Annual EU healthcare index puts The Netherlands in “uncontested leadership”

The Netherlands win the 2009 Euro Health Consumer Index (EHCI), for the second year in a row - the first time this happens since the EHCI started in 2005 - and with an outstanding margin. Nevertheless, Denmark keeps its runner-up position from last year.

Besides the Dutch and Danish system there is a small group of strong performers: Iceland, Austria and Switzerland.There are general improvement trends among most of the measured healthcare systems, with examples of reform making impact not only in Netherlands but in Ireland and the Czech Republic as well.

There is continuous decline in the Spanish, Portuguese and Greek healthcare systems which do not keep up with the improvement rate one can find in countries like the Netherlands, Denmark or Ireland. Large parts of Eastern and Central Europe seem to be affected by the financial crisis.

The HCP research director, Dr. Arne Bjornberg, comments on the EHCI 2009 outcomes: "As the Netherlands are expanding their lead among the best performing countries, the Index indicates that the Dutch might have found a successful approach. It combines competition for funding and provision within a regulated framework. There are information tools to support active choice among consumers.

The Netherlands have started working on patient empowerment early, which now clearly pays off in many areas.Johan Hjertqvist, President of Health Consumer Powerhouse, commented: "With patient mobility growing around Europe, there is a strong need for transparency exposing the pros and cons of the national healthcare systems. The EU intends to introduce a crossborder care scheme which requires significantly better information to patients. This years´ measurement indicates that forward-looking governments start using healthcare information and choice to engage patients in the decision-making, building a pressure from below for improvement".


EHCI categories
The EHCI 2009 groups 38 indicators of quality into six categories: Patient rights and information, e-Health, Waiting time for treatment, Outcomes, Range and reach of services provided and Pharmaceuticals. Each sub-discipline is weighted for importance to provide the overall Index score.The individual category leaders were as follows:

• Patient rights and information: Denmark
• e-Health: Denmark, Netherlands
• Waiting time for treatment: Albania, Belgium, Germany, Switzerland
• Outcomes: Sweden
• Range and reach of services provided: Belgium, Luxembourg, Sweden
• Pharmaceuticals: Denmark, Netherlands

The 2009 EHCI is developed in co-operation with the European Commission DG Information Society and Media and works under the auspices of the Swedish EU Presidency.

Obesity Causes More than 124,000 New Cancers a Year in Europe

According to estimates from a new modeling study, at least 124,000 new cancers in 2008 in Europe may have been caused by excess body weight. The proportion of cases of new cancers attributable to a body mass index of 25kg/m2 or more were highest among women and in central European countries such as the Czech Republic, Latvia, Slovenia and Bulgaria.

The lead author of a study called ‘Incident cancer burden attributable to excess body mass index in 30 European countries’, published in the International Journal of Cancer, Dr Andrew Renehan, told oncologists and other medical professionals gather together in Berlin, Germany during the combined 15th congress of the European CanCer Organisation and the 34th congress of the European Society for Medical Oncology: “As more people stop smoking and fewer women take hormone replacement therapy, it is possible that obesity may become the biggest attributable cause of cancer in women within the next decade.”

Dr Renehan, who is a senior lecturer in cancer studies and surgery at the University of Manchester (UK), and his colleagues in the UK, The Netherlands and Switzerland, created a sophisticated model to estimate the proportion of cancers that could be attributed to excess body weight in 30 European countries. Using data from a number of sources including the World Health Organization and the International Agency for Research on Cancer, they estimated that in 2002 (the most recent year for which there are reliable statistics on cancer incidence in Europe) there had been over 70,000 new cases of cancer attributable to excess BMI out of a total of nearly 2.2 million new diagnoses across the 30 European countries.

The percentage of obesity-related cancers varied widely between countries, from 2.1% in women and 2.4% in men in Denmark, to 8.2% in women and 3.5% in men in the Czech Republic. In Germany it was 4.8% in women and 3.3% in men, and in the UK it was 4% in women and 3.4% in men.

Then, the researchers projected the figures forward to 2008, taking into account what was known about shifts in the distribution of BMI, the dramatic decline in women’s use of hormone replacement therapy (HRT) from 2002 onwards following research that showed it increased the risk of breast cancer, and the wider use of PSA screening for prostate cancer in men.

They found that the number of cancers that could be attributed to excess body weight increased to 124,050 in 2008. In men, 3.2% of new cancers could be attributed to being overweight or obese and in women it was 8.6%. The largest number of obesity-related new cancers was for endometrial cancer (33,421), post-menopausal breast cancer (27,770) and colorectal cancer (23,730). These three accounted for 65% of all cancers attributable to excess BMI.

“I must emphasize that we are trying not to be sensationalist about this,” said Dr Renehan. “These are very conservative estimates, and it’s quite likely that the numbers are, in fact, higher.”

The number of new cases of obesity-related esophageal cancer was particularly high in the UK relative to the rest of Europe. “This country accounts for 54% of new cases across all 30 countries,” said Dr Renehan. “This may be due to synergistic interactions between smoking, alcohol, excess body weight and acid reflux – and is currently an area where research is required.”

Until 2002 when HRT use dropped dramatically following the results of the Women’s Health Initiative Trial (USA) that showed an increased risk of breast cancer in women taking HRT, Dr Renehan said that HRT masked and diluted the effects of obesity on the incidence of breast cancer. “In women who used HRT it wasn’t clear what proportions of breast cancers were caused by HRT or by obesity. In women who don’t take HRT, the effect of obesity was much clearer. Now that far fewer women are using HRT, it is much easier to see the effect of obesity on the incidence of breast cancer, and also on endometrial cancer. Consequently, the proportions of these cancers attributable to obesity have increased.”

Dr Renehan said that although European countries were taking steps to tackle the obesity epidemic, this study underlined the urgency of the task and the scale of the problems caused by increasingly overweight populations.

“The overall size of the burden of increasing cancer incidence should inform health policy. For example, it is clear that, in both relative and absolute terms, obesity-related cancer is a greater problem for women than for men. At a country level, it is a greater problem for central European countries like the Czech Republic, whereas it is less of a problem in France and Denmark. Similarly, obesity-related esophageal cancer seems to be a substantial and unique problem in the UK.

“The study also identifies priorities for research into certain cancers, namely endometrial, breast and colorectal cancers. In the face of an unabating obesity epidemic, and apparent failure of public health policies to control weight gain, there is a need to look at alternative strategies, including pharmacological approaches.”

Dr Renehan’s own research is trying to relate these epidemiological findings back to the biological mechanisms that are at work. His research uses the observed interactions between excess BMI and cancer risk to guide questions in the laboratory.

For more information:

• ECCO15 – ESMO 34 Abstract no: 327, Oncopolicy session: Drug and lifestyle mediated prevention initiatives in Europe. Thursday 11.15-12.15 hrs CEST (Hall 3)

Survey Shows that Diabetic Nerve Pain Significantly Impacts Daily Activities

In a new online survey conducted among 553 men and women, 18 and older who have either type I or II diabetes and are suffering from diabetic nerve pain in the United States, eighty-five percent said that their pain was one of the top three most bothersome complications of their diabetes.

Despite the fact that people with diabetic nerve pain recognize the condition's impact on their lives and eighty-four percent of those surveyed said they have discussed the condition with a healthcare provider, just slightly less than half of respondents (49 percent) were treating their pain.

The survey was fielded as part of a new educational campaign, "Take the Next Step," which is designed to help people with diabetes recognize the symptoms of painful diabetic peripheral neuropathy (pDPN) and proactively talk to their healthcare professional about incorporating the treatment of pDPN into their overall diabetes care, which may include blood sugar control, diet, pain management, exercise or other changes in lifestyle. The initiative is supported through a sponsorship by Pfizer Inc.

Taking Control of Your Diabetes (TCOYD), a leading non-profit organization dedicated to educating people about diabetes, and Kim Lyons, personal trainer and nutritionist featured on NBC's hit show, "The Biggest Loser," are participating in this campaign to raise awareness of pDPN, one of the most common and debilitating complications of diabetes. "Take the Next Step" features an activity program developed by Lyons to demonstrate activities that are appropriate for people with diabetes and help people with pDPN understand how increasing their activity level can help them control their pain.

"Optimal blood sugar control has been shown to prevent the onset and delay the progression of pDPN and ease its symptoms," said Steven Edelman, MD, Founder and Director of the not-for-profit 'Taking Control of Your Diabetes' and Professor of Medicine, University of California at San Diego. "Given the debilitating impact of pDPN, such as on a person's ability to be physically active and to fall asleep at night, treating the pain can really make a difference for these patients and help them get back to normal daily activities which in turn can help them better manage their diabetes."

Many patients are unaware of treatment options.
Of the people surveyed, almost two-thirds (64 percent) said that their nerve pain interfered with the daily activities that matter to them. The most common activities that respondents said were impacted by their pain were exercising (76 percent), falling asleep (71 percent) and spending time with or caring for family (68 percent). Of the more than half of those surveyed who were not being treated (51 percent), less than a third (32 percent) were aware of treatments that are approved to treat the condition.

Currently, nearly 24 million Americans suffer from diabetes. Approximately 20 percent of people with diabetes experience painful diabetic peripheral neuropathy, most commonly caused by poorly controlled blood sugar levels that result in nerve damage over time. Symptoms of pDPN may include burning, throbbing or painful tingling in the feet or hands.

The pain associated with the condition can become extremely debilitating, affecting patients' everyday activities such as the motivation needed to exercise and be active and the ability to fall asleep. Difficulty maintaining an active lifestyle can hamper patients' ability to control their weight, an important key to diabetes management. Treatment guidelines point to the unique nature of pDPN and the need for specialized treatment, which can include prescription treatment for the pain.

"I was motivated to be a part of this campaign because I've seen the benefits of activity for people who suffer from pDPN," said Kim Lyons. "I know that for people with this kind of pain, engaging in physical activity might seem daunting at first, but people will be amazed to see that taking small steps towards increasing activity level can make a big difference."

Prevention, early diagnosis and aggressive treatment are critical
People with diabetes can develop nerve pain at any time, but the risk is greater the longer a person has suffered from diabetes, with the highest rates among those who have had the condition for at least 25 years. In the early stages of nerve damage, some people have no symptoms, or may have numbness or tingling in the feet. These symptoms can be mild at first and because nerve damage can occur over several years, these cases may go unnoticed until the nerve damage progresses and becomes painful, sometimes leading to painful diabetic peripheral neuropathy (pDPN).

A number of prescription medications are approved by the U.S. Food and Drug Administration (FDA) to help relieve the specific symptoms of pDPN. These medications can play an important role in helping to reduce the pain associated with this condition. Over-the-counter pain medicines such as acetaminophen and ibuprofen are frequently used, but have not been specifically approved by the FDA to treat painful diabetic peripheral neuropathy.

For more information:

• Diabetes Pain Help

Introducing a More Powerful WIN CoQ10™

Vitaelin Nutraceuticals today introduced the new and improved WIN CoQ10™ packs a powerful punch with its new size.

WIN CoQ10™ contains the most advanced, form of CoQ10 available, ubiquinol, which plays a vital role in energy production. Additionally, this ubiquinol form is an active antioxidant protecting the body’s cells from damage caused by oxidative stress and free radicals. Experience new sustained energy and promote your overall health with WIN CoQ10™ .

WIN CoQ10™ is a nutritional supplement containing ubiquinol, the reduced form of coenzyme Q10, which has been shown to help lower blood pressure and improve symptoms related to heart disease and may help improve brain functioning. Additionally, WIN CoQ10™ may help restore coenzyme Q10 which can be lost when taking certain medications to lower cholesterol levels, such as statins, and dietary supplements containing red yeast rice. Maintaining coenzyme Q10 levels are essential as coenzyme Q10 is a critical component of energy metabolism at the cellular level. WIN CoQ10™ 's protective effect on the heart may slow the aging of cells associated with the cardiovascular system.

WIN CoQ10™ 's 100% natural, high-absorption formula is far superior to most CoQ10 supplements because they primarily consist of ubiquinone which isn’t as easily absorbed by the body. Studies show WIN CoQ10™ absorption rate is 8 times higher than supplements with ubiquinone and maintains higher levels of CoQ10 in the blood over time. It took 2400mg of ubiquinone to reach the same level of CoQ10 in the bloodstream with only 300mg of WIN CoQ10™ 's ubiquinol formulation.

WIN CoQ10™ may:

• Support and maintain energy production
• Promote heart health
• Help prevent free radical damage
• Help protect against oxidative stress
• Maintain healthy, normal blood pressure
• Help manage the entire circulatory system
• Promote a healthy immune system
• Maintain healthy neurological function

Studies show WIN CoQ10™ formula additionally supports periodontal tissue well-being, musculoskeletal health and the body’s natural defense system.

Now More Powerful
WIN CoQ10™ now includes a new, patent-pending crystal free technology, WIN-CFT™, which provides a clearer appearance and improves CoQ10’s absorption rate within the body. The solution featuring D-Limonene oil helps better protect ubiquinol from oxidization. When oxidization does occur, ubiquinol crystallizes resulting in a cloudy, opaque appearance. By keeping the CoQ10 solubilized, things start to look much clearer and the required amount of oil solution is halved, providing us with a smaller soft gel, all while improving CoQ10 bioavailability within the body.

WIN CoQ10™ now also contains a versatile antioxidant called alpha lipoic acid (ALA) to help extend CoQ10’s energy production benefits.Though its appearance is a little different, the new and improved WIN CoQ10™ is still filled with 50 mg of the most advanced, high-absorption form of CoQ10 available with WIN-CFT™ maximizing its absorption rate.

• For more information and to order, click here.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, mitigate or prevent any specific disease or class of diseases.

Obesity Driving America's Healthcare to a Tipping Point

The Obesity Society, a leading scientific organization dedicated to the study of obesity, and other steering committee members of the Strategies to Overcome and Prevent (STOP) Obesity Alliance, and two former US Surgeons General, join together today to develop effective recommendations to urge policymakers to act on the inclusion of obesity as the largest and most urgent driving factor in healthcare reform.

The two most recent Surgeons General of the United States, David Satcher MD, PhD and Richard H. Carmona, MD, MPH, respectively 16th and 17th US Surgeons General, jointly urged policymakers to take direct action on obesity and its associated chronic diseases by including obesity as a key element in healthcare reform.

"Health reform will succeed only if we address obesity and the chronic diseases it causes," said Robert Kushner, MD, President of The Obesity Society. "Obesity is the number 1, most serious health issue facing the country. It is also the largest single driver of our increasing healthcare costs and we need to address it now."

More than one third of US adults -- more than 72 million people -- and 16 percent of US children are now estimated to be overweight or obese. Obesity and overweight are associated with several chronic health risks and conditions, including: diabetes, heart disease, stroke, hypertension, some types of cancer, sleep apnea, osteoarthritis, and gallbladder disease. Furthermore, the medical costs of obesity are now estimated at more than $147 billion per year.

The Obesity Society supports the four targeted recommendations for effective healthcare reform issued by the STOP Obesity Alliance at the meeting held today at the Newseum in Washington, DC:

• Standardized and effective clinical interventions, flowing from evidence-based guidelines, such as those approved by the National Heart, Lung and Blood Institute (NHLBI), that include acknowledging the health benefits of five to ten percent sustained weight loss to
  aid and support those individuals who are currently overweight or obese achieve improved health.
• Enhanced use of clinical preventive services to monitor health status and help prevent weight gain, especially for individuals who are already overweight and are at risk of becoming obese.
• Effective, evidence-based community programs and policies that encourage and support healthy lifestyles, focus on health literacy, address health disparities, and represent a significant investment in population-based prevention of obesity.
• Coordinated research efforts to build the evidence for all three of the above elements, continuously improving quality of care, bolstering our understanding of what does and does not work in various settings, and helping to translate the scientific research into practice
  recommendations for real-world clinical settings and communities.

"These recommendations are designed to improve the dialogue and interventions around obesity. Successful reform will address clinical treatment, prevention, community programs and research to reverse the medical burden of obesity," said Dr. Kushner. "Lending our support to the STOP Obesity Alliance recommendations will also bring us one more step closer to providing a health system that can effectively lessen the grip of obesity on our society."

For more information:

• OBESITY, Halting the Epidemic by Making Health Easier (Centers for Disease Control)
• Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, NHLBI.
• Eric A. Finkelstein, Justin G. Trogdon, Joel W. Cohen, William Dietz, [Health Affairs 28, no. 5 (2009): w822-w831 (published online 27 July 2009; 10.1377/hlthaff.28.5.w822)]

Simple ABCs of Weight Loss and Fitness: Advice From Someone who Knows

Modern American society is filled with easily accessible fatty foods, a growing obesity epidemic and a general lack of healthy living. In his new book,Lose Weight, Feel Great: How I Lost Over 60lbs. with the Help of a Personal Trainer,author Kevin Given tells of his personal struggles with obesity, how he lost over 60 pounds with the help of a personal trainer, and how others can change their lifestyles and bodies as well.

Says Given 'This book is different from other weight loss books because it is my personal story of how I overcame the obstacle of obesity. I also avoid going into unnecessary detail. I find that most problems with weight loss books are that they get bogged down with details on how certain things work. My book cuts to the chase and makes it simple. "If you do this, then this is what will happen."

Given Continues: "If you eat certain foods, this is how they will affect your system. If you do a certain exercise; for example dumb-bell curls, then this is what will happen; your biceps will develop. There are no unnecessary details here that will only slow you down. In my book you will find the simple ABCs of weight loss and fitness."

Given had ongoing issues with his weight for over 20 years with many failed attempts at change. He tried numerous fad diets that never worked, so he then decided to hire a personal trainer to aid him in losing weight and keeping it off for good. Now a certified personal trainer himself, Given hopes to help others through a combination of historical knowledge of human health, personal testimony, exercises and fitness techniques, nutrition, and other information vital to weight loss and good health.

While the use of this book and practicing a healthy lifestyle are certainly reliable ways to lose weight and get in shape, Given also believes the aid of a personal trainer helps immensely in this journey toward the ideal you.

"If the military sent a soldier to basic training with only an army manual and no guidance, that soldier wouldn't learn much! How many soldiers would get up at four or five AM without the drill sergeants going through the hall with a stick and a garbage can banging as loudly as he or she can? Who would be motivated to do pushups if the drill sergeant didn't yell, "Drop and give me twenty"? Just as the soldier is guided to his peak performance during army basic training, so an individual seeking to get into better shape will be guided by the personal trainer into reaching his/her goal", Given explains.