Research: Canadians Have Less Disease than Americans, Too

First the redcoats, now the red leaves! Last week Followhealthlife looked at a study published in the Journal of the American Medical Association showing the British are healthier than Americans. This week new research indicates our neighbors to the north are healthier too. MSNBC reports:

Americans are 42 percent more likely than Canadians to have diabetes, 32 percent more likely to have high blood pressure, and 12 percent more likely to have arthritis, Harvard Medical School researchers found. That is according to a survey in which American and Canadian adults were asked over the telephone about their health.

This graph from the Associated Press shows additional health disparities found during this study:


The knee-jerk reaction to this study (other than panic) is to point to Canada's national health insurance program as an explanation. Some researchers adhere to the idea, but others dismiss it as anecdotal:

Canada's national health insurance program is at least part of the reason for the differences found in the study, Dr. Steffie Woolhandler, a co-author of the Canadian study said. Universal coverage makes it easier for more Canadians to get disease-preventing health services, she said.

James Smith, a RAND Corp. researcher who co-authored the American-English study, disagreed. His research found that England's national health insurance program did not explain the difference in disease rates, because even Americans with insurance were in worse health.

"To me, that's unlikely," he said of the idea that universal coverage explains international differences.

Research like this is fascinating. But it does little improve your health, no matter where you live. In the meantime do your own research. Check out all the research on a nutrient-rich vegetable-based diet and how it can protect against diseases such as cancer, diabetes, heart disease, etc.

Report: One Third of Americans are Diabetic

According to HealthDay News a new study concluded that 30 percent of American adults are diabetic or pre-diabetic. Researchers also determined nearly 30 percent of diabetics remain undiagnosed. Steven Reinberg reports:

The number of Americans diagnosed with type 2 diabetes has now topped 19 million, and a new study says a third of adults with the disease don't even know they have it.

The researchers found that another 26 percent of adults had "impaired fasting glucose," a precursor to diabetes.

"So, if you add that together with the 9.3 percent of people with diabetes, that means that fully one-third of the adult population -- 73 million Americans -- have diabetes or they may be on their way to getting it," said lead researcher Catherine Cowie, director of the diabetes epidemiology program at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

Her team's report appears in the June issue of Diabetes Care.

Research: Mice Healthier with Japanese Diet

The standard American diet's (SAD) streak of defeats continues. According to the Associated Press researchers from Tohoku University determined the traditional Japanese diet (touted as the reason for low levels of obesity in Japan) is healthier than the American diet. Kozo Mizoguchi reports:

A nutritionist created two menus comprising 21 typical foods from the United States and Japan, according to reports of the study seen by The Associated Press.

Each meal, freeze dried and mixed into powder, was given to eight mice for a period of three weeks, the reports showed.

The American menu included hamburgers and fried chicken, while the Japanese menu included sashimi, or raw fish, and rice porridge.

The study found that several genes that work to break down cholesterol and fat were 1.5 times more active in the mice which received the Japanese menu as opposed to those fed with American food.

The study also found that the level of cholesterol was 10 percent higher in the American-food fed mice.

But Mizoguchi reports the future is uncertain:

Health experts, however, are worried about rising rates of obesity, especially among young people who prefer fast food.

Diet and Disease Prevention

A new study shows the British are healthier than Americans despite U.S. health care spending per person that is more than double what Britain spends.

The study, published in the Journal of the American Medical Association concludes:

The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer. Within each country, there exists a pronounced negative socioeconomic status (SES) gradient with self-reported disease so that health disparities are largest at the bottom of the education or income variants of the SES hierarchy. This conclusion is generally robust to control for a standard set of behavioral risk factors, including smoking, overweight, obesity, and alcohol drinking, which explain very little of these health differences. These differences between countries or across SES groups within each country are not due to biases in self-reported disease because biological markers of disease exhibit exactly the same patterns. To illustrate, among those aged 55 to 64 years, diabetes prevalence is twice as high in the United States and only one fifth of this difference can be explained by a common set of risk factors. Similarly, among middle-aged adults, mean levels of C-reactive protein are 20% higher in the United States compared with England and mean high-density lipoprotein cholesterol levels are 14% lower. These differences are not solely driven by the bottom of the SES distribution. In many diseases, the top of the SES distribution is less healthy in the United States as well.

Based on self-reported illnesses and biological markers of disease, US residents are much less healthy than their English counterparts and these differences exist at all points of the SES distribution.

No one is sure why the two similar cultures have such different results. Gina Kolata of The New York Times takes a crack at it.

The question of which country is healthier, Dr. Nortin M. Hadler, professor of medicine at the University of North Carolina and others say, turns out to be a perfect illustration of an issue that has plagued American medicine: the more health problems you look for, the more you find. And Americans, medical researchers say, are avid about looking.

The British, doctors say, are different.

"The U.K. has a tradition of independent and perhaps more skeptical primary-care practitioners who are probably slower to label and diagnose people and more reluctant to follow guidelines than their U.S. counterparts," says Dr. Iona Heath, a general practitioner in London. "I have heard it argued that the U.S. believes more in the perfectibility of humanity and the role of science than the Europeans."

Some people call it disease-mongering, says Dr. Lisa Schwartz of Dartmouth Medical School. She once calculated that if everyone had the recommended tests for blood cholesterol, blood sugar, body mass index and diabetes, 75 percent of adults in the United States would be labeled as diseased. And new diseases arise by the minute, she says, her favorite example being "restless legs."

Maybe it's overanalysis. Maybe it's stress. Maybe it's something else. We can all guess why it might be that Americans are "sicker" than Brits even though we spend more money on healthcare. (Your thoughts?)

But one thing is certain: the killer diseases in America today, afflictions like type-II diabetes, cancer, and heart disease, need not ruin your health no matter where you live. On Followhealthlife we have trotted out study after study showing that we could make a huge dent in those diseases by abandoning the standard American diet (SAD) in favor a diet based on vegetables, fruit, legumes, nuts, and seeds.

This post summarizes many of the benefits of a healthy diet in preventing disease. Here is a collection of some of the most important research behind Dr. Fuhrman's work. The role diet can play in precenting cancer is discussed in detail here and here. Dr. Fuhrman says you need not settle for diabetes and that there is a counter attack for heart disease.

The result? Let's not wait around until researchers unravel the mystery of what makes English people seem to be healthier. Instead, let's do what has already been shown to be effective preventing and reversing the chronic diseases that are killing so many of us, starting with a plant-based, nutrient-dense diet that is effective in both Americans and the British.

Exercise For Sanity

New research concludes staying active decreases the risk of dementia and Alzheimer's disease. The New York Times reporter Nicholas Bakalar reports:

Researchers studied a group of more than 2,200 people over 65 and without dementia from 1994 to 1996, then followed them through October 2003, examining their mental abilities with standard tests and their physical performance with strength and agility tasks.

During the follow-up, 319 people developed dementia. Of them, 221 had Alzheimer's. But the poorer their physical performance at the start of the study, even among people with no signs of dementia, the more likely they were to develop dementia.

The associations held even after adjusting for age, family history of dementia, heart disease and other factors.

The study appears in The Archives of Internal Medicine.

Hunting for Calories in the Supermarket is Cheap and Easy

On his blog "On the Table" New York Times contributing writing Michael Pollan provides a compelling take on people's dietary selections, citing low income levels and high cost of fresh produce as major reasons why people eat poorly. Research indicates junk food is more cost effective:

A 2004 article in the American Journal of Clinical Nutrition by Adam Drewnowski and S.E. Specter offers some devastating answers. One dollar spent in the processed food section of the supermarket � the aisles in the middle of the store � will buy you 1200 calories of cookies and snacks. That same dollar spent in the produce section on the perimeter will buy you only 250 calories of carrots. Similarly, a dollar spent in the processed food aisles will buy you 875 calories of soda but only 170 calories of fruit juice. So if you're in the desperate position of shopping simply for calories to keep your family going, the rational strategy is to buy the junk.

Mr. Drewnowski explains that we are driven by our evolutionary inheritance to expend as little energy as possible seeking out as much food energy as possible. So we naturally gravitate to "energy-dense foods" � high-calorie sugars and fats, which in nature are rare and hard to find. Sugars in nature come mostly in the form of ripe fruit and, if you're really lucky, honey; fats come in the form of meat, the getting of which requires a great expense of energy, making them fairly rare in the diet as well. Well, the modern supermarket reverses the whole caloric calculus: the most energy-dense foods are the easiest � that is, cheapest � ones to acquire. If you want a concise explanation of obesity, and in particular why the most reliable predictor of obesity is one's income level, there it is.

Double Trouble: Obesity and Smoking

You don't need a doctorate to know smoking and being overweight aren't going to help you live longer or more healthfully. But according to the British Medical Journal 80 million American adults seemingly don't realize this, and are at risk for poor health and early death. Reuters reports:

The research published in the British Medical Journal showed that 23.5 percent of adults were obese and 22.7 percent smoked.

Among people who were obese and smoked, the proportion was higher in African Americans than other racial or ethnic groups.

Research has shown that smoking is a leading cause of preventable death. It increases the risk of heart attack and stroke, respiratory problems as well as lung and other types of cancer.

Obesity raises the odds of suffering from diabetes, cardiovascular disease, joint problems, depression and some cancers.

Big Portions, Small Waistlines

The driving force behind permanent weight control is not eating less, it's eating more! No, not more chips, cookies, and cheeseburgers (staples of the standard American diet), but rather large quantities of nutrient-dense appetite-blunting foods like fruits and vegetables. Dr. Fuhrman elaborates in Eat to Live:

Eating large quantities of high-nutrient foods is the secret to optimal health and permanent weight control. In fact, eating much larger portions of food is one of the beauties of the Eat to Live diet. You eat more, which effectively blunts your appetite, and you lose weight�permanently.

Once you being to learn which foods make the grade�by having a high proportion of nutrients to calories�you are on your way to lifelong weight control and improved health.

A recent report on discusses a new Penn State University study uncovering similar findings to Dr. Fuhrman's claim. Karen Collins, R.D. reports:

In the second half of the Penn State study, when portion sizes were kept the same and subtle changes were made to the foods so that they were 25 percent lower in calories, the women ate virtually the same portion as before. Since they did not eat more food to compensate for the lower calorie content, their calorie consumption dropped by 24 percent, or about 575 calories a day. The women's calorie intakes were slightly below what they needed to maintain their weight. If they continued eating this way for a longer period, they could expect to see weight loss of about one pound a week.

While the first round of research only decreased the amount of food eaten by participants (without focus on nutrient density), the next phase did the opposite; portion size remained the same, but the participants were supplied better nutrition. Collins' report closes with the following recommendations:

When you prepare your own meals and snacks, it's easy to make them less concentrated in calories by substituting ingredients with less fat or calories and increasing the proportion of vegetables and fruits. However, when you eat foods prepared by others, it's harder to judge the number of calories.

In these studies, despite dramatic differences in calorie content, the women thought the foods were equal in calories. Although they could usually tell when foods were lower in fat, lowfat foods are not always low-calorie. When you do eat foods prepared by others, watch your portions and choose plenty of vegetables and fruits.

Click here to read the skinny on nutrient density--and the thinking behind Dr. Fuhrman's approach. And a few parting words of inspiration from Dr. Fuhrman:

The Eat to Live diet does not require any deprivation. In fact, you do not have to give up any foods completely. However, as you consume larger and larger portions of health-supporting, high-nutrient foods, your appetite for low-nutrient foods decreases and you gradually lose your addiction to them. You will be able to make a complete commitment to this diet for the rest of your life.

Research: "Baby Fat" in Pre-Adolescents Leads to Grown Up Fat

"Oh it's just baby fat. You'll lose it when you grow up." Remember hearing that? HealthDay News reports a new study in the British Medical Journal says that's not necessarily true. Steven Reinberg reports:

"Contrary to our expectation, children who are overweight at 11, stay that way right through to 16, with no sign that they were growing out of their 'puppy fat,' " said lead researcher Jane Wardle, director of the Cancer Research UK, Health Behavior Unit in the Department of Epidemiology and Public Health at University College London.

In the study, researchers collected data on 5,863 children as they developed into young adults. The results clearly showed that weight problems are established before adolescence. The researchers found that children who were overweight when they were 11, continued being overweight through adolescence.