Small Lifestyle Changes, Big Health Benefits

Two-thirds of American health care dollars go to a handful of chronic diseases: diabetes, hypertension, asthma and depression. Host Guy Raz talks to health correspondent Allison Aubrey about the way minor modifications in diet and exercise can help reduce risks and costs.

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GUY RAZ, host:

Joining me here in the studio is NPR's consumer health correspondent Allison Aubrey.

Allison, what do we know about how to treat people, you know, at risk for developing preventable chronic diseases? Things like type 2 diabetes?

ALLISON AUBREY: Well, with diabetes what we know is that you've got to get to people early. There was a very interesting study done over the course of the last decade and a half where researchers enrolled people. They found them at health fairs, people who may have stopped into a booth and took a two-question survey to find out if they were at risk of diabetes. They enrolled about 3,000 of them into a study. And they wanted to know what will work in terms of behavior modification and will that cut the risk of developing diabetes.

So they basically took these folks, and they put them into all kinds of behavior modification programs, if you will. They helped them exercise. Now, it wasn't so that they were going to go out and train for marathons. I mean these folks did a half hour of exercise a day, and they helped them with diet. They didn't turn them into vegans. They basically made some modifications that eliminated sugar. And they found over several years that the people who were able to make these behavior modifications cut the risk of developing diabetes by 60 percent.

RAZ: So it works.

AUBREY: So it works.

RAZ: Well, so why isn't it being done nationwide? Why isn't this just a regular practice?

AUBREY: This knowledge is relatively new. The study that I just described, when that started, researchers really thought that the drug that they were giving to people with pre-diabetes, a drug called metformin, that that might work better. So they were surprised when they saw how well these behavior modifications worked.

I think what the struggle is now is to figure out how can we take what we know from the diabetes prevention program and somehow scale it in a way that we put it into communities? I mean let's face it; doing these hospital-based interventions are expensive. These people in the study had minders, had keepers, had somebody nudging them And we need to find a way to scale it in a way that it's A, affordable and B, doable for people.

RAZ: Allison, you're about to go off for six months, to leave us for six months here at NPR to do a Kaiser health fellowship. What are you going to be studying there?

AUBREY: Yeah. I'm really going to be looking deeper into these diseases that accounts for the two-thirds of the health care dollars spent. And, instead of talking about what we can do right at that point when people are about to develop these diseases, I want to go back three decades. What can we be doing in homes and schools and communities that cuts the chances that we will develop these things? I want to look at what researchers are finding out when they're really talking about how you create sort of the culture of wellness.

There's an interesting school of thought out there that when it comes to nutrition, that there really isn't an information gap. You can go to kindergarteners in the inner city and ask them about carrots and they will tell you that they're good for your eyes.

RAZ: People know these things.

AUBREY: Right. They have a lot of the basics. What there is is an action gap because it's downright hard to get home every night and put something healthy on the table. And it takes awareness, so it has to be sort of top of mind and that component is just missing for a lot of folks.

This change is not going to happen in a doctor's office. It's not going to happen in hospitals. It's not really a result of quote, unquote "health care reform." It's really about sort of a cultural shift, and it happens in your backyard, in your kitchen, in your community, in your school.

RAZ: That's NPR's consumer health correspondent Allison Aubrey.

Allison, thanks so much.

AUBREY: Thanks, Guy.

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