NHS reforms likely to cost up to £3bn with no guarantee of improved performance

"I am romantic about the NHS; I love it. All I need to do to rediscover the romance is to look at health care in my own country." Donald Berwick, MD, head of the Centers for Medicare and Medicaid Services.

The radical reorganisation of the NHS in England is likely to cost between £2bn and £3bn to implement with no guarantee that it will improve performance or lead to better care for patients, warns an expert in an editorial published on bmj.com.

Kieran Walshe, Professor of Health Policy and Management at Manchester Business School says that there is very little evidence that past NHS reorganisations have produced much, or any, improvement, and argues that the new government “looks likely to make all these mistakes again.”

Few NHS reorganisations have been properly evaluated, writes Walshe, but a recent National Audit Office study of over 90 government reorganisations found that, despite huge costs, the benefits were unclear, the process was often poorly managed, and that its impact on performance was often adverse.

Oops.

For blood pressure, can you be fit but fat?

Another reason to lose the weight bronto sapiens - you cannot be fit and fat, just as we have been saying at Fitness Watch for years.

If you're trying to bring your blood pressure to healthy levels, a new study suggests that how much you weigh is more important than how fit you are.

As expected, the study found that overweight or obese people were more likely to have a high systolic blood pressure - the top number in a blood pressure reading. But for those with a high body mass index (BMI) - a measure of weight versus height -- how in shape they were only had a small impact on their blood pressure.

The results suggest that people who are trying to decrease their risk for high blood pressure should focus on losing weight however they can most effectively do that, the authors say, and that increasing physical fitness should be a secondary goal.

"Obesity is such a strong predictor of blood pressure or hypertension risk that having a normal body weight is really what's going to drive your blood pressure" rather than your fitness level, Dr. Susan Lakoski, a cardiologist at the University of Texas Southwestern Medical Center and one of the study's authors, told Reuters Health.

At least in terms of lowering your risk for high blood pressure, she said, "it's not realistic to be fit and fat."

Yup.

Do multivitamins improve student performance?

No.

...a daily multivitamin may not help students ace exams or even make it to school on time, suggests a new study of New Jersey elementary school kids.

The finding counters previous research that reported improved academic performance and behavior with supplements use, particularly for underserved children at risk of a poor diet.

"We wanted to design a study that would have readily translated into the real world, so that if the results were positive you could lobby for school-based programs," lead researcher Dr. Adam Perlman of the University of Medicine and Dentistry of New Jersey told Reuters Health. "Unfortunately, our research didn't show that."

More money wasted at Whore Foods.

Wise up.

'Lazy, militant, aggressive': NHS boss disciplined after withering attack on staff on Facebook

"I am romantic about the NHS; I love it. All I need to do to rediscover the romance is to look at health care in my own country." Donald Berwick, MD, head of the Centers for Medicare and Medicaid Services.

In an online discussion, David Forster said the NHS employed 'too many who are lazy, unproductive, obstinate, militant, aggressive at every turn and who couldn't secure a job anywhere outside the bloated public sector where mediocrity is too often shielded by weak and unprincipled Hr policies'.

Oops.

NHS should use term fat instead of obese, says minister

Whatever..

GPs and other health professionals should tell people they are fat rather than obese, England's public health minister says.

Anne Milton told the BBC the term fat was more likely to motivate them into losing weight.

She said it was important people should take "personal responsibility" for their lifestyles.

But health experts said the word could stigmatise those who are overweight.

Ms Milton, who stressed she was speaking in a personal capacity, said: "If I look in the mirror and think I am obese I think I am less worried [than] if I think I am fat."

She said too many staff working in the NHS were worried about using the term, but suggested it could help encourage "personal responsibility".

"At the end of the day, you cannot do it for them. People have to have the information," she added.

But they still won't act on it.

The "information" has been out there for, like, ever.

Face it. The fat simply will not act until they have to experience the consequences of their caloric irresponsibility absent the rest of us paying for their rescue.

'Excellence' centers no better for bariatric surgery

Oops.

For weight-loss surgery, "Centers of Excellence" may not be any safer than their undistinguished peers, a study of 25 Michigan hospitals suggests.

Just as well. IMHO malpractice is malpractice no matter where it is committed or how excellently it is done.

Dog eats Rockford man's big toe, saves his life

A heartworming tail of fat person diabetes.

Dogs that bite are not ordinarily lavished with praise, but Jerry Douthett's little dog Kiko is being hailed as a lifesaver.

Kiko apparently sensed an infection festering in his master's right big toe -- and chewed most of it off after Douthett passed out in a drunken stupor.

A trip to the hospital confirmed Douthett's digit required amputation, and Kiko is being heralded by his owner for helping him realize he has been suffering from Type 2 diabetes. Douthett had a dangerously high blood-sugar level of 560 when admitted -- many times the recommended 80 to 120.

"Jerry had had all these Margaritas, so I just let him sleep," said his wife, Rosee, a registered nurse. "But then I heard these screams coming from the bedroom, and he was yelling, 'My toe's gone, my toe's gone!'"

Good nurse, good dog, good riddance toe, good set of chins there, Jer.

Quality-Adjusted Life Years Lost to US Adults Due to Obesity More Than Doubles from 1993-2008

Of course, the loss in quality of life is only about the fatsos. There is no caring about the loss in quality of life for the rest of us who are expected to and do underwrite the repair and rescue of the calorically irresponsible.

Although the prevalence of obesity and obesity-attributable deaths has steadily increased, the resultant burden of disease associated with obesity has not been well understood. A new study published in the September issue of the American Journal of Preventive Medicine indicates that Quality-Adjusted Life Years (QALYs) lost to U.S. adults due to morbidity and mortality from obesity have more than doubled from 1993-2008 and the prevalence of obesity has increased 89.9% during the same period.

Using data from the 1993-2008 Behavioral Risk Factor Surveillance System, the largest ongoing state- based health survey of U.S. adults, Haomiao Jia, PhD, Columbia University, and Erica I. Lubetkin, MD, MPH, The City College of New York, examined trends in the burden of obesity by estimating the obesity-related QALYs lost, defined as the sum of QALYs lost due to morbidity and future QALYs lost in expected life years due to premature deaths, among U.S. adults. They found the overall health burden of obesity has significantly increased since 1993 and such increases were observed in all gender and race/ethnicity subgroups and across all 50 states and the District of Columbia.

"The ability to collect data at the state and local levels is essential for designing and implementing interventions, such as promoting physical activity, that target the relevant at-risk populations," according to Dr. Lubetkin. "Although the prevalence of obesity has been well documented in the general population, less is known about the impact on QALYs both in the general population and at the state and local levels….Our analysis enables the impact of obesity on morbidity and mortality to be examined using a single value to measure the Healthy People 2020 objectives and goals at the national, state, and local levels and for population subgroups."

From 1993 to 2008, the obesity prevalence for U.S. adults increased from 14.1% to 26.7% (89.9%). Black women had the most QALYs lost due to obesity, at 0.0676 per person in 2008, which was 31% higher than QALYs lost in black men and about 50% higher than QALYs lost in white women and white men. A direct correlation between obesity- related QALYs lost and the percentage of the population reporting no leisure-time physical activity at the state level also was found.

The prevalence of obesity increased over time for all states, while obesity-related QALYs lost tended to follow a similar pattern. However, disparities among states lessened over time, with less obese states "catching up" to more obese states and producing a greater percentage change of QALYs lost.

"Collaborative efforts among groups at the national, state, and community (local) levels are needed in order to establish and sustain effective programs to reduce the prevalence of obesity, "commented Dr. Jia. "Although the impact of current and future interventions on curtailing the burden of disease might not be available for a number of years, this method can provide an additional tool for the Healthy People 2020 toolbox by providing a means to measure objectives and goals. The availability of timely data would enable the impact of evidence-based interventions to be assessed on targeted populations and subgroups, promote continuous quality improvement through monitoring trends, and facilitate head-to-head comparisons with other modifiable health behaviors/risk factors and diseases."

As long as the rest of us are forced to repair and rescue the overfat, the problems they cause to themselves, their kids and the rest of us will not be solved.

Pregnancy-related diabetes likely to recur: study

Type 2 diabetes is fat person diabetes.

Pregnant women with a history of pregnancy-related diabetes, also called gestational diabetes, have a good chance of developing the condition again, suggests a large new study.

Researchers found that the risk of having gestational diabetes during a future pregnancy increases with each previously affected one -- from 41 percent after the first to 57 percent after two pregnancies complicated by gestational diabetes.

Gestational diabetes typically strikes during late pregnancy and is characterized by high blood sugar that results from the body's impaired use of insulin. While it rarely causes birth defects, complications can arise that threaten the health of both mom and baby...

The study, which was supported by funds from Kaiser Permanente, did not take into account lifestyle factors such as weight. This, the researchers say, limits the findings' applicability given that overweight and obesity -- now affecting approximately one out of every three women of childbearing age -- is thought to contribute to the recurrence of gestational diabetes.

The American College of Obstetrics and Gynecology and the American Diabetes Association both recommend that women at risk of type 2 diabetes be counseled on the benefits of modifying their diet, exercising and weight loss. This group includes those with a history of gestational diabetes.

"Early identification of at-risk populations and the timely initiation of a (post-delivery) lifestyle intervention may help to prevent gestational diabetes and related adverse pregnancy outcomes," Getahun told Reuters Health.

Kudos, fatsos.

More than 70 million US adults obese: US CDC

The numbers are on the rise.

More than 72 million U.S. adults, or 26.7 percent, are obese, up 1 percentage point in two years, the U.S. government reported Tuesday.

Obesity has become "a major public health threat" and is steadily worsening, the U.S. Centers for Disease Control and Prevention reported.

"We need intensive, comprehensive and ongoing efforts to address obesity," CDC director Dr. Thomas Frieden said in a statement.

"If we don't more people will get sick and die from obesity-related conditions such as heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of death."

Besides the fact that "the efforts to address obesity" are simply wrong, the fact is people die anyway and these are the ways fat people choose.

This is not significantly different from mountain climbers dying in a fall, motorcyclists dying in a crash, etc.

If fatsos want to die in a different way, let them either lose the weight or pay for their rescue.

BTW, they are probably too fat to really "dance to the music."

Overweight pregnant women are target of new guidelines

And about time, too, as Fitness Watch has been saying for years.

Obesity levels among pregnant women have reached epidemic levels, putting the health of their babies at risk, experts say.

The health watchdog NICE has issued new guidelines encouraging women in England to attain a healthy weight before they get pregnant...

It says almost half of women of childbearing age are overweight or obese, which could harm their child.

A start in the direction of preventing early nutritional child abuse.

Body Mass Index at Age 17 Within the Normal Range Can Predict Future Risk for Hypertension in Later Life

Watch your BMI, kids.

Ben-Gurion University of the Negev (BGU) researchers reveal in a new, large-scale study that "normal" blood pressure at age 17 can still predict hypertension at early adulthood and that teenage boys are three to four times more likely to develop high blood pressure in early adulthood than girls...

The BGU researchers examined the development of blood pressure from adolescence to young adulthood in 23,191 boys and 3,789 girls from ages 17 to 42 by taking regular readings of their blood pressure and BMI of Israel Defense Forces personnel who were not hypertensive at age 17 in their initial evaluation before recruitment.

The study revealed two substantive findings:

In boys, there is a strong correlation between blood pressure and BMI at age 17. This means that while the blood pressure reading may be in the "normal range," there is a greater risk for hypertension when BMI is also evaluated. The rate of progression to hypertension is higher in boys whose systolic blood pressure is 110 versus those whose blood pressure is 100.

For girls, only the sub-group considered obese had substantially higher risk of high blood pressure. The researchers believe that estrogen may protect against hypertension.

"Collectively, the study suggests that pediatricians caring for adolescents and physicians caring for young adults should be more aware of the need to monitor weight and blood pressure even when they are considered "normal," explains Dr. Iris Shai, an associate professor in the Department of Epidemiology in the Faculty of Health and Sciences. "For the individual person, a 'normal value' may still be associated with a significant elevated risk of disease when the BMI and sex of the patient is also considered."

Once again, a "healthy" BMI is the way to go.

Decreased Meat Intake May Help Weight Loss And Maintain Healthy Bodyweight

It is NOT about the meat. Read on.

A team of European researchers have found that reducing meat consumption may be a key factor in losing weight and maintaining an healthy body weight. The researchers wrote in The American Journal of Clinical Nutrition that meat intake, because of its high energy and fat content might be linked to weight gain.

It is about the Calories, i.e., "energy...content."

And it can go either way.

Fat cow:



Skinny cow:

Persistent Heaviness May Bring Higher Risk of Midlife Problems

"Persistent heaviness" is being fat.

People who have been consistently overweight since high school appear to be at greater risk of both chronic disease and social disadvantage by the time they're 40, researchers say.
A study of more than 5,200 individuals followed for 22 years found those who reported being heavy since their teens had a more than threefold increased risk of a chronic health problem by age 40 (OR 3.33, 95% CI 2.44 to 4.21, P<0.05), compared with those who started out with a normal body mass index (BMI) in high school and gradually gained weight, according to Philippa Clarke, MD, of the University of Michigan, and colleagues.

Persistently overweight people also had almost a twofold increased risk of being on welfare or unemployment (OR 1.76, 95% CI 1.49 to 2.04, P<0.05), Clarke and co-authors reported online in the American Journal of Epidemiology.

"These findings highlight the importance of addressing persistent obesity and overweight early in the life course," they wrote.

Duh, yeah.

Pass child nutrition bill: Michelle Obama

Hey, First Fatty:

First Lady Michelle Obama is calling on the Congress to pass legislation to improve nutritional standards and help fight childhood obesity in American schools.

"We owe it to the children who aren't reaching their potential because they're not getting the nutrition they need during the day," she wrote in the Monday edition of the Washington Post.

"And we owe it to our country - because our prosperity depends on the health and vitality of the next generation."

The Child Nutrition Bill would allocate $4.5 billion over a decade to support school cafeterias and introduce new standards for food sold in schools, including in vending machines.

The legislation, if passed, would effectively allow the Agriculture Department to ban junk food in schools.

Tackling childhood obesity has become Michelle Obama's signature issue as she spearheads a national campaign with a 70-point plan, challenging Americans to defeat the problem in a generation.

And by the way, her program has nothing to do with the activities associated with childhood obesity.

Here is the moron champion of kids and role modelette, Michellesie "The Cow" Obama:

Study Probes Obesity And Chronic Pain Links

And about time, too, since fat people hurt us and keep on hurting us.

Though it is well known obese individuals have a high incidence of persistent pain problems, a new study in The Journal of Pain, published by the American Pain Society, reports that comorbid obesity and pain also are linked to family history and mood disorders.

Chronic pain and obesity are rampant in the U.S. and responsible for a significant percentage of physician visits and health care expenditures. Costs related to obesity are estimated at $118 billion a year and for chronic pain the estimate is $70 billion in direct health care expenses and lost productivity. Several studies have shown that overweight persons are at greater risk for chronic pain mainly from increased pressure that excessive weight places on the joints. As a result, the most common pain disorders related to weight are low back pain and osteoarthritis.

Oh. no.

It is another article about them, not us.

Too bad.

Decreasing Time Spent Sitting Could Be Life-Saving

Seems a bit peculiar.

A new study from American Cancer Society researchers finds it's not just how much physical activity you get, but how much time you spend sitting that can affect your risk of death. Researchers say time spent sitting was independently associated with total mortality, regardless of physical activity level. They conclude that public health messages should promote both being physically active and reducing time spent sitting. The study appears early online in the American Journal of Epidemiology.

Increasing obesity levels in the United States are widely predicted to have major public health consequences. A growing epidemic of overweight and obesity has been attributed in part to reduced overall physical activity. And while several studies support a link between sitting time and obesity, type 2 diabetes, cardiovascular disease risk factors, and unhealthy dietary patterns in children and adults, very few studies have examined time spent sitting in relation to total mortality. Thus, public health guidelines focus largely on increasing physical activity with little or no reference to reducing time spent sitting.

This'll get you on your feet.

Risk Of Coronary Heart Disease Indicated By Increased Waistline And High Triglyceride Levels

Kudos, fatsos.

People with a larger waistline and high triglyceride levels are at increased risk of coronary heart disease, according to a research study published in CMAJ (Canadian Medical Association Journal...

In both men and women, increased waist circumference (even without higher triglyceride levels) and increased triglyceride levels (even without higher waist circumference) increased the risk of developing coronary heart disease. However, the key finding of the study was that the combined presence of increased waist circumference and increased triglyceride levels was associated with the highest risk of coronary heart disease.

Really.

We have to stop paying for fat people's diseases of choice.

Calcium supplements may raise risk of heart attack

And stroke and death. The supplement trifecta.

Calcium supplements, which many people consume hoping to ward off osteoporosis, may increase the risk of heart attack by as much as 30 percent, researchers reported on Friday.

These tiny tablets which carry concentrated doses of calcium were also associated with higher incidences of stroke and death, but they were not statistically significant.

The researchers advised people consuming calcium supplements to seek advice from their doctors, take more calcium-rich foods and try other interventions like exercise, not smoking and keeping a healthy weight to prevent osteoporosis.

"People regard calcium supplements as natural but they are really not natural at all," Ian Reid, professor of medicine at the University of Auckland in New Zealand, said in a telephone interview.

Reid and colleagues in Britain and the United States conducted a meta-analysis encompassing 11 studies that tracked nearly 12,000 elderly people over four years.

Half of them were given calcium supplements and the other half placebo or dummy pills with no therapeutic content. The results were published in the British Medical Journal.

"What we found was a 30 percent increase in heart attacks in the people who were randomised to take calcium," Reid said.

"If you have 1,000 people taking calcium for five years, we will expect to find 14 more heart attacks, 10 more strokes and 13 more deaths in the people given calcium than they would have had if they hadn't been treated with calcium," Reid said.

"That is 37 more adverse events and we expect 26 fractures being prevented. So calcium is associated with more bad things happening than with bad things prevented."

Still think they have any idea what a safe supplement is?

BTW, Anabolic Clinic. Now.

Childhood Obesity Leads To Lack Of Exercise Not Other Way Round Says New Research

Not unlike poverty, which obesity causes, i.e., poveresity.

New research from the UK suggests that physical inactivity in children is the result of obesity and not the other way around, challenging the popular view that getting overweight children to exercise more is the key to preventing the childhood obesity; the researchers maintain the path to childhood obesity is set very early in life, long before children go to school and is linked to early feeding habits.

"Exercise" is an idiot's game for weight control.

It is inefficient, easily undone (if any weight is lost) and the recommendations are insane.