Category: News

As waistlines continue to expand at an alarming rate, how do we begin to tackle the weight-gain pandemic?

Dr. Samuel Klein takes obesity every seriously. And he should. After all, it’s his job and main focus 24/7.

As the director of the Center for Human Nutrition at Washington University School of Medicine, he is a leading researcher on obesity. And there is, no doubt, plenty of research to be done. Unfortunately, we don’t yet have a clear understanding of this disease, so that can make it difficult to treat.

Sadly, obesity has become one of the top public health issues facing the nation and the world today. In fact, this year, obesity was designated as a chronic disease by the American Medical Association.

Vivian Wang, President, Lifescan EMEA

Likewise, diabetes is on the rise. Why? “More people are getting diagnosed,” said Vivian Wang, president of Lifescan EMA. “As countries become more wealthy, a more Westernized diet becomes available and people become more sedentary.”

With that said, it comes as no surprise that diabetes is the main driver of health care costs in the U.S. In fact, the total cost is a whopping 234 billion, according to Wang. And more than a third of American adults and nearly one child in five are now obese, according to the Centers for Disease Control and Prevention. What’s frustrating, though, is that “95 percent of Type 2 diabetes is preventable by practicing healthy eating habits,” Wang said.

“We are experiencing a pandemic of obesity,” said Dr. Daniel Kelly, Sanford-Burnham’s scientific director at last month’s Lake Nona Impact Forum held in Orlando. “It’s a lethal problem in that it’s driving Type 2 diabetes.”

What’s worse, is that is has now moved into the pediatric population. “We’re seeing children with not Type 1 but Type 2,” Kelly said.

Clearly, it will take a multidisciplinary approach to solve the massive problem.

On a positive note, though, “we are starting to understand the behavioral aspects of diabetes,” said John Brooks, president and CEO of Joslin Diabetes Center. “Having that kind of understanding is going to be critical.”

How did we become so fat?

To fully comprehend what comes next, we must first look at the past and how we got where we are.

One problem is the fact that it doesn’t take very much to become obese in the first place. The environment we live in, for starters, makes it very easy. We are all genetically predisposed to become obese. We were geared to be in a very harsh environment.

Sam Klein, MD Danforth Professor of Medicine, Washington University School of Medicine

“We are eating more refined foods,” said Klein. “And food portions have become much larger.”

“There is some data to suggest food intake has changed, particularly snack foods,” Klein said. “The ingestion of snack foods has really increased, which has contributed a lot to the caloric intake. Whereas physical activity has gone down a little bit, but not so much as we think.”

And it’s not just Americans. More than 100 million people in China now have Type 2 diabetes, according to a comprehensive survey published in the Journal of the American Medical Association. This means diabetes is now more prevalent in China than in the U.S.

But if you glance back at China a few generations ago, that didn’t exist. As they move toward an urban society, there have been changes in their eating habits.

It truly is a global issue.

However, we are starting to see people taking action. New York, for example, has continued to try and ban large, non-diet sugary beverages.

How do we fight back?

“While obesity itself may not be lethal, the complications that it drives truly are lethal,” said Kelly. It is now, in fact, the leading cause of preventable death.

One reason for this is because it drives heart failure and numerous other conditions ranging from stroke and hypertension to osteoarthritis and sleep apnea.

“We clearly don’t understand this disease,” Kelly said. “Complex diseases have a very significant environmental and lifestyle component. And the genetic variation evolves over millions of years.”

Daniel Kelly, MD Distinguished Professor & Scientific Director, Sanford Burnham Medical Research Institute

So where does that lead us? Could we harness the power of the genome to help solve this problem? Could gene discoveries help us to take actions that would reduce Type 2 diabetes in the population?

That remains to be seen.

One thing we do know is that objective monitoring and positive feedback play a key role in the grand scheme of things. Whether it’s the genome or the metabolome, to learn more would allow the patient to get the feedback that they need. And many experts agree that this could have potential for behavioral modification and weight loss.

“We have CEOs of companies who walk through walls to get objectives done, they can solve anything, but they are unable to make that small lifestyle change in order to lose weight,” said Klein. “They control their environment – they schedule the lunches, they schedule the dinners – but they are unable to make that change.”

It’s a very complex problem, indeed.

There are many irons in the fire because we know it’s an extremely complicated disease. While it’s crucial that we continue to focus on the science of the matter, it’s equally important for physicians to have a clearer understanding of obesity, too, so they can counsel patients on ways to lose weight. Oftentimes, physicians are not trained in the treatment of obesity. However, they essentially are the quarterbacks for Type 2 diabetes.

Take the cell phone, for example. In many parts of the world it could, in fact, be a great diabetes management device. The key is: How do we use it to reinforce good behaviors?

At the end of the day, of course, there aren’t any silver bullets. It’s a multi-factorial problem. And sometimes it boils down to simple programs. For instance, how do we get people to take the medications that have been given to them? And, more importantly, do we know which medications are the right ones?

We’re going to have to tackle a lot of these issues just given the magnitude of the problem.

“What we do know is how individualized things have become,” said Wang. “We definitely see that with people who have diabetes or people who are prone or predisposed. It’s very individualized as to what they are able to overcome or change or not.”

Looking into the future, it’s important to really understand what causes people to adopt certain behaviors. This is really where the solution’s going to be.

How exactly do we tackle this across the board? How do we come up with better ways to prevent or treat obesity and obesity-related diseases?

Many agree that a widespread campaign could help change behaviors.

Think about what helped drive smoking rates down from 40 percent to 20 percent. Remember when the government banned tobacco ads from television in the 70s? After that, tobacco taxes hiked up. The nicotine patch eventually was created and smoking was banned in many public places.

Just like it took decades for smoking rates to go down, obesity cannot be cured overnight. But there is certainly hope in the long run. There is such a huge focus on this issue right now that we’re bound to make strides at some point.

In other words: “This will actually be a very exciting time to be obese,” said Klein.

“Less than one decade ago, some leaders thought plans for Lake Nona would never materialize,” said UCF President Dr. John Hitt as he welcomed Forum attendees on day two. “Now, Lake Nona is said to be the biggest economic game changer for Central Florida since Walt Disney World.”

And the Medical City is certainly a beacon for hope. “Because our community dared to dream big, Lake Nona has become a model for the nation,” he said.

With that inspirational note, Scott Wapner, CNBC host of of “Fast Money Halftime Report,” took the stage to set the framework for the day. “Today we’re going to hear from those who have used their own entrepreneurial spirit to transform the way we live our lives,” he said. “Unique business opportunities have clearly been created from this new health care model that we are all living in today.”

And we can certainly learn from those already leading the way. Take Mark Verstegen, for example. He launched API-Core Performance. He addressed what can we learn about proactive health and performance from elite athletes. We marvel at their seemingly superhuman prowess, as well as their determination, motivation and their ability to recover. What is it about their training that could apply to the rest of us seeking optimal health?

“Every day is game day,” he said. But the most important thing to remember is, “we have to realize that we are dealing with people.”

One thing to keep in mind, he said, is that “we need to practice what we preach. Sometimes our health givers are the least cared for population out there. These are the ones providing your services. If we don’t upgrade them, that’s going to affect the outcomes of all our organizations.”

A Conversation with Kevin Plank, CEO Under Armour

Up next was Kevin Plank, CEO and founder of Under Armour, who continued the conversation about entrepreneurship and proactive health.

CNBC’s Scott Wapner introduced Plank as a guy who “literally turned his sweat into a $2 billion business.” Today, Plank’s focus on innovation empowers not only athletes but everyday people who strive for healthy living.

Scott Wapner, Host of CNBC’s “Fast Money Halftime Report” and Kevin Plank, CEO, Under Armour

Where exactly does this sort of drive come from, Wapner asked? “I always enjoyed creating a team of people with a shared vision,” said Plank. “Entrepreneurship is something that we try to teach, but I think you have to inspire the culture. It’s a 360-degree approach. It has to come from all facets and assets of your body.”

And the road is never easy. “Entrepreneurship is a painful process,” he said. “You want to be known and to be recognized, but it takes a really long time for that to happen. In those early stages there’s no one thing. There’s simply the entrepreneur who finds a way to get it done. I knew I’d go broke before I made a nickel.”

A New Era of Engagement: Maximizing Optimization & Personalization to Foster Wellness

Daniel Amen, MD, CEO of Amen Clinics, Sharecare CEO Jeff Arnold, Delos Living Founder Paul Scialla, Fitness expert and trainer on ‘The Biggest Loser’ Dolvett Quince, Tictrac Co-Founder Jeremy Jauncey, and Cleveland Clinic Chief Wellness Officer Michael Roizen, MD

The panel discussion focused on “the person” – the consumer, patient, caregiver — and how we inspire this person using technology to change their lives. The main question here is: Can you change the health of the population with a return on investment that makes sense for an organization?

The biggest problem we have, of course, is medical costs, which are constantly soaring across the country and world. “The only way we can bend this curve to flat, is if we can decrease the influx of chronic disease,” said Michael Roizen, Cleveland Clinic Chief Wellness Officer. “We have the most disease in the world between ages 55 and 65 years old.” The four factors causing this are tobacco, food choice/portion size, physical inactivity and stress. Stress is the most important factor.

Roizen told the audience about a case study of a patient who was able to lose 43 pounds, control his type 2 diabetes and get rid of his osteoarthritis. Part of the success was due to personal touch formed through email updates. “It was our way of nudging him,” Roizen said. And the combination of technology, care and consistency worked. The patient’s healthier lifestyle saved $30,000 direct costs because of the foods and health issues he avoided.

He also engages patients by using MyChart, where they can review suggestive care maneuvers, book doctors appointments, etc., and Wellness Widget, where patients enter their own data on an iPad.

Founding a New Industry – The Canyon Ranch Story

Due to an asthmatic condition, Mel Zuckerman, founder of The Canyon Ranch and a pioneer in health and wellness, was told he couldn’t exercise as a child. So he didn’t. For 40 years. Until he ended up in a “fat farm.”

That’s when he had his aha moment. When he discovered that he actually could exercise, he felt empowered. “I was feeling like I had never felt in the first 50 years of my life,” he said. “I need to feel this way for the rest of my life. I lost 30 pounds in 4 weeks.”

He immediately wanted to pass along this discovery to others. So, he built the first Canyon Ranch resort in 1978. “Most people don’t realize how empowered they will feel if they live a healthy lifestyle,” he said.

Rasesh Thakkar, Senior Managing Director, Tavistock Group and Mel Zuckerman, Founder, Canyon Ranch

How did he turn his newfound passion for wellness into a respectable business model?

“We hired staff that was nurturing and caring,” he said. “The people I surround myself with share the same passion.”

Revitalizing America

In 1980, the world shifted a lot, Alex Friedman, chief investment officer of UBS, began. There was a big push to revitalize the economy. And it worked. America started borrowing more.

By 1987, “It felt like the sky was falling,” he said. And by 2008, when the housing bubble burst, things just got worse. Now, as the economy recovers, the climate is just right for innovators and entrepreneurs. Innovation is creating jobs and igniting economic growth.

Overall, this gathering of 150 of the best and brightest in the health and wellness industry was a huge success. As Florida Blue’s Renee Finley said, “we’re in the crossroads of something very transformative. There will be a tsunami of opportunities that emerge, and Lake Nona will clearly capitalize on this.”

When a handful of key leaders from around the globe get together in Lake Nona, Fla., here’s what happens: a lively discussion that is altogether inspiring.

Healthcare Reform

“This is arguably one of the most transformative times in health in history,” said Tom Daschle, former U.S. Senator. “Over the next few years this country will be building a new paradigm in health.”

And with that, Daschle launched the Forum with a real spirit of optimism. Likewise, he was equally positive about Lake Nona’s Medical City.

“This is really one of the of the most innovative experiences that I’ve had,” he says. “What you’ve done in a very short period of time and what you are about to do over the course of the next few years is extraordinary.”

As the architect of Obamacare, he set aside the question of what government’s role should be and instead addressed cost, access and quality issues, pointing out that 45,000 people die a year because they don’t have health insurance.

Transforming the Health of Cities

Nancy Snyderman, chief medical editor at NBC News, kicked off the following panel, which was meant to take Daschle’s ideas and move them forward. The key take away is that leadership really matters especially at a grassroots level. In order to move the dial, a community and its key stakeholders must roll up its collective sleeve and take charge.

Ginny Ehrlich, CEO of Clinton Health Matters, is taking that to heart. “We like to say we’re in the how business,” she said. “We use a common formula. We take on complex problems, and look at how we try to move the needle.”

Health Policy and New Models of Care

“Innovating a Learning Health Care System” Panel

“All physicians share a special relationship with the patient,” said Jim Madara, CEO of the American Medical Association. “We call it ‘the magic moment.’”

Along those lines, “we need to engage patients in coproduction of health,” said Susan Dentzer, Senior Policy Advisor, Robert Wood Johnson Foundation.

At the end of the day, if you have a satisfied physician, you have a satisfied patient.

After this session, Florida Blue announced its new innovation center as “a next step in a transformation of the health and healthcare community in the state of Florida.” The 92,000-square-foot, three-story building will break ground in the first half of 2014 across from the Sanford-Burnham Medical Research Institute.

Lake Nona’s Thad Seymour Announces the Lake Nona Innovation Center

Medical Technology

“How do we decode connectivity?” Carlos Dominguez, EVP, office of the chairman and CEO of Cisco, asked the crowd. And perhaps, more importantly, “How do you get your organization to follow? How do you lead people through this transformation?”

“Build a culture of experimentation,” he said.

Carlos Dominguez, EVP, office of the chairman and CEO of Cisco

Technology has rebooted all industries. Take the car insurance industry, for example. Thanks to technology, Progressive is monitoring actual behavior now and charging premiums based on that.

Healthcare is no different. Consider Proteus. It has developed ingestible sensors that gather information about medication-taking, activity and rest patterns providing valuable insight for patients and caregivers alike. Or, consider connected inhalers, which help give an accurate picture of what is happening in asthma patients. And finally, what has a lot of people, including Dominguez, intrigued: 3-D printing.

Disruptive Innovation

“How do we leverage what we know about the genome?” said Bob Brigham, chief administrative officer of the Mayo Clinic in Florida. “Regenerative medicine is going to allow the body to heal itself; one day we won’t be doing transplantation anymore.”

“You are continually regenerating yourself,” said Tom Gonwa, M.D., chair of transplantation at the Mayo Clinic in Florida. “Pluripotent stem cells can make anything.”

Essentially, you take a simple skin biopsy, reboot it and turn it into whatever you want.

“It’s one of the most important discoveries in medicine so far,” he said.

Beyond that, The Mayo Clinic is making other technological strides. Take RP7, for example. It’s a telemedicine robot that allows doctors to be face to face with patients even if they are miles away. It also allows doctors to consult with other doctors in different locations, saving precious time.

Focusing Where It Matters

The day ended with an important discussion on obesity, one of the most daunting public health issues facing the nation and the world today. In fact, this year, obesity was designated as a chronic disease by the American Medical Association.

Diabetes is on the rise. Why? “More people are getting diagnosed,” said Vivian Wang. As countries become more wealthy you can eat a more Westernized diet. People are becoming more sedentary.”

It’s no surprise that diabetes is the main driver of healthcare costs in the U.S. In fact, the total cost is 234 billion, according to Wang.

What’s frustrating is that “95 percent of type 2 diabetes is preventable by practicing healthy eating habits.”

On the positive side, “we are starting to understand the behavioral aspects of diabetes,” said John Brooks, president and CEO of Joslin Diabetes Institute Harvard. “Having that kind of understanding is going to be critical.”

Sam Klein, director of the Center for Human Nutrition at Washington University School of Medicine, concurred by ending the day with a zinger. “This will actually be a very exciting time to be obese,” he said.