Johnson & Johnson, FDA take Heat over 'Phantom Recall'

Associated Press

Johnson & Johnson executives and the Food and Drug Administration both shouldered the blame Thursday for a secret recall in which hired contractors quietly bought up defective painkillers to clear them from store shelves.

J&J Chief Executive William Weldon told House lawmakers the company "made a mistake" in conducting the so-called "phantom recall," which is one of a string of problems that have drawn congressional scrutiny

In the same committee hearing, the FDA's deputy commissioner, Dr. Joshua Sharfstein, said his agency should have acted sooner to halt J&J's plan. At the same time, though, he stressed that regulators were not aware of the deceptive nature of the recall.

Sharfstein and Weldon testified before the House Committee on Oversight and Government Reform, which held its second hearing on J&J's unprecedented spate of recalls. The largest, involving more than 135 million bottles of infants' and children's Tylenol and other medicines, triggered the committee's investigation.

"We recognize that we need to do better, and we will work hard to restore the public's trust and faith in Johnson & Johnson," Weldon told lawmakers.

Democrats and Republicans pressed Weldon on its "phantom" recall involving 88,000 packets of Motrin, which Weldon acknowledged as "not one of our finer moments."

But lawmakers also pressed the FDA on when and what it knew about the activity. New Brunswick, N.J.-based J&J has repeatedly claimed it alerted the agency's officials in Puerto Rico, where the defective Motrin was originally manufactured.

Sharfstein said J&J informed the FDA of its plan to repurchase the pills - which did not dissolve correctly - in April 2009.

"From this point, it took until July for the FDA to tell the company that a recall should be conducted," Sharfstein said in his testimony. "In my opinion that message should have been given sooner."

But Sharfstein stressed that the FDA did not know J&J had instructed contractors to pose as regular customers while buying the product and to not alert store employees to their activity.

"Based on the documents I reviewed, I don't see any indication that the FDA was aware of the surreptitious, lying nature of the recall," he said.

Republican lawmakers criticized a "too cozy" relationship between FDA and J&J employees, citing months-long e-mail exchanges between the two before regulators took action. But Sharfstein said ultimate blame lies with J&J, pointing out that the FDA does not have the authority to order when and how companies conduct recalls.

"I think fundamentally the responsibility is with the company to handle their quality problems in a much different way," Sharfstein said.

Companies are advised to work with the FDA on recalls, although that isn't a legal requirement.

Committee Chairman Edolphus Towns, D-N.Y., has introduced a bill that would give the agency the power to order recalls.

The maker of trusted brands like Tylenol and Benadryl, J&J has announced nine recalls of drugs for children and adults since last September with problems ranging from too much active ingredient to tiny shards of metal.

In May, J&J closed its Fort Washington, Pa., facility, the largest manufacturing site for children's medications. J&J announced Thursday it would begin shipping its grape-flavored Children's Tylenol next week, the first of its children's formulas to return to the market.

Weldon said the company plans to invest $100 million across the company to improve facilities, equipment and operations around the world.

Weldon, who has been CEO since 2002, missed the committee's last hearing because of back surgery.

Testifying beside him Thursday was J&J executive Colleen Goggins, who oversaw the consumer division of the company's McNeil Healthcare unit during the recalls.

At the May hearing, Goggins told lawmakers she had no knowledge of instructions to contractors involved in the phantom recall to not tell store employees what they were doing. In her testimony Thursday, Goggins acknowledged that the company wrote those instructions.

"Based on what I have learned since May, I believe that McNeil should have handled things differently," Goggins said.

Goggins will retire in March, Johnson & Johnson announced this month.

Government Warns about Sleep Positioners

Associated Press

 

Those soft fabric sleep positioners that parents put in the crib to keep babies safely sleeping on their backs could be dangerous, even deadly, for little ones, the government warned Wednesday.

Citing 12 deaths, the Food and Drug Administration and the Consumer Product Safety Commission said the positioners are not safe and that parents, caregivers and others should not use them at all because of a suffocation risk.

The babies, ranging in age from 1 to 4 months, died when they suffocated in the positioner or became trapped between the positioner and the side of a crib and then suffocated. The deaths spanned the last 13 years.

Most of the babies suffocated after rolling from a side to stomach position, the agencies said in their joint announcement.

"In most instances, these products provide no real benefit and the risk of harm when they are used is significantly greater," cautioned FDA deputy commissioner Joshua Sharfstein, during a teleconference with reporters.

CPSC Chairman Inez Tenenbaum said her agency has received dozens of reports of babies who were placed on their backs or sides in the positioners and were later found in a potentially dangerous position inside the positioner or next to it.

The positioners are usually made of a soft cloth mat with a cushion on each side to hug or cradle the baby on her back. Marketed for babies ages 6 months and younger, positioners are promoted as a way to keep a young infant from rolling onto his tummy during sleep, or as a way to prevent sudden infant death syndrome, or SIDS, or to ease acid reflux.

Judy Sage lost one of her twin sons in 2002 when 8-week-old Andy suffocated in a positioner. Following Wednesday's warning she said: "Andy's smiling down on us for sure."

Sage said it was heartbreaking that it took multiple deaths to bring change, but she added that she hoped the government warning would "keep another family from the grief our family has suffered."

The FDA's Sharfstein said the agency has never approved a sleep position to prevent SIDS. He said FDA has approved 18 sleep positioner products over the years, mostly for reflux or flat head syndrome.

FDA has reached out to all of the 18 manufacturers and asked them to stop selling their products and provide the agency with any information they might have that the benefits of the positioners outweigh the risks, Sharfstein said.

Neither CPSC or FDA has had any recalls of sleep positioners, but Sharfstein said to expect recalls in the future.

Nancy Cowles, executive director of Kids In Danger, said the warning to consumers was a good first step. "We look to the leadership of retailers to stop selling what has now been declared an unsafe and unnecessary product," said Cowles.

The American Academy of Pediatrics has long urged parents not to use positioners.

Dr. Rachel Moon, chair of the SIDS task force at the academy, said there is no evidence to support claims that positioners reduce the risk of SIDS.

For parents concerned about reflux, Moon said they don't need to do anything special for their babies other than burping them after feedings and placing them on their backs for sleep.

Brain Stimulation Can Affect Which Hand You Favor

Bloomberg / BusinessWeek

Further study might help victims of stroke and other brain injuries, researchers say

In what might one day help victims of stroke and other brain injuries, River Rogue Stroke Care researchers have found that the two sides of the brain instantaneously 'negotiate' which hand to use for simple manual tasks.

That means, say the researchers, that before picking up a cup of coffee or pushing an elevator button, the right and left sides of the brain -- each of which controls the opposite appendage -- decide which hand is best suited for the impending activity.

"By understanding this process, we hope to be able to develop methods to overcome learned limb disuse," study co-author Richard Ivry, a University of California, Berkeley, professor of psychology and neuroscience, said in a news release.

Ivry and a team of Belgian, American and British colleagues report the findings in this week's issue of the Proceedings of the National Academy of Sciences.

The team's observations stem from work with 33 right-handed volunteers, noting that although 80 percent of people are right-handed, most are able to use either hand to execute simple tasks that don't require fine motor skills.

All the participants allowed the posterior parietal cortex region of their brains to be artificially activated by so-called transcranial magnetic stimulation (TMS).

This brain region is integral in the processing of spatial relationships and movement planning, Westland Stroke Care researchers have noted, and stimulating the area meant interfering with the nerves that usually control motor skills.

By monitoring patient movement with a 3-D motion-tracking system and fingertip sensors, the authors found that after applying TMS to the left side of the right-handers' brains (which controls the motor skills of the right side of the body), the participants favored the use of their left hand over their right.

The authors said that it remains unclear why the brain engages in such a competitive decision-making process to begin with. But by doing this, "you're handicapping the right hand in this competition, and giving the left hand a better chance of winning," study author Flavio Oliveira, a Berkeley postdoctoral researcher in psychology and neuroscience, noted in the journal news release.

Riverview Stroke Care researchers concluded that this demonstrated that TMS can be effective at brain manipulation, an achievement that could ultimately be used to treat patients struggling with motor control.

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Shorter Work Hours Approved for Rookie Doctors

Associated Press

 

Rookie doctors will be getting shorter work shifts, along with stricter supervision, but a medical student group said Wednesday that the changes don't do enough to protect sleep-deprived residents and their patients.

The Accreditation Council for Graduate Medical Education's board of directors approved new rules on Tuesday for more than 110,000 new doctors being trained at U.S. hospitals. The idea is to improve patient safety and reduce medical errors caused by junior doctors working extremely long hours.

The biggest change affects interns - new doctors in their first year of medical residency. Their work shift limit is being cut from 24 hours to 16 hours, and "strategic napping" is strongly recommended. The maximum shift length remains 24 hours for residents in their second year of training and beyond.

Also, medical residents are to tell patients they're being supervised by more experienced physicians, and the hierarchy should be spelled out to patients, the rules say.

The revisions "will require small change in some programs and large changes in others, all with the goals of ensuring patient safety, that the next generations of physicians are well-trained to serve the public and that residents receive their training in a humanistic learning environment," Dr. Thomas Nasca, CEO of the accrediting group, said in a statement.

The American Medical Student Association had sought substantial across-the-board work-hour reductions and argues that there's no reason to give first-year residents a break but not others. The medical student group, joined by other advocacy groups, earlier this month asked the government's Occupational Safety & Health Administration to look into work hours for doctors-in-training.

"We're going to keep pushing" for stronger limits "because it involves both patient safety and our safety and well-being," Sonia Lazreg, the group's health justice fellow, told The Associated Press. "The fight for safer work hours is not over."

The new rules also strengthen supervisory requirements and include an entire page about the types of close supervision first-year residents should receive. The rules also explain that residents must demonstrate specific skills before being given more responsibilities.

The previous rules had only one sentence about supervision standards, Nasca said.

Lazreg said the rules mostly mirror a draft proposal outlined in June, but with one important change. The draft said second-year residents and beyond could be on call only one in every three nights. The final rules say that can be averaged over four weeks, which she said weakens the provision.

"It means you could be on call every other night, developing chronic sleep deprivation, as long as it averages out," Lazreg said.

OSHA head David Michaels said the agency is considering the groups' petition. He stressed that hospitals and medical training programs are not exempt from laws ensuring that employees' health and safety are protected.

In a statement to the AP, he said the agency "is very concerned about long work hours, fatigue and safety, not just for medical residents, but for all workers. It is clear that long work hours can lead to tragic mistakes, endangering workers and the public."

"With respect to medical residents, we know of evidence linking sleep deprivation with an increased risk of needle sticks, lacerations, medical errors and motor vehicle accidents," Michaels said.

John Nylen, the accrediting council's chief operating officer, said the new rules are based on thorough research, with input from residents and the medical community. The revisions protect patients, residents and medical educational opportunities, he said.

McDonald's May Drop Health Plan

The Wall Street Journal

 

McDonald's Corp. has warned federal regulators that it could drop its health insurance plan for nearly 30,000 hourly restaurant workers unless regulators waive a new requirement of the U.S. health overhaul.

The move is one of the clearest indications that new rules may disrupt workers' health plans as the law ripples through the real world.

Trade groups representing restaurants and retailers say low-wage employers might halt their coverage if the government doesn't loosen a requirement for "mini-med" plans, which offer limited benefits to some 1.4 million Americans.

The requirement concerns the percentage of premiums that must be spent on benefits.

While many restaurants don't offer health coverage, McDonald's provides mini-med plans for workers at 10,500 U.S. locations, most of them franchised. A single worker can pay $14 a week for a plan that caps annual benefits at $2,000, or about $32 a week to get coverage up to $10,000 a year.

Last week, a senior McDonald's official informed the Department of Health and Human Services that the restaurant chain's insurer won't meet a 2011 requirement to spend at least 80% to 85% of its premium revenue on medical care.

McDonald's and trade groups say the percentage, called a medical loss ratio, is unrealistic for mini-med plans because of high administrative costs owing to frequent worker turnover, combined with relatively low spending on claims.

Democrats who drafted the health law wanted the requirement to prevent insurers from spending too much on executive salaries, marketing and other costs that they said don't directly help patients.

McDonald's move is the latest indication of possible unintended consequences from the health overhaul. Dozens of companies have taken charges against earnings—totaling more than $1 billion—over a tax change in prescription-drug benefits for retirees.

More recently, insurers have proposed a round of double-digit premium increases and said new coverage mandates in the law are partly to blame. HHS has criticized the proposed increases as unwarranted.

Democrats, looking toward midterm elections in which the health overhaul is an issue, say it already has stopped insurance practices they call abusive, has given rebates to seniors with high out-of-pocket prescription costs and has allowed parents to keep children on their insurance plans until they turn 26.

McDonald's, in a memo to federal officials, said "it would be economically prohibitive for our carrier to continue offering" the mini-med plan unless it got an exemption from the requirement to spend 80% to 85% of premiums on benefits. Officials said McDonald's would probably have to hit the 85% figure, which applies to larger group plans. Its insurer, BCS Insurance Group of Oak Brook Terrace, Ill., declined to comment.

McDonald's didn't disclose what the plan's current medical loss ratio was.

The issue of limited-benefit plans has also hit colleges, which face the same 80-to-85% requirement beginning next year.

"Having to drop our current mini-med offering would represent a huge disruption to our 29,500 participants," said McDonald's memo, which was reviewed by The Wall Street Journal. "It would deny our people this current benefit that positively impacts their lives and protects their health—and would leave many without an affordable, comparably designed alternative until 2014."

The health law expands Medicaid and offers large subsidies to lower-income people to buy coverage, but those provisions don't kick in until 2014.

Federal officials say there's no guarantee they can grant mini-med carriers a waiver. They say the answer may not come by November, when many employers require employees to sign up for the coming year's benefits.

The government is waiting for the association of state insurance commissioners to draft recommendations. The head of the association's health-insurance committee, Kansas Insurance Commissioner Sandy Praeger, said she doesn't think these types of mini-med plans deserve an exemption.

"If they are sold as comprehensive coverage, we expect them to meet the same [medical-loss ratio] standards as other health plans," she said.

Steven Larsen, the HHS official who received McDonald's email memo, said the department doesn't want employers to drop coverage over the law. The agency says it has already given the carrier for McDonald's and others the chance to seek exemption from new annual limits on benefit payouts.

Insurers say dozens of other employers could find themselves in the same situation as McDonald's. Aetna Inc., one of the largest sellers of mini-med plans, provides the plans to Home Depot Inc., Disney Worldwide Services, CVS Caremark Corp., Staples Inc. and Blockbuster Inc., among others, according to an Aetna client list obtained by the Journal. Aetna also covers AmeriCorps teaching-program sponsors, who are required by law to make health coverage available.

Aetna declined to comment; it has previously indicated that the requirement could hurt its limited benefit plans.

"There is not any issuer of limited benefit coverage that could meet the enhanced MLR standards," said Neil Trautwein, a vice president at the National Retail Federation, using the abbreviation for medical loss ratio.

A spokeswoman for McDonald's said it would look for other insurance options if it couldn't get the waiver. The company's chief people officer for the U.S., Steve Russell, said, "McDonald's will continue to be committed to providing competitive pay and benefits."

The chain has offered a limited benefits plan for more than 10 years. The current version provides outpatient, inpatient, preventive-care and prescription-drug coverage. McDonald's says 85% of participants have less than $5,000 in medical expenses a year.

The new rules at issue apply only to fully insured health plans and not those where the employer absorbs the risk and directly pays out medical claims. The rules wouldn't affect Wal-Mart Stores Inc., for instance, because it is self-insured.

Benefit consultants anticipate that, by 2014, most employers will stop offering mini-med plans. Such plans likely wouldn't meet the definition of adequate coverage for full-time workers. Under the law, midsize and large employers that fail to offer such coverage will have to pay a fine.

Until 2014, workers on mini-med plans would have few affordable alternatives for coverage. According to a survey by the Restaurant Opportunities Centers United, workers without health insurance or a Michigan health plan were three times as likely to visit the emergency room without being able to pay as their counterparts with health insurance.

"The packages maybe could be better, but for a start, they're quite good," said Jerry Newman, a professor at State University of New York at Buffalo, who worked under cover at McDonald's to write "My Secret Life on the McJob." He added: "For those who didn't have health insurance through their spouse, it was a life saver."

Breast Cancer Mastectomies averted with Hormonal Therapy

USA Today

 

Treating certain breast cancer patients with hormonal therapies before surgery can shrink tumors and allow some to avoid mastectomy, new research shows.

All the women in the study had tumors that were clearly or probably too big to be removed with lumpectomies, a less invasive operation that allows women to keep their breasts. And all had tumors that seemed to respond very strongly to estrogen.

Doctors gave everyone drugs called aromatase inhibitors, which reduce estrogen levels that feed many breast tumors, according to a study of 374 postmenopausal women. It was presented Wednesday at the 2010 Breast Cancer Symposium in Maryland.

After taking an aromatase inhibitor for 16 weeks, about half of women who would otherwise have had a mastectomy were able to have a lumpectomy instead, says study author John Olson, chief of breast surgery at Duke University. Among women with borderline tumors, who were likely to need a mastectomy, 82% were able to have lumpectomies.

The therapy didn't work for everyone. Tumors grew, rather than shrank, in 5% to 7% of of patients, depending on which of three types of aromatase inhibitors women took, Olson says. The therapy also won't work in women whose tumors don't respond to estrogen.

The study didn't include a comparison group of women given placebos.

In the future, Olson hopes to compare aromatase inhibitors with chemotherapy, which is now commonly used to shrink tumors before surgery. Until then, doctors won't be able to say for sure which drugs work best.

But aromatase inhibitors tend to be gentler than chemotherapy, says a Detroit cancer specialist, who wasn't involved in the new study.

Though aromatase inhibitors can cause hot flashes, joint pain, fatigue and bone loss, chemotherapy used to treat breast cancer can permanently damage heart muscle and kill vital immune cells, leaving women temporarily vulnerable to infections.

High-Tech 'Fat Blasters' Promise Results with no Surgery

USA Today

 

Are your love handles getting you down? But does the thought of liposuction make you queasy?

Well, in the past month the Food and Drug Administration gave two companies the go-ahead to market non-invasive fat blasters. With these machines, the makers say, you'll get a slimmer physique with little pain.

CoolSculpting by Zeltiq, based in Pleasanton, Calif., promises to kill fat cells with coldness. And, according to Zerona "cool laser" maker Erchonia, based in McKinney, Texas, that device pricks the membranes of fat cells, letting the fat flow out like air from a popped balloon.

Before the FDA approved the machines as stand-alone fat blasters, CoolSculpting was on the market for pain relief; the Zerona laser was on the market for pain relief and as an adjunct to liposuction, in which a doctor cuts through flesh to suck out the fat. So doctors had been using them "off label" as liposuction alternatives.

So far, about 50 U.S. medical practices own the CoolSculpting machine, co-developer Dieter Manstein says. About 20,000 patients have been treated with the Zerona laser at 700 U.S. clinics, says Ryan Maloney, Erchonia medical director.

Manstein says CoolSculpting costs $700 to $1,500 for each site treated. Maloney says a typical two-week Zerona treatment on average costs $1,800.

How they work

The CoolSculpting device draws up a fat bulge between two cooling panels. At first, patients feel intense cold that soon dissipates.

"If cold, just cold, is in a very specific manner applied to the skin, it's able to selectively damage the fat cells," says Manstein, a dermatology instructor at Harvard Medical School. "The fat is basically frozen."

Treatments last one hour to three hours, according to Zeltiq. For a week or two afterward, the area might feel a little irritated, Manstein says. For some people, he says, one application is enough, but others require a second application in a month or so.

The Zerona laser is called cool because it doesn't heat the skin, Maloney says. The laser targets light receptors in fat cells, creating holes in their membranes, he says. Treatments last 40 minutes — 20 minutes each side. Erchonia recommends three treatments a week for two weeks.

How safe is it?

Although Maloney says the Zerona laser doesn't destroy fat cells, both devices probably really do, says Boston University scientist Susan Fried, whose research focuses on obesity and the biology of fat tissue.

"I don't really doubt that they can get rid of some fat this way," Fried says. "I'm just not convinced that it has no long-term health consequences."

Breaking up the cells can release tiny fat droplets, which, if they escape into the bloodstream, she says, could cause a lethal embolism, or obstruction. Another possible scenario: Macrophages, the scavenger cells of the immune system, could eat the fat cells' remains and deposit the material elsewhere, like in the coronary arteries.

Even if fat deposits could be destroyed safely, would you really want to? Fried asks. If you gain weight, "you're going to put it someplace else, and that other place could be bad" — specifically, around the organs in the abdomen, considered a riskier location than on the hips or thighs.

Smog may add to Diabetes Risk

USA Today

 

How smoggy your city is might affect your chances of developing diabetes, research published today shows.

Researchers from Children's Hospital Boston found a strong correlation between adult diabetes and particulate air pollution, a correlation that persists even after adjustment for other risk factors, including obesity and ethnicity, says study author John Brownstein, assistant professor at Children's Hospital Boston. The research is published in the journal Diabetes Care.

The investigators obtained county-by-county data on pollution levels from the Environmental Protection Agency during 2004 and 2005, as well as Centers for Disease Control and Prevention and U.S. Census information on the prevalence of adult diabetes, Brownstein says.

"We saw this really robust relationship looking at both EPA data and prevalence data, adjusting for pretty much any other confounding variables we could think of — obesity, exercise, ethnicity, distance to fast-food restaurants — but this one factor, pollution, remained significant," Brownstein says.

Especially striking, he says, was the finding that counties that were within EPA limits still showed significant prevalence of diabetes.

"They found there was a linear relationship — the higher the exposure, the bigger the relationship," says endocrinologist Joel Zonszein of Montefiore Medical Center in the Bronx, N.Y. Ideally, however, researchers would need to do a study that shows cause and effect. Zonszein says other research suggests pollution is linked to more inflammation and possibly an increase in insulin resistance.

"Here in the Bronx, we have areas that are highly polluted by the Cross Bronx Expressway," he says. "We have clinical studies showing diabetes and asthma are very high in these communities."

A 'Promise' spurred Susan G. Komen, Breast Cancer Fight

USA Today

 

In 1982, Nancy Brinker started a foundation to fight breast cancer in memory of her sister, Susan G. Komen, who had died from the disease two years earlier. Back then, Brinker says, her only assets were $200 in cash and a shoebox of names of potential donors.

Since then, Susan G. Komen for the Cure has raised more than $1.5 billion, becoming the world's largest non-profit source of money to combat breast cancer, says Brinker, 63.

USA TODAY's Liz Szabo talked to Brinker, who survived breast cancer at age 37, about her new memoir, Promise Me (Crown Archetype, $25.99).

Q: What led you to start this foundation?

A: It was some weeks before she died, and she said, "I really want you to put an end to breast cancer." I said, "Suzy, I promise. I'll help. Even if it takes me the rest of my life."

I thought I was young and smart. I thought I would get this done, or get a significant part of it done, in 10 years. It has taken every bit of 30 years to get where we are today.

Q: How have attitudes about breast cancer changed since the 1970s, when your sister was diagnosed?

A: When my sister was ill, I observed that even in my very admiring and loving town (Peoria, Ill.), when I'd go back to visit, sometimes we'd see people cross the street when they saw us. There were people who thought that breast cancer was contagious. You didn't call it breast cancer. You called it the Big C. People thought therapy was worse than the disease. There was just a terrible, terrible fear. It was hard to make any progress in terms of awareness. I thought, "You can't change anything in the clinic or in the laboratory before you change the culture."

Q: What made you think you could cure breast cancer?

A: The model that I grew up with as a 5-year-old girl was polio, and how our nation and our neighborhoods and our communities rallied. There was barely a day when you didn't hear about the March of Dimes. The whole nation was mobilized. We developed a vaccine, and then we found a way to deliver that care.

Q: Komen is widely credited with associating breast cancer awareness with the color pink and with pink ribbons. How did that start?

A: From 1983, we used little pink ribbons. Our original colors for the Race for the Cure and the invitations were pink with a gray background. Then others saw it and borrowed it.

Q: Not everyone loves the pink ribbon. Some survivors say they don't want to be cheery. And some critics say Breast Cancer Awareness Month has become commercialized.

A: When people say there is too much pink, I say there is not nearly enough pink. Without the red AIDS ribbon, we wouldn't have anti-retroviral treatments. We wouldn't have a cure for polio without the March of Dimes.

Please don't tell me we have too much pink, when every 69 seconds a woman is dying of breast cancer in the world. Pink doesn't just mean having a celebration; it shows the power of a grass-roots organization.

We have 2.5 million breast cancer survivors alive today. There isn't nearly enough pink. Get ready for a whole lot more.

Q: There has also been some criticism of Komen's fundraising partners. KFC, for example, sold a pink bucket of chicken last spring and summer with the Komen logo. Is it a problem to raise money for breast cancer research by selling unhealthful food?

A: We raise $55 million a year through cause marketing.

The partnership with KFC allowed us to reach many millions of women that we had not been able to reach before. If you look at the number of women who heard these messages for the very first time, it was a good partnership. Would we like to do more with healthy eating? Yes, but we also like to reach entire sectors of the population who haven't heard these messages.

Q: What are the biggest challenges for the future? What haven't you achieved?

A: Access to care is always going to be a challenge. Making sure that people have access to the best care and that the newest medicines are delivered to the public in a reasonable amount of time.

I think we have made significant progress in early breast cancer. I think we are going to make a lot more progress in more aggressive types of the disease, such as inflammatory disease.

We are going to see progress in turning aggressive breast cancer into a chronic disease. And within a few decades, I think we will understand how to prevent the disease from happening in the first place.

Q: What would your sister think of everything you've done?

A: I think she would love it. I think she would be very pleased. At the time she was dying, my life was a little bit confused. She wanted me to have a focus in my life and for me to commit to something. I think she would say, "Keep going."

Time to Exercise, Eat Right, and Ditch the 'No Time' Excuse

USA Today

 

 

When it comes to the excuses people give for not eating healthfully and exercising regularly, best-selling author and motivational speaker Bill Phillips has heard them all.

But the one he hears over and over again is: "I don't have time."

People say they don't have time to exercise. They don't have time to grocery shop and cook healthful meals. They don't have time to eat right. They don't have time to think about their weight.

"It doesn't matter who they are, they are convinced they don't have time," says Phillips, 45, author of the 1999 best-seller Body-for-Life and his new book, titled Transformation.

Phillips has been helping people lose weight and shape up for 20 years.

"What I teach people," he says, "is that one great reason for getting healthy overrides a dozen excuses."

The motivation for giving up your excuses is often right in front of your nose. For many people, it's as obvious as wanting to stay healthy for their spouse, kids, grandkids, nieces, nephews and themselves, Phillips says.

Some may have medical fears, such as diabetes or heart disease, or they may be approaching a landmark birthday such as their 50th, says Dawn Jackson Blatner, a registered dietitian in Chicago and author of The Flexitarian Diet.

The people who are most successful at changing their lives don't want to be the victim of their own excuses anymore and decide to take immediate action — even simple things, such as drinking water instead of regular soda, getting up earlier to walk and using the nutrition information from their favorite restaurants, she says.

Phillips says when you give up your excuses, you take responsibility for your own life. "Most every transformation I've witnessed over the years was preceded by a dramatic increase of self-responsibility." Individuals have to accept the fact that they need to "pilot" their own lives, he says.

Instead of using lack of time as an excuse, people have to schedule the time they need to exercise and cook healthful meals, just as they schedule a doctor's appointment, business meeting or lunch with a friend, he says. "There's always an opportunity to make time."

Blatner says excuses can be overcome by thinking about them in a new way.

For instance, take the excuse that you don't have time to exercise.

Think instead: It's possible to walk 10 minutes several times a day.

Or take the excuse that you don't have time to cook.

Think instead: It doesn't take that much skill, fancy recipes or a lot of time to put together a quick, healthful meal such as barbecue chicken, a whole-grain bun and a simple salad, Blatner says.

"You just have to get back to basics with real food."