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2/25/2009 Obesity in Late Adolescence Increases Mortality in AdulthoodHere is a fabulous study based on a huge amount of data with a disturbing result given today’s obesity epidemic: being obese in late adolescence increases mortality in adulthood as much as smoking. In this study, the researchers followed 45,920 Swedish military recruits, average age 18.7 years for 38 years. Over 1,700,000 person years, 2,987 men died. After 38 years of study, the data showed that the mortality rates in
- normal weight (BMI 18.5 to 25) was 1.7 per 1,000 per year
- overweight (BMI 25 to 30) was 1.33 per 1,000 per year
- obese (BMI > 30) was 2.14 per 1000 per year
This study started in 1950; three decades before the obesity epidemic began. This message is sobering given the huge increase in adolescent obesity and consistent with the projections of Olshansky that the obesity epidemic might, for the first time in a century, decrease the next generation's life expectancy. Obesity in America is a serious epidemic that began in the early 1980s. As this study highlights, the serious effects of this epidemic will be with us for many, many years to come. Posted 9:49 AM 2/23/2009 Your Medications Will Not Work if You Do Not Take ThemShalev and Chodick have just published a great study (see " Continuation of Statin Treatment and All-Cause Mortality" in the Archive of Internal Medicine - 2009;169(3):260-268) that supports your mother’s good advice: medicine won’t work if you don’t take it. They studied 230,000 men and women, average age 58, in an Israeli HMO, comparing how often prescriptions for statins were filled at the pharmacy and then followed them for four years in the primary prevention arm and five years in the secondary prevention arm of the study. (Primary prevention is a heart attack has not yet happened and secondary is a heart attack has occurred and they are trying to prevent the second). The study looked for all-cause mortality. The results are crystal clear: People who take their statins more than 90 percent of the days were half as likely to die as those who took their medications less than 10 percent of the time in both the primary and secondary arms of the study. Further, people who took their medications half of the time were 50 percent more likely to die than those who took their medications more than 90 percent of the time. Some people worry about what statin they are taking. Perhaps they would be wiser to be certain that they actually take their prescribed pill every day. Posted 10:37 AM 2/16/2009 Activity, Obesity and Diabetes — an Unexpected ResultRegular physical activity has important and wide-ranging health benefits. People with at least a moderate level of fitness have less chronic disease, and, importantly, when moderately fit people do have a chronic disease they live longer lives. Church and Blair followed 2,316 men with type-2 diabetes for 15.9 years. They sorted the results by into three groups of BMI (18.5 to 25; 25.1 to 30; and 30.1 to 35) and by fitness level (low, middle, and high). The expected result is that in every BMI group, the mortality of people with low fitness was two times higher than people with even moderate fitness. The unexpected result is that obese men (BMI 30 to 35) who were moderately or highly fit had less than half of the risk of dying as normal weight men (BMI 18.5 to 25) who were unfit. Wow, that's an impressive result. The recommendation could not be clearer: being active lowers mortality rates, even for obese diabetics. Stay well. Dr. Bob
Posted 8:03 AM 2/4/2009 Why an Executive Physical at Froedtert?A recent New England Journal of Medicine article criticized executive physicals as being excessive, inefficient, and elitist. An executive physical at Froedtert & The Medical College of Wisconsin, I would argue, is the opposite: it is cost-effective, efficient, and good basic medicine.
I agree with Dr. Rank that some executive physical programs are excessive and elitist: whole body scans without cause are bad medicine and monogrammed terry cloth bathrobes belong in a spa, not a medical clinic. And some exams are an exorbitant waste of money. Recently a patient brought me a hardcover, 50-page book describing some 250 blood tests they had as part of an executive physical — I'd never even heard of most of the tests.
But the executive physical program at Froedtert & The Medical College is efficient: We meet you at the information desk and escort you to all of your appointments so you do not waste time.
The exam is targeted and individualized to your needs, your past history, and your recent medical tests, even if they were done elsewhere.
Our exam offers 75 minutes of physician face time for a full review of your medical issues and your wellness issues (diet, exercise, sleep, stress, alcohol).
Thanks to Froedtert & The Medical College technology and speed of service, most of your lab results will be ready for review with the physician 90 minutes after the blood is drawn.
You end with a review and recommendations of your medical problems, a written assessment of your medical risk factors, and easy referral to leading specialists if necessary.
The Executive Physical Program of Froedtert & The Medical College is efficient, cost-effective, personalized, and valuable. I'll bet Dr. Rank would praise our program. Posted 6:12 PM
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