the epidemic of pre-diabetes, ineffective health campaigns, and why i try to take such good care of myself

WHY GOVERNMENT HEALTH CAMPAIGNS DON’T WORK IS PART OF WHY I TRY TO TAKE SUCH GOOD CARE OF MYSELF

Public Health Campaigns

Although the study we are about to discuss supplies no new information (HERE), it helps us to understand just how big the wave of PRE-DIABETES (Insulin Resistance) sweeping across our nation like sugar-coated tsunami really is.  Take, for instance, sunny California. 

California, like Florida, is an important state as far as non-grain related agriculture is concerned.  This means that if you live in California, you probably have better year-round access to FRESH FRUITS AND VEGETABLES than the rest of us.  On top of that, because of the warm climate, Californians are not cooped up indoors for months at a time, waiting for the big thaw to occur.  This means that at least in theory, Californians should be both eating better and more active than the rest of us.   Despite the potential advantages that these two points provide Californians, a brand new study from UCLA tells us it’s not working out so well.

“In California, more than 13 million adults (46 percent of all adults) are estimated to have prediabetes or undiagnosed diabetes. An additional 2.5 million adults have diagnosed diabetes. Altogether, 15.5 million adults (55 percent of all California adults) have prediabetes or diabetes.”

This is crazy folks.  In the lowest county in the state (Lake County), over one in four adults had Prediabetes.  Once you understand that virtually all health problems — including most that people enjoy blaming on BAD GENETICS — are arguably and intimately linked to BLOOD SUGAR issues, you can begin to see how big and ugly this problem really is.  This can be true even though one’s blood tests are “normal”.  The UCLA Newsroom (Majority of California Adults have Prediabetes or Diabetes) spells it out for us.  Remember that one of the catchwords for this decade is “sustainability”.  This next quote provides some insight into just how unsustainable our current healthcare trajectory really is.

This is the clearest indication to date that the diabetes epidemic is out of control and getting worse…..  [Thanks to] a preponderance of soda and junk food marketing, and urban neighborhoods lacking safe places to play, we have created a world where diabetes is the natural consequence. If there is any hope to keep health insurance costs from skyrocketing, health care providers from being overwhelmed and millions of Californians from suffering needlessly from amputations, blindness and kidney failure, the state of California must launch a major campaign to turn around the epidemic of type 2 diabetes.”

Campaigns.  They’re the easiest way to approach problems like this.  It’s why everyone looks to throw money at the problem by creating yet another Public Health Campaign (Don’t Smoke, Don’t Drink, Don’t do Drugs, GET YOUR ANNUAL PHYSICAL, GET YOUR MAMMOGRAM, GET YOUR COLONOSCOPY, DON’T EAT EGGS OR RED MEAT, etc, etc, etc).  This begs the question of how effective PSA’s and ‘Health Campaigns’ really are in relationship to the billions of dollars being spent on them each year? 

According to any number of sources (almost all being GOVERNMENT or government-related), Health Campaigns are incredibly effective.  They help people stop the bad habits that are destroying them, or show them how early diagnosis creates the best pathway to health (WHICH IS, UNFORTUNATELY, A HUGE MISNOMER).  We know, however, from the miserable failure known as the ‘War on Drugs’ that what works in theory and what works in reality, are often as distant from each other as medical practice is from medical research (HERE).

In similar fashion to the way that industry-driven anti-tobacco and anti-drinking campaigns for children have actually worked in reverse (probably because there is a vested interest by these industries in seeing kids drink and smoke — if they don’t start young, research says they are much less likely to ever start), why should we believe that other types of ‘Health Campaigns’ will fare any better?  Face it; BIG PHARMA is big business.   And don’t kid yourself; even though individual doctors typically want to see a healthier population, drug companies and the healthcare industry at large do not.   Let’s look at some of the evidence to show that “Campaigns” are failing; or at the very least, not living up to expectations.

  • Writing for Ad Age (Whatever Happened to the Ad War on Drugs?), EJ Schultz recently wrote, “After peaking at a rate of some $1 million in media time a day in the late 1980s, anti-drug campaign airtime has been on a steady decline. The reasons range from government cutbacks to competition from a range of causes such as fighting cancer and curbing texting while driving. Advertising’s role in the war on drugs has been heavily scrutinized and criticized over the years, but recent studies suggest that some messages might be getting through, at least to a certain percentage of teenagers.”  What percentage of teens might Schultz be talking about here?   We’ll get there in a moment, but suffice it to say it’s not nearly as big as you’ve been led to believe it is.
  • Writing for Linked In, Pat Kelly wrote a critique of Canada’s latest misguided effort in their War on Drugs called BustedHealth Canada’s Anti-drug Campaign.  Despite acknowledging Canada’s youth drug problem, she said, “This post offers Lessons Learned from a wrong-headed and bad-hearted campaign targeting drug use among young Canadians.
  • The Journal of Health Communications (A 10-Year Retrospective of Research in Health Mass Media Campaigns: Where Do We Go From Here?) published a study in 2006 that stated, “Mass media campaigns have long been a tool for promoting public health. How effective are such campaigns in changing health-related attitudes and behaviors?  The overriding conclusion is that the literature is beginning to amass evidence that targeted, well-executed health mass media campaigns can have small-to-moderate effects…”  Did you catch that?  The best you can hope for is small to moderate effect.
  • From an Australian newspaper (The Age),Richard Baker and Nick McKenzie wrote in May of last year that, “When it comes to warning young people about the dangers of drugs, shock and awe advertising campaigns are a turn off, according to confidential research commissioned by the federal government.   2013 research advised that a “drugs are bad” approach to advertising had no credibility with a young target audience. Instead, it found advertising campaigns needed to accept that people take drugs for a reason and provide a “harm minimization” message rather than “zero tolerance”.  Any consequence that feels overblown is likely to be seen as scare-mongering and therefore be less likely to be considered or have an impact.”  Easy solution; just tell them that DRUGS ARE GOOD.
  • Last October, Robert Montenegro wrote an article for Think Big called Anti-Bullying Campaigns Still Largely Ineffective.  In it he stated, “According to researchers at Clemson University, campaigns such as NBPM are falling on deaf ears in all age groups. Bullying is still a big problem and doesn’t appear to be slowing down anytime soon.  Whether or not you buy into the notion that we’re in the midst of a bullying epidemic, the studies speak for themselves: Between 1 in 3 and 1 in 4 teens in America now say they’ve been bullied in some form or another. More than half say they’ve witnessed it. There’s bullying happening in the workplace; there’s bullying happening against teachers.
  • For the September 18, 2014 issue of the Johns Hopkins News Letter, Joan Yea wrote an article called “Drink Responsibly” Campaigns Found to be Ineffective.
  • Writing for a September 2014 issue of the Daily Caller, Eric Owens’ article, Michelle Obama’s ‘Let’s Move’ Campaign Fails Miserably says it all with its title.  Owens’ goes on to reveal that, “So far, things aren’t going well. The latest data on kid fitness suggests that 3 in 4 kids aged 12 to 15 fail to meet the federal government’s minimum recommendations of an at least an hour of vigorous activity each day.  Federal researchers would not express disappointment in a statistic showing that fully 75 percent of American kids don’t do a bare minimum of exercise each day.  ‘There’s always room for improvement,’ said Tala Fakhouri, an optimistic scientist at the Centers for Disease Control and Prevention who was the lead author of the study.  It’s definitely very concerning to see that our kids are engaging in such a limited amount of physical activity each day when we are still battling the national obesity problem, said Stephen Pont, chairman of the American Academy of Pediatrics’ section on obesity.” 
  • Speaking of Obesity, the medical journal BioMed Central published a study in Feb of 2011 (Public Health Campaigns and Obesity – A Critique) that concluded, “Controlling obesity has become one of the highest priorities for public health practitioners in developed countries. In the absence of safe, effective and widely accessible high-risk approaches (e.g. drugs and surgery) attention has focused on community-based approaches and social marketing campaigns as the most appropriate form of intervention. However there is limited evidence in support of substantial effectiveness of such interventions. To date there is little evidence that community-based interventions and social marketing campaigns specifically targeting obesity provide substantial or lasting benefit.
  • A year later, the journal Current Obesity Reports (Public Health Messages: Why Are They Ineffective and What Can Be Done?) came to essentially the same conclusion.  “Programs to address obesity that are largely based around health education alone have been unable to produce any significant improvements in body fatness.

A brand new study published in last month’s issue of the British Medical Journal (The Impact of Communicating Genetic Risks of Disease on Risk-Reducing Health Behavior: Systematic Review with Meta-Analysis) sums up the magnitude of this problem in a couple of cherry-picked paragraphs. 

“Searching for gene variants associated with risks of common complex conditions, including diabetes and various cancers, continues to receive considerable attention.  Although the main target of such research is more effective treatments, more precise prediction of disease has also been anticipated.  Our results are consistent with the third, suggesting that high expectations of the potency of such communications to change behavior are unfounded. This is consistent with the results of a recent cohort study reporting no impact on diet or physical activity of direct-to-consumer genome-wide testing. It is also in accord with the results of a Cochrane review in which the authors concluded that the current evidence does not support the hypothesis that biomedical risk assessment increases smoking cessation.

The theoretically oriented literature on behavior change also highlights the typically small effect of risk communication on behavior.  The one large and well conducted trial included in this review that assessed the impact of DNA risk communication on colorectal screening found no effect on uptake. The available evidence does not provide support for the expectations raised by researchers and proponents of personalized medicine as well as direct-to-consumer testing companies that the receipt of results from DNA based tests for gene variants that confer increased risk of common complex diseases motivates behavior change.”

What does this mean in English?  It means that even those who have spent the money from out of their own pockets to undergo genetic testing in order to make themselves aware of their predisposition toward certain specific health problems, aren’t doing jack diddly about it.  If personalized data is not enough to motivate people to modify their behavior, do you really think that impersonal Campaigns such as “IF YOU MUST DRINK SODA, MAKE IT DIET” are going to work any better?  Of course not! 

Even though some of these “Health Campaigns” help on some small level, statistics clearly reveal that we are FATTER, SICKER, and struggle with more CHRONIC PAIN, DEPRESSION, and ADDICTION than any generation in history — even though we are living longer (HERE).  This despite the fact that we both spend more money on healthcare and consume more drugs than any other society since the beginning of recorded history (approximately 75% of the world’s medications according to the CDC — HERE).  Sicker, but living longer — it’s a drug company’s wet dream.  And that does not even begin to touch on the ways that Health Campaign statistics are fudged and finagled.

As I noted earlier, the people and organizations who squawk the loudest about the huge benefits of Health Campaigns are almost always the people who, in the words of Steve Miller’s famous song, “make their living off other people’s taxes.”   These are governmental organizations or universities who receive tax monies for the express purpose of studying, creating, and modifying said Campaigns.  And as the old saying goes, figures never lie, but liars figure

Once you understand the numerous ways you are being bamboozled with “EVIDENCE-BASED MEDICINE” it will come as no surprise that the “New Math” used to calculate the effectiveness of the Health Campaigns you are constantly being blitzed with, is murky at best. Not sure what I’m talking about?  Take a look at a statement made on Mental Health dot com (When Is A Difference Between Two Groups Significant?).   By the way, I have seen this number as low as 7%.

“In mental health, the convention is that a 12% improvement or greater represents a clinically significant difference. This 12% is selected because antidepressant medications are, on average, 12% better than placebo in the treatment of moderate depression.”  

What is our national epidemic of unbridled Obesity and other INFLAMMATORY DISEASES doing to us other than destroying our health?  For one, it’s helping dig us into a financial hole we will never be able to climb out of.  Tack on exploding healthcare costs to our already out of control public and private indebtedness, and we can see a crisis looming on the horizon like an unholy mirage (HERE).  I’m not talking about an apocalyptic scenario that looks like something out of THOSE BOOKS by 90 year old evangelical mouthpiece, Tim LaHaye.  Nor am I suggesting that we try taking over the government Oregon-style.  I am simply reminding people that taking care of a chronic health crisis of this magnitude is — as the good doctor implied earlier — unsustainable, and could easily prove to be the straw that financially speaking, breaks the camel’s back.

We have have outstripped our collective ability to pay for the newest and latest medical technology. CANCER is a great example.  It has recently become America’s number one killer at a cost of well over one hundred billion dollars a year.  Yet when we GET DOWN TO BRASS TACKS, we see that things aren’t much better than they were forty years ago. The thing is folks, we don’t need more technology.  Technology might save your life, but it can’t make you healthy.  Sure; it promises you health.  But when you understand the difference between being alive and being healthy, you can see how hollow this promise really is.

What does this mean for Americans who are truly interested in their health?  It means you’ll have to step outside the box.  It means not trusting THE FDA.  It means having your babies in a more natural manner (HERE) and nursing them — or possibly nursing them longer (HERE).  It means staying away from chemicals (HERE), avoiding antibiotics and other drugs as though our lives depend on it (HERE), growing a garden (HERE), eating healthy foods (HERE), understanding Gut Health (HERE) and Inflammation (HERE), and on and on and on. 

Simplification is the solution.  Not technology.  Not that medical technology is somehow bad (although more often than we care to admit IT IS), but it is taking our focus away from the real problem at hand — ourselves and our COLLECTIVE ADDICTION TO HIGHLY PALATABLE FOOD.  Not to mention our sedentary lifestyles.  The cold-hard truth is, you can’t fix inflammatory problems like Type II Diabetes with drugs (HERE).   Most of what we struggle with health-wise on a day-to-day basis is self-inflicted, and the only way out is to totally revamp our lifestyles — LIKE THIS PERSON DID

SO DOC, WHAT DO YOU DO TO TAKE
SUCH GOOD CARE OF YOURSELF?

Today is my birthday (thus the St. Patty’s Day cake I won’t be eating).  How old am I?  This particular birthday brings to mind one of the little ditties I made up to teach MY KIDS their multiplication tables back in the day — seven times seven is kind of nifty; forty nine is almost fifty.  Although I certainly don’t look like I used to; nor am I able to physically do what I used to, I DON’T DO TOO BAD considering some of the speed bumps I’ve faced along the way. 

Because I work at taking care of myself, people who do not assume that it’s purely the result of good genetics sometimes ask two different questions, the first being, “What do you do to stay in such good shape doc?”  Truthfully, I try and live out the advice I provide on my site.  The other question, however, is more telling.  “Why bother“?  

I take care of myself because know that doctors aren’t going to do it for me.  They can’t.  Taking care of your health is not something someone else does for you — it’s something you have to do for yourself.  I plan on working a long time.  Not because I have to, but because it’s where I get to accomplish THE MISSION that God put me on earth for.  If I don’t take care of myself, how can I possibly take care of you?  Truth is, I was just like many of you (HERE) — living the HIGH CARB LIFESTYLE, and thinking nothing about it because I had not yet developed overt health problems.  Trust me, as you get older, you either change your ways or you fall into that pit we talked about earlier.  But that’s not the only reason I take care of my health,

I pay for my own healthcare.  When other people pay for your stuff (healthcare, cell phones, FOOD, housing, etc, etc, etc), there is a tendency not to appreciate it — to TAKE IT FOR GRANTED.  I’ve heard it time and time again in my clinic. “Doc; I’m not really interested in watching what I eat or exercising because I have really good insurance.  If I get sick I just go to my doctor and get some medicine.”  Few things chap me more than healthcare providers who don’t take care of their health (just the other day I took care of a Respiratory Therapist who was pack and a half a day smoker).  It’s my duty to lead from the front.

If you are interested in making real changes in your health, the first thing to do is study.  My site is a great starting point because I’m not trying to sell you anything.  The information is 100% free, and for the most part, is not something your doctor is going to share with you.  Maybe because he / she is to busy clicking their mouse and typing on their computer to talk to you — or for that matter, even touch you (HERE).  Or maybe it’s because they are PART OF THE PROBLEM.  Either way, it’s never too late to create your own EXIT STRATEGY and reinvent yourself.

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