Preventive Medicine

Los Angeles has one of the highest diabetes-related amputation rates in the country. Yet vascular surgeon Dr. George Andros can't seem to draw enough attention to the problem, which has skyrocketed not just here but nationally. "It's not sexy," he acknowledges. "Who cares about diabetic feet? It has no sizzle." Over the last 15 years, the U.S. rate of foot amputations from complications of diabetes has soared, approaching 100,000 annually, according to studies and government statistics.

Americans eat too damn much. And we all pay a rising cost for this gluttony in the form of higher insurance premiums and lost productivity. A study last year by the Society of Actuaries calculated the total economic cost of an overweight and obese population in the United States and Canada at about $300 billion a year (with 90% of that figure attributable to America's dietary issues). Now comes word from the American Journal of Preventive Medicine that, if current trends continue, about 42% of the U.S. population will be obese by 2030.

Americans eat too damn much. And we all pay a rising cost for this gluttony in the form of higher insurance premiums and lost productivity. A study last year by the Society of Actuaries calculated the total economic cost of an overweight and obese population in the United States and Canada at about $300 billion a year (with 90% of that figure attributable to America's dietary issues). Now comes word from the American Journal of Preventive Medicine that, if current trends continue, about 42% of the U.S. population will be obese by 2030.

The Obama administration's willingness to defend insurance coverage for family planning services against attacks from conservatives and religious groups is good news for women and for the health of the nation. Last year, the administration first proposed that, like other preventive medical goods and services, contraception and general family planning coverage should be available under the healthcare reform law without a co-payment or deductible. Not just churches but many of their affiliated organizations protested — with the backing of conservative Republicans — that they should not have to pay to provide insurance coverage for medical services that run counter to their beliefs.

A new state program that went into effect this month requires HMOs and health insurance plans to provide free, comprehensive annual physicals to millions of New Jersey adults. The New Jersey Health Wellness Promotion Act, described as the first of its kind in the nation, requires many insurers to provide a 17-point "Healthful Life Program" aimed at encouraging more healthful living and catching problems early. Already, creator Dr. Donald B.

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It seems it never ends. Once you've set up a portfolio, conventional wisdom says, you're supposed to rebalance it--reevaluating annually, looking at what's gotten out of whack and shifting money away from the winners and toward the losers. Guess what? Going through the hassle of rebalancing wouldn't have made a heck of a lot of difference to your portfolio's performance over the last two decades. Nonetheless, rebalancing is a sound strategy and still may prove helpful.

Exercise can help older people avert a form of arthritis that can turn ordinary activities such as getting out of bed into a painful, perhaps impossible, chore, a study finds. Those who regularly walked or did weight training were less likely to lose abilities to perform activities of daily living, such as getting out of bed, the study says.

Childhood vaccinations and anti-smoking counseling for adults are the most effective preventive medicine, says a new study that ranks medical services based on how many lives they save and how much they cost. The findings also suggest that some of the best preventive measures--such as screening for colon cancer and warning teenagers about drugs--are reaching surprisingly few Americans.

To stay healthy when you travel abroad, divide the world into three regions: Region I. Good Health Standards: most of Western Europe, Australia, New Zealand, Japan. Region II. Fair Health Standards: Greece, Spain, Portugal, southern Italy, Eastern Europe, Israel, Singapore, South Africa, the islands of the Caribbean (except Haiti and the Dominican Republic). Region III. Unreliable Health Standards: Mexico, Central and South America, Africa, most of Asia, Haiti and the Dominican Republic.

Going to see the doctor for a checkup usually includes a chat about diet and exercise, especially if the patient is overweight. But those talks may not have any influence on shedding pounds, says a new study -- unless the doctor was motivating and empathetic. Conversations between 40 primary care physicians and 461 of their overweight or obese patients were recorded by researchers who wanted to see if weight was mentioned by the doctor and, if so, in what manner. Overall, doctors talked about weight in 69% of appointments, and that conversation took up an average 3.5 minutes, or 15% of a typical 20-minute visit.

"Is there an app for that?" When it comes to consumer healthcare applications for smart phones, the answer, increasingly, is yes. There are now close to 6,000 consumer health apps, according to a review published in March by mobihealthnews, which reports on the mobile health industry, and more are being added every day. Many are free, or cost $1 to $10 to download. Some physicians are concerned about the reliability of the medical information provided by many of these apps, which offer advice and information on a wide array of health topics, including how to find a doctor, first aid for an emergency and exercise instructions.

Setting the pace Getting 10,000 steps per day roughly coincides with the latest U.S. Department of Health and Human Services recommendation that adults get a minimum of 150 minutes of moderate-intensity exercise per week. The key word here is "moderate" -- not all steps meet that requirement. Shuffling around the kitchen making dinner is hardly equivalent to racing to catch a bus or walking an energetic dog. Any movement is good, of course, but to make the steps count as beneficial as possible, they should be fairly sustained.

It seemed like a good idea at the time. In 1984, Japan began screening the urine of 6-month-old infants for neuroblastoma, the most common type of solid tumor in young children. The test was simple and could show signs of cancer long before clinical symptoms arose. Hundreds of infants went through the ordeal of diagnosis and treatment, but it didn't reduce the number of tumors, including deadly ones, found later. Almost none of the tumors caught by screening turned out to be dangerous -- and more of the screened children died from complications of surgery and chemotherapy than from the cancer itself.

Healthcare giant Johnson & Johnson is jumping into the increasingly hot vaccine business by taking an 18% stake in Dutch biotechnology company Crucell and focusing more on preventive medicine. Under the deal, Johnson & Johnson is spending 301.8 million euros ($440 million) for new shares of Crucell in a deal focused initially on developing a universal vaccine or treatment against influenza from Crucell's genetically engineered antibody technology.

Rafael Furcal tapped his knuckles on the armrest of his chair. "I can say that the only games I was forced to sit out this season had nothing to do with my back," he said. "I had an extremely complicated surgery. It wasn't easy to come back." Looking off into the distance, Furcal recalled his off-season workout program. He talked about the two rounds of special exercises he does every day to prevent a reoccurrence of the back problems that haunted him last season -- the first round, shortly after showing up at the ballpark; the second, after batting practice.

"Age fast, age slow--it's up to you." That's the message of Dr. Kenneth H. Cooper, the man who coined the term "aerobics" with the publication of his 1968 best-seller of the same name. Cooper, founder and president of the Aerobics Center in Dallas, brought his message to the Crystal Cathedral on Friday, the final day of the three-day "Prime Time: A Possibility Thinkers Conference for Retired Persons (and Those Anticipating Retirement)."

Doctors recommend against eating more than 2,300 milligrams of sodium a day. Order a Denny's double cheeseburger and you'll consume 3,880 milligrams in one sitting, almost double the suggested daily allowance of salt. Denny's meals "are dangerously high in sodium," according to a lawsuit filed Thursday by a New Jersey man with the support of the Center for Science in the Public Interest, a nonprofit group active in nutrition and food safety issues.

Los Angeles has one of the highest diabetes-related amputation rates in the country. Yet vascular surgeon Dr. George Andros can't seem to draw enough attention to the problem, which has skyrocketed not just here but nationally. "It's not sexy," he acknowledges. "Who cares about diabetic feet? It has no sizzle." Over the last 15 years, the U.S. rate of foot amputations from complications of diabetes has soared, approaching 100,000 annually, according to studies and government statistics.