Disease Management Update
Volume IV, No. 46
March 13, 2008
Dear Healthcare Intelligence Network Client,
As the American Dietetics Association celebrates its 35th annual National Nutrition Month this March, this week's Disease Management Update looks at nutrition and the impact it can have on health. Researchers have discovered a correlation between eating greens and decreasing your risk of breast cancer, and another study documents the effect dietary changes can have on lowering cholesterol levels.
Visit HIN's blog to read about some other health-related problems that diet can create.
Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update
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Table of Contents
- Link Found Between Vegetables and Decreased Risk of Breast Cancer
- Disease Management Q&A: The PCP's Role in Weight Management
- HealthSounds Podcast: Healthcare Toolkits Award — Breast Cancer Survivors Navigation Kit
- Many Patients Can Reach LDL Cholesterol Goal Through Dietary Changes Alone
- Survey of the Month: Pain Management in Healthcare and the Workplace
- Managing Digital Mammography: Hardcopy Printer Improves Detection and Treatment of Breast Cancer
1. Link Found Between Vegetables and Decreased Risk of Breast Cancer
Researchers with Vanderbilt-Ingram Cancer Center and the Shanghai Cancer Institute in China have discovered a possible link between a diet rich in certain vegetables and a decreased risk for breast cancer. A total of 3,035 women diagnosed with breast cancer were closely matched with 3,037 women randomly chosen from the general population there. The women filled out questionnaires about their diet, including consumption of cruciferous vegetables.
While there was only a small positive relationship between a diet rich in these vegetables and a reduction in breast cancer risk for the overall study population, there was a striking risk reduction — 50 percent — among women with a certain genetic profile. Researchers identified three forms of the GSTP1 genotype among the cancer patients: Ille/Ile, Ile/Val and Val/Val.
"Women who consumed more of these cruciferous vegetables and who also had the Val/Val genetic polymorphism had a lower breast cancer risk. So we cautiously interpreted this as diet being a factor that may reduce the impact of genetic susceptibility in overall breast cancer risk," said Jay Fowke, Ph.D., assistant professor of medicine at Vanderbilt-Ingram.
To learn more about this study, please visit:
2. Disease Management Q&A: The PCP's Role in Weight Management
Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Eric Berman, D.O., M.S., medical director for Horizon Blue Cross Blue Shield of New Jersey.
Question: Are you involving the participants' primary care physicians (PCPs) with weight management?
Response: (Erin Berman) Horizon has not incorporated the PCP, because it's difficult. It depends on what kind of health management organization (HMO) model you're using. If you have a physician-gatekeeper model, then it's difficult because most PCPs would do nothing more than just say whether the patient has an abnormal BMI and refer them to a weight management program. It's very time-consuming for PCPs to work with a patient on an individual basis.
You probably could get more bang for the buck if the HMO developed a program that your members could access, or if you approved other programs like Weight Watchers or offered other incentives. There was a program in California where participants were paid $1,000 if they reduced their weight and got into the normal BMI classification. Participants were paid half of the money up front for getting into a normal range and then the other half of the money six months later if they maintained that weight. Health plans are starting to look at a lot of incentives.
It is difficult to change personal behavior. At Horizon we try to allow the members to find a method they feel comfortable with. Some people may like Weight Watchers, and some people may not. Other people may like going to a health club, other people would just like to start walking. I think you have to individualize it because everybody is different and you have to allow for variety, because the same thing is not going to work for each person. Again, putting forth a very simple message of reducing portion size, eating the right kind of foods and starting to walk would be a good way to start the program.
For more information on patient behavior modification, please visit:
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3. HealthSounds Podcast: Healthcare Toolkits Award — Breast Cancer Survivors Navigation Kit
In this week's disease management podcast, the winners of HIN's annual Healthcare Toolkits contest talk about the development and implementation of their toolkit "MyHealth, MyJourney," a post-diagnosis patient navigation kit developed by The Eden Communications Group, accented with artwork and writings by breast cancer survivors.
To listen to this complimentary HIN podcast, please visit:
4. Many Patients Can Reach LDL Cholesterol Goal Through Dietary Changes Alone
For people with high cholesterol, a national study led by University of Michigan (U-M) Health System researchers shows the importance of nutrition help from aregistered dietitian (RD). The new results are based on data from 377 patients with high cholesterol who were counseled by 52 registered dietitians at 24 sites in 11 states.
In the group of 175 patients who started the study with triglycerides less than 400 milligrams per deciliter of blood (mg/dL), and who had their cholesterol measured before they changed or added medication, 44.6 percent either reduced their levels of “bad” cholesterol by at least 15 percent, or reached their cholesterol goal. The results reflect progress in approximately eight months, after three or more appointments with a dietitian. But the results add further evidence that medical nutrition therapy can make a big difference in a patient’s life.
"This is the first national study to show what happens when high-risk patients work with RDs to follow nutrition guidelines grounded in the best evidence," says lead author Kathy Rhodes, Ph.D., RD. “We hope that this demonstration of how well cholesterol can be lowered without medication or increases in medication will be very useful for patients and physicians, and perhaps insurers too.”
To see more about this study's results, please visit:
5. Survey of the Month: Pain Management in Healthcare and the Workplace
Complete our online survey on pain management in healthcare and the workplace by March 31, and you'll get a free executive summary of the compiled results.
To participate in this survey and receive its results, please visit:
6. Managing Digital Mammography: Hardcopy Printer Improves Detection and Treatment of Breast Cancer
Full Field Digital Mammography (FFDM) has the near-term potential to dramatically improve the way physicians detect and treat breast cancers, as well as radically change how mammography facilities record, archive, share and dispatch images. Part of the latter may involve a shift toward dry hardcopy printing of digital breast imaging.
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