Friday, April 27, 2018

Primary Care Can Fight Obesity with the Help of the Community

In a recent post, we discussed the MDPP or the Medicare Diabetes Prevention Program. In our discussion, we indicated that the program’s purpose is to treat Medicare beneficiaries who are prediabetic. Further, we said that the program would be administered in community settings such as YMCAs. Based on past studies, it has been concluded that a partnership between healthcare organizations and community organizations can effectively address prediabetes in Medicare beneficiaries. This kind of partnership could also be cost effective in addressing obesity.

Cost-effectiveness is of the utmost importance in healthcare. Weight loss and weight loss maintenance are extremely difficult to accomplish. It requires frequent interventions with the obese individual. And it is costly for a healthcare provider, such as a physician, nurse practitioner or physician assistant to engage the patient in a way that causes the patient to lose and maintain weight loss on a long-term basis. This is where partnerships between healthcare providers and community organizations could make a difference.

Indeed, in an article entitled “Collaborations Between PCPs, Community, Needed to Tackle Obesity Epidemic,” a primary care physician indicated how he set up a weekly obesity class with community help. He used a high school coach to give weight loss related pep talks at each one of the weekly sessions. The physician said that 25% of the program’s participants lost at least 6 pounds during six months, and that he received Medicare reimbursements of $19,000 during the first year of the program.

The AAFP (American Academy of Family Physicians) recognizes the importance of partnerships between healthcare providers and the community. In an article entitled, “Integration of Primary Care and Public Health,” the AAFP indicated that “Family Medicine within the Primary Care specialties must co-align with the public health sector, two fields with a common interest yet functioning independently for the last century.”

Since obesity is one of the biggest problems facing our society, it makes sense to create relationships between healthcare organizations and community organizations to address the problem. These relationships will benefit PCPs, patients, and the community as a whole.

Tuesday, April 24, 2018

The Importance of Protein in Our Diet

We all know that macronutrients are important components of any diet. The macronutrients are protein, fat and carbohydrates. One must consider the quantities of these nutrients when trying to determine the most effective diet. Experts often delineate the amount of fats and carbohydrates that one should consume on a daily basis for good health. Some experts will weigh the merits of a low fat diet compared to a low carbohydrate diet for example. But while there is some question as to what a high or low protein diet is, with few exceptions, experts don’t often recommend a very low protein diet. That’s because there is agreement that protein confers many health benefits on an individual.

There are at least two ways to determine the amount of protein required for good health. It can be done with respect to body weight or with respect to daily food intake. With respect to body weight, the recommended daily protein allowance for a person is .8 grams of protein for each kilogram (2.2046 lbs.) of body weight. That means that for a sedentary woman weighing 140 pounds, the recommended protein daily allowance is a little over 50 grams of protein. With respect to daily food intake, a healthy diet should consist of between 10 and 35% of a person’s intake. 

A high protein diet is considered by some to be conducive to weight loss. In one study, consisting of 105 participants, 51 of the participants were on a standard protein diet, and 54 of the participants were on a high protein diet. It was determined that the high-protein participants lost more weight than the standard-protein participants.

Another study indicated that a 35% protein diet, which is considered to be a high protein diet, will lead to improved triglycerides. And in one study, the researchers reasoned that whey protein promoted weight loss in female patients who were regaining weight after gastric bypass surgery. Indeed, the researchers stated that “Whey protein supplementation promoted body weight and FM [fat mass] loss in women with long-term weight regain following RYGB [Roux-en-Y gastric bypass].”

Finally, in a study looking at protein intake for patients in ICU settings, it was found that critically ill patients (CIPs) often don’t receive the amount of protein needed to maintain health.  Investigators determined that “energy and protein intakes in CIPs are low, disproportionate to their requirements. Therefore, actual dietary intake records, individual dietary requirement calculation, and individual dietary planning in relation with the patients' disease and stress should be considered. Such an accurate nutritional care process can promote patient safety.”

Based on the studies mentioned above, both health care providers and patients should pay close attention to daily protein intake.

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