit for Life and Weight Talk programs — designed to help employees overcome tobacco addiction and weight challenges — is a great place to start.
Jennifer Lovejoy, PhD, Senior Vice President, Clinical & Quality Support
Alere Wellbeing’s exciting new collaboration with the American Diabetes Association was announced today. It brings the experience and expertise of a world-class professional association to employers wanting to offer an evidence-based weight loss program to their employees.
The American Diabetes Association is the recognized leader in advocating for people affected by diabetes, pursuing a broad agenda to fight against this deadly disease and its complications. When I was a full-time research scientist, I always looked forward to attending the American Diabetes Association annual scientific meetings which, then as now, gathered the brightest scientists and clinicians in the world to present the latest research on diabetes treatment and prevention. I was also fortunate early in my career to be the recipient of a career-development grant from the Association – a key factor in my decision to study obesity and diabetes for many years. The American Diabetes Association provides a significant amount of research funding in both basic and clinical science – inspiring generations of diabetes investigators and leading the way in innovation in the field.
Alere Wellbeing and the American Diabetes Association have united in this new collaboration in recognition of the fact that obesity is a leading cause of type 2 diabetes and that modest weight loss is effective at preventing diabetes onset and reducing the complications of diabetes once it develops. We also agree that the workplace is an important target for diabetes prevention and management efforts. The Stop Diabetes @ Work initiative of the American Diabetes Association exists to support employers in creating a healthy workplace environment that promotes diabetes prevention and reduces diabetes risk for employees, while Alere Wellbeing’s Weight Talk® and Weight Talk® D programs provide convenient, effective one-on-one phone coaching to employees.
The agreement is very timely given our recent launch of Weight Talk® D, a weight loss program tailored specifically for individuals with type 2 diabetes. Participants work with a Registered Dietitian as their designated coach over 6 months, working through the evidence-based Weight Talk curriculum. Because losing weight can be especially challenging for people with diabetes, the coaching calls and content are tailored to the unique needs of this population.
The collaboration between Alere Wellbeing, a leader in worksite behavioral health coaching, and the American Diabetes Association provides employees who are dealing with type 2 diabetes, as well as those with prediabetes who are trying to lower their risk for developing the disease, with state of the art support, education, and resources. How can our team help support your employees with diabetes and pre-diabetes?
For more information on the collaboration, take a look at the press release.
To learn more about Weight Talk®
visit our website.
To many, common sense suggests that limiting the size of soda servings represents a solid step toward reducing consumption of sugared beverages. It’s the logic behind many efforts not to – rather than trying to eliminate certain products , instead limit consumption of those products. Thus far, the campaign that’s achieved the most notoriety is in New York City, where Mayor Michael Bloomberg’s initiative to limit the size of sugared beverage servings has been a source of ongoing controversy.
While some hold up the initiative as a prime example of government overstepping its bounds, many consider the mayor’s efforts a necessary and critical part of the battle against obesity and its related conditions and illnesses
As is often the case with controversial issues, there is very little agreement. According to an article published earlier this month, a group of California researchers believes that restricting larger-size sodas may actually increase overall soda consumption. (In case you’re wondering, you did read that correctly.)
The study was conducted by Brent M. Wilson of the University of California San Diego and his colleagues. Specifically, the researchers conducted a behavioral simulation driven by the question of whether or not putting size limits on sugary drinks would be effective.. The simulation was conducted by offering participants menus in which drink options varied:
- One menu offered 16-, 24-, and 32-ounce drinks
- One had 16-ounce drinks, a bundle of two 12-ounce drinks and a bundle of two 16-ounce drinks
- One offered only 16-ounce drinks
The researchers found that participants who ordered from the menu with bundled drink options bought significantly more soda that those who ordered from the menus with a variety of drink sizes.
For businesses that profit from soda sales, the message of the research is fairly clear: If the drink size is limited there’s a strong business incentive to offer bundles of soda. “Restricting larger-size drinks,” the authors wrote, “may have the unintended consequence of increasing soda consumption rather than decreasing it.”
This study, like many others, reminds us at Alere Wellbeing of the critical importance of intrinsic rather than extrinsic motivation when trying to achieve sustained behavior change. If you want your employees to make healthier choices, policy changes will only go so far. For lasting behavior change, consider a program like Weight Talk®, our personalized weight loss coaching program that teaches people how to overcome the physiological, psychological, emotional, and behavioral issues that contribute to obesity
In 2010, after conducting a survey of the height and weight of students at each grade level to determine their Body Mass Index (or BMI), the superintendent of the Chula Vista Elementary School District in suburban San Diego, Calif., was not pleased to learn that 40 percent of the students were overweight or obese. “It was not a good picture,” Francisco Escobedo said when interviewed for an article published recently by the San Diego Union Tribune.
In response to the sobering findings, Escobedo and other district officials worked together to craft what they called a multi-faceted policy that promotes physical activity while also eliminating unhealthy snacks and food celebrations from the school days. In fact, at the beginning of this school year last July, the district removed flavored milk from meal offerings, a move reported as “the ultimate death knell to sweets.” In conjunction with these steps, at every school board meeting principals urged campus trustees to do their part for the effort by encouraging physical activities such as running clubs and to install salad bars to demonstrate the district-wide commitment to better health and nutrition.
To gauge the effectiveness of its efforts, the district weighed and measured more than 25,000 students in prekindergarten through sixth grade and learned that obesity rates have fallen by 3.2 percent since the first survey.
Commitment to encourage students to lose weight and adopt healthier exercise and nutrition habits did not stop at the schoolhouse doors. Examples of community involvement in the effort include:
- Focusing more attention on the Safe Routes to School programs, which include improving sidewalks and pedestrian access to schools
- Encouraging local markets to provide healthier options
- Renewing and reaffirming the commitment to school and community garden projects by helping teachers incorporate nutrition education into their curriculum
- Getting everyone moving with Zumba, which was included in wellness fairs
In addition to the community’s involvement in the effort, the benefits of the policy extend beyond the school grounds as well. “In addition to the life-health issue, we are saving our society hundreds of thousands of dollars in health care costs by reducing the number of obese children today,” said Escobedo.
Employers today are facing the same problems with their employees. What are you doing to encourage your workforce to lose weight and adopt healthier nutrition and exercise habits? How does your worksite environment support or hinder those efforts?
We’ve created a free tool to help you evaluate the health of your worksite and get ideas for improvement.
If you’re on your way to creating a healthy worksite environment, consider taking it a step further with our personalized weight loss coaching program, Weight Talk®.