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courier-journal.com (Related) (Related) (Related) courier-journal.com > Local News (Related) (Related) (Related) Local News Friday, May 11, 2007 E-mail this (Related) (Related) (Related) | Print page (Related) (Related) (Related)
Good choices are only the first step
By Mark Coomes
mcoomes@courier-journal.com (Related) (Related) (Related)
The Courier-Journal
This special project first appeared in The Courier-Journal in 2005.
Kentuckians suffer from a host of chronic diseases for which there are three straightforward cures:
Stop smoking. Eat better. Exercise more.
"It's hard work to make the right choices," University of Kentucky bioethicist Sara Rosenthal said.
Jim and Mary Lund of La Grange, who own a remodeling and interior trim business, made two of those choices about three years ago. Consulting with a physician and a personal trainer, they increased their exercise and started switching their family to a healthier diet, cutting out junk foods and serving more vegetables and low-fat meats.
He has lost 100 pounds. She lost 72 -- and last month placed fifth in a division of the Kentucky Muscle figure competition.
But for Kentuckians, the decision to take responsibility to lead healthier lives can be difficult to turn into reality.
Lack of access to health care providers, healthy foods and safe places to exercise can be roadblocks to healthier lives for the those in rural areas and the poor across the state.
As a largely poor and rural state, Kentucky owns some of the worst rates in the nation for smoking, obesity, exercise and deaths due to cancer and heart disease.
Chronic illnesses have left Portia Henley, a 50-year-old grandmother from Louisville, unable to keep a steady job. She has diabetes and struggles to pay for the better food and special drugs her condition requires; asthma inhibits her ability to exercise.
"I'm fighting a real battle," said Henley. "It's hard to stay on the straight and narrow in terms of what you eat when you don't have the income to handle the price of medicine, the price of going to doctors and the price of keeping a roof over your head, plus the cost of buying food for this one specific health problem."
But across the state, it is our propensity to light up, chow down and sit around that makes us susceptible to the health problems that UK President Lee Todd calls "Kentucky's Uglies." And that includes those who live in the state's cities and suburbs, who have good access to health care and the jobs that provide good health insurance.
In a national survey of 153 counties published this month by the Centers for Disease Control and Prevention, Jefferson County ranked last in exercise, fourth-to-last in smoking and 137th in obesity.
Said Steven Aldana, professor of lifestyle medicine at Brigham Young University:
"You've got a triple whammy going on over there. Chronic health problems really come down to three things, and that's why your state is in trouble: tobacco use, lack of physical activity and poor nutrition."
And too many of us are choosing poorly.
TEMPTING MESSAGES
Society helps us makepoor lifestyle decisionsChronic diseases such as lung cancer, colorectal cancer, obesity and heart disease have made Kentucky one of the sickest states in the nation.
And they're largely the result of poor lifestyle choices.
About 40 percent of all cancers are caused by poor nutrition and insufficient exercise, according to the Harvard Report on Cancer Prevention. And 82 percent of heart disease and 91 percent of diabetes stem from the same causes, other studies show.
Modern America tempts people with messages about the ease of picking up a high-fat, fast-food meal or the pleasure of driving a comfortable car to the corner store rather than walking.
"Temptation is socially produced," Rosenthal said. "Acting on it is a personal choice."
"I know I should quit smoking," said Don Cornwell, general manager of Perry Manufacturing Co., in Hazard. "I've tried. I was like Hitler without the charm."
Cultivating healthy habits isn't easy, not even for people like Aldana, who holds a doctorate in exercise science and lives in Utah, where the rates of smoking and obesity are among the lowest in United States.
Aldana is 43 but only in the past few years did he trade red meat and french fries for grilled fish and green salads.
The professor said "it took a lot of data" to persuade him to change his ways.
"People who choose well are swimming upstream against all the media pressure, against all the advertising, against all the reasons in the world not to do this," Aldana said.
NEED TO ADJUST
We're just not built forfatty foods, little exerciseHumans once had to work hard just to survive; there was little chance to store fat for energy.
But in the modern world, food is abundant and physical labor is scarce. Human metabolism has not adjusted to that change.
"Simply put, we weren't genetically programmed for the automobile and fast food," said Dr. L. Raymond Reynolds, a professor of endocrinology and associate director of UK's Weight Management Resources program.
But it has just been in the past 15 years that obesity has begun a precipitous rise. In 1991, no state had an obesity rate greater than 19 percent. In 2004, 33 states were over 20 percent and nine, including Kentucky, exceeded 25 percent, according to the CDC.
CDC researchers noted that portion sizes and access to in+expensive junk food have grown at the same time. People also have been doing less physical work and exercise, contributing to obesity.
"It's not a genetic thing, it's an environmental thing," said Dr. James Anderson, head of UK's Metabolic Research Group. "The good news is that we have the potential to take control of that."
As director of UK's Weight Management program, Anderson instructs patients to take control by exercising more, eating less and eating better; i.e., to trade burgers and fries for fruits and vegetables.
Anderson said only 50 percent of obesity is attributable to genetics. Very few people, for example, can authentically claim to have a slow metabolism.
"The metabolic rates of obese people are usually within 5 to 10 percent of normal," Anderson said.
Yet there is no doubt that some people store fat more easily than others. Anderson is one of them. So is Deborah Finkel, a behavioral psychologist at Indiana University Southeast.
Several members of Finkel's family are overweight, and she struggled with the issue herself before losing 50 pounds that she has not regained.
Heredity is not destiny when it comes to gaining weight, Finkel said. Nor are eating habits learned in childhood. Studies show that adults eat like the people around them eat, not as they ate as children.
"Genetics loads the gun," Anderson said. "Environment pulls the trigger."
So he forces himself to exercise by parking at Commonwealth Stadium each day and walking 1.2 miles to his office instead of riding the shuttle.
"The vast majority of people can get their weight under control and keep it under control," Anderson said. "It requires changes in lifestyle habits that are difficult but not impossible -- more physical activity, less snacky foods, more fruits and vegetables."
Getting started on such changes can come with the help of a program offered by an employer.
Mary Thorpe, director of the Upward Bound program at the University of Louisville, participates in employee wellness programs offered by the school.
She took a health assessment, received education about healthy eating and works out in the employee gym with the help of trainers. Thorpe, 44, said the programs have helped her by providing motivation, practical tips and coaching.
"I didn't realize how many fruits and vegetables you should be eating," she said. As far as exercising, she added, "Everything you do during the day counts."
BUCKING THE TREND
Rural residents facechallenges but can do itHowever, it is easier for relatively affluent, educated urban professionals like Anderson and Finkel to eat well and exercise than it is for people of limited means who live in remote places.
In Eastern Kentucky, the rural poor often live miles from a well-stocked supermarket on treacherous country roads.
"If you live in the sticks, the only grocery store is a corner mart with little more than white bread, bologna and Fruit Loops on the shelf," said Gerry Roll, executive director of Hazard Perry County Community Ministries.
In some cases, residents might not own a car, and walking is more likely to be hazardous than beneficial to health.
"If you're trying to walk where there are no sidewalks and trucks are whizzing by at 65 mph, you can't say that the person who doesn't walk has chosen poorly," Aldana said. "Actually, they have chosen pretty well because they don't want to die -- not from car accidents at least."
People in rural areas also lack easy access to health clubs, and home exercise equipment can be prohibitively expensive.
But where there's a will, there's a way.
Shella Keeton, 49, lives in Knott County and drives an hour out of her way to get her 30-minute daily workout at the Curves gym in Hazard. The regimen is part of a wholesale lifestyle change prompted by her decision to quit smoking after 20 years.
"It was like I lost my best friend," said Keeton, a registered nurse. "I was really depressed over it. But I decided to go get myself a new body instead."
Gwen Black, a 71-year-old who lives in a rural area eight miles outside Paducah, said she decided to join an exercise program offered by a regional health department because she needed to keep up her strength to help care for her 67-acre farm. Black, a widow, said it's no longer a working farm, but she still needs to care for the huge lawn and the trees.
Although the exercise program has ended, she still has a membership at the local gym where it was held and still works out there. She said she has heart disease and cancer in her family, and wants to stave them off.
Eddie Feltner, 53, injured a disc in his back before he retired from the state Transportation Department, where he worked on a road crew. He discovered that diet and exercise were the best medicine for his chronic pain.
Feltner stopped frequenting all-you-can-eat buffets and started walking four miles in Manchester's Stinson Park almost every day. His weight dropped from 288 to 260 before creeping back to 275.
"I still feel good, and this is the way," Feltner said, gesturing toward the park's walking trail. "We're figuring this thing out, I think. Fifteen years ago, you couldn't get a bunch of men to walk out here with a gun to their heads. But people are changing. They don't want to die. They want to be able to enjoy their senior citizenship."
'MORTALITY MOMENT'
Some seek changesafter a health scareRay Welch walks too. It's not something he takes for granted. Fate forced the 31-year-old college student to face a different set of obstacles -- sudden health problems of the sort that wreck the fitness of thousands every day.
In 1991, Welch was a strapping 6-foot-4, 260-pound football player at Louisville's Western High School. His weight nearly doubled over the next 13 years due to bad eating habits and bad luck.
Welch gained 100 pounds after an emergency appendectomy in 1992. In 2000, while trying to move a couch, he fell down a flight of stairs and herniated four discs. He couldn't walk for five months. By April 2004, he weighed 509 pounds.
"I was like, 'It's time to do something,' " Welch said. "I had become a lazy bum. I was using my back as an excuse for being inactive."
Fifteen months passed before Welch made serious changes. His mother, who also is overweight, suffered double kidney failure, "and that kind of woke me up," Welch said.
Rosenthal, the UK bioethicist, calls those wake-up calls a "mortality moment."
"People get a scare -- they have a mild heart attack or they are diagnosed with diabetes -- and only then do they start making personally responsible choices," Rosenthal said. "Until that happens, most people think, 'It's not going to happen to me.' We somewhat live in denial that our choices are going to have serious consequences."
By forsaking fast food and eating smaller, more frequent meals, Welch has lost 31 pounds since July. In October he started walking 30 minutes a day, four days a week in Louisville's Park DuValle neighborhood.
Welch weighed 476 pounds last month, his lightest weight in three years. "It's a small accomplishment," he said, smiling.
Another issue for some people is what is perceived to be the higher cost of healthy foods.
But that didn't turn out to be much of a problem for the Lund family of La Grange when they changed to a healthier diet, adding more vegetables and leaner meats.
"Our grocery bill is a little bit higher, but not much," said Mary Lund, 45. "When you cut out the chips and cokes and stuff, it pretty much balances out."
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View All Comments (Related) (Related) (Related) Today's Anti-Smoking Purge Is Borrowed From The Nazis
Smoking is healthier than fascism
Prison Planet | April 25, 2007
Paul Joseph Watson
A wealth of overlooked yet frightening literature concerning the Nazi crusade against smoking provides a clear parallel to contemporary developments and an alarming warning that state restriction of personal habits is the pre-cursor to dictatorship.
Beginning in the early 1930's, as part of the Nazi agenda for racial purity, Hitler spearheaded a national campaign to ban smoking in all public buildings, and denounced the practice as a betrayal of the fascist drive for bodily purity.
"Brother national socialist, do you know that our Fhrer is against smoking and think that every German is responsible to the whole people for all his deeds and emissions, and does not have the right to damage his body with drugs?" stated one magazine.
As I wrote earlier this year , "The regulation of the personal habit of smoking, including new legislative moves in San Francisco to ban cigarettes in private homes, and its enforcement by an eager cadre of state snoops and snitches, represents nothing more than a move on behalf of big brother towards the complete subjugation and shackling of the individual."
Read these shocking parallels and compare them to the endless lecturing we are forced to endure today about our personal lifestyle choices by the state and their propaganda arm, the mass media.
Nazi anti-smoking propaganda poster.
- The Nazis banned tobacco advertising and financed huge public relations campaigns to propagandize people into giving up smoking.
- The Nazis banned smoking in government offices, civic transport, university campuses, rest homes, post offices, many restaurants and bars, hospital grounds and workplaces, and Hitler gave awards to associates who quit the habit.
- A ban on smoking in private vehicles was called for.
- The Nazi Reich Health Office warned that smoking caused impotence and produced posters depicting smoking as a dirty habit of Jews, Gypsies, blacks, intellectuals and Indians.
- Nazi lobbyists lectured terrified children in schools on the horrors of racial impurity as a result of smoking.
- The term "passive smoking" (Passivrauchen) was coined by the Nazi Anti-Tobacco League. Its author, Fritz Lickint, offered no supporting evidence to claim that smokers poisoned everyone around them, while also stating that drinking coffee caused cancer.
- Hitler was an ardent vegetarian and did not smoke or drink after the age of 30, even accrediting the rise of fascism to his success in kicking the habit. He forbade anyone from smoking in a room he might enter. Fellow fascist leaders Mussolini, Napoleon and Franco also detested smoking.
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- The Nazi anti-smoking crusade was unleashed with the help of manufactured junk science on behalf of the medical and health establishment, one such example being that smoking caused "spontaneous abortions" in pregnant women.
- Hitler attempted to price out smoking for Germans, levying huge taxes on cigarettes.
- Despite the Nazi propaganda crusade against smoking, tobacco sales increased in Germany, leading some history professors to hypothesize that smoking was an act of cultural resistance against fascism, until the late 1930's after smoking was banned in most public buildings and tobacco sales rapidly declined.
Another Nazi anti-smoking propaganda poster depicts a jackboot kicking a cigarette, a cigar and a pipe.
What conclusions can we draw from these parallels? Either the Nazis were benign really cared about everyone's health or they used the specter of anti-smoking to exert massive control over people's lives and scale back basic freedoms, getting a foot in the door for the political dictatorship that was to follow.
Similarly today, either the same elite that advocate "mass culling" of the majority of the world's population really do care about public health and well-being or they are using the excuse of the anti-smoking drive to condition us to accept state regulation over every aspect of our personal lives.
It's all about control, it's all about letting you know who the bosses are. If the government can regulate personal habits and behavior, what's next? If the state is so concerned about our good health as they would have you believe, why not use the latest scientific advancements to remove that nasty aggressive gene that causes so much unhappiness? Well, you're causing those around you distress and harming their health so why not? Are your political opinions a mental illness? Are they harming society? Perhaps we should ban certain types of "free" speech that is offensive to others.
You see where this is all heading - how long before our wall mounted personal x-ray body scanners are accompanied by special smoke detectors that inform on you to the local Stasi if you dare to light up?
We live in a paranoid world overpopulated by ninnying jellyfish who dare not dip their toe in the water in case there's a law against it, it might upset someone, or it might be bad for their health.
Many people will read this article having lost loved ones as a result of smoking. Please don't have a knee jerk emotional reaction, try to understand that the point I'm making - smoking is unhealthy but it is healthier than fascism and government regulation of personal habits leads to dictatorship.
The fact that the very language and policies that we are now bombarded with as a justification for state regulation of our personal lifestyle choices are directly lifted from Nazi policies for racial hygiene from the 1930's should alarm us all and act as a wake up call to the true agenda behind today's anti-smoking purge.
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