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Paddles & p-Values: Down the Stream, or Up the Creek?

Explore the connection between lifestyle choices and health outcomes in this informative article by Dr. David L. Katz. Discover the importance of living well to prevent chronic diseases and improve overall health. Learn about evidence-based interventions and strategies for promoting healthy behaviors.

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Paddles & p-Values: Down the Stream, or Up the Creek?

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  1. of Paddles & p-Values:-down the stream, or up the creek?-David L. Katz, MD, MPH,FACPM, FACPDirector, Prevention Research CenterYale University School of MedicinePresident, Turn the Tide Foundationwww.davidkatzmd.comASTPHNDBaltimore, MD6-13-10

  2. Route Information*: • Donne, but just starting • Life & Death • Feet, Forks, & Fingers • Knowledge & Power • Peril & Promise • Pollan & Polar Bears • Science & Sense • Sandbags, Raindrops, & Snowflakes • Failure, from the jaws of success • Levers & Levees • Paddles & p Values • Will & Way • Bodies, & the Body Politic *please make sure you are on the right boat

  3. Life & Death

  4. There is Lifestyle… and everything else • McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270:2207-12 • Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238-45 • Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases: how many lives can we save? Lancet. 2005 Oct 29-Nov 4;366(9496):1578-82 • Epping-Jordan JE, Galea G, Tukuitonga C, Beaglehole R. Preventing chronic diseases: taking stepwise action. Lancet. 2005 Nov 5;366(9497):1667-71

  5. The People in Potsdam- • Ford ES, Bergmann MM, Kröger J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med. 2009 Aug 10;169(15):1355-62 and the UK, for that matter: • Kvaavik E, Batty GD, Ursin G, Huxley R, Gale CR. Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: the United Kingdom health and lifestyle survey. Arch Intern Med. 2010 Apr 26;170(8):711-8

  6. Nurturing Nature: the leverage of living well- • Ornish D, Magbanua MJ, Weidner G, Weinberg V, Kemp C, Green C, Mattie MD, Marlin R, Simko J, Shinohara K, Haqq CM, Carroll PR. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proc Natl Acad Sci U S A. 2008 Jun 17;105(24):8369-74

  7. The Master Levers of Destiny- • Feet • Forks & • Fingers • But….

  8. Knowledge & Power

  9. Knowledge, alas, isn’t power… • Katz DL. Life and death, knowledge and power: why knowing what matters isn’t what's the matter. Arch Intern Med. 2009 Aug 10;169(15):1362-3

  10. Peril & Promise

  11. Our plight… Adult Population 100% Overweight / Obesity Insulin Resistance Diabetes Mellitus Cardiovascular Disease Time

  12. our children’s peril… 100% Overweight / Obesity Insulin Resistance Cardiovascular Disease Diabetes Mellitus Time

  13. What lifestyle can do… • 80% reduction in heart disease • 90% reduction in diabetes • 60% reduction in cancer • and so on…

  14. The Public- • in private parts…

  15. Pollan & Polar Bears

  16. we live where good advice… • “Eat food, not too much, mostly plants.” • Michael Pollan …can be hard to swallow!-

  17. Even when clear where “there” is- -it may seem… • you can’t get there from here:

  18. Science & Sense

  19. Sandbags, Raindrops, &Snowflakes

  20. Incriminating droplets, exonerating snowflakes

  21. Failure, from the jawsof success

  22. P values, and downstream despotism- • Anderson LM, Quinn TA, Glanz K, Ramirez G, Kahwati LC, Johnson DB, Buchanan LR, Archer WR, Chattopadhyay S, Kalra GP, Katz DL; Task Force on Community Preventive Services. The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: a systematic review. Am J Prev Med. 2009;37:340-57 • Katz DL. School-based interventions for health promotion and weight control: not just waiting on the world to change. Annu Rev Public Health. 2009 Apr 29;30:253-72 • Katz DL, O'Connell M, Njike VY, Yeh MC, Nawaz H. Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis. Int J Obes (Lond). 2008;32:1780-9 • Katz DL, O'Connell M, Yeh MC, Nawaz H, Njike V, Anderson LM, Cory S, Dietz W; Task Force on Community Preventive Services. Public health strategies for preventing and controlling overweight and obesity in school and worksite settings: a report on recommendations of the Task Force on Community Preventive Services. MMWR Recomm Rep. 2005;54(RR-10):1-12

  23. Nihilists in burning buildings:Relative absence of evidence- • Durant N, Baskin ML, Thomas O, Allison DB. School-based obesity treatment and prevention programs: all in all, just another brick in the wall? Int J Obes (Lond). 2008 Dec;32(12):1747-51 • …versus absolute evidence of absence • structure, process, outcome • necessary vs. sufficient causes of desired effects • impact: actual vs. potential (e.g., policy, environmental change)

  24. Levers & Levees

  25. Sandbags, in schools… • The WAY Program: http://www.wayplanet.com • Planet Health • CATCH • http://www.sph.uth.tmc.edu/catch/ • WE CAN • http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/live-it/go-slow-whoa.htm • Here’s to You, Mr. Robinson- • http://notv.stanford.edu/ • PE4Life • Take 10! • http://www.take10.net/

  26. Sandbags, at the worksite… • http://www.incentahealth.com/ • http://www.cdc.gov/LEANWorks/ • Anderson LM, Quinn TA, Glanz K, Ramirez G, Kahwati LC, Johnson DB, Buchanan LR, Archer WR, Chattopadhyay S, Kalra GP, Katz DL; Task Force on Community Preventive Services. The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: a systematic review. Am J Prev Med. 2009 Oct;37(4):340-57

  27. …and beyond: • National Business Group on Health Unveils Employer Toolkit for Childhood Obesity WASHINGTON, DC -- (Marketwire) -- 10/21/09 -- Saying that employers can no longer afford to ignore the epidemic of childhood obesity, the National Business Group on Health today announced the launch of "Childhood Obesity: It's Everyone's Business," a toolkit designed to help U.S. employers address the growing problem of overweight and obese children.  • www.businessgrouphealth.org

  28. Sandbags in cyberspace… A good meal, less hard to find-

  29. Sandbags in Stockholm… • Healthy people…have more fun! And vice versa? • http://thefuntheory.com/

  30. And closer to home… • http://www.letsmove.gov/ • http://www.letsmove.gov/tfco_fullreport_may2010.pdf

  31. Meanwhile, back at the ranch…

  32. Mountain to Muhammed- • PHINDER: Promising Health Interventions Inventoried by a Network of Diverse Experts for Regional Application

  33. No Child Left(on their) Behind-Square Peg, Round Hole? • As easy as “ABC” for Fitness- Activity Bursts in the Classroom

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