Look AHEAD trial shows eating right and exercising may not solve ...

Diet and exercise:they were supposed to be the answer to all that ails America?s obesity and health care cost problem.

Signs of this Utopian vision are everywhere. From entire government departments encouraging healthy lifestyles through fitness, sports and nutrition,governmentwebsitesthat encourage ?healthy lifestyles,? and entire community efforts to partner with health care organizations to fight obesity with the hope of cuttinghealth care costs.

What if, believe it or not, when it comes to people with Type II diabetes, diet and exercise don?t affect the incidence of heart attack, stroke, or hospital admission for angina or even the incidence of death?

Suddenly, all health care cost savings bets are off. Suddenly, we have to re-tool, re-think our approach, understand and appreciate the limitation of lifestyle interventions to alter peoples? medical destiny. Suddenly we have to come to grips with a the reality that weight loss and exercise won?t affect outcomes in certain patients. Suddenly, there is a sad reality that patients might note be able toaffect their insurance premiums by enrolling in diet and exercise classes after all.

These thoughts are so disruptive to our most basic ?healthy lifestyle? mantra that few can fathom such a situation.Nor would any members of the ever-beauty-and-weight-conscious main stream media be likely to report such a finding if it came to pass.

And yet, that is exactly what has happened.

The Look AHEAD trial studied 5,145 adults with type 2 diabetes who had a body mass index (BMI) > 25. The purpose of the study was to compare theincidence ofnonfatal myocardial infarction (heart attack), nonfatal stroke, death, or hospitalization for angina between diabetics who received arigourous weight loss and exercise programwith education tojust aneducational approach alone. Interestingly, the studyfailed to show any effect of weight loss and exercise over simple education about the disease in the incidence ofthese ?macrovascular? endpoints. In fact, the study was stopped early.

So disturbing were these findings to our basic understanding of disease prevention that the principle investigator recently appeared on Medscape in print and in video format to reassure the physician community: ?I can tell you from the outset that we were successful.?

And yet, they were not: they did not affectthe indicence of stroke, heart attack, death, or admission to a hospital for angina in overweight Type II diabetic patients one bit, even after 11 years of trying.

You see, it is uncomfortable to sit with the reality that exercise and fitness might not be as helpful as we had hoped at altering certain health care outcomes. So we ignore these trials. We don?t report them in main stream media because we don?t like to feel uncomfortable withthe realization that there?s much we still don?t know or understand aboutexercise and weight loss at affecting health outcomesin medicine.

Yet there is so much to learn from trials like this BECAUSE they fly in the face of conventional wisdom.

Maybe we should stop pouring money into fitness rooms and health clubs and promote other intellectual or spiritual pursuitsinstead. Maybe we should reconsider the benefits of exercise and weight loss as psychologic more than physical. Maybe we should de-fund all those government programs set up to promote exercise and fitness as our path to health care cost-savings.

Or at the very least,we should justeat some humble pie, stop fooling ourselves,and understand the limitations oflifestyle interventions like weight loss and exercise to improve medical outcomes or to reduce health care costs in America.

But be careful.

Saying the truth is sure to get you banned from main stream media.

-Wes

References:

1.Look AHEAD Research Group, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010;170:1566-1575. (Pubmed)

Copyright 2012 MedCity News. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Source: http://medcitynews.com/2012/11/what-if-eating-right-and-exercising-dont-solve-our-health-problems/

duggar family gilbert arenas facebook timeline kim jong il kim jong il vaclav havel vaclav havel