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Obesity, Diabetes, and Feet

11/18/2013

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Picture
As obesity rises in our country, so does diabetes, especially Type II, the kind many overweight adults come down with. In extremely obese individuals, one of the major dangers from diabetes is the foot ulceration, which occurs in about 15% of people with diabetes. Podiatry Management, (www.podiatrym.com), a journal for foot doctors, devoted its November/December issue to
“the diabetic foot.”

They quote a number of interesting statistics: in the last ten years, obesity incidence has increased by 60% in adults; in 1985 ten states had less than 10% obesity prevalence and none had one over 15%. Today, about 30% of US adults are obese and about 70% are overweight or obese. The journal explained that in 2012 $471 billion was spend on diabetes-related healthcare worldwide. Yes, obesity isn’t strictly an American epidemic. In the US, diabetes affects nearly 26 million or about eight percent of the population. However, as obesity rises, so will diabetes.

One article emphasized that the five-year mortality rate associated with a foot ulcer is 45%. Compare that to the five-year mortality rate of breast cancer patients, which is 18%. Not pleasant.

Some of the articles showed photos of foot ulcers, which, of course, you can see instantly by searching for them on a Google image search. They’re not pretty. And, according to a friend of mine who practices podiatry, diabetic patients with foot problems come in every day. And most are obese. According to him,
“Everybody wants to play but nobody wants to pay.”

The LifeNuts lifestyle seems difficult for the average person to adopt but actually it’s much easier than it appears. And, if you know a friend or relative with a weight problem, why not suggest this new lifestyle? It might prevent him or her from succumbing to diabetes and, in a worse case scenario, losing a foot!

Last week I had lunch with an old friend (in his 50s) whose BMI was probably in the low 30s, just beyond the obesity threshold. He complained that he was recently diagnosed with diabetes and had to limit his food choices along with changing some other unhealthy habits. So I spent most of the lunch time talking about choices, the LifeNuts lifestyle, and the books of Dr. Neal Barnard, especially his book on reversing diabetes through diet. I hope my friend listened and makes some changes in his life. If not, his future will not be fun. “Everybody wants to play … "


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What's Your Fitness Age?

11/8/2013

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PictureMike at IMM
Yesterday  (Thursday) Mike had his shoulder repaired (a canoe lifting incident), which he had postponed until after the Indy marathon – since he did not want to disappoint anyone, especially after the Indy newspaper featured him on the front page. Surgery successful! Now for the rehab, which will take time. Next Feb. features a new age for him to set new world records! What a LifeNut and what an inspiration to us all!

We walked in the park on the day before surgery since my legs had recovered from the marathon. He told me that his legs weren’t sore at all and, in fact, had “run” ten miles on Tuesday. Just like the Energizer Bunny: he never stops.

Mike also gave me numerous clippings from the Sunday edition of the New York Times, which he faithfully scouts for me. One piece, “How Old Is Your Health,” from the NYT magazine was particularly fascinating. Researchers in Norway evaluated almost 5,000 people between ages 20 and 90, taking measurements: BMI, heart rate, HDL and total cholesterol. Each person completed a lifestyle questionnaire and then ran to the point of exhaustion on a treadmill – to measure VO2max, a term denoting how well the body delivers oxygen to cells. Other studies have shown VO2max to determine fitness age and life expectancy.

It was fascinating to see that the researchers used the data and an algorithm to predict a person’s VO2max accurately from the data – without the treadmill test. They published their results in the journal,
Medicine & Science in Sports and Exercise. And, get this, they developed an online calculator to allow anyone to determine his or her fitness level. Try it: www.ntnu.edu/cerg/vo2max.

For example, a 50-year-old man who exercises moderately a few times a week, has a 36-inch waist, and a pulse of 75, will have a fitness age of 59. Nice, huh? This also is probably a good predictor of life expectancy as well as how one will spend his time in the "golden" years - in a nursing home or walking/running in the woods with the younger set.

I entered data for an overweight female, age 25, waistline 38 (be sure to convert inches to cm), little exercise, and a pulse of 80. Result: fitness age was doubled to 50.

Mike told me that his fitness age was 54 – nearly 40 years younger. Mine was 40, almost 30 years younger – with a VO2max of 48. One of my sons, who is a very good runner, had fitness level 12 years younger!

This calculator is significant since it offers a large databank reflecting exercise, waistline, and pulse. LifeNuts uses the BMI calculator, which is great and a good indicator of fitness but does not incorporate heart function.

So, try the Norwegian calculator and see how old you really are!

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No New World Record, but a Gutsy Performance

11/3/2013

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PictureMike at the expo presentation
Mike and I gave presentations on the LifeNuts program and lifestyle at the
Indianapolis Monumental marathon on Friday. The race director also allowed us to speak at the pasta dinner that evening: so, hopefully some runners will take the program to his or her city and implement it there. We can only hope. Sadly no mayors or city council people attended even though I sent emails several times to 40 towns. 

In the seminar, I tried to explain that the concept of old age in America is that of wheelchair-bound people, assisted living, and dementia, which unfortunately is fairly accurate. Mike Fremont and his lifestyle prove that old age doesn’t have to be a drain on society and that, at 91, one can be happy, vibrant, and productive – as he is. I think those attending were lucky to see Mike, listen to him, and take in his wisdom.

The beautifully organized marathon demonstrated the race director’s attention to detail and his ability to delegate. And, since the temps were absolutely perfect for marathon running, I thought Mike would break his half-marathon record of 3:03. But, alas, that didn’t happen. After the race, Mike told me that his shoulder (which will be repaired surgically this week) didn’t bother him too
much but that he was distracted by some individuals. Being famous is tough, eh? Many cheered him on at street corners and a TV station interviewed him. And, I’m sure we’d all agree that it would be wonderful if we could run 13.1 miles in 3:24 at the age of 91.

So, no more blogs from Mike for awhile, though I’m sure he’ll write some occasionally. I will take over for now and post at least a couple each month. If you like us on Facebook, you’ll be alerted when the blogs are posted. In the meantime, stay healthy and happy!


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    Dr. Bob Kroeger is the founder of LifeNuts. He's also proud to be a LifeNut.

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