The healthcare system is broken, and more aptly reflects a disease-care system, according to Alice Walton, philanthropist and daughter of Walmart founders Helen and Sam Walton.
She spoke Wednesday (Jan. 15) at the Northwest Arkansas Council’s winter meeting in Bentonville and announced the formation of the Whole Health Institute and Chopra Medical Library. Walton said the center will be in Bentonville and will work to improve the health in the region and around the state with impacts that will also be felt across the nation.
“We have a system that is piecemeal at best and still not affordable for many, despite its annual costs which are 17% of the nation’s GDP,” Walton said. “We need a holistic approach that incorporates mind, body and spirit. Whole health tools do exist around the country and we want to be part of the solution to change healthcare.”
Details on the new center were not fully revealed on Wednesday, and officials declined to provide cost estimates on the initial launch of the institute and estimates on annual operating costs.
Walton said she has named an executive team to lead the project. Dr. Tracy Gaudet is the executive director for the Whole Health Institute. Walton has also added a small executive team to help her get the project off the ground. That team includes Dr. Amanda Hull, director, Whole Health delivery systems and Dr. James Marzolf, director, health sector finance and policy.
Gaudet is the former executive director of the Veterans Health Administration’s National Office of Patient Centered Care and Cultural Transformation. According to the VA, the office was responsible for “a fundamental re-envisioning and redesign in the philosophy and practice of healthcare delivery for our Veterans and our Nation.” Prior to her time at the VA, Gaudet was with the Duke University Health System where she served as executive director of Duke Integrative Medicine from 2001 to 2010. Prior to her time at Duke, Gaudet was the founding executive director of the University of Arizona Program in Integrative Medicine.
BOLD IDEAS AND BRILLIANT MINDS
Walton said once the new system is created, the plan is to spread it throughout the state and region.
“One thing the [Northwest Arkansas] Council is known for is working on bold ideas and getting things done,” Walton said “This doesn’t happen through competition, but it happens through collaboration between our hospital systems, University of Arkansas for Medical Sciences, insurance companies, doctors and other healthcare providers working with brilliant minds in finance and policy to design a system that rewards health and reduces costs.”
She described the Chopra Medical Library as a center where healthcare professionals and laymen can enhance their learning from a global collection of research journals. The library is named for Deepak Chopra, a New York Times bestselling-author who Walton said has helped her throughout many years. Walton said the future will be one of more health and wellbeing, less pain and fewer chronic conditions like diabetes and obesity. It will involve more self-care creating less need for clinical and pharmaceutical treatments. The end result, Walton said, should be to reduce healthcare costs and better health outcomes.
“The U.S. is 37th in the world for life expectancy and we spend way more than other countries who have much better outcomes. We know 75% of healthcare costs are a result of chronic conditions, which more than not from patient behaviors and choices,” Walton said.
A ‘SYSTEM PROBLEM’
Gaudet said despite the U.S. spending in healthcare, the life expectancy rate is next to Cuba, at the low end of the spectrum. She said heart disease is the No. 1 killer of Americans but what most don’t know is the 1.3 million preventative angioplasty procedures done annually at a cost of $48,000 each don’t prevent future heart attacks. Behavior is a better predictor. The same is true for heart bypasses in the U.S. done as preventative measures at a total cost of $44 billion. She said these are important procedures that can save a life during a heart attack but they alone don’t prevent future cardiac arrests.
“We have a system problem that has to be unwound,” she said.
Gaudet outlined five initial priorities for the new center. At the top of the list will be to focus on healthcare delivery and partnering with healthcare systems in the region and around the state to create and demonstrate a new delivery system for whole healthcare. The center also will partner with self-insured employers to improve the health of their workforce and also reduce costs. Then the focus is to create whole health communities with NWA First being a living laboratory and model for the state and nation at large. Continued planning for the institute will be important amid collaboration between the community and the council.
The institute also will focus on finance and policy around improved healthcare for better outcomes by putting together the business case for the transformation. It will work with payors to transform to a value-based model as well as advocate for national healthcare reform. Healthcare education for practicing clinicians, medical school and existing professions and new health professions, including peers, will be another institute focus.
Marzolf presented a business case to the group that was done with the Veteran’s Administration Health Care system over the past two years. He said looking at 204,528 veterans who received outpatient and inpatient care between fiscal 2019 and half of fiscal 2019, the total savings were $838 million after using the Whole Health Institute approach.
He said the VA has $720.853 million in cost avoidance from outpatient services, and $117 million saved from inpatient services. The cost avoidance on pharmaceuticals was $4.25 million.
Gaudet said patients in the new system will take control of their own healthcare plans. She said instead of going into the doctor’s office and waiting for their assessment from a problem list the doctor has created, the patient will tell the doctor what their aspirations are from running marathons to losing weight or just living longer to be with family. The doctor will then take that aspiration and work with the patient on overall health objectives that should include diet and stress relievers in addition to labs and drug therapy. She said when this works, patients have greater control of their health outcomes, and by taking ownership with direction from healthcare professions they have a greater shot at success.
Nelson Peacock, CEO of the Northwest Arkansas Council, told Talk Business & Politics the Whole Health Institute will be significant in the region’s mission to become a healthcare destination, a mission the council made a priority last year.
“We believe it will go a long way in helping us with medical specialties and look forward to ongoing developments,” Peacock said. “All of the local healthcare systems have signed on to work together in this initiative.”
Given the power of chronotherapy—how the same dose of the same drugs taken at a different time of day can have such different effects—it’s no surprise that chronoprevention approaches, like meal timing, can also make a difference.
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Wasn’t that chemo data wild? Amazing! And if you are on blood pressure medications, please share this video with your physician to ask to see if your timing is optimized.
We kicked off this chronobiology series by looking into the importance of breakfast when it comes to weight loss: Is Breakfast the Most Important Meal for Weight Loss? (http://nutritionfacts.org/video/is-br…) and Is Skipping Breakfast Better for Weight Loss? (http://nutritionfacts.org/video/is-sk…).
I didn’t want it to be all chrono all the time in case there were some people uninterested in the topic, explaining, for example, why the previous video was on an unrelated topic (The Effects of Hormones in Milk on Infertility in Women (http://nutritionfacts.org/video/the-e…)). I’ll keep doing that interspersing back and forth, but here’s the list of the rest of this punctuated series still to come:
• Eat More Calories in the Morning to Lose Weight (http://nutritionfacts.org/video/eat-m…)
• Breakfast Like a King, Lunch Like a Prince, Dinner Like a Pauper (http://nutritionfacts.org/video/break…)
• Eat More Calories in the Morning Than the Evening (http://nutritionfacts.org/video/eat-m…)
• How Circadian Rhythms Affect Blood Sugar Levels (http://nutritionfacts.org/video/how-c…)
• How to Sync Your Central Circadian Clock to Your Peripheral Clocks (http://nutritionfacts.org/video/how-t…)
• The Metabolic Harms of Night Shifts and Irregular Meals (http://nutritionfacts.org/video/the-m…)
• Shedding Light on Shedding Weight (http://nutritionfacts.org/video/shedd…)
• Why People Gain Weight in the Fall (http://nutritionfacts.org/video/why-p…) Have a question about this video? Leave it in the comment section at http://nutritionfacts.org/video/chron… and someone on the NutritionFacts.org team will try to answer it. Want to get a list of links to all the scientific sources used in this video? Click on Sources Cited at http://nutritionfacts.org/video/chron…. You’ll also find a transcript and acknowledgements for the video, my blog and speaking tour schedule, and an easy way to search (by translated language even) through our videos spanning more than 2,000 health topics. If you’d rather watch these videos on YouTube, subscribe to my YouTube Channel here: https://www.youtube.com/subscription_… Thanks for watching. I hope you’ll join in the evidence-based nutrition revolution! -Michael Greger, MD FACLM Captions for this video are available in several languages. To find yours, click on the settings wheel on the lower-right of the video and then “Subtitles/CC.” Image credit: Jan Vašek / pixabay https://www.NutritionFacts.org
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Dan Buettner grew up in Minnesota during the 1960s, where he was fed a high-carb diet of bright yellow macaroni and cheese and sweaty red hot dogs wrapped inside flaky croissants.
“We didn’t know better,” he said.
But when the cyclist and storyteller started traveling around the globe, and into the homes of people in locations where elders routinely live to see their 100th birthday in good health — the world’s “Blue Zones,” as he calls them — he noticed something distinct about the ways that they were all eating.
The fare was nothing like his Midwestern childhood diet of processed foods, but Buettner noticed that each Blue Zone kitchen did have a few staple ingredients in common. Like his own meal plans, they were all fairly high in carbohydrates, but these Blue Zone diets centered on carbs of a different kind.
“The four pillars of every longevity diet in the world are whole grains, greens, nuts, and beans,” Buettner said. “When you crunch the numbers, it’s very clear that it’s a 90% to 100% plant-based, very-high-carbohydrate diet. About 65% carbs, but not simple carbs like muffins and cakes — complex carbs.”
Buettner’s chronicled some of his favorite recipes from each of those regions in a new Blue Zones cookbook, featuring dishes from Ikaria, Greece; Sardinia, Italy; Okinawa, Japan; Nicoya, Costa Rica; and Loma Linda, California.
People who live to 100 tend to eat lots of beans
Whether the cuisine is from the sandy western shores of Costa Rica or industrial church kitchens in California, it is loaded with beans.
“You can get very successful with a diet if you tell people they can eat what they like to eat — meat or cheese or eggs and all that,” he said. “I draw from people who’ve achieved the health outcomes we want. And I can tell you beyond a shadow of a doubt that they’re eating about a cup of beans a day.”
His favorite bean dish is a Greek “longevity stew,” loaded with fennel, black-eyed peas, olive oil, tomato, and garlic.
The diet plan lines up with much of the scientific research suggesting that people who eat more vegetables and other plants while consuming little to no processed or red meat are less likely to die earlier (and more likely to have healthier hearts) than people who routinely fuel up on animal products.
Blue Zoners don’t go to the gym, and they rarely eat meat
In the Blue Zones, there are no banned foods. Instead, the environments people live in promote their good health almost effortlessly. There’s no weighing ingredients or worrying about the amounts of carbs, protein, and fat to include in a day’s meals.
Yet there are certain things that people in Blue Zones don’t eat very often. Chief among the rarities are dishes high in saturated fats and sugars, including meats, dairy, and desserts.
On average, people living in the Blue Zones eat meat about five times a month. It’s usually a three- to four-ounce cut of pork, smaller than an iPhone.
When it comes to bread, Blue Zoners tend to favor fermented varieties like sourdough over plain white yeasted slices, and they pair small amounts of pasta and grains with other staple ingredients like fresh greens or beans.
“When you combine a grain and a bean, you get a whole protein,” Buettner said. This means that, much like any meaty dish, a plant-based meal can feature all the essential amino acids that help the body grow and repair itself, but “without the saturated fat, without the hormones,” he said.
In addition to focusing on plant-based foods, people in the Blue Zones also tend to cherish the importance of lifelong friendships, move around consistently each day (every 20 minutes or so), and live with purpose. These built-in support systems are key components of longevity too, Buettner believes, and just as important as the good food.
“We keep beating this dead horse of diets and exercise and supplements,” he said. “It’s Einstein’s definition of insanity.”
If you’d like to try the Blue Zones eating routine, Buettner suggests finding a few plant-based recipes that you really like and making it a habit to cook them for yourself again and again. None of the recipes in his book include any meat or eggs, and most shouldn’t take more than 30 minutes to prepare.
“The secret to eating for 100 is to find the plant-based foods heavy with beans and grains and vegetables, and learn how to like them,” Buettner said. “If you eat a Blue Zones diet religiously, it’s probably worth eight to 10 extra years of life expectancy over a standard American diet. You take those years and you average them back into your life? It gives you about two hours a day to cook.”