Brainstorm Health Daily: May 22, 2017

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Hi, this is Chip Bergh, your Monday morning quarterback, stepping in for Cliff.

What if I told you there was a new prescription drug that could conceivably forestall many of the chronic illnesses that afflict Americans today? Or that this same pill could reduce stress and depression—or likely extend not only the number of years in your life, but also the overall quality of the years you have remaining? In fact, this drug is so successful, it might even be able to replace the meds you may be taking now to control your blood cholesterol or blood pressure, for instance—and I can almost guarantee you that it will make you happier, more disciplined, more confident, more productive, and dare I say, better looking?

Better yet, this medicine won’t bankrupt you and it’s a heck of a lot easier to swallow than a horse pill. The only catch is, you have to renew this prescription everyday. (You knew there was a catch, didn’t you?)

This prescription, after all, is for a change in lifestyle. And here’s what that means in a nutshell: You’ll have to swap out your sedentary life, if you’ve got one, for one of daily exercise; eat whole and healthy foods (with a purpose to fuel your body for performance) rather than junk food (with the aim of merely filling your gut); get the amount of sleep your mind and body truly need (rather than boast about how little you think you do need); and trade in your habitual reliance on a smartphone or other electronic device for a meaningful live conversation or two with another human being.

Oh yes—that’s the other catch with this prescription: It requires some genuine and lasting effort on your part to make it work.

But work it does:

Consider obesity, which over the past several decades has become one of the most monumental health challenges the U.S. faces. Since 1980, the rate of obesity among children ages 6 to 11 has more than doubled (from 7% to 17.5%) and the same rate among teens (ages 12-19) has quadrupled from 5% to 20.5%, according to a research project by the Trust for America’s Health and the Robert Wood Johnson Foundation. Adult obesity, meanwhile, has reached near-epidemic proportions, with roughly four of every ten American adults clinically obese. And obesity, as study after study has shown, is significantly associated with type 2 diabetes, as well as conditions like high blood pressure, asthma, and generally poor health status.

So what can lifestyle-oriented solutions do to tackle such a seemingly unyielding health problem? Much more than many would believe possible. Witness this important study, published some years ago in the New England Journal of Medicine, which randomly assigned more than 3,200 obese adults with impaired glucose tolerance to three different test groups: one which underwent lifestyle and diet changes through the “Diabetes Prevention Program”; another that received metformin, a standard anti-diabetes medication; and a third group which got a placebo. After less than three years, those in the diet-and-exercise group not only lost much more weight than those in the other groups, they also sharply reduced their risk of developing diabetes—a 58% greater reduction in risk compared with the placebo arm and a 31% greater reduction compared with those receiving the actual medicine (metformin).

Lots of other research has arrived at similar findings.

So given that, I cannot help but wonder “WHY?” Why, for example, are we more focused on curing diseases than debating and acting upon the causal factors underpinning these health issues, particularly when they are beginning to cripple America?

What if the key metric around our healthcare system wasn’t just the number of people covered by insurance (which, to be clear, is important), but instead was the number of people who don’t require healthcare interventions today because they are healthy? What if our focus was on avoidable, lifestyle-related illnesses, and society began shaping economic incentives to drive the right lifestyle choices to prevent them? What if the scorecard for the Surgeon General, the USDA, the FDA, Congress, and other key policy makers was the overall health of Americans?

What if the nutrition pyramid every child learns in school at a young age recommended that we eat more healthy fruits, leafy veggies, and other whole, natural foods—and less cheese, dairy, fats, and meat? (The average American eats some 200 pounds of meat per year—more than twice the amount consumed by the average person around the world. U.S. cheese consumption has more than doubled on a per capita basis between 1970 and 2012. And while calculating the amount of sugar Americans consume each year is more complicated than it seems, virtually every expert agrees that we eat and drink way too much of the stuff.)

Individual Americans, I believe, have an opportunity—and a responsibility— to choose smart behaviors when it comes to protecting their health and well-being. And, as I said above, government can and should help on this front as well. But then, so too should businesses—the entities that, after all, end up paying for much of the healthcare needs of tens of millions of Americans.

Indeed, I’ve given a lot of thought to the role that the company I lead can play in driving the right kind of healthcare outcomes for our employees. At Levi Strauss & Co., we are creating a high-performance culture where everyone has the opportunity to contribute their fullest. We’re focused on overall employee wellness, not just to try to lower our own healthcare bills, but also because I firmly believe it will lead to healthier and more engaged workers. Our company cafeteria serves fresh, high-quality organic foods, sourced locally. We are even considering pricing the few “unhealthy” menu items at a premium so as to subsidize the good stuff and make it less expensive—the aim being to create an economic incentive for eating a healthier breakfast or lunch. (We haven’t implemented that policy yet, but it’s on the table.)

For employees at our San Francisco headquarters, we subsidize gym memberships (the out-of-pocket cost for employees is $50 per month versus a typical monthly membership of nearly $200 per month). And when I’m not traveling, I make it a point to work out there at lunchtime. My hope is that, if my Levi’s colleagues see the CEO heading to the gym, they’ll know that ours is a workplace culture that truly supports that.

Prior to the company subsidy, we had fewer than 100 employees who were members of this gym. After the subsidy, nearly half of our San Francisco employee base of roughly 1,000 people, use it regularly. Some of my coworkers have told me that it’s the best benefit we offer; and we have similar programs in many parts of the world now. Our in-house wellness program has incentives to quit smoking, lose weight, and begin an exercise program. And at our headquarters, we offer free and confidential consultation with a registered dietitian and a doctor on a monthly basis.

As a result of these efforts, we are seeing higher levels of engagement, higher levels of business performance, higher retention of top performers, and early evidence of a real impact on our company healthcare costs. Employees, in sum, are healthier, happier, and more energized at work.

That’s how Levi’s is answering that litany of “Why’s” and “What If’s” that I asked above. And as Congress debates our national health policies, I’d say this is a great time for them and the rest of the country to think about those questions as well.

More news below.

DIGITAL HEALTH

There’s no evidence fidget spinners help with ADHD. Made from two or three blades that can be flicked and spun, these gadgets are a white-hot category on Amazon. They might be fun to play with but despite claims from manufacturers, there’s no scientific evidence they can improve concentration, relieve stress, or help with ADHD and autism symptoms. In fact, because there aren’t any peer-reviewed studies illustrating the devices' impact on kids with ADHD, it’s possible they “may well make things worse,” behavioral pediatrician Mark Wolraich told STAT. It’s a good general reminder to be wary of consumer products peddling unsubstantiated health claims (There are a lot of them out there.) (STAT)

A wrinkle in the march of the microbiome. Scientists are just beginning to uncover the many ways human gut bacteria could impact overall health. Which is why new research, showing that caterpillars don’t have any gut microbes, is so interesting. “If they’re not relying on the bacteria in their guts to help with their diet, what are they relying on? It’s got to be something entirely different,” Melissa Whitaker, an ecologist at Harvard, told Nature. “As a discipline we’re really ready to claim that everything is related to the microbiome and every organism has one. It only takes one exception before all of that goes out the window.” (Nature)

INDICATIONS

Nutrition experts pen a letter to health officials. More than 40 nutrition researchers and professors wrote to health secretary Tom Price and FDA commissioner Scott Gottlieb, pressing them to implement new requirements for nutrition labels by the July 2018 deadline. Most notably, these new rules would force major food and beverage manufacturers to list the amount of added sugar in their products. “Americans consume added sugars, especially sugar-sweetened beverages, in amounts that are linked to a higher risk of heart disease, type 2 diabetes, obesity, tooth decay, and nutrient-poor diets,” the researchers wrote. Meanwhile, the food industry has mounted an intense lobbying campaign focused on stalling or, in some cases, rolling back, nutrition label requirements. The Trump administration has already delayed implementing a rule that would require restaurants to list calorie counts on menus.

THE BIG PICTURE

No more juice for babies. That’s according to the American Academy of Pediatrics, which just updated its guidelines to state that children less than a year old shouldn’t be drinking the beverage. “The high sugar content in juice contributes to increased calorie consumption and the risk of dental caries,” the group wrote in a report published in Pediatrics. “In addition, the lack of protein and fiber in juice can predispose to inappropriate weight gain (too much or too little).” (New York Times)

REQUIRED READING

General Mills Loses the Culture Wars, by John Kell

Facebook’s Content Screening Guidelines Leaked, by David Z. Morris

Microsoft’s Old Software Is Dangerous. Is There a Duty to Fix It?, by Jeff John Roberts

The Financial Tech Revolution Will Be Tokenized, by Robert Hackett