"If you aren't seeing a chiropractor, you must be on drugs."

September 20, 2005 [Volume 6, Issue 20]

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.