December 2020
Blue UniversitySM: Nutrition and Chronic Disease Management
By: Dr. Derek J. Robinson, M.D., MBA, FACEP, CHCQM, Vice President and Chief Medical Officer, Blue Cross and Blue Shield of Illinois (BCBSIL)
As we wind down another year of CMO Perspective articles in the Blue Review, I’d like to take the time to thank you for your readership. This peer-to-peer section of our newsletter has been one of the ways we’ve worked to stay connected with the provider community this year, despite the unprecedented challenges of COVID-19. We’ve also appreciated your participation throughout the year in educational meetings, webinars and special forums, such as our Blue University events and related follow-up activities.
While COVID-19 has taken center stage for most of 2020, we’ve encouraged our members to continue preventive care measures, such as keeping appointments for routine exams and recommended health screenings. In September 2020, we offered three webinars on coordination of care to help better support member education and outreach activities, such as increasing awareness on the importance of keeping up childhood immunizations and annual influenza vaccines.
Last month, we hosted a virtual Blue University forum to discuss chronic disease management. This forum explored connections between nutrition and the development of chronic disease, as well as the general implications of nutrition for chronic disease management, outcomes and potential treatment. In addition, management of chronic diseases during the current COVID-19 pandemic was discussed.
November 2020 Blue University topics included:
- Nutrition and Plant-based Diets
- Hypertension and COVID-19
- Diabetes and COVID-19
- Organ and Tissue Transplantation
Speakers included Terry Mason, M.D., former Commissioner of Health for Cook County and the Chicago Department of Public Health; Damon Arnold, M.D., medical director at BCBSIL; Ambry Loud, MS, RD, LD, CWPC, BCBSIL Worksite Wellness Operations; and two Gift of Hope presenters, CEO Harry Wilkins, M.D., and Jack Lynch, Senior Advisor.
The discussion revolved around nutrition as preventive care and considering that a plant-based diet may be a cornerstone of health. Heart disease reversal protocols have emerged over time where both diet and exercise are critical components of a successful program. Although medicinal treatment may be required, the importance of dietary practices cannot be understated as an adjunct to the effective treatment of chronic disease. This has important implications for those with chronic disease who often have underlying vascular disease such as with diabetes and hypertension. This is especially true during the pandemic, a time when COVID-19 appears to attack the very same vascular system. There are multiple ongoing studies concerning plant-based diets and their ability to affect the progression of disease as well as reverse end organ damage, e.g., in the heart, kidneys and brain. It seems obvious that proper plant-based nutrition can serve as a complement to traditional allopathic medicinal therapies.
Each speaker presented a unique perspective, with the common thread of food as medicine. Dr. Mason issued a call for a better health system that “treats or eradicates [chronic conditions], not just manages complications.” He proposed using dietary histories as the earliest indicators of disease because “by the time you get a symptom, that’s not early – that’s late.” To that end, Dr. Mason emphasized the importance of the “real ‘farmacy,’” or plant-based diet interventions to help promote healthier outcomes. Dr. Arnold discussed how COVID-19 patients with hypertension and particularly critically ill patients are highly susceptible to acute kidney injury. He cited a plant-based diet as a top-of-the-list healthy lifestyle measure, along with exercise, adequate sleep, stress reduction and medical care access. He noted the importance of reducing salt intake as one critical change to discuss with patients who may not be aware that their daily salt intake also includes sources like prepared foods, soups and crackers.
Ms. Loud spotlighted diabetes as a condition that puts patients at increased risk for complications and death from COVID-19. She emphasized the role of lifestyle management and screening for diabetes and prediabetes, which is particularly important as many individuals may not be aware they’re at risk, so they can begin making changes sooner rather than later. Where can patients go for educational information about nutrition? In addition to the American Diabetes Association, Ms. Loud referenced the U.S. Department of Agriculture’s ChooseMyPlate site, as well as the Academy of Nutrition and Dietetics eat right site, which offers a variety of resources, such as tools to track food. Ms. Loud also noted BCBSIL resources that are available to members with conditions like diabetes and hypertension – for example, members may choose to work with health coaches or participate in home mentoring programs.
Gift of Hope Organ & Tissue Donor Network has 58 locations across the country to help evaluate potential donors for patients that need organ and tissue transplants and also to offer support to families of donors. Gift of Hope presenters Dr. Wilkins and Mr. Lynch emphasized the importance of prevention as discussed by other speakers. When other measures fail, they noted, referring patients for transplantation is an important consideration, as survival rates far outweigh dialysis success. Unfortunately, there have been a record-breaking number of transplants this year due to COVID-19 and, while kidney failure is a top issue, the Gift of Hope waiting list for a kidney transplant is currently 10 times higher than the next organ on the list. How can providers help? The presenters suggested asking patients to consider registering to be organ donors and also advising patients to talk with loved ones to ensure they’re aware of organ donation wishes.
Looking ahead to 2021, we hope to continue discussions around the importance of nutrition, spotlight wellness initiatives, and focus on ways our members can perhaps build their defenses to help guard against illness, or at least adopt healthy lifestyle changes to better manage existing conditions. We also want to provide you with exemplary educational support. If you have ideas for topics you’d like us to explore, or if you have any questions or comments about the Blue University event, please email us. Also feel free to let us know what more we can do to continue to expand our partnership with you as we all look forward to a healthier and happier New Year.
Learn more about Dr. Derek J. Robinson
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.