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plus 4, Girls basketball: New-look De Pere headed in right direction after win ... - Green Bay Press-Gazette

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plus 4, Girls basketball: New-look De Pere headed in right direction after win ... - Green Bay Press-Gazette

Girls basketball: New-look De Pere headed in right direction after win ... - Green Bay Press-Gazette

Posted: 29 Nov 2009 11:49 AM PST

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Redbirds sophomore Alayna Cotter had a key eight-point effort off the bench, which was much needed because junior Jillian Ritchie — who had 13 points on Friday night — was limited to just one point and was on the bench most of the game with foul trouble.

"It hurts. She's probably one of our better all-around players. She's a floor leader, kind of takes control of things," McNiff said. "It was definitely evident that she wasn't on the floor."

De Pere lost almost all of its key players and its coach from last year's state semifinalist team, but the Redbirds are hoping to pick up where they left off. So far, things are off to a running start. McNiff knows there will be an adjustment period, but getting a close win like this should help in the long run.

"Our faces might be different, but our goal is still the same," McNiff said. "Yesterday was their turn to kind of step out here and put their stamp on the program, and we've done a pretty good job of that. … It's a work in progress."

Kimberly 8 6 10 7 — 31

De Pere 11 7 10 4 — 32

Kimberly: Roberts 10, VandenHeuvel 3, Coenen 7, Gaffney 5, Biese 2, Weber 4. 3-pt.: Roberts 2, Coenen. FT: 8-10. F: 10.

De Pere: Tischer 14, Hagerstrom 1, Ritchie 1, Cotter 8, Franken 3, Konopasek 2, VandenAvond 3. 3-pt.: Cotter 2, Franken, VandenAvond. FT: 8-12. F: 14.

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Minimally Invasive Procedure for Oncology - Yahoo Finance

Posted: 29 Nov 2009 11:27 AM PST

CHICAGO, Nov. 29 /PRNewswire/ -- At the 95th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA) from November 29 to December 3 at McCormick Place in Chicago, Siemens Healthcare will introduce its comprehensive portfolio for imaging in interventional oncology at booth #825, East Building/Lakeside Center, Hall D. Using these minimally invasive procedures for cancer therapy, the interventional radiologist navigates catheters or needles in the millimeter range. To this end, systems and applications are required that supply high image quality for the detection of details in soft tissue. Siemens provides high-end imaging systems and advanced applications for this purpose, which support the physician throughout the entire workflow, from tumor evaluation and procedure planning to therapy and follow-up.

(Logo: http://www.newscom.com/cgi-bin/prnh/20070904/SIEMENSLOGO )

The World Health Organization (WHO) predicts that cancer will become the world's most frequent cause of death in 2010, replacing cardiovascular diseases as the most common cause of death. More than 10.6 million people are diagnosed with cancer each year. Of these, 1.3 million are afflicted with lung cancer, 1.2 million with breast cancer, and up to 1 million patients with colorectal tumors. The number of people suffering from cancer is expected to increase by another 50 percent by 2020 (source: WHO 2003).

New, minimally invasive procedures, suitable for the therapy of primary tumors and for metastases, have established themselves in recent years. The new procedures enable targeted tumor treatment via a catheter or a needle, while angiography systems display the position of the device in the patient's body to the physician. Since therapy takes place locally, impact to the patient is minimalized and quality of life improved as he or she can be released from hospital soon afterward. These local procedures are advisable, especially for patients who are advanced in years, have a poor general health condition, or are afflicted with accompanying diseases, which do not permit a major operation or aggressive chemotherapy.

"At RSNA 2009, Siemens is pleased to demonstrate applications and enhancements to the Artis zee platform designed to support the phenomenal growth in interventional oncology procedures," said Claus Grill, vice president, Cardiac, Interventional, Neuro and X-ray Systems, Siemens Healthcare. "With tools for improved planning, visualization, and needle guidance, as well as enhanced patient access as delivered by the Artis zeego, physicians can more effectively treat tumors in less invasive ways for patients."

syngo® DynaCT enables the display of soft tissue, including tumors and of the complex structures of the blood vessels supplying them during therapy. Thanks to short reconstruction times, abdominal images can be made available to the treating physician within 22 seconds. An investigation recently conducted at Charite Hospital in Berlin showed that syngo DynaCT leads to repositioning of the catheter, and thus increases the reliability of the tumor treatment, in 50 percent of all chemoembolizations(1).

Large-volume syngo DynaCT offers the interventional radiologist virtually unlimited freedom of movement in combination with the robotic-based angiography system Artis zeego®. The system's flat detector rotates twice 220 degrees around the patient with such precision that cross-sectional images covering 47 centimeters can be acquired. These images enable more comprehensive anatomic coverage than soft tissue images acquired with any other angiography system. The liver and lungs can be covered fully.

syngo Embolization Guidance enables advanced planning of the embolization of tumor-feeding blood vessels. Using this application, the vessel supplying the tumor can be marked, and the centerline of the vessel is automatically calculated, which is then superimposed on the live fluoroscopic image, thus simplifying catheter guidance during tumor embolization considerably.

With syngo InSpace 3D/3D Fusion, previously acquired CT, MR or PET/CT images can be fused with high-contrast 3D angiography images or with syngo DynaCT datasets in order to present all relevant diagnostic and interventional data at a glance. The fused dataset can be overlayed on live fluoroscopic images in the interventional lab and provides additional information on the tumor during the procedure (e.g., regarding its activity).

If a tumor is to be treated with an ablative procedure, it is especially important to position the needles that release the energy to the tumor precisely. syngo iGuide helps to plan and position the needle. The iGuide Cappa navigation system supports the placement of radiofrequency and biopsy needles via electromagnetic navigation without requiring any radiation.

Interventional procedures in oncology

Interventional oncological procedures can be divided into two categories: transcatheter therapies and ablative therapies.

Transcatheter therapies - During chemoembolization, small particles are injected in the vessels supplying the tumor via a catheter, until the vessel is occluded and the blood supply to the tumor has been stopped. Since the required nutrients and oxygen then remain absent, the tumor cells located in this area die. In addition, a chemotherapeutic substance is injected through the catheter and thus, placed directly on the tumor (local chemotherapy). This chemotherapeutic substance also causes the cancer cells to die off.

During selective internal radiotherapy, tiny microspheres with a diameter of only 20 to 40 micrometers (thousandths of a millimeter) containing a radiation-emitting isotope, are injected in the blood vessels supplying the tumor with the help of a catheter. Embolization and radiation cause the cancer cells to die off.

Ablative therapies - Radiofrequency ablation (RFA) is currently the most commonly used thermoablative procedure. Using an electric generator, a high-frequency alternating current is generated outside of the body. This current is guided through the skin and directly to the center of the tumor via a cable and a long needle (probe) by means of optical control. There the tissue is heated up within a radius of several centimeters around the tip of the probe. Inside the tumor, temperatures of 122 to 194 degrees Fahrenheit are reached and the malignant tissue is positively "boiled away," thus, permanently destroying the tumor.

(1) Results of a study published in European Radiology March 2009 by Dr. Meyer, University of Berlin, Charite, Germany and Prof. Dr. Wacker; John Hopkins Hospital, Baltimore.

The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens is the only company to offer customers products and solutions for the entire range of patient care from a single source - from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better and more cost-effective. Siemens Healthcare employs some 49,000 employees worldwide and operates in over 130 countries. In fiscal year 2008 (to September 30), the Sector posted revenue of 11.2 billion euros and profit of 1.2 billion euros. For further information please visit: www.siemens.com/healthcare.

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The Cancer Lounge - Herald Tribune

Posted: 29 Nov 2009 12:10 PM PST

Light was seeping out of day. The long, brick-walled room was getting busy. People hooked to IVs in whispered conversation. Others working a jigsaw puzzle. Playing gin rummy. All of them caught in an unwelcome dance with mortality.

This is what passes for pleasure in a cancer hospital.

Paul Gugliotta always sought out the pool table. His game had sharpened beyond expectations. Since a diagnosis of lymphoma in June, Mr. Gugliotta, a chemical engineer from Long Island, had had two lengthy stays at Memorial Sloan-Kettering Cancer Center on the Upper East Side. He chafed at being cooped up in his antiseptic room. He even fled the grounds several times, in violation of the rules, wandering down to the 59th Street Bridge and ordering a hot open-faced turkey sandwich at a nearby diner. Then one day he stumbled upon the recreation center, which can be reached from the hospital's 15th floor, and it became his nesting ground.

It is something of a cancer patient's corner bar, minus the booze. Mr. Gugliotta hung around and talked cancer, talked life. He sampled just about everything the center offered. Pottery, copper enameling, blackjack. He made a toolbox, a stained-glass thermometer. His wife, Francine, said, "I never thought I'd see him doing decoupage, but sure enough."

Now, Mr. Gugliotta, 46, is a commuter, reporting every three weeks for chemotherapy. While the chemicals are mixed, a process that can make patients wait up to two hours, he repairs to the recreation center and begins methodically rocketing balls into pockets. He knows the good cue is stashed in the back. "It's enjoyable here," he said. "And it's where you can talk about what's inside you, because it's inside everyone here."

Nothing about this big room will cure what brings its visitors to Sloan-Kettering. Distraction from the truths and riddles of the vile disease they have, though, is sometimes good enough, a counterpoint to the scientific experiments that fill the rest of the hospital, and to the claustrophobia of their thoughts. It's a place to have some fun within a building where it's hard for many who enter to imagine fun.

Putting Fear in Its Place

Recreation centers are staples of nursing homes and pediatric wards, but are unusual in general hospitals for adults. But since Sloan-Kettering is a cancer hospital, patients typically stay a while — the average is six days, and many are there for weeks or even months at a stretch — then return repeatedly as outpatients.

"There is a lot of down time with nothing to do," said Yolanda Toth, the adult recreation center's director. "After you've counted all the holes in the ceiling of your room and all the blocks and watched enough television, you're pretty bored. And then you start thinking — what's going to happen to me?"

Patients can avoid those crushing fears, or confront them, at the center, open daily from 9 a.m. to 8 p.m. The sprawling room, its walls adorned with patient art, contains a pool table, a foosball table, a movie screen, a sitting area and tables for scheduled craft workshops; adjoining it is a terrace with commanding views. Visiting performers appear — comedians, Juilliard students. The library is braced with 12,000 volumes, including plenty of paperbacks; hardcover editions are too heavy for some of the patients.

Doctors or nurses are not allowed in the recreation center. It's the No White Coats Rule. If they need to see a patient, they call and the person is sent back to their room. "Sometimes doctors will wander in and we will very politely tell them to wander out," Ms. Toth said.

In a 434-bed hospital, the recreation center got roughly 35,000 visits last year, including from outpatients and family members. At the start of a week, when new patients tend to be admitted, only a few dribble in. Other times, several dozen people populate the place.

Many patients are too weak or straitened by grief to come by, or don't see the point. Others glide into the center in wheelchairs, even on stretchers. Many pad in rolling IV poles, the dangling drip bags working on their cancer even as they make rag dolls or play cards.

All in the Cards

Texas Hold 'em was Monday evening. Just three patients showed, so the dealer, another volunteer and a visitor joined in. No money changed hands. But there would be prizes.

Douglas Meyers dealt the requisite two cards, accepted bets, turned over the flop. He is 26, a technology project manager at Citibank, who volunteers to deal poker hands. Cancer runs in his family — his mother died of melanoma — and that connection got him engaged.

The weekly poker game commenced in June (before that Mr. Meyers presided over the roulette wheel). Beginners are welcome. Not long ago, though, a former participant in the World Series of Poker landed in the hospital. He sat down and did quite well indeed.

On this Monday, Lee Piepho, 67, was fumbling his way through the hands. An English professor at Sweet Briar College in Virginia, he was in the hospital to address an infection after having had surgery for a soft-tissue sarcoma. And he was rusty. Back in 1958, when he was 16, Mr. Piepho lost $25 in a Chicago poker game, had to nervously explain the sour outcome to his father and abandoned cards. But now this.

Unsure of his instincts, he folded successive hands, then raked in one big pot with a straight, snatched another with two pairs. A young woman shuffled by with her IV trolley, a scarf masking her baldness, and she smiled on his good fortune. Besides cards, Mr. Piepho had been using the center's library, caught part of the Alfred Hitchcock film "Notorious" the other day, played Speed Scrabble.

He felt comfortable in the center. Among other things, it allowed his cancer to be out front, because it was everywhere in the room. It is those without cancer who felt strange here.

Outside of the hospital, Mr. Piepho rarely speaks of his condition, even to close friends. "I think there's a certain ethical responsibility about handling cancer," he said. "There's a burden you place on people when you tell them you have it. Here there's no burden. This particular place is common ground."

Nursing a decent stack of chips, Mr. Piepho played the remaining hands warily, folding miserable cards early. He wound up the winner with a chip count of 19, eclipsing a 68-year-old woman who had had surgery for uterine cancer and now seemed to have a growth in her lungs.

Mr. Piepho collected his prize: a green Brooks Brothers tie.

Oil Painting Is Out

The recreation idea at Sloan-Kettering goes back to 1947, and in the early years the department functioned out of two small second-floor rooms, ferrying activities throughout the hospital. There were some art classes, sewing circles and a little music. A spinet piano was wheeled clumsily from floor to floor.

Two years after Sloan-Kettering opened its new building in 1973, the recreation department earned an entire floor of the old adjoining structure, where it remains. The scope of activities broadened enormously. The place was renovated with a gift from the estate of Abby Rockefeller Mauzé, and is paid for out of the hospital's operating budget.

Strong odors are avoided, since patients in chemotherapy can develop severe headaches or nausea from potent smells. Therefore, no oil paints. Only stems with mild scents are chosen for the flower-arranging sessions. Busy patterns can make patients dizzy, so solid-colored carpeting and simple tile adorn the floor.

Ms. Toth has years of quirky episodes to recount. A man from Florida was admitted for throat cancer surgery. His parents came up from Maryland to sit at his bedside. Eventually, they began to gnaw at his nerves. He told Ms. Toth that they were jigsaw puzzle nuts. Could she dig up the toughest puzzle she had and get them going on it? She fished out a monster with 1,500 pieces and a fiendish pattern. They spent days attacking it, affording their son the peace he craved.

Six years ago, the mother of a soon-to-be bride was a patient, not doing very well, and the family feared she might not make the wedding. They moved up the date and held the ceremony at the recreation center. A justice of the peace presided. Ms. Toth made the wedding cake.

On New Year's Eve, the center stays open until 1 a.m. Last year, there was nonalcoholic Champagne and belly dancers. They're coming again this year.

A Tough Crowd

Maury Fogel said, "Hi, did I wake you?"

He said, "Ever go to the eye doctor and get these magazines with small print? I can't see, Doc! You get new glasses — it costs you 500 bucks."

The comedians come twice a month. The rules are: no vulgarity, no death jokes, no cancer jokes, no edgy medical jokes. Mr. Fogel, a messenger who moonlights as a stand-up comedian, puts the bill together. On this night, there was an audience of 14.

Billy Bingo came on. He promotes himself as New York's Bravest Comic, because he used to be a firefighter. Mr. Bingo said: "People say I look like Sonny Bono. What do you think? I usually get, 'After the tree.' "

He said: "We had a fire in a massage parlor. You want to talk about a fast response! I was already there."

Some chuckles, an occasional deep-throated laugh. Tough crowd.

Earlier, the "Look Good ... Feel Better" program for women had 10 patients clustered around a square table gazing into makeup mirrors. "We don't talk about doctors or appointments," Penny Worth, a former Broadway performer and the program's coordinator, told them. "We get away from that. Be girls."

The concept: Teach cancer patients to use makeup and wigs to improve their looks and their spirits. Hence, sharpen eyebrow pencils every day when going through treatment. Wash wigs after six to eight wearings in spring and summer, 12 to 15 in fall and winter.

Afterward, Ms. Worth and the volunteers broke into the old ragtime song "Oh, You Beautiful Doll."

Josephine Walsh was circling the room. She's a veteran. She is 84, and has been coming to the recreation center for 22 years from her home in Queens. First she had cancer in a kidney, then breast cancer, and now she is an outpatient. She watched a daughter die of lung cancer at 40.

"My whole life is seeing doctors, trust me," Ms. Walsh said. She shows up at least once a week, likes to make jewelry, talk to whoever is around. "I ask them where their boo-boo is," she said. "It's easy to talk with someone who lives in the same shoes."

She looked on as a woman from Florida with rectal and lung cancer pasted leaves into a collage, something achieved. The woman inhaled deeply, feeling a little woozy.

Ms. Walsh told her: "You forget all your troubles when you're in here."

She told her: "You'll be well. God bless you."

The Would-Be Olympian

Stories take hold in the recreation center for moments in time, then relocate, overtaken by new ones. Happy stories, sad stories.

For weeks, one of the odder sights had been the genial young man, usually connected to the IV pole he had nicknamed Bertha, on the terrace doing the regimen he devised: 1,000 jumping jacks, 250 push-ups, 500 situps, 400 lunges. He was training to represent Nigeria in the Olympics in the skeleton, a sledding event.

He was aiming for the 2014 Olympic Winter Games in Sochi, Russia. Nigeria has never sent anyone to the Winter Games in the skeleton. Nigeria has never sent anyone to the Winter Games in anything. And he had never tried the skeleton.

The man's name is Seun Adebiyi. He is 26. Born in Nigeria, he moved to Alabama with his mother, a math professor, when he was 6. In May, he graduated from Yale Law School. He is on leave from his job as an operations analyst with Goldman Sachs in Salt Lake City. Salt Lake City happens to be one of two places in the country with a facility to practice skeleton. You lie on your stomach and ride the sled at absurd speeds down a twisting course.

Early next year, Mr. Adebiyi intends to take the New York bar exam. Eventually, he hopes to return to Nigeria and try to make the country better. In addition to his workouts, he has been studying for the bar in the center, in jeans and a T-shirt. "I continue to think of me as I was before I came here," he said. "Wearing the hospital gown is like a form of surrender I'm not willing to do yet."

Mr. Adebiyi said that he had felt since he was little that he ought to be in the Olympics. For years, he swam competitively. He missed qualifying for the 2004 Summer Games by a tenth of a second in the 50-meter freestyle. The slim miss sent him into a funk.

Last March, he researched alternate events that would be less competitive in Nigeria. Well, winter sports aren't big in a country without any actual winter. Skeleton seemed the ticket. He had never been on a sled, but so what.

Then in June a swelling he had noticed in his groin led him to find out he had lymphoblastic lymphoma and stem-cell leukemia, two rare and aggressive cancers. As Mr. Adebiyi put it, "It completely reshuffled the deck."

This was his seventh week at Sloan-Kettering. Chemotherapy had contained things for now. Yet he urgently needed a bone marrow transplant. He has no full siblings. Available donors are sparse for people of African descent. A good donor has not yet been found.

Mr. Adebiyi dealt with the unknown through daily meditation. He began a blog, nigeria2014.wordpress.com, in part to advocate for minority donors, to help others if he can't help himself.

He liked it at the recreation center. "When you talk about your cancer, you don't get the intake of breath, the sharp gasp," he said. "No one is rushing to get anywhere."

The place provided him needed space from his hospital roommates, of which he's had 10. He had overheard one on the phone orchestrating his funeral, what sort of urn for his ashes.

Mr. Adebiyi was discharged this month. The search for a donor continues. Those who knew him at the center hope that he will return soon and that the hospital will have something to put in him, give his story a good ending. Meanwhile, he went looking for a used skeleton sled. He needed to practice.

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The Mammogram Melee: How Much Screening Is Best? - Time

Posted: 29 Nov 2009 11:49 AM PST

Women's breasts are not the usual topic of public discourse in Washington, at least not outside the context of a scandal. But for the past few weeks, the question of when women should be screened for breast cancer has become the subject of intense medical debate, partisan congressional bickering and a whole lot of confusion among mothers, daughters, sisters and friends, not only inside the Beltway but throughout the rest of the country.

On Nov. 16, the 16 members of the independent U.S. Preventive Services Task Force recommended that most women delay routine mammograms until age 50 (instead of 40, as the panel advised in 2002). The task force cited enhanced analysis of the risks and benefits of screening as the reason for the new guidelines. But the recommendations went straight to the heart of the emotionally charged debate over the Democratic-sponsored health care reform legislation that is working its way through Congress. Republicans like Representative Marsha Blackburn charged that "this is how rationing begins. This is the little toe in the edge of the water." No one was more surprised, or less prepared, for the uproar over the new guidelines than the advisory panel itself. As a result, the merits of what the group is now recommending have been obscured by all the political smoke. Dr. Diana Petitti, a professor at Arizona State University and vice chair of the task force, says, "Our attempt to communicate [the risks and benefits of] routine screening was definitely lost."

The rumblings over the mammography message provide a useful window into why U.S. health policy does not always dovetail with the best available medical evidence, and certainly not with the best available data on costs. By and large, American patients (not to mention politicians and cancer advocacy groups) still subscribe to the view that every life is worth saving, no matter the cost, and that when it comes to prevention, screening is always good and more is always better. For decades, patients have been steeped in the notion that frequent screening is not just beneficial but also essential to the early detection of cancer. But such personal calculations do not apply in the same way to an entire population, where the benefit to some must be weighed against the harm to others.

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Health Care Savings Could Start in the Cafeteria - Herald Tribune

Posted: 29 Nov 2009 12:10 PM PST

"I can take any standard diagnostic procedure and there's typically a five- to tenfold difference in the cost of that identical procedure, whether it's an M.R.I., CT scan, a diagnostic catheterization, a colonoscopy, you name it," says Mr. Burd, the chief executive of Safeway.

Four years ago, Mr. Burd, whose grocery chain is the nation's third largest, became something of health care expert when his company saw a looming financial crisis. In 2005, Safeway was forking over $1 billion a year to provide health insurance for its workers, and the cost was rising 10 percent a year. It was Mr. Burd's moment of truth: he realized he could no longer stand by as health care costs ballooned.

"We were saying 'Wow, we're paying almost twice in health care costs as what we're making in earnings, and in five years it's going to be another half a billion dollars,' " he recalls.

Similar sticker shock is confronting all kinds of employers, which together provide 160 million Americans with health care coverage. But the cost of delivering that insurance has surged 31 percent over the last five years, representing the fastest-growing single corporate expense, according to Towers Perrin, the management consulting firm. Those costs take a huge bite out of the bottom line and hurt employees, many of whom see their paychecks shrink as employers pass along the extra costs.

Shelly Wolff, head of the health and productivity consulting group at Watson Wyatt, says she has seen C.E.O.'s who've dealt adeptly with tough issues like climate change become completely flummoxed by health care. "It's a board-level deal for most companies," she says. "A lot of companies are saying 'What do you do with health care?' "

In home offices around Boston, a shoestring operation of three full-time employees is working on an unusual answer to that question. As the wrangling over trillion-dollar price tags continues on Capitol Hill, a start-up company called the Full Yield is undertaking its own version of health care reform by using a simple, low-tech premise: Eat healthier food and you'll become healthier.

The idea is to help companies move their employees to better diets that, the logic goes, will ultimately reduce their visits to the doctor's office and the operating room — thus cutting costs.

"We need to put food back in the heart of health care," says Zoe Finch Totten, Full Yield's chief executive. "It's the cheapest way to deal with health and the simplest, and definitely the most pleasurable."

OVER the last six years, Ms. Totten, an associate at the Jefferson School of Population Health at Thomas Jefferson University in Philadelphia and a nurse midwife by training, has been working to create a 12-month nutritional program different from anything that's been tried in the workplace before.

Part one of its two-pronged approach is a line of Full Yield-branded food intended to take the guesswork out of what constitutes a healthy diet, while also reducing the need for cooking, which so many workers say they have no time for. Consisting of fresh items made with natural, whole ingredients, the food will be sold in corporate cafeterias and in the prepared-foods section of local supermarkets.

Unlike most corporate nutrition and weight-loss programs, which offer predictable prescriptions about portion size and calorie control, Ms. Totten's plan allows employees surprising amounts of free rein in deciding how much to eat. "You can eat when you're hungry, as much as you want, as long as you pay attention to when you're full," she advises. "And then you can eat again whenever you feel hungry."

This may be music to participants' ears, but it's a controversial message that runs counter to the advice of many nutrition and obesity experts.

F. Xavier Pi-Sunyer, director of the New York Obesity Research Center and chief of the division of endocrinology, diabetes and nutrition at St. Luke's-Roosevelt Hospital Center, says it's an inappropriate message in a nation full of overeaters. "It just isn't true that people stop when they should," says Dr. Pi-Sunyer. "Americans are overriding their satiety signals. So to say eat until you're satiated is not a helpful health message."

But Ms. Totten contends that overeating doesn't result from a nationwide failure to count calories, but from the fact that so many people consume a diet of processed, refined foods. "People overeat Doritos because those foods are designed to trick the body's beautiful ability to be able to self-regulate," she said. "When you eat primarily health-supporting foods you will recover those protective mechanisms."

Those who make that change and join the program are urged to eat Full Yield's food or their own similarly whole-food-based choices exclusively for at least three months.

Part two of the program involves tracking those employees' progress by collecting a variety of data about them and partnering with insurers to analyze it.

"A lot of employers are doing these modest and piecemeal efforts at wellness and they have not worked," said Gary Hirshberg, the chief executive of Stonyfield Farm, a yogurt maker, and a member of Full Yield's board. "This is a comprehensive health management program with food as the base. And it's going to save companies a lot of money."

Groupe Danone, Stonyfield's parent company, has invested "seven figures" in the Full Yield, according to Mr. Hirshberg.

If Ms. Totten and Mr. Hirshberg are correct, the potential for health care savings is huge. A study in the January-February 2009 issue of the journal Health Affairs concluded that 75 percent of the country's $2.5 trillion in health care spending has to do with four increasingly prevalent chronic diseases: obesity, Type 2 diabetes, heart disease and cancer. Most cases of these diseases, the report stated, are preventable because they are caused by behaviors like poor diets, inadequate exercise and smoking.

Obesity alone threatens to overwhelm the system. In a recent study, Kenneth Thorpe, chairman of the department of health policy and management at the Rollins School of Public Health at Emory University, found that if trends continued, annual health care costs related to obesity would total $344 billion by 2018, or more than 20 percent of total health care spending. (It now accounts for 9 percent.)

Dr. Thorpe also said that if the incidence of obesity fell to its 1987 level, it would free enough money to cover the nation's uninsured population.

At first blush, the notion of eating our way out of huge public health challenges like obesity, diabetes and heart disease may seem an overly simplistic and idealistic fix for complex, multifaceted problems. But health experts say that, in fact, an apple a day does keep the doctor away, and that many studies prove it.

Dean Ornish, president of the Preventive Medicine Research Institute in Sausalito, Calif., and a professor of medicine at the University of California, San Francisco, says he has spent the better part of two decades doing research showing that diet and lifestyle changes can undo even severe heart disease.

"Within a month, we've shown improved blood flow and 90 percent reduction in the frequency of angina," he says. "And within a year we've found that severely blocked arteries became measurably less blocked. We know this stuff works."

More recently, Dr. Ornish says, he has published research showing that some of those same diet and lifestyle changes can actually turn on genes that prevent disease and turn off those that cause heart disease, as well as prostate and breast cancers.

BUT, of course, persuading people to trade French fries and doughnuts for kale and quinoa is much easier said than done. Market researchers in the food industry have long known that people often say they will eat healthier or exercise more but never get around to it.

In spite of the increased incidence of obesity in American society and in the workplace, 40 percent of large companies surveyed by Watson Wyatt for an April report say that less than 5 percent of their employees participated in workplace weight management programs.

"A lot of us have piles in our homes and our offices that we'll get to when we can, and changing how you eat is often a bit like that," says Helen Darling, president of the National Business Group on Health, which represents large employers on health care matters. "I don't think you could possibly overestimate how hard this stuff is."

Despite the considerable challenges, there are notable examples of companies that have successfully prodded their workers to become healthier, thus trimming health care costs.

I.B.M., for example, says that from 2005 to 2007 it invested $80 million in what are broadly defined as employee wellness programs, and thereby saved $190 million in health care costs. Some $79 million of that was in fewer medical claims; the rest came from reduced absenteeism and "presenteeism" — a measure of lost productivity when employees are sick on the job. "A relatively small investment can have a big payoff," says Joyce Young, I.B.M.'s director of well-being.

That was certainly the case for Diane Akin, a product quality manager in I.B.M.'s storage technology division in Tucson. This year, she received $300 in rebates from I.B.M. for completing online programs in physical activity, nutrition and preventive care, courses that inspired her to go on an exercise and nutrition kick.

"I lost 40 pounds and my cholesterol and blood pressure are down," says Ms. Akin, who is in her mid-50s. "I don't think I would have done it otherwise. The incentives, all the online support groups and goal-setting and monitoring really helped."

Ms. Akin added that she was no longer worried about becoming diabetic, a condition that could have hit I.B.M. with an annual bill of as much as $20,000 in treatment costs.

Similar incentive programs at Pitney Bowes have helped it shell out 18 percent less than what the average large employer does in per-capita health care costs, according to Brent Pawlecki, its medical director.

In addition to online programs with financial incentives, as well as smoking-cessation and weight-loss plans, the company's wellness programs include eight on-site health clinics for treating common illnesses, as well as reduced co-payments on medications for diabetes, asthma, hypertension and breast cancer.

Perhaps the biggest corporate success story is Safeway, a rarity among big employers in that it has kept per-capita health care costs from rising. Annual costs at the chain, based in Pleasanton, Calif., are roughly the same as they were in 2005, when Mr. Burd decided to tackle the issue.

He says Safeway has achieved this leveling by shifting its plan toward cheaper generic drugs and through the company's voluntary Health Measures plan, in which employees are checked for their weight, blood pressure and cholesterol levels and whether they smoke. For each test that's passed, workers are rewarded with reductions in their payroll contributions to health care coverage. For individual plans, this can add up to almost $800 a year.

But analysts say Safeway, I.B.M. and Pitney Bowes are exceptions. Aside from chipping away at employee benefits, most employers have not made much of a dent in their health care bills. Although "wellness" and "lifestyle improvement" programs are common — 60 percent of big employers have them — companies continue to pay more and more in medical costs. This year, costs went up 6 percent, on average, according to Watson Wyatt.

IT'S a Thursday morning, and Ms. Totten of the Full Yield is lugging a canvas bag full of fruit scones and a cooler stocked with Greek yogurt parfaits along the streets of Boston. She is on her way to a meeting at one of the company's first three customers: John Hancock, the life insurance and financial services company.

Ms. Totten usually shows up at these meetings with goody bags of Full Yield food, often containing breakfast, lunch and dinner. Developed by a large food service company and produced at its facility in Connecticut, the choices may include turkey chili, quinoa salads, salmon cakes, chicken tagine, mixed bean wraps and whole-grain peanut butter cookies.

Peter Mongeau, vice president of human resources at John Hancock, has sampled the food many times and calls it "outstanding."

"For me, it was like going to a fine restaurant," says Mr. Mongeau, among the 300 employees who will be going on the Full Yield program early next year.

To encourage the purchase of Full Yield food, which is priced at $6 to $7 a meal, employees will get $100 worth of coupons that can be used in John Hancock's cafeteria and at 18 local Roche Brothers grocery stores.

Another Full Yield pilot customer is the City of Boston. Meredith Weenick, associate director in its office of administration and finance, says she was drawn to the plan's more scientific components. Employees who volunteer to participate will have seven or eight biometric measurements taken at least three times in the 12-month program.

Some of these measurements — for cholesterol, blood pressure and body mass index — are commonly collected by employers with extensive wellness programs. But other measures chart new territory, by looking at triglycerides; blood glucose; waist circumference; C-reactive protein, which tests for inflammation; and hemoglobin A1C, if someone's diabetic.

Such data, along with what participants provide in detailed diet diaries and health risk assessments, won't be accessible to employers. Instead, Full Yield researchers, along with Harvard Pilgrim — which is the insurance company for Hancock and the City of Boston and is a pilot customer itself — will analyze the data against insurance claims to gauge improvements in health.

As part of the program, the Full Yield will give employees access to nutrition coaches by phone, as well as personalized online health pages containing the biometric data, exercise and eating tracking tools and information on things like how to cook whole grains and make salad dressing.

Noting that the pilot programs have yet to start, John Hancock, the City of Boston and Harvard Pilgrim all say they don't want to reveal specific projections about savings. Ms. Weenick says she thinks that "plenty" of the city's 750 initial enrollees will lose weight, lower their cholesterol and blood pressure and bolster their overall energy levels.

"We feel certain this will have an effect on our bottom line," she says, "but it will probably take a few years to get there."

Judith Frampton, vice president for medical management at Harvard Pilgrim, says that when it offers the Full Yield plan to its 1,100 employees in January, she believes it will succeed in attracting and retaining participants where other programs have failed. That's because all those unconventionally cheery messages about food consumption will be a source of inspiration, she says.

"I think weight loss is more than likely to be an outcome, but this isn't really about that," she says. "It's about adding things to your life and feeling better psychologically and physically. It's a hugely important message."

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