Chewing On The “Best Diets”
Guest Post: David L. Katz, MD, MPH, FACPM, FACP, Director, Yale University Prevention Research Center
As you may know, US News & World Report released a list of “best diets” to coincide with the annual bumper crop of weight loss resolutions as the New Year begins. I was privileged to be one of the 22 judges.
I get the sense we agreed more than we disagreed, and am fairly comfortable with most of the outcomes. We based our judgments of each of 25 diets in 7 different categories on published papers, on-line materials, and personal clinical experience.
The results were an endorsement of balanced, sensible approaches to weight control. No diet based on a gimmick, or on wild distortions of a healthful dietary pattern scored well. Those diets that did score well were generally conducive both to losing weight, and finding health. Big winners included Weight Watches, which came in first for both weight loss and ease; and DASH, a diet developed at the NIH for blood pressure control and since shown to confer other health benefits. The Mediterranean diet, and the low-fat, plant-based diet developed by my friend Dean Ornish, placed highly as well.
However, different diets did come in first for health, weight loss, diabetes, and heart disease- and personally, I find that a bit silly. Weight loss, by healthy means, is among the most important ways of reducing risk for diabetes and heart disease. A diet that reduces diabetes risk reduces heart disease risk. A diet that reduces risk of heart disease and/or diabetes, two of the leading public health perils of our time, is obviously good for health. A diet cannot be good for health unless it reduces the risk of heart disease and diabetes.
I trust you see where this logic leads. A good diet is a good diet, period.
But is there a ‘best’ diet?
I have weighed in on that topic Huffington Post, and basically said- no. We have abundant evidence to support a basic theme of healthful eating, and almost none to say which of the several reasonable contenders (Asian, vegan, Mediterranean, etc.) is truly best.
That’s good, because it means we do have an evidence-based theme of healthful eating- conducive to weight control- and variations on that theme allowing for customization and the indulgence of your personal preferences and priorities.
But let’s be clear, there IS a theme- and though you are the boss, you abandon the theme at your potential peril. The fundamentals of the theme were pithily captured by Michael Pollan with: “eat food, not too much, mostly plants.Eating food means real food. Pronounceable food. If it glows in the dark, you probably shouldn’t eat it. The longer the shelf life of the product, the shorter the shelf life of the person eating the produc
“Not too much” might seem like hard advice to take, but quality control provides for quantity control. Many processed foods are of the “betcha’ can’t eat just one” variety. Wholesome foods- an apple, for instance- are of the “betcha’ won’t eat than one” variety. In fact, I’ve recently learned of a Mom who lost 115 lbs due almost entirely to use of the NuVal system in her supermarket, and simply trading up to more nutritious choices in each aisle. By addressing quality, quantity and weight mostly took care of themselves.
Mostly plants is pretty straight-forward. An emphasis on plant foods is evident in almost diets associated with both weight control and health, and is, into the bargain, important for the health of the planet.
I am a proponent of Weight Watchers; their programming clearly works for weight loss, is sensibly aligned with healthful eating, and provides the structural support many people need. I believe, however, we can do even better- building skill power systematically to facilitate lifelong health and weight control, while addressing the needs of all family members at once. A program I have helped develop, Weigh Forward, is an example. I also see opportunities for customizing variations on the theme of weight control based on genetic testing.
As we size up best diets at the start of a new year, we can celebrate the winners- but note that too many of us are still losing. A majority of adults in the US are overweight or obese. Our best efforts to date are not yet good enough.
What would truly be best is modifying the world- so that eating well and being active simply prevailed. While waiting for that change- or better, while working for it- the best diet is bounded by considerations of not just losing weight, but finding health; not just you, but your family; not just now, but lifelong. Stay within the bounds of the theme, and shop the variations to find your best way forward in the New Year.
Employee Wellness Is A Strategic Initiative, Not An Altruistic HR Initiative
In what can only be described as a bizarre turn of events, it would appear that doughnuts and soda have become more expensive than real estate and electricity. Ben Franklin would be so confused.
As odd as it may seem, this was exactly the news that came out of a recent survey on corporate sustainability. The combination of direct and indirect costs associated with employee health and happiness has gotten so great that executives participating in the CoreNet Global/Jones Lang La Salle Sustainability Survey revealed that employee health, satisfaction and productivity outranked energy costs and real estate as top concerns in 2010.(1) You see, in a world of rapidly increasing health costs and rapidly decreasing employee engagement, a company’s sustainable competitive advantage (or lack thereof) will be a result of their ability to positively impact the health and happiness of its employees.
Given this trend, employers increasingly turn their cost-cutting, happy-making attentions towards employee wellness programs. Let’s face it, wellness programs are neither novel nor new. Whether it be an Employee Assistance Program (EAP), a health “portal” on the company intranet or an employer-sponsored walk-a-thon, your company has spent and will continue to spend time and money attempting to impact employee health. According to Human Resource Executive, companies will increase their wellness spend by 35% in the coming year.(2) That, in short, is the good news. The bad news is that while companies are increasing their wellness spend, more than half of them still report that low participation and engagement in wellness programs is the number one obstacle to behavior change. Put simply, companies are admittedly spending more money on things they know people aren’t using. Try explaining that to the CFO.
At a time when 1 in 3 Americans is obese,(4) you wouldn’t expect to hear good news regarding our country’s health. Well, depending on your perspective, that’s exactly what the Journal of Occupational & Environmental Medicine gave us when it reported that 50-70% of healthcare costs are attributed to lifestyle.(5) What’s so great about that? Well, it means we can reverse this trend by changing our behavior. Easy? No. Doable? Absolutely.
Healthcare Costs On average, unhealthy workers cost employers $11,176.(7)
Not only are costs going up for employers but for employees as well. According to Towers Watson, 73% of companies will increase employees’ share of premiums in 2012.(7) Given relatively flat wage increases, this means that many of your employees will be taking home less pay in the coming year and what started out as a conversation about health costs has quickly become one about compensation. Think about this for a second—private sector employers increased wages by 2.1% in 2011.(8) In 2012, employer medical costs are scheduled to increase by 8.5%.(6) By comparison, companies’ health costs are increasing at a rate 270% greater than what they’re paying their employees.
If one of HR’s roles is that of risk management, then the healthcare cost trend is a pretty significant risk. Manage away. The connection between employee health, engagement, productivity and costs is so great that maybe your company needs a Chief Wellness Officer. For example:
• Actively disengaged employees cost the U.S. $370 Billion annually. (9)
• $2.30 in lost productivity for every $1 spent on healthcare/pharma for unhealthy employees (10)
• 27% of employees are actively engaged (11)
• 54% of disengaged employees report that works has a negative impact on their health. (12)
• 21% more likely that engaged employees will participate in wellness programs (13)
• 58% of companies cite low employee engagement as the biggest obstacle to behavior change (14)
• 54% of employees plan to leave when the economy improves (11)
If I wanted negative feedback, I’d call my doctor (or my in-laws).
Herein lies the problem with many employee wellness programs—negative feedback. Companies don’t understand that the piece of information, data or feedback that keeps someone training for a half marathon going that extra mile, is the exact same thing that may keep your highest-risk employees on the couch wondering, “Why do I even bother?”
If I’m unhealthy, I know that this “pie of death” contains massive amounts of trans-fats, sugars, bad cholesterol, chemicals I can’t spell, gluten I don’t need and likely isn’t even remotely eco-friendly. I know I should be walking, checking my blood sugar, staying on top of my blood pressure and drinking eight glasses of water a day. Reminding me of that just lets me know exactly how unhealthy I am and how much I still want the pie in spite of the needed life insurance adjustment. If you want your employees to create healthy behaviors, make wellness fun and make it positive. More on this later.
Skinnier bottoms make for fatter bottom lines.
According to The World Economic Forum,(15) when health and well-being are actively promoted, companies are:
• 3.5x more likely to encourage creativity and innovation
• 3x more productive
• 4x less likely to lose talent within one year
• 8x more likely to have engaged employees
• 2.5x more likely to be a best performer
When is the last time a fellow employee gave you a hug or high five? What about the CFO? Was it when you implemented that goal management product? Or was it the learning & development portal that you built? Probably neither. And that’s unfortunate, because they’re both very important and probably took a lot of your and your team’s time and effort. Employee health and happiness is different, though. There is nothing more personal, more emotional or more human than helping employees get (and stay) healthy and happy. Here’s the thing—it’s not charity work. It’s not some altruistic HR initiative. It’s arguably the most strategic initiative you can champion and it has direct, measurable effects to your company’s top and bottom lines. Wellness lives at the intersection of employees’ personal goals and executives’ financial ones. What’s more “HR” than that?
Pet insurance is a voluntary benefit. Employee wellness is a growth strategy. Sorry, Fido.
So, now what? What should you do next? First of all, lose the mindset of wellness as a voluntary benefit. That’s not saying that you have to make wellness programs compulsory (though it’s a good idea), but if your company treats employee wellness the same as concierge service, dry cleaning or pet insurance, you’re not going to get real results.
Wellness is cultural, it’s strategic and it’s a growth strategy. Your company probably falls into one of two categories: (a) you’re just starting to think about wellness programs or (b) you’ve implemented programs and they either haven’t worked or you’re looking for something fresh and different.
In either case, the KARDIO KREW is here to help you.
Endnotes
1 “Employee Health, Productivity, Gain Importance in Sustainability Survey,” CoreNet Global/Jones Lang LaSalle Sustainability Survey, National Real Estate Investor, 14 February 2011
2 “Wellness Spend Up, But Measurement is Lacking,” Human Resource Executive Online, 1 April 2011
3 “Health Care Spending in the United States and Selected OECD Countries,” Kaiser Family Foundation, April 2011
4 “Adult Obesity,” Centers for Disease Control and Prevention
5 Whitmer R., Pelletier K., Anderson D., et.al, “A Wakeup Call for Corporate America,” Journal of Occupational and Environmental Medicine, September 2003
6 “Employer Medical Costs increase 8.5% in 2012,” PwC, 18 May 2011
7 The Road Ahead: Shaping Health Care Strategy in a Post-Reform Environment, 16th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care, 2011.
8 “National Compensation Survey,” United States Bureau of Labor Statistics
9 “Dilbert Is Right, Says Gallup Study,” GALLUP Management Journal, 13 April 2006
10 “Unhealthy Employees Cut Productivity, Study Finds,” Workforce
11 Kevin Sheridan, “Top 2011 Employee Engagement Trends,” Monster Thinking, 10 January 2011
12 ”Gallup Study: Unhappy Workers Are Unhealthy Too,” GALLUP Management Journal, 13 January 2005
13 Jennifer Robison, “The Business Case For Wellbeing,” GALLUP Management Journal, 9 June 2010
14 “Boosting Employee Wellness Participation Without Breaking the Bank,” Towers Watson, July 2010
15 “The Wellness Imperative: Creating More Effective Organizations,” World Economic Forum and Right Management, 27 January 2010
Childhood Obesity – Pizza Is Not a Vegetable
Guest Post: Dr. David Katz, MD – Kardio Advisory Board Member, www.davidkatzmd.com, www.turnthetidefoundation.org
It is at best ironic that America duped its families about food just as Americans gathered for the quintessential celebration of family and food. Congress just gave us all permission to serve our children pizza as a vegetable. I have a response in mind that suits the season. We’ll get to that, but first, the season warrants a consideration of reasons for thanks.
As I write this- still sated a day after our family’s Thanksgiving indulgence- I am thankful for the annual reminder to reflect on all the reasons I have to be thankful. I can- and I suspect I’m not alone- get so caught up in a job I care a lot about, and the stresses attached to it- that I at times take for granted people I care about a whole lot more.
I adore my wife. Differently, perhaps from when in my youth I climbed onto a rooftop and yelled at the top of my voice ‘I love this woman!’- but certainly not less. I love my children who are each in their own way a source of great pride. I am thankful for them in my life, and deeply thankful that- so they tell me- the feelings are mutual.
I am thankful for the vitality of my parents. For a mother who has the vigor and enthusiasm to prepare a magnificent feast for our extended clan- and then deal with the aftermath and keep smiling. I am thankful for a father who, at 72, nearly killed my triathlete brother-in-law and me, 25 years his juniors, on an outrageously hilly 30-mile bike ride.
I am thankful as well for the expansive solidarity of Thanksgiving. We, Americans, share in this holiday regardless of religious or political affiliation. We share in a reverence for the nation, the ideals, the history, the legacy and the lore that are America. And we share the love of that legacy and lore with people we love- friends and family, with whom we gather to feast.
For such good fortune, and the fruits of good labor- I say thanks! I append a regret that not all have good fortune to toast, nor the equity borne of sweat America should place within reach of all. While toasting a bounty of blessings and food surrounded by a tribe of fellow parents, grandparents, and miscellaneous children- and considering what our Congress seems to have in mind for those children- I recall another reason for thanks in America. In America, we can say: no, thanks!
Good health is perennially on the list of reasons any family has to be thankful, and food is among the most potent of influences on health- for good or for ill. The differential effects of pizza and a mixed green salad on health don’t change just because politicians play around with the lexicon. The putative excuse for listing pizza as a vegetable – like ketchup before it- is the inclusion of tomatoes in the recipe. That would be ludicrous enough if pizza were mostly about tomato sauce, and if tomato sauce were all about tomatoes. Of course, pizza tends to be much about cheese, white flour and toppings that include pepperoni. The plot thickens in the vat where the tomato sauce is made.
Commercial tomato sauces, like ketchup, can and often do contain mildly surprising concentrations of salt and downright shocking additions of sugar. In fact, I have personally analyzed marinara sauces that, calorie for calorie, contain more added sugar than chocolate ice cream topping. Letting tomato sauce on its own qualify as a vegetable would be questionable enough. As for the fact that a tomato is technically a fruit- well, let’s not even go there. Congress reached its preposterous judgment about pizza at the urging of lobbyists working on behalf of food companies working to protect their slice of the pie, as it were. Pizza is a good moneymaker in school cafeteria lines.
But we the people- the parents and grandparents of the United States- need not submit passively to such obvious, exploitative nonsense. We need not sit idly by as corporate interests trump interest in the well-being of our children. Not at a time when what used to be adult onset diabetes (i.e., type 2) becomes ever more common in children under age 10. Not at a time when cardiac risk factors proliferate in pre-teens. Not at a time when a reported 35% increase in the rate of stroke among 5-14 year-olds demands nothing less than a crisis response.
We need not submit to such folly, fraught with such peril. We can, and should, say: no thanks.
We can say no thanks to superintendents, school boards, principals, and school food service directors. I can’t think of a reason a loving parent or grandparent would remain silent.
We can say no thanks to the food companies that put this modest addition to their profits ahead of the dire prognosis facing our children- and theirs, for that matter.
And we can say no thanks to members of Congress who bartered the fate of our children for the favors of the highest bidder. We can show them out, at the next election. And unless something springs readily to mind that matters more than protecting the health and potential of our kids- we certainly should.
At a holiday interlude that highlights the love of family and the great traditions of our country- I am thankful for the possibility that loving families can still shape the traditions of our country. When righteous indignation unites us, a nation of loving parents and grandparents can be the mightiest special interest group that ever was.
I have abundant cause to give thanks, and so I do. Among them is the fact that I live in a country that affords me, and you, many ways to say ‘no thanks!’
Corporate Wellness – Creating a Culture of Healthy Living
Corporate wellness is maturing…as a result the employee wellness programs that are being implemented must keep pace. A big part of this change is the recognition that 75% of life is lived outside the workplace and that wellness programs being implemented in the enterprise need to go beyond the office walls. Employers can no longer look at employee health in isolation as it pertains to their office or company, instead today’s employee wellness programs need to be available where we work, live, play and pray. In other words, it has to transcend into the community we live in.
Increasingly, employers are allowing spouses and children to access and utilize their online and telephonic wellness tools. In the coming years, I believe we’ll see more employers evaluating the use of incentives and penalties for employees and their families. In fact, the 16th Annual Towers Watson Study highlighted that 58% of employers are now offering cash incentives or premium credits and among those 46% are increasingly including dependents.
The Center for Health Value Innovation recently released a report that confirmed “Health care costs can exceed 20 cents of every dollar”. I believe one key to curtailing these costs will be to implement wellness programs that are personalized, based on validated data that is objectively measured and recorded (not self-reported) and ties incentives to both rewarding effort, as well as, results. This maturation of thinking is driving an emphasis on quantitative ROI analysis that when properly implemented can push a basic ROI of $3:1 to ROI = $6:1 or even ROI = $12:1 for sophisticated wellness initiatives.
Remember, the fundamental goal of Wellness is to improve the health of our employees and our population. We implement employee wellness programs to create healthier people so they have lower direct (Medical, Pharmaceutical) and indirect (Productivity, Absenteeism, Presenteeism, Turnover) health care costs to the organization. If you just wanted to cut costs, you could reduce your workforce, implement cut backs, renegotiate contracts, etc… Wellness works when you measure, reward and repeat.
Six Pack Abs vs. Holiday Eats & Treats
Believe it or not, everyone has a set of six pack Abs…unfortunately they are usually hidden under a layer of belly fat. While Ab workouts can strengthen your core and accentuate the muscles, the key to seeing the results of all this hard work is watching what you eat. During the holiday season this can become particularly hard for everyone. Don’t let all your weight loss and fitness efforts go down the tubes by over indulging in all the tasty holiday eats and treats. They key to a surviving the holiday food frenzy is moderation, plus making smart, healthy food choices.
There are three very simple steps you can take on a regular basis that will help give you a set of washboard Abs:
Reduce Carbs After Breakfast: It’s important to set a good foundation for starting your day by including plenty of complex carbohydrates (a.k.a. Fuel) in your first meal of the day. Complex carbohydrates include foods like oatmeal that deliver lasting energy. As you move through your day you should eat fewer carbs, especially at night. You don’t need fuel as you’re winding down your day as it will only go unused and turn into fat. In other words, go easy on the mashed potatoes, stuffing and cake.
Eat Often and Eat Small: You’ve heard this a lot, but it’s true…instead of eating three meals a day, shoot for five snack-size meals. This way you won’t get famished and eat unnecessary calories that turn into belly fat. Plus this type of eating will allow you to speed up your metabolism, creating a calorie deficit that will burn fat for you. One of my favorite parts about the holidays is all the food to choose from, which, if you’re disciplined, should make it easy for you to eat five little snack-size meals a day and not pig out at dinner. Another great way to add a small meal to your diet is to use a meal replacement shake or protein bar.
Eat The Right Calories: This can be a tough one to follow, but if you eliminate refined sugars and reduced calorie-dense foods, like all processed foods you’ll be on the right track. If you really want a ripped stomach, make sure to eat plenty of veggies (yes veggies) which are filling but won’t spike your sugar levels and turn into fat. This holiday season you might want to try an extra serving of green beans and skip the extra helping of stuffing.
Finally, don’t skip your workouts during the holidays. I know it’s easy to feel like you should take a “holiday” from your workouts; after all it is the holiday season, right? But don’t….you’ve built up some momentum; you’re in a routine now, keep it up. One thing I like to do is watch football during the holidays. Last year I told myself I would not sit on the couch and watch football, so I put a TV in the garage above the treadmill and now I can go for a run and watch the game or I can use my homemade treadmill desk, bring out my laptop and do e-mail while I watch the game. Point being…keep moving so those extra holiday calories don’t get the best of you.
NBC TODAY Show’s Nutrionist and Health Expert – Joy Bauer Joins KardioFit Advisory Board
This is an exciting day for all those involved in the development of KardioFit (a.k.a. KARDIO). I am excited to announce that the Individual consumer part of the KardioFit Wellness Rewards Program went live today and is now open for enrollment. The Group/Enterprise part of KARDIO will go live later this week.
I’m also excited to announce that Joy Bauer, MS, RD, America’s favorite and most trusted nutrition expert has joined the KardioFit Advisory Board. Joy’s mission is to improve the health of our nation; she believes it’s never too late or too early to reap the benefits of healthy living.
As the nutrition and health expert for The TODAY Show, Joy shares reliable, practical, and straightforward advice that helps millions of Americans eat better and lead healthier, more fulfilling lives. She is the author of multiple New York Time bestsellers, Joy’s most recent cookbook is titled Slim & Scrumptious. Packed with more than 75 easy–to–make family–friendly recipes, the book helps adults and kids eat healthier from morning ‘til night. Plus, Joy offers tips, tools, and techniques that save you time and money in the kitchen, so you can put together quick, affordable meals without compromising on taste or nutrition. Joy’s other New York Times bestseller titles include Your Inner Skinny and Joy Bauer’s Food Cures.
We are very fortunate to have Joy as a member of the KARDIO KREW and we’re confident she will provide valuable insights and guidance as we continue to evolve the KardioFit Wellness Rewards Program.
Jim Miller’s Thouhghts On The Pending Launch Of KardioFit
JM: I first conceived the idea for the KardioFit (a.k.a. KARDIO) Wellness Rewards Program in late 2008, shortly after Lehman Bros. tanked. While it has certainly taken us quite a while to get to this point, it looks like KARDIO will finally launch before the end of the year. I’d like to thank our strategic partner dotFIT. They have been fantastic to work with and truly understand what it means to be a partner. I also need to thank our kick ass software developers, who have worked tirelessly to get KARDIO to this point and have put up with an inordinate number of “change requests”. Last but not least I would like to recognize our stellar, expert Advisory Board and latest members of the KARDIO KREW, Dr. David L. Katz, MD, Dr. Jeffery B. Blumberg, PhD, Dr. David Chenoweth, PhD, serial health and wellness entrepreneur Jim Kean and former ESPN SVP and Managing Director for the X-Games franchise Rick Alessandri who are all playing important roles as we evolve the KARDIO program.
KARDIO’s core values include a work hard, play hard, live life environment, a got-your-back team mentality, the inspiration of ideas, driving positive change within our community, our members and beyond, powered by a thirst for excellence. Fueled by these values KARDIO intends to become a leading provider of corporate and individual wellness rewards programs that helps to motivate and reward healthy behavior, generate improved productivity, improve employee morale and anonymously track employee fitness and diet performance to deliver the best return on investment. KARDIO’s Wellness Rewards Platform provides our corporate clients and individual members with real-time feedback and motivational tools to drive better performance and overall health.
Did you know that 70% of healthcare costs in the United States are preventable? According to the American Heart Association, we lose $32 Billion a year because of premature illness associated with cardiovascular diseases like high blood pressure, diabetes and obesity. Our Nation, employers and insurance companies are all struggling to deal with the rapidly rising health care costs. The solution is NOT digitizing medical records; the solution IS to properly incentivize and reward people to take better care of themselves, by paying them cash to exercise and make better food choices that will ultimately prevent many of the chronic diseases attributed to obesity. By focusing on “cost reduction”, traditional wellness companies miss the mark. They end up focusing mostly on the already healthy demographic and not the individuals with significant health risks or chronic conditions.
Our goal at KARDIO is not to make “Uber Athletes” out of everyone, rather it is to simply get people off the couch, moving more and eating less. We want to provide a fun, safe and healthy environment with easy access to powerful tools, expert coaching and educational resources that empower people to make healthier decisions and then reward them for their efforts. It could be as simple as putting down the soda and potato chips, drinking more water and walking a mile or two per day. Simple steps like this get you moving in the right direction and eventually you’ll develop a diet and exercise routine that will change your life forever. KARDIO focuses on rewarding “effort” and doesn’t discriminate by only rewarding those who are already physically fit, but instead provides all members an equal opportunity to win so long as they put forth the effort towards becoming and/or staying fit.
KARDIO is fun, it’s social, and it’s for everyone. Once you’ve set up your profile and created your fitness plan you’re ready to go. Every time you record the food you ate, the exercise you performed or some other qualifying action you earn one sweepstakes entry that is automatically e-mailed to you and entered into the next drawing. It’s that simple. You can learn more by going to the KARDIO KOMMUNITY and checking our FAQ or go to the Our Solution section of our website. One final tip, when you do register, I highly recommend buying the BodyMedia for ExerSpy Biometric Armband to track your fitness activity. You don’t have to wear it all the time…f you like you can wear it only when you work out. It’s up to you, but it definitely makes tracking calories burned, fitness activity, steps and sleep efficiency a breeze, plus every time you upload the data you get a sweepstakes entry!
I sincerely hope you will give KARDIO a try! Who knows, you might not only get in shape and feel better, but you could win some cold hard cash too! We would love to hear from you, so please feel free to share your successes, struggles or ideas within the KARDIO KOMMUNITY.








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