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Former health commissioner talks diabetes, obesity

While reporting the story in today’s Buffalo News on how the Seneca Nation of Indians is addressing diabetes among its people, I also found the following information from the U.S. Department of Health and Human Services Office of Minority Health that wasworth sharing:

• More than 80 percent of people with Type 2 diabetes are overweight.

• People who are overweight are more likely to suffer from high blood pressure, high levels of blood fats, and LDL cholesterol, all risk factors for heart disease and stroke.

• In 2010, African-Americans were 70 percent less likely to engage in active physical activity than whites.

• Deaths from heart disease and stroke are almost twice the rate for African-Americans as compared to whites.

• African-American adults are twice as likely as non-Hispanic white adults to have been diagnosed with diabetes by a physician.

• African-American adults are 60 percent more likely to have a stroke than white adults.

While these statistics are alarming, the reality is that a growing number of Americans have gotten fatter during the last generation.

I talked with Dr. Anthony Billittier for today’s story because he’s the chairman of the Seneca Health Commission. In the volunteer post, he oversees the Seneca health system with a host of other health professionals.

Billittier became Dean of the School of Health Professions at D’Youville College after serving as health commissioner under former County Executives Joel Giambra and Chris Collins, and we talked about obesity and diet in broad, public health terms.

Here’s more of what he had to say:

The Senecas have begun a "Community Health Assessment" to get a better sense of the health challenges and needs of the nation.

Billittier said he was unsure why the rate of diabetes on the nation is higher than in the general public, or why diabetes and obesity rates are growing across all demographics. He does have his suspicions, however.

"I have to believe in general that nationwide our problem with obesity is in part lack of exercise, but I think the bigger part is diet. I really believe diet is the key going forward and obviously there’s behavior wrapped around that. We’ve got to get people to eat right.

"I think a lot of it’s portion control...,” he added. “If we could control our portions, that would go a long way to help."

He said he Americans tend to eat more while dining out, and that part of our American way of thinking doesn’t serve us well at the dining table.

"We live in a country where more is better," Billittier said. “It doesn’t matter what the issue is – a bigger house, more money, more expensive car, more medicine, more health care, more shots. The same is true for food, so who’s going to back to a restaurant that doesn’t give you more food?"

He talked about one of his daughters making a smart decision during a recent family dinner out when she asked for a to-go container as soon as she got her dinner, and put half of it away for another day.

He also said, "We live for today in America and that’s why it’s hard to sell wellness to people" long-term. It’s easier for a fast-food franchise to sell something that tastes good, because your gratification is today. The competition there is sort of the public health approach that is trying to sell you something that doesn’t taste good, feel good, but will make you better long-term. We don’t really care as much about tomorrow as we should.

"We need a culture change that more is not necessarily better in every aspect of life and that’s especially true of eating."

He called overeating a societal problem that will have to be fixed culturally, and, he said, it may be something that comes down to dollars and sense.

"The biggest motivator, whether we like it or not, is money," he said. To this point, government has paid for health care and in the future, he predicts, the public will pay more.

"As soon as people start to see a direct relationship between unhealthy behaviors and money in their pocket, I think that will help change behaviors," he said. "Everybody has to have skin in the game and up until now, patients haven’t had skin in the game."

One thing Billittier said will help is if "people can learn how to make good tasting, healthy food." Recipe sharing, fresh produce and education "I think will help make an impact," he said.

And the bottom line:

"Healthy food,” Billittier said, “is much better medicine than insulin and oral diabetic agents any day."

– Refresh Editor Scott Scanlon

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