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Wholist - Individual and Corporate Lifestyle Transformation- Lifestyle Medicine
- 1. From Individual to Corporate Lifestyle Transformation Evidence, Education and Empowerment
- 2. Heather Hammerstedt MD MPH Medical Doctor Emergency Medicine Lifestyle Medicine Global Health Speaker Author Mom Skier Runner Hiker Biker Rafter
- 3. Lifestyle Medicine what is it and why should you care?
- 4. Why lifestyle medicine is different
- 5. What are we going to do today and why? Individual transformation Food Weight Mindset Exercise Sleep Corporate transformation
- 6. Food is Medicine “Eat Food. Not Too Much. Mostly Plants” M.Pollan “Nothing Added in. Nothing Taken Out” M.Greger
- 7. 80% of disease is preventable Top 10 killers are preventable Heart disease Hypertension Diabetes Cancer Mood disorders Obesity
- 12. WHY and WHEN we eat Now we are getting to weight issue
- 15. Your food prescription Whole food Mostly plants Unprocessed carbohydrates No added sugars Analyze your hunger cues Stop snacking 1/2 complex carbs (veggies), 1/4 healthy fat, 1/4 protein- KISS
- 19. Mindfulness Based Stress Reduction
- 20. Wellbeing Physical Health Mental Health Work productivity
- 21. Mindset Prescription Delay responses to stimuli Take time at least once per hour to really NOTICE you and your surroundings Thought Download issues using the circumstance -> results model Mindfulness Based Stress Reduction programs Mindfulness Meditation
- 22. Exercise
- 26. Exercise Prescription 150 minutes of moderate intensity exercise / week (75 vigorous) Two resistance sessions per week Flexibility sessions: 20 min 2/week Balance session: 20 min daily
- 27. Who doesn’t love to sleep???
- 28. Who doesn’t love to sleep???
- 29. 12 n o o n SCN Hyp o th a la m u s Sle e p Ph ysio lo g y, Osc illa to rs, Mo d ifie rs, a n d Flo w 12 m id n ig h t 12 n o o n c o rtiso l sp ike p in e a l g la n d a d re n a l g la n d re tin a RGC m e la p sin b lu e lig h t se n sitivity m e la to n in se c re tio n m e la to n in b lo o d flo w te m p e ra tu re fo o d in ta k e te m p e ra tu re e p in e p h rin e n o re p in e p h rin e a ld o ste ro n e NO Na d ie t c a rb s h yd ra tio n a u to n o m ic n e rvo u s syste m sp la n c h n ic syste m n on visu a l lig h t d e n sity p u p illa ry re fle xe s SNP PER CRY 2 3 1 c o re te m p p ro p e n sity m e la to n in 4 a m Slo w, re sto ra tive sle e p Lo n g REM Fe a r e xtin g u ish in g sle e p 7 a m
- 30. Sleep Prescription 7-9 hours, consistent wake and sleep times Cool room for core, warm extremities No carbs 3 hours before bed Red hued lights better than blue Hydrate throughout day, limit before bed Exercise outside, afternoon Sleep entrainment is possible
- 31. So we’ve fixed you!! Whole food, plant based diet with no snacking Mindfulness meditation and metacognition work 150 min of exercise per week goal 7-9 hours of sleep per night
- 36. Annual Costs to Employers The top five chronic conditions cost employers: $11.2 billion (obesity) $10.3 billion (hypertension) $9.1 billion (physical inactivity) $3.6 billion (current smoking) $2.2 billion (diabetes) Total of $36.4 billion (Asay et al., 2016)
- 37. Moderate and Severe Obesity Increase Total Healthcare Costs Dollar costs: $116 billion from all levels of obesity across all healthcare payers $69 billion from severe obesity alone 2x cost for severe obesity vs. moderate obesity for all age groups and both men and women Who pays for severe obesity? 41% public sources (30% Medicare and other federal sources and 11 percent for Medicaid) 27% private insurance 30% out-of-pocket Among adults <65 yrs, costs of severe obesity borne by: 13% Medicaid 36% commercial plans (Wang et al., 2015)
- 38. Cost Savings with BMI Reduction Private payers and employers can potentially save money by supporting employees in weight loss Biggest gains will be among those 45-65 Older adults incur greater health problems & costs Healthcare costs of those over 65 are largely paid by public sources (Medicare) Targeting those in highest weight class will yield biggest cost reduction Weight reduction from severe obesity moderate obesity should on average should cut total healthcare expenditures due to obesity in half (Wang et al., 2015; Ghanta, 2017)
- 39. T2D, Cost, and Physical Activity Cost of diagnosed type 2 diabetes attributable to not meeting Guidelines in the US in 2012 estimated to range from $7.34 billion to $38.55 billion Cost of all type 2 diabetes ranged from $10.19 billion to $53.45 billion (Shah et al., 2017)
- 40. Indirect Costs Cost component Productivity loss Total cost attributable to diabetes ($) Proportion of indirect costs* Work days absent 14 million days 3.3 3.7% Reduced performance at work 114 million days 26.9 29.7% Reduced productivity days for those not in labor force 14 million days 2.3 2.6% Reduced labor force participation due to disability 182 million days 37.5 41.7% Mortality 277,000 deaths 19.9 22.1% Total 89.9 100% Indirect burden of diabetes in the U.S., 2017 (in billions of dollars) (ADA, Diabetes Care, 2018)
- 41. Indirect Costs (Born Largely by Employer) Includes Reduced employment Presenteeism Premature mortality Work days absent Reduced productivity for those not in the workforce Total $3,640 per individual in 2017 dollars (ADA, Diabetes Care, 2018)
- 42. T2D Annual Direct Individual Medical Costs Without diabetes ($) With diabetes* Ratio (with/without) Attributed to diabetes ($)* 7,151 16,752 2.3 9,601 * Adjusted for age and sex (ADA, Diabetes Care, 2018)
- 43. CVD Prevalence and Cost
- 44. Employer-Sponsored Healthcare Total cost of health care, including premiums and out-of-pocket costs for employees and dependents, is estimated to average $14,800 per employee in 2019, up from $14,099 in 2018 Large employers will cover roughly 70% of those costs $4,400 on average for employees out-of-pocket expenses
- 45. So what can you do?
Editor's Notes
- Today we are going to talk about using LIFESTYLE changes to transform YOU, the individual, and maybe even YOUR COMPANIES if you take the right steps....
- Companies have more to gain with healthy employees than good looking meetings LOL Individual or team based programs that are based on evidence and empowerment and education have results. Can you imagine if everyone got the health and mind relief from using food as medicine, exercise prescriptions, mindful interactions and the sleep they need? Someone who is an active participant in their healthcare is an active participant in LIFE. The interactions and efficiency changes you would see?
- Not to mention the cost savings. Here are a few of many stats….80% of health care spending is on lifestyle related illness and injuries. Each additional day of exercise decreases health care costs by 47% An inactive person costs the $1500 more per year than an active person and it costs only approximately $500 to convert an inactive to active person. JH researchers found that being obese added an average of $14,059 in health care costs—either paid by them or their health insurer—over the course of their lifetime. But that’s not all: it would also cost them $14,141 in productivity losses, for a grand total average of $28,020.
- Not to mention the cost savings. Here are a few of many stats….80% of health care spending is on lifestyle related illness and injuries. Each additional day of exercise decreases health care costs by 47% An inactive person costs the $1500 more per year than an active person and it costs only approximately $500 to convert an inactive to active person. JH researchers found that being obese added an average of $14,059 in health care costs—either paid by them or their health insurer—over the course of their lifetime. But that’s not all: it would also cost them $14,141 in productivity losses, for a grand total average of $28,020.
- study also showed the cost-savings opportunities in helping someone move from an obese to overweight, or from overweight to a normal, it makes the monetary value of weight loss more concrete. Rather than waiting for someone to have a heart attack before investing in their care, money would be better spent on helping that person lose weight instead. report increased productivity, reduced absenteeism, fewer accidents, lower turnover, increased ability to attract top talent, and medical costs that grow slower than industry norms, reduced rates of obesity and progress in reducing risk factors like high cholesterol and blood pressure
- THESE ARE ALL PREVENTABLE AND MODIFIABLE RISKS are they worth investing in? Asay GRB, Roy K, Lang JE, Payne RL, Howard DH. Peer reviewed: absenteeism and employer costs associated with chronic diseases and health risk factors in the US workforce. Prev Chronic Dis. 2016;13.
- 116bill dollar spent on obesity, 36% of which is paid by commercial insurance plans (most of which are employer sponsored) Wang YC, Pamplin J, Long MW, Ward ZJ, Gortmaker SL, Andreyeva T. Severe Obesity In Adults Cost State Medicaid Programs Nearly $8 Billion In 2013. Health Aff (Millwood). 2015;34(11):1923-1931.
- Wang YC, Pamplin J, Long MW, Ward ZJ, Gortmaker SL, Andreyeva T. Severe Obesity In Adults Cost State Medicaid Programs Nearly $8 Billion In 2013. Health Aff (Millwood). 2015;34(11):1923-1931. Ghanta RK, LaPar DJ, Zhang Q, et al. Obesity Increases Risk-Adjusted Morbidity, Mortality, and Cost Following Cardiac Surgery. J Am Heart Assoc. 2017;6(3).
- Shah P, Shamoon F, Bikkina M, Kohl HW, 3rd. Medical cost of type 2 diabetes attributable to physical inactivity in the United States in 2012. Diabetes Metab Syndr. 2017;11(1):13-17.
- American Diabetes A. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-928.
- American Diabetes A. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-928.
- American Diabetes A. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-928.
- https://millionhearts.hhs.gov/learn-prevent/cost-consequences.html Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=12&ved=2ahUKEwj414iw2bXdAhVMEawKHVCoBioQFjALegQIBRAC&url=https%3A%2F%2Fwww.cdc.gov%2Fchronicdisease%2Fresources%2Fpublications%2Faag%2Fpdf%2F2016%2Faag-heart-disease.pdf&usg=AOvVaw3gavMFahmqll3h0V_D5wlf
- https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/employers-adjust-health-benefits-for-2019.aspx
- Start following your individual lifestyle prescriptions I gave you today. But start thinking big, thinking outside, thinking different. Is it something small like a carrot incentive instead of a stick consequence? Is it MBSR programs offered on site quarterly? Is it forming relationships with companies that can coach for specific needs? Is it investing in people up front and saving in productivity now and health cost later? Is it an entire new lifestyle focus in the company (new food, new exercise, new staff meeting topics, new chairs)? Can you transform your company? Can you prove it will ROI for you? I’m excited to hear how it will go and how far you can go?! We are all better together, so let's banter some ideas before we go!