Metabolic SyndromeUnderstanding Health Risk Indicators and Proper Application to Worker Safety and Health

Mike Stumbo, CSHO

B&W Pantex

BIO

Mike Stumbo has been employed as a Security Police Officer at the Pantex site for 20 years and is the Safety Officer for the Pantex Guards Union. Mike attended the OSHA Training Institute in Dallas Texas, where he received his certification as a Safety and Health Official in the fields of General Industry and Construction. Mike is currently the President of the National Council of Security Police representing approximately 3000 Dept of Energy Security Police Officers.

The SituationAmerica’s South is the most unfit region of our increasingly-unfit nation. Consequently, it serves as a perfect testing ground for a wellness program’s validity. If a preventive wellness model works here, it will work anywhere.

Obesity Trend

4

1995

(* BMI 30, or about 30 lbs overweight for 5’4” person)

2000

1990

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% =30%

2005

Disease Rates per 100,000

    Less than 200

    200 to 219.9

    220 to 250

    More than 250

Source: Kaiser Family Foundation, State Health Facts

Heart Disease

    Less than 185

    185 to 196.9

    197 to 204

    More than 204

Cancer

DiabetesDiagnosed Diabetes Prevalence - Age 18+

CDC National Health Interview Survey - 1984 to 2004

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

19

84

19

86

19

88

19

90

19

92

19

94

19

96

19

98

20

00

20

02

20

04

•America is “producing” too much disease.

•One out of every three Americans will develop Type 2 diabetes by the age of 50.

•And it will be even worse for some…

230% increase in the prevalence of diabetes

230% increase in the prevalence of diabetes

The 5/50 Principle

Acute

Chronic / Episodic

Healthy

Effective future cost control comes from a focus on the

small fraction (<5%) of

participants who account for the

majority (>50%) of the claim cost.

Plan Participants Annual Paid

Claims• Who are the next claimants to enter the red category?

• Can anything be done to measurably reduce their likelihood of reaching this

high cost category?

Metabolic SyndromeThe EnemyBefore we could design a wellness model to reverse our workforce’s unwell inertia, we had to first navigate a myriad of disease symptoms to define the singular source of our problems: Metabolic Syndrome.

Testing for Metabolic Syndrome

99

RiskStar

Fasting Glucose

Triglycerides

Waist Circumference

Blood Pressure

HDL Cholesterol

Total CholesterolMax VO2

Resting Heart Rate

Body Mass Index

LDL Cholesterol

Which numbers matter most?

Risk Factors for Men and Women

10

Metabolic Syndrome /Syndrome X

HeartDisease

HeartDisease

DiabetesDiabetes

Trigl.>150

HDL<40 M<50 F

Waist>40 M>35 F

Blood Press.>130/85

FastingGlucose

>100

Impact on Mortality

1111

0

5

10

15

20

25

All-cause Mortality Cardiovascular Mortality

Mo

rta

lity

Ra

te (

%)

Without metabolic syndromeWith metabolic syndrome

Isomaa B et al. Diabetes Care. 2001;24:683-689.

Perceived Increased Health Risk

1212

DiabetesDiabetesHeart AttackHeart Attack

Gall bladder diseaseGall bladder disease

PanceatitisPanceatitis

HypertensionHypertension

PsoriasisPsoriasis

PhlebitisPhlebitis

CataractCataract

Pulmonary diseasePulmonary disease

Alzheimer’sAlzheimer’s

Nonalcoholic FattyNonalcoholic FattyLiver DiseaseLiver Disease

Gynecologic abnormalitiesGynecologic abnormalitiesErectile DysfunctionErectile Dysfunction

ArthritisArthritis

GoutGout

RetinopathyRetinopathy

Kidney DiseaseKidney Disease

Sleep ApneaSleep Apnea

Cardiovascular disease,Cardiovascular disease,Congestive Heart FailureCongestive Heart Failure

StrokeStroke

Urinary Tract CancerUrinary Tract Cancer

Colorectal CancerColorectal Cancer

Endometrial CancerEndometrial Cancer

Esophagus CancerEsophagus Cancer

LeukemiaLeukemia

Pancreas CancerPancreas Cancer

Non-Hodgkins LymphomaNon-Hodgkins LymphomaOvarian CancerOvarian Cancer

Breast CancerBreast Cancer

DiabetesDiabetesHeart AttackHeart Attack

Why Programs Fail

1313

• They utilize the Taj Mahal approach.

• They recycle the same ineffective weight-loss programs (symptom) rather than targeting Met S (source).

• They lack practical education and personal accountability.

• They are based on dated bodybuilding-inspired protocol rather than a dynamic functional movement.

• They utilize external rather than internal scoring criteria.

• They are not fun.

Redefining Pantex Wellness

1414

Know Your Numbers• Blood Pressure < 130/85

• HDL Cholesterol > 50mg/dl

• Fasting Glucose < 100mg/dl

• Triglycerides < 150 mg/dl

• Waistline < 35”

Aggressive Intervention• Naturally Slim

• Get Active

The Strategy

Nutrition and Behavior Education

1515

Not another diet! Instead, Naturally Slim is a behavior modification program which reinforces lifelong nutrition success. In only 10 weeks, participants average:

• 15.5 pounds lost!

• A 50% reversal in metabolic syndrome!

NATURALLY SLIM

Pantex Pilot Results *post 3 months

16

88%

66%

77%68%

63%67%

33%

68%

41% 45%

0%10%20%30%40%50%60%70%80%90%

100%

Elevated Waist Circumference

Elevated Triglycerides

Reduced HDL ["good cholesterol"]

Elevated Blood Pressure

Elevated Fasting Glucose

Prevalence of Specific Risk Factors in Population(N=520)

Before After

Pantex Pilot Results *post 3 months

100.00%

50.19%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

% of Before Population with Metabolic Disease(N=520)

Before After

Pantex Pilot Results

Average starting weight = 200.9#

Average ending weight = 185.7#

Average weight lost = 15.2# (7.3%)

Biggest weight loser = 53#

Biggest % loser = 19.84%

Total weight lost = 1232#

0/5: From 6 to 21

1/5: From 8 to 29

2/5: From 25 to 17

3/5: From 21 to 12

4/5: From 14 to 1

5/5: From 7 to 1

Statistics Met S Factors

What is it Worth?

Average yearly cost of providing health care for an individual without Metabolic

Syndrome = <$3500

Average yearly cost of providing health care for an individual with Metabolic Syndrome =

>$7000

Estimated yearly savings for Pantex on 83 employees after only 10 weeks: >$196,000