To Your Health
July, 2008 (Vol. 02, Issue 07)
The Health Benefits of TLC
In numerous studies, TLC has been shown to be highly effective in helping prevent, manage or even reverse some of our most prevalent chronic diseases, including heart disease and diabetes.
For example, a study published in the American Journal of Cardiology
concluded that many patients with conventional risk factors for coronary heart disease can reduce their risk without medications within 12 weeks of starting a TLC program, refuting the notion that intensive lifestyle modification is not worth the effort. A study published in the Journal of the American Geriatrics Society
, involving 3,051 men ages 60-79 years with no diabetes mellitus or diagnosis of heart disease, concluded that modification of lifestyle factors, even later in life, has considerable potential for primary prevention of metabolic syndrome. And a randomized, clinical trial of 348 Caucasian, middle-aged adults indicated that a TLC program incorporating various behavior modification tools, such as live lectures, workbooks and professional advice, could reduce the risk factors for cardiovascular disease after six months.
Does Your Doctor Offer TLC?
With so much evidence supporting the value of TLC, why don't more health care providers offer these programs? Much of the answer lies in prevailing attitudes toward wellness and prevention versus treatment of disease. For instance, in a recent study, researchers from Texas A&M University attempted to discover how much time doctors spent talking to their patients about lifestyle issues by videotaping more than 100 medical encounters between primary care physicians and patients ages 65 and older. The findings were startling: During an average 17.5-minute office visit, only 58 seconds were spent discussing physical activity and only 83 seconds were spent discussing nutrition. Less than 10 percent of the entire average visit was spent discussing physical activity, nutrition or smoking cessation.
These attitudes are entrenched in the American health care delivery and financial reimbursement systems, which lean toward the use of high-cost diagnostics, procedures and pharmaceuticals, but place little emphasis on wellness and prevention. To wit: Of the $2 trillion spent annually on health care, 75 percent is for the diagnosis and treatment of chronic diseases. But, its name notwithstanding, the U.S. Centers for Disease Control and Prevention has allocated less than 3 percent of its 2008 budget to chronic disease prevention, even though its own guidelines call for therapeutic lifestyle changes and medical nutrition therapy to reduce the risk for chronic heart disease!
Fortunately, the balance has begun to shift toward a focus on promoting wellness rather than treating symptoms of disease. Medicare has begun to offer prevention-focused benefits such as a one-time physical examination, key screenings and counseling for nutrition and smoking cessation. In the private sector, a recent MetLife survey found more than a quarter of all employers and half of large employers offer some type of wellness benefit. And health care professionals, faced with diminishing reimbursement rates and increasing patient demand for lifestyle modification guidance, might be more willing to offer TLC than in the past.