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News Tips

Indiana University Healthy Living Conference

IU health experts to discuss obesity-related topics

Editors: Health experts from Indiana University's School of Health, Physical Education and Recreation, School of Medicine, School of Dentistry and several departments at Indiana University-Purdue University Indianapolis will discuss more than a dozen obesity-related topics critical to Hoosiers' health at the IU Conference on Healthy Living on Feb. 22 in Indianapolis. Reporters are welcome to cover the discussions. The tips below involve just three of the health issues to be addressed. The day-long conference, which begins at 9 a.m., is open to the public and includes a lunch panel discussion moderated by Indiana State Health Commissioner Judy Monroe. Descriptions of the sessions and more information about the conference can be found at http://www.alumni.indiana.edu/docs/iupui2006.pdf or by contacting Karen Deery at 317-274-8959 and kdeery@iupui.edu. Registration information for the public can be found at https://alumni.indiana.edu/reserve/index.php?r=69. The event will be held at the Indiana Government Conference Center South Auditorium, 302 W. Washington St., Indianapolis.

Sticking to an exercise routine is a lot like quitting smoking -- most people want the health and aesthetic benefits and know they should do it but knowing just isn't enough. "Staying with it is incredibly hard for most people," said John Raglin, a psychologist in the Indiana University Bloomington Department of Kinesiology who conducts research on exercise and sport. "Most people who do quit do so within two months." Half of the people who begin a workout routine can be expected to quit, which is the same drop-out rate as 20 years ago despite the growth of the fitness industry, more sophisticated equipment and fitness clubs, and better-trained instructors. Raglin said people quit -- or don't start -- for a variety of reasons, some of which are difficult or impossible to address, such as socioeconomic factors that can include unsafe neighborhoods or a lack of parks or recreational facilities. Some factors and behaviors, however, can more easily be addressed or even exploited. Raglin will discuss these and other behavioral patterns at the IU Conference on Healthy Living during a session from 1:25 to 2:15 p.m.:

• Companionship and responsibility: In a study of married couples and exercise adherence, Raglin and IU exercise physiologist Janet P. Wallace found that only 8 percent of the participants who exercised with their spouses quit compared to half of the participants who exercised independently of their spouses. Raglin said the social support is key. "It's more important what the people around you think," he said. "For many people, their exercise routine becomes their social network, which brings with it social obligations. If you see it's raining outside and think, 'Maybe I'll skip my walk today,' it's an entirely different matter if people are waiting for you."
• Stress and anxiety: Improved health and potentially a longer life are poor motivators when it comes to exercise, Raglin said, because the payoff is not immediate. The stress relief and mood boosts from exercise, however, can be felt immediately and last for hours. "The psychological consequences are significant," he said. "When you exercise you don't know what your blood pressure or insulin levels are even though they're important health benefits."
• Social stress and "meat markets": Many people find the emphasis on body image at some fitness or recreational facilities too much to bear, so they quit. This stress can be avoided by choosing a facility or exercise class that's more comfortable, where staff are more cognizant of these stresses and other special needs. Some facilities cater to women, for example, or offer classes geared toward specific age groups.
• It doesn't just happen: Time is one of the "environmental barriers" that can be tweaked to make room for exercise. Raglin said lack of time is often cited as a reason people quit exercising, but studies of prison populations have found similar drop-out rates. He suggests looking at a typical week and finding the pockets of time that are consistently available. Exercise broken into five- and 10-minute increments is just as beneficial as one 30-minute stint, he said.

Raglin can be reached at 812-855-1844 and raglinj@indiana.edu.

As American waistlines have increased substantially during the past 20 years, so has the prevalence of type 2 diabetes, with the debilitating condition, once called adult-onset diabetes, appearing more frequently in children. Incurable, type 2 diabetes affects how the body metabolizes its main energy source -- sugar. It develops slowly but can cause serious health problems including death. Complications include nerve damage, most often involving the hands and feet, kidney damage, blindness, cardiovascular disease and an increased susceptibility to infections. Type 2 diabetes is by far the most common form of diabetes, affecting more than 20 million people nationwide. But the news is not all bad, said Dr. Sue Kirkman, staff physician at Clarian Health Partners, Roudebush Department of Veterans Affairs and Wishard Memorial Hospital, and associate professor of medicine in the IU School of Medicine's Division of Endocrinology and Metabolism. Promising research -- some carried out at Indiana University -- is showing that the progression of obesity to diabetes can be slowed or even halted by certain medications and by achievable changes in diet and exercise. Here are some of the findings she will discuss at the Conference on Healthy Living during a session from 2:30 to 3:30 p.m.:

• People at high risk for diabetes, due to their family history and being overweight, could reduce their risk by 58 percent with weight loss and exercise, according to a multicenter Diabetes Prevention Program study for which Kirkman was an investigator. The weight-loss goal should be 7 percent, Kirkman said. The exercise goal should be 150 minutes per week of medium-intensity aerobic exercise such as walking.
• Use of the medication metformin can reduce the risk of developing type 2 diabetes by 31 percent. Studies also have shown that the medication acarbose can reduce the risk.

Kirkman can be reached at mkirkman@iupui.edu.

Weight-loss surgery is something of a Rodney Dangerfield of surgeries, viewed with a skeptical eye despite the substantial benefits to health and quality of life that patients can experience, advances that minimize potentially deadly complications, and a newer emphasis on pre- and post-surgery counseling and lifestyle changes. Last year an estimated 177,000 people had bariatric surgeries performed, compared to just 50,000 four years earlier. "It's a lifelong relationship between patient and doctor," said Dr. Don Selzer, a surgeon with the Clarian Bariatric Center and an assistant professor of surgery at the Indiana University School of Medicine. After his surgical residency, Selzer had an additional year of training, much of which involved learning how to perform laparoscopic bariatric surgery and how to help patients manage their pre- and post-operative dietary and lifestyle changes to prepare for this relationship. Selzer said physicians who do not perform bariatric surgery may not understand it completely, which can discourage potential patients from considering it. While not for everyone, the surgeries can significantly improve patients' lives, resulting in the improvement or resolution of the following obesity-related conditions, all of which can lead to death:

• Type 2 diabetes
• Hyperlipidemia
• Hypertension
• High cholesterol
• Sleep apnea

Complications -- such as death, pneumonia and blood clots -- are real, which is why the surgery cannot be taken lightly. Most bariatric centers in the Indianapolis area, for example, take a multidisciplinary approach, employing psychologists and nutritionists to help patients before and after the surgeries. Sometimes alternative weight loss approaches are recommended, Selzer said. He added that the different types of surgeries offer different results, and some are more suitable for particular people than others. Selzer will discuss advances in surgical techniques, which increase surgical options for weight loss and improve patients' recovery, from 10:30 to 11:30 a.m. at the IU Conference for Healthy Living. He also will discuss the criteria for potential candidates for surgery, specifics of the various surgical techniques currently available, and the results patients can expect. For more information, contact Selzer at dselzer@iupui.edu.

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