Alice Dodge "Weighing in on Disease Prevention"

Weighing in on Disease Prevention By: Alice Dodge

Proper diet and exercise, which are often lacking from the majority of Americans lives, are the two greatest things that can be done to reduce the incidence of chronic disease and many types of cancer. This paper will focus on the prevalence of disease, some contributing factors and what nurses can do to improve the occurrence of healthy habits and positive outcomes.
The Centers for Disease Control and Prevention state that sixty percent of Americans do not engage in exercise at a level that gets any health benefits (CDC, 2007). The Boston Haitian Reporter adds that seventeen to twenty-three million Americans have diabetes (Jackson, 2006), and the American Cancer Society claims that two thirds of Americans are either overweight or obese (ACS, 2006). The National Academies which report findings to congress state that thirty-eight percent of all deaths are due to avoidable factors such as: tobacco use, poor nutrition, physical inactivity and alcohol consumption (nationalacademies.org, 2007). The American Cancer Society also states that one third of all cancer deaths can be attributed to lack of weight control or obesity, lack of proper nutrition, and physical inactivity and that one third more are from tobacco use or exposure. The lack of proper nutrition in American diets and sedentary lifestyles are killing Americans from somewhat preventable diseases. The nurse can promote wellness in these clients by giving them encouragement, education and providing oneself as a good role model.
The first strategy that nurses can implement is to teach on the prevalence of disease and to identify those at risk. According to a Finnish Diabetes Prevention Study, twenty-five percent of the Finnish are obese (Absetz, 2007). Through this study they showed that a large sample of clients with prediabetes were able to reduce the incidence of the diabetes progressing into type two diabetes mellitus by fifty-eight percent if the subjects were able to maintain four of the five goals listed here.

1. Less than thirty percent of total energy intake from fat.
2. Less than ten percent of total energy intake from saturated fat.
3. At least fifteen grams of fiber per one thousand kilocalories.
4. At least four hours of moderately intense physical activity per week.
5. Attaining more than a five percent weight reduction.

This study that came out this year clearly states the importance of proper diet, maintaining a healthy weight and physical activity in the role of diabetes prevention. Nurses can reference studies to provide data to interested clients hereby reinforcing the potentially enormous lifelong benefits of diet modification and increased exercise. A Fifty-eight percent chance of not progressing to type II diabetes mellitus is a strong case for behavior modification and which can offer some hope to the pre-diabetes client. With the increases in diabetes rates this is one area in which nurses can influence the lives of many people. As nurses it is one of our key responsibilities to educate the client when appropriate, while providing encouragement, which may be just what the client needed to begin their transition. We will now look at how diabetes is only one of the many areas in which the nurses can provide help in disease prevention.
The American Cancer Society reports the incidences of many cancers can be reduced by smoking cessation, alcohol intake reduction, and proper nutrition which include lots of fruit, vegetables, fiber, whole grains, good oils and less red meat. Achieving or maintaining a proper weight for body build and height, and increased levels of physical activity are factors as well. For example, smoking cessation reduces the incidence of kidney, bladder, and oral, esophageal, pancreatic and of course lung cancer. Reducing your alcohol to none or one drink per day for women and two drinks per day for men can reduce the incidence of oral, esophageal, breast, liver and colon cancers. Proper nutrition has been associated with a reduction of the incidences of oral, esophageal, colon, prostate, lung, stomach, endometrial, and pancreatic cancer. Proper weight maintenance is associated with fewer cases of oral, esophageal, kidney, breast, colon, stomach, pancreatic, endometrial, and prostate cancer. Increasing physical activity to thirty minutes of moderate exercise per day or more can reduce the rates of breast, endometrial, prostate and pancreatic cancers. The cancer link to each of these modifiable factors is a strong one, which shows directly how you can reduce the incidences by cutting out one or more of the associated behaviors. One strategy is for the nurse to inform the client about the risks associated with their specific behaviors and using the American Cancer Society’s information can help reinforce your teachings.
Nurses can clearly make an impact in the lives of clients by promoting and demonstrating lifestyle changes. A few ways to help are: Planned walks with the client during recovery and ideas on how they can easily incorporate extra physical activity in their daily lives. Taking the stairs, parking furthest from the entrance in parking lots, and taking a brisk thirty-minute walks are great ways to start. Pursuing and obtaining ones own healthy dietary habits, increasing your own physical activity level, and maintaining your own healthy weight are ways you can influence the clients and others around you by being positive proof that it can be done. You may just live a longer healthier life because of it!
In addition to the steps, which the nurse can take to promote wellness in the client on a one to one personal level, it is important to try and become involved in policy change to have a bigger impact. Becoming involved in the community on a local level and perhaps representing them with your state and federal governments are two ways which you can affect change on their behalf. Fighting to increase funding for schools, so they can reduce their dependence on profits from sweetened sodas, snacks and franchised fast food in the cafeterias could help reduce the obesity levels of school aged children and adolescents. One can follow the lead of New York City in removing harmful trans-fatty acids from the food chain that could show an overall improvement in the cardiovascular health of that region. Clients of low socioeconomic background need to have access to inexpensive fresh fruits and vegetables as well as whole grains, lean red meats and fish. It is important to compete in this area with the attractive low prices and convenience of fast food meals that can, in excess, promote weight gain, as these foods tend to be calorie dense but nutritionally poor. The nurse’s role in wellness promotion can be achieved on a one to one level of educating the client, as well as achieving policy change to enable the client to make the healthy choice by having them readily available. Remember that the lack of proper nutrition in American diets and sedentary lifestyles are killing Americans from somewhat preventable diseases. Let us be the nursing generation that changes these ominous trends for our own health and for the health of our country.
References:
1. (2006). American Cancer Society, A Cancer Journal for Clinicians, 56, 254-281 retrieved October 10, 2007 from ProQuest.
2. Absetz, P., Valve, R., Oldenberg, B., Heinonen, H., etal. (2007). Type two diabetes prevention in the “real world”: one-year results of the GOAL implementation trial. Diabetes Care, 30(10), 2465-2471 retrieved October 10, 2007 from ProQuest.
3. Jackson, S., (2006). Nutrition key to management & prevention of diabetes. Boston Haitian Reporter, 6(4), 13 retrieved October 10, 2007 from ProQuest.
4. Centers for Disease Control; United States Department of Health and Human Services http://cdc.gov/ retrieved October 10, 2007 from the World Wide Web.
5. The National Academies http:/www.nationalacademies.org/ retrieved October 10, 2007 from the World Wide Web.

Interventions for Weighing in on Disease Prevention:
a. Increase activity level: set a goal and slowly work to achieve it. (30 minutes aerobic exercise per day, like brisk walking)
i. Psychological barriers to achieving an increase in physical activity
1. Some general barriers brought up women in one study were: professional obligations, injuries, weather, illness, psychosocial factors, and personal obligations (Journal of Holistic Nursing). Some psychosocial issues mentioned by some women when they found barriers to maintaining an exercise program were: fear of pain, fear of safety, lack of places, inadequate instruction, lack of family support, older weight, overweight, threat of embarrassment, multiple role expectations, poverty status, cost and lack of time (Journal of Holistic Nursing).
2. Mary A Nies, Carrie L Motyka. Journal of Holistic Nursing. Springfield: Mar 2006. Vol. 24, Iss. 1; pg. 7

ii. Physical barriers to achieving an increase in physical activity

1. In an Australian study, adults reported size was a barrier to physical activity, with women reporting more so than men. 22.6% of the obese stated that their physical size, or obesity was a barrier to obtaining physical activity.
2. Kylie Ball, David Crawford, Neville Owen. Australian and New Zealand Journal of Public Health. Canberra: Jun 2000. Vol. 24, Iss. 3; pg. 331, 3 pgs

b. Increasing the amount of healthy foods into the diet (fruits, vegetables, fish, nuts, sources of fat, processed foods, trans fats, refined sugars, etc.)
i. Socioeconomic barriers to consuming a healthier diet.
1. Some of the greatest challenges to obtaining a healthy diet are issues of poverty and other socioeconomic factors. The costs of some foods, mainly energy-dense foods, which may be higher in added fats, added sugars, and are high in processed grains, are much lower than the healthier alternatives such as: fresh fruits and vegetables, as well as fish and lean meats (Nutrition Today). Positive relationships were shown between most nutrients and income in a Canadian study (Ricciuto, Tarasuk). In a piece in USA TODAY, researchers showed a comparison of the availability of fresh fruits and vegetables in poorer black neighborhoods versus wealthier predominantly white areas revealed these statistics: 21 vegetable choices and 13 fruit choices, as opposed to the 38 vegetable choices and 26 fruits in the higher socioeconomic white areas. These are obvious barriers as they also mentioned quality differences; nobody wants to eat a pithy apple, if given the choice.
2. Laurie E Ricciuto, Valerie S Tarasuk. Social Science & Medicine. Oxford: Jan 2007. Vol. 64, Iss. 1; pg. 186

ii. Media barriers to consuming a healthier diet

1. The media can be a barrier for teaching children and parents good eating habits. Of the television ads aimed at children, greater than 50% are for sweetened breakfast cereals, candy, sodas, and fast food (U of C, Berkeley). Other ways, in which the media encourages the consumption of these decidedly unhealthy foods, are their promotion of these foods with popular sports figures and cartoon or movie characters (U of C, Berkeley). Food advertising budgets range from 75% of budgets going to television ads and 95% of the fast food advertising going to television advertising (U of C, Berkeley). As children average seeing one food ad for every 5 minutes of viewed television time, they are constantly being urged to consume an unhealthy diet (U of C, Berkeley).

2. Center for Weight and Health, UNIVERSITY OF CALIFORNIA, BERKELEY 3 www.cnr.berkeley.edu/cwh



References:
1. 1. Mary A Nies, Carrie L Motyka. Journal of Holistic Nursing. Springfield: Mar 2006. Vol. 24, Iss. 1; pg. 7
2. Kylie Ball, David Crawford, Neville Owen. Australian and New Zealand Journal of Public Health. Canberra: Jun 2000. Vol. 24, Iss. 3; pg. 331, 3 pgs
3. Laurie E Ricciuto, Valerie S Tarasuk. Social Science & Medicine. Oxford: Jan 2007. Vol. 64, Iss. 1; pg. 186
4. Center for Weight and Health, UNIVERSITY OF CALIFORNIA, BERKELEY 3 www.cnr.berkeley.edu/cwh

Weighing in on Disease Prevention By: Alice Dodge

Proper diet and exercise, which are often lacking from the majority of Americans lives, are the two greatest things that can be done to reduce the incidence of chronic disease and many types of cancer. This paper will focus on the prevalence of disease, some contributing factors and what nurses can do to improve the occurrence of healthy habits and positive outcomes.
The Centers for Disease Control and Prevention state that sixty percent of Americans do not engage in exercise at a level that gets any health benefits (CDC, 2007). The Boston Haitian Reporter adds that seventeen to twenty-three million Americans have diabetes (Jackson, 2006), and the American Cancer Society claims that two thirds of Americans are either overweight or obese (ACS, 2006). The National Academies which report findings to congress state that thirty-eight percent of all deaths are due to avoidable factors such as: tobacco use, poor nutrition, physical inactivity and alcohol consumption (nationalacademies.org, 2007). The American Cancer Society also states that one third of all cancer deaths can be attributed to lack of weight control or obesity, lack of proper nutrition, and physical inactivity and that one third more are from tobacco use or exposure. The lack of proper nutrition in American diets and sedentary lifestyles are killing Americans from somewhat preventable diseases. The nurse can promote wellness in these clients by giving them encouragement, education and providing oneself as a good role model.
The first strategy that nurses can implement is to teach on the prevalence of disease and to identify those at risk. According to a Finnish Diabetes Prevention Study, twenty-five percent of the Finnish are obese (Absetz, 2007). Through this study they showed that a large sample of clients with prediabetes were able to reduce the incidence of the diabetes progressing into type two diabetes mellitus by fifty-eight percent if the subjects were able to maintain four of the five goals listed here.

1. Less than thirty percent of total energy intake from fat.
2. Less than ten percent of total energy intake from saturated fat.
3. At least fifteen grams of fiber per one thousand kilocalories.
4. At least four hours of moderately intense physical activity per week.
5. Attaining more than a five percent weight reduction.

This study that came out this year clearly states the importance of proper diet, maintaining a healthy weight and physical activity in the role of diabetes prevention. Nurses can reference studies to provide data to interested clients hereby reinforcing the potentially enormous lifelong benefits of diet modification and increased exercise. A Fifty-eight percent chance of not progressing to type II diabetes mellitus is a strong case for behavior modification and which can offer some hope to the pre-diabetes client. With the increases in diabetes rates this is one area in which nurses can influence the lives of many people. As nurses it is one of our key responsibilities to educate the client when appropriate, while providing encouragement, which may be just what the client needed to begin their transition. We will now look at how diabetes is only one of the many areas in which the nurses can provide help in disease prevention.
The American Cancer Society reports the incidences of many cancers can be reduced by smoking cessation, alcohol intake reduction, and proper nutrition which include lots of fruit, vegetables, fiber, whole grains, good oils and less red meat. Achieving or maintaining a proper weight for body build and height, and increased levels of physical activity are factors as well. For example, smoking cessation reduces the incidence of kidney, bladder, and oral, esophageal, pancreatic and of course lung cancer. Reducing your alcohol to none or one drink per day for women and two drinks per day for men can reduce the incidence of oral, esophageal, breast, liver and colon cancers. Proper nutrition has been associated with a reduction of the incidences of oral, esophageal, colon, prostate, lung, stomach, endometrial, and pancreatic cancer. Proper weight maintenance is associated with fewer cases of oral, esophageal, kidney, breast, colon, stomach, pancreatic, endometrial, and prostate cancer. Increasing physical activity to thirty minutes of moderate exercise per day or more can reduce the rates of breast, endometrial, prostate and pancreatic cancers. The cancer link to each of these modifiable factors is a strong one, which shows directly how you can reduce the incidences by cutting out one or more of the associated behaviors. One strategy is for the nurse to inform the client about the risks associated with their specific behaviors and using the American Cancer Society’s information can help reinforce your teachings.
Nurses can clearly make an impact in the lives of clients by promoting and demonstrating lifestyle changes. A few ways to help are: Planned walks with the client during recovery and ideas on how they can easily incorporate extra physical activity in their daily lives. Taking the stairs, parking furthest from the entrance in parking lots, and taking a brisk thirty-minute walks are great ways to start. Pursuing and obtaining ones own healthy dietary habits, increasing your own physical activity level, and maintaining your own healthy weight are ways you can influence the clients and others around you by being positive proof that it can be done. You may just live a longer healthier life because of it!
In addition to the steps, which the nurse can take to promote wellness in the client on a one to one personal level, it is important to try and become involved in policy change to have a bigger impact. Becoming involved in the community on a local level and perhaps representing them with your state and federal governments are two ways which you can affect change on their behalf. Fighting to increase funding for schools, so they can reduce their dependence on profits from sweetened sodas, snacks and franchised fast food in the cafeterias could help reduce the obesity levels of school aged children and adolescents. One can follow the lead of New York City in removing harmful trans-fatty acids from the food chain that could show an overall improvement in the cardiovascular health of that region. Clients of low socioeconomic background need to have access to inexpensive fresh fruits and vegetables as well as whole grains, lean red meats and fish. It is important to compete in this area with the attractive low prices and convenience of fast food meals that can, in excess, promote weight gain, as these foods tend to be calorie dense but nutritionally poor. The nurse’s role in wellness promotion can be achieved on a one to one level of educating the client, as well as achieving policy change to enable the client to make the healthy choice by having them readily available. Remember that the lack of proper nutrition in American diets and sedentary lifestyles are killing Americans from somewhat preventable diseases. Let us be the nursing generation that changes these ominous trends for our own health and for the health of our country.
References:
1. (2006). American Cancer Society, A Cancer Journal for Clinicians, 56, 254-281 retrieved October 10, 2007 from ProQuest.
2. Absetz, P., Valve, R., Oldenberg, B., Heinonen, H., etal. (2007). Type two diabetes prevention in the “real world”: one-year results of the GOAL implementation trial. Diabetes Care, 30(10), 2465-2471 retrieved October 10, 2007 from ProQuest.
3. Jackson, S., (2006). Nutrition key to management & prevention of diabetes. Boston Haitian Reporter, 6(4), 13 retrieved October 10, 2007 from ProQuest.
4. Centers for Disease Control; United States Department of Health and Human Services http://cdc.gov/ retrieved October 10, 2007 from the World Wide Web.
5. The National Academies http:/www.nationalacademies.org/ retrieved October 10, 2007 from the World Wide Web.

Interventions for Weighing in on Disease Prevention:
a. Increase activity level: set a goal and slowly work to achieve it. (30 minutes aerobic exercise per day, like brisk walking)
i. Psychological barriers to achieving an increase in physical activity
1. Some general barriers brought up women in one study were: professional obligations, injuries, weather, illness, psychosocial factors, and personal obligations (Journal of Holistic Nursing). Some psychosocial issues mentioned by some women when they found barriers to maintaining an exercise program were: fear of pain, fear of safety, lack of places, inadequate instruction, lack of family support, older weight, overweight, threat of embarrassment, multiple role expectations, poverty status, cost and lack of time (Journal of Holistic Nursing).
2. Mary A Nies, Carrie L Motyka. Journal of Holistic Nursing. Springfield: Mar 2006. Vol. 24, Iss. 1; pg. 7

ii. Physical barriers to achieving an increase in physical activity

1. In an Australian study, adults reported size was a barrier to physical activity, with women reporting more so than men. 22.6% of the obese stated that their physical size, or obesity was a barrier to obtaining physical activity.
2. Kylie Ball, David Crawford, Neville Owen. Australian and New Zealand Journal of Public Health. Canberra: Jun 2000. Vol. 24, Iss. 3; pg. 331, 3 pgs

b. Increasing the amount of healthy foods into the diet (fruits, vegetables, fish, nuts, sources of fat, processed foods, trans fats, refined sugars, etc.)
i. Socioeconomic barriers to consuming a healthier diet.
1. Some of the greatest challenges to obtaining a healthy diet are issues of poverty and other socioeconomic factors. The costs of some foods, mainly energy-dense foods, which may be higher in added fats, added sugars, and are high in processed grains, are much lower than the healthier alternatives such as: fresh fruits and vegetables, as well as fish and lean meats (Nutrition Today). Positive relationships were shown between most nutrients and income in a Canadian study (Ricciuto, Tarasuk). In a piece in USA TODAY, researchers showed a comparison of the availability of fresh fruits and vegetables in poorer black neighborhoods versus wealthier predominantly white areas revealed these statistics: 21 vegetable choices and 13 fruit choices, as opposed to the 38 vegetable choices and 26 fruits in the higher socioeconomic white areas. These are obvious barriers as they also mentioned quality differences; nobody wants to eat a pithy apple, if given the choice.
2. Laurie E Ricciuto, Valerie S Tarasuk. Social Science & Medicine. Oxford: Jan 2007. Vol. 64, Iss. 1; pg. 186

ii. Media barriers to consuming a healthier diet

1. The media can be a barrier for teaching children and parents good eating habits. Of the television ads aimed at children, greater than 50% are for sweetened breakfast cereals, candy, sodas, and fast food (U of C, Berkeley). Other ways, in which the media encourages the consumption of these decidedly unhealthy foods, are their promotion of these foods with popular sports figures and cartoon or movie characters (U of C, Berkeley). Food advertising budgets range from 75% of budgets going to television ads and 95% of the fast food advertising going to television advertising (U of C, Berkeley). As children average seeing one food ad for every 5 minutes of viewed television time, they are constantly being urged to consume an unhealthy diet (U of C, Berkeley).

2. Center for Weight and Health, UNIVERSITY OF CALIFORNIA, BERKELEY 3 www.cnr.berkeley.edu/cwh



References:
1. 1. Mary A Nies, Carrie L Motyka. Journal of Holistic Nursing. Springfield: Mar 2006. Vol. 24, Iss. 1; pg. 7
2. Kylie Ball, David Crawford, Neville Owen. Australian and New Zealand Journal of Public Health. Canberra: Jun 2000. Vol. 24, Iss. 3; pg. 331, 3 pgs
3. Laurie E Ricciuto, Valerie S Tarasuk. Social Science & Medicine. Oxford: Jan 2007. Vol. 64, Iss. 1; pg. 186
4. Center for Weight and Health, UNIVERSITY OF CALIFORNIA, BERKELEY 3 www.cnr.berkeley.edu/cwh