In this issue of To Your Health:
- Obesity: Tough on the Hips,
Tougher on the Knees
- How Do You Spell Good
Patient Care? R-E-S-P-E-C-T
- Processed Foods Cause
Prostate Blues
Obesity: Tough on the
Hips, Tougher on the Knees
 Obesity
can lead to a wide range of health problems in adults, one of
which is osteoarthritis. Osteoarthritis is one of the leading
reasons for people to have hip- or knee-replacement surgery.
It doesn't take much, then, to assume that obesity contributes
to having to have a joint replaced. Researchers in this study
attempted to determine exactly what role obesity plays in
joint replacement, and whether obese patients are more likely
to need their hip joints or knee joints replaced.
In this study, the
authors looked at the health records of more than 17,000
people undergoing hip or knee replacement surgery. The
patients were then grouped into one of four categories -
obese, overweight, acceptable weight, or underweight - based
on their body mass index, or BMI.
Results: Eighty-one
percent of joint replacement patients with BMI measurements
were classified as obese or overweight. Only 18 percent had an
"acceptable" weight, with a BMI between 18.5 and 24.9. After
adjusting for age and gender, obese patients were three times
as likely to have a joint replaced compared to acceptable
weight patients; overweight patients were twice as likely to
have joint replacement surgery.
The authors concluded
that being overweight or obese "not only increases the
likelihood of needing a joint replacement, but it also has a
negative impact on how well a patient recovers and how long a
patient remains in hospital following surgery." They added
that being obese or overweight could cause other
complications, such as repeat surgeries, because the extra
weight could lead to more wear and tear on an artificial
joint.
Canadian Joint
Replacement Registry. 2005 Report - Total Hip and Total
Knee Replacements in Canada. Ottawa, Ontario, Canada:
Canadian Institute for Health Information.
How Do You Spell Good
Patient Care? R-E-S-P-E-C-T
It's well-known that the
more involved a patient is in the care they receive, the more
likely that patient is to have a good outcome. However,
there's a big difference between getting a patient involved in
their care, and having patients feel respected by the doctor
who sees them. What's the difference between respect and
involvement, and how does it affect what your patients do? The
answers to those questions formed the basis of this recent
survey.
In the survey,
researchers asked more than 5,000 patients who had a "medical
encounter" in the past two years about the quality of care
they received and how involved they were in making decisions
about their care. The patients were also asked about the level
of dignity and respect with which they were treated, and to
note any times where they didn't follow their doctor's advice,
get a recommended test, or chose not to see another doctor
that was referred to them.
Most of the patients
reported "being treated with a great deal of dignity and
respect," "being involved in decisions to the extent that they
wished," or both. When patients were treated with dignity,
they were "more likely" to report being satisfied with the
care they received and to stick to a treatment plan. Patients
who helped decide their course of care also reported feeling
more satisfied with their doctor, and were more likely to
adhere to their treatment plan.
While most patients
expect to be treated with respect by their doctors, the sad
fact is, it doesn't always happen. Spending a few extra
minutes to explain what's being done (and why), and letting a
patient have more of a say in his or her care, will go a long
way toward ensuring that a health-related complaint or problem
will have a happy ending for patients - and their doctors.
Beach MC,
Sugarman J, Johnson RL, et al. Do patients treated with
dignity report higher satisfaction, adherence, and receipt of
preventive care? Annals of Family Medicine, July/August
2005;3(4):331-338.
Processed Foods Cause
Prostate Blues
Research has shown that
the more fat you consume, the greater your chances of
developing prostate cancer. However, fat isn't the only
factor. The types of food a person eats, along with the amount
and frequency of food, can also contribute to an increased
prostate cancer risk.
In this Canadian study,
scientists explored the link between diet and prostate cancer
in more than 400 men ages 50 to 80, using questionnaires that
detailed the men's dietary habits in the previous two years.
After reviewing the questionnaires, each of the men fell into
one of four dietary patterns: "healthy living" (high intake of
fruits, vegetables, whole grains, fish, and poultry);
"traditional Western" (red meat, processed meats, sweets, and
hard liquor), "processed" (processed meats, red meat, organ
meats, refined grains, vegetable oils, and soft drinks), and
"beverages" (high intake of tap water, soft drinks, fruit
juices, poultry, and potatoes).
Results: Men whose diets
fell into the "processed" pattern had a significantly higher
risk of developing prostate cancer than men in the other
groups. According to the researchers, "the highest tertile of
factor score for the Processed Diet pattern ... was associated
with a >2.5-fold increased prostate cancer risk." Men with
traditional Western diets showed a "slightly increased
prostate cancer risk," while men in the other groups either
had no risk or less risk of developing prostate cancer.
While prostate cancer is
quite common in men, there are simple steps you can take to
reduce your chances of getting it. For instance, you can lower
your intake of processed foods and red meats, and increase
your intake of fruits, vegetables and whole (unrefined)
grains. You can also speak with your doctor of chiropractic
about setting up a health plan that incorporates all of the
features necessary for a balanced diet.
Walker M,
Aronson KJ, King W, et al. Dietary patterns and risk of
prostate cancer in Ontario, Canada. International Journal
of Cancer, Sep. 10, 2005;116:592-598. |
