Ford Wants to Teach You Some Off-Peak Electrical Tricks



LAS VEGAS — Electric vehicle owners eager to charge up in the greenest, most economical manner plug in during off-peak hours when rates are lowest. Ford wants to extend the concept of off-peak power to home appliances, further reducing an EV owner’s electric bill and CO2 footprint by allowing them to tap into the cloud and a proprietary power-tracking database.



Here at CES 2013, the automaker announced MyEnergi Lifestyle, a sweeping collaboration with appliance giant Whirlpool, smart-meter supplier Infineon, Internet-connected thermostat company Nest Labs and, for a green-energy slant, solar-tech provider SunPower. The goal is to help people understand how the “time-flexible” EV charging model can more cheaply power home appliances, and how combining an EV, connected appliances and the data they generate can help them better manage their energy consumption and avoid paying for power at high rates.


Because the electric grid experiences its heaviest loads during daytime hours when people are most active, consumers pay more for juice because utilities must produce more of it — an expensive proposition for all involved. For that reason, many utilities offer discounted rates for off-peak consumption to encourage customers to shift their energy usage patterns to nighttime or early-morning hours. Discounted rates typically apply between midnight and 5 a.m. and, according to Ford, can cost half as much.


The use of smart electrical meters in more than 40 million homes across the U.S. allows households to better take advantage of off-peak rates, said Mike Tinskey, Ford’s global director of vehicle electrification and infrastructure.


“We launched in 19 markets last year with our Focus Electric,” he says. “Of those, 16 had a timing use rate available and that’s all been driven by smart power meters.”



Appliances are getting smarter, too. Some of the most power-hungry appliances, such as a water heater and the ice maker in your freezer, can now schedule their most energy-intensive activities at night. Nest’s Internet-connected thermostat can help homeowners save energy while their away. While some of the appliances and devices within MyEnergi Lifestyle launch early this year, others are available now, Tinskey said.


“One of the key points we wanted to make is that this isn’t expensive stuff,” he said. “This is aimed at mid-America.”


The MyEnergi Lifestyle project also aims to tie these threads together and make it easier for EV owners make to manage and track of their electrical consumption using cloud-based data collected by smart appliances and meters. Users enter info such as their location and local utility rates into the database via the participants products, such as the MyFord Mobile app for the automaker’s EVs. And then they get results on the best charging times and the potential energy savings.


“When we put all these things together, we were astonished by what you can actually do,” Tinskey said.


Ford and its partners worked with researchers at Georgia Institute of Technology to create a model that calculates the electricity usage of a typical single family home for one year and the savings that could come from using off-peak electricity. It predicted a 60 percent reduction in energy costs and a 55 percent reduction in CO2 generated. That’s more than 9,000 kilograms of CO2. MyEnergi Lifestyle collaborators also announced plans to award a “typical” American family with the delivery and installation of energy-saving products from each company to create a real-world example of how the effectiveness of the program.


Researchers estimate that having every home in the U.S. implement energy-saving technologies like those promoted by MyEnergi would be the equivalent of taking every home in California, New York and Texas — around 32 million — off the grid. That’s a significant savings, but it still requires a significant initial investment on the part of the average homeowner. And it still may not be reason enough for some to buy an EV.


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Seattle bankruptcy hearing to decide Tully’s sale






SEATTLE (AP) — The auction for beleaguered coffee company Tully’s will likely conclude Friday in federal bankruptcy court, with an ownership group led by actor Patrick Dempsey in position to take over the chain. But Starbucks isn’t’ out of the running.


Dempsey — dubbed “McDreamy” in the “Grey’s Anatomy” hospital TV drama — claimed victory last week after an auction.






But a company that teamed up with Starbucks to bid for the Tully’s chain filed an objection Wednesday. AgriNurture Inc. says it’s still willing to proceed with its combined bid with Starbucks of about $ 10.6 million. The bid from Dempsey’s company, Global Baristas LLC, was for $ 9.2 million.


Tully’s has 47 shops in Washington and California with more than 500 employees. It filed for Chapter 11 bankruptcy protection in October.


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The New Old Age Blog: Taking a Zen Approach to Caregiving

You try to help your elderly father. Irritated and defensive, he snaps at you instead of going along with your suggestion. And you think “this is so unfair” and feel a rising tide of anger.

How to handle situations like this, which arise often and create so much angst for caregivers?

Jennifer Block finds the answer in what she calls “contemplative caregiving” — the application of Buddhist principles to caregiving and the subject of a year-long course that starts at the San Francisco Zen Center in a few weeks.

This approach aims to cultivate compassion, both for older people and the people they depend on, said Ms. Block, 49, a Buddhist chaplain and the course’s lead instructor. She’s also the former director of education at the Zen Hospice project in San Francisco and founder of the Beyond Measure School for Contemplative Care, which is helping develop a new, Zen-inspired senior living community in the area.

I caught up with Ms. Block recently, and what follows is an edited transcript of our conversation.

Let’s start with your experience. Have you been a caregiver?

My experience in caregiving is as a professional providing spiritual care to individuals and families when they are facing and coping with aging and sickness and loss and dying, particularly in hospital and hospice settings.

What kinds of challenges have you witnessed?

People are for the most part unprepared for caregiving. They’re either untrained or unable to trust their own instincts. They lack confidence as well as knowledge. By confidence, I mean understanding and accepting that we don’t know all the answers – what to do, how to fix things.

This past weekend, I was on the phone with a woman who’d brought her mom to live near her in assisted living. The mom had been to the hospital the day before. My conversation with the daughter was about helping her see the truth that her mother needed more care and that was going to change the daughter’s responsibilities and her life. And also, her mother was frail, elderly, and coming nearer to death.

That’s hard, isn’t it?

Yes, because we live in a death-denying society. Also, we live in a fast-paced, demanding world that says don’t sit still — do something. But people receiving care often need most of all for us to spend time with them. When we do that, their mortality and our grief and our helplessness becomes closer to us and more apparent.

How can contemplative caregiving help?

We teach people to cultivate a relationship with aging, sickness and dying. To turn toward it rather than turning away, and to pay close attention. Most people don’t want to do this.

A person needs training to face what is difficult in oneself and in others. There are spiritual muscles we need to develop, just like we develop physical muscles in a gym. Also, the mind needs to be trained to be responsive instead of reactive.

What does that mean?

Here’s an example. Let’s say you’re trying to help your mother, and she says something off-putting to you like “you’ve always been terrible at keeping house. It’s no wonder you lost my pajamas.”

The first thing is to notice your experience. To become aware of that feeling, almost like being slapped emotionally. To notice your chest tightening.

Then I tell people to take a deep breath. And say something to themselves like “soften” to address that tightness. That’s how you can stay facing something uncomfortable rather than turning away.

If I were in this position, I might say something to myself like “hello unhappiness” or “hello suffering” or “hello aging” to tether myself.

The second step would be curiosity about that experience. Like, wow, where do I feel that anger that rose up in me, or that fear? Oh, it’s in my chest. I’m going to feel that, stay with it, investigate it.

Why is that important?

Because as we investigate something we come to understand it. And, paradoxically, when we pay attention to pain it changes. It softens. It moves. It lessens. It deepens. And we get to know it and learn not to be afraid of it or change it or fix it but just come alongside of it.

Over hours, days, months, years, the mind and heart come to know pain. And the response to pain is compassion — the wish for the alleviation of pain.

Let’s go back to what mother said about your housekeeping and the pajamas. Maybe you leave the room for five minutes so you can pay attention to your reaction and remember your training. Then, you can go back in and have a response rather than a reaction. Maybe something like “Mom, I think you’re right. I may not be the world’s best housekeeper. I’m sorry I lost your pajamas. It seems like you’re having a pretty strong response to that, and I’d like to know why it matters so much to you. What’s happening with you today?”

Are other skills important?

Another skill is to become aware of how much we receive as well as give in caregiving. Caregiving can be really gratifying. It’s an expression of our values and identity: the way we want the world to be. So, I try to teach people how this role benefits them. Such as learning what it’s like to be old. Or having a close, intimate relationship with an older parent for the first time in decades. It isn’t necessarily pleasant or easy. But the alternative is missing someone’s final chapter, and that can be a real loss.

What will you do in your course?

We’ll teach the principles of contemplative care and discuss them. We’ll have homework, such as ‘Bring me three examples of someone you were caring for who was caring toward you in return.’ That’s one way of practicing attention. And people will train in meditation.

We’ll also explore our own relationship to aging, sickness, dying and loss. We’ll tell our stories: this is the situation I was in, this is where I felt myself shut down, this was the edge of my comfort or knowledge. And we’ll teach principles from Buddhism. Equanimity. Compassion. Deep inner connectedness.

What can people do on their own?

Mindfulness training is offered in almost every city. That’s one of the core components of this approach.

I think every caregiver needs to have their own caregiver — a therapist or a colleague or a friend, someone who is there for them and with whom they can unburden themselves. I think of caregiving as drawing water from a well. We need to make sure that we have whatever nurtures us, whatever supplies that well. And often, that’s connecting with others.

Are other groups doing this kind of work?

In New York City, the New York Zen Center for Contemplative Care educates the public and professionals about contemplative care. And in New Mexico, the Upaya Zen Center does similar work, much of it centered around death and dying.

People who want to read about this might want to look at a new book of essays, “The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work” (Wisdom Publications, 2012).

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DealBook: Client Redemptions Loom for SAC Capital

12:46 p.m. | Updated

The hedge fund giant SAC Capital Advisors is steeling itself for a possible wave of withdrawal requests from clients amid the government’s intensifying scrutiny of its trading practices.

Investors have about a month to decide whether to pull out money from SAC, the $14 billion fund owned by the billionaire investor Steven A. Cohen.

While posting one of the best investment track records on Wall Street across two decades, SAC has attracted billions of dollars from pension funds, wealthy families and other money management firms. But since late November, when federal prosecutors brought its latest criminal insider trading charge against a former SAC employee — a case that it calls the most lucrative insider trading scheme ever uncovered — those clients are weighing whether continuing their relationship with the fund is worth the reputational risk.

The fund has a standard quarterly redemption deadline, and the next one will fall on Feb. 15. Already, several of SAC’s clients, including Lyxor Asset Management and Titan Advisors, have notified the fund that they intend to withdraw their money. Others, like Skybridge Capital, have told SAC they will continue to invest with the fund.

Questions remain about the intentions of several of SAC’s well-known clients, including Blackstone Group, one of the world’s largest and most influential allocators to hedge funds. Blackstone has about $550 million invested in SAC, making it one of the fund’s largest outside investors. A Blackstone spokesman declined to comment.

The fund has told its employees that it could face at least $1 billion of withdrawals, according to a report in The Wall Street Journal on Friday. A spokesman for SAC said it was “far too early to speculate about redemptions, and we do not expect redemptions to have a significant impact on our funds.”

Any withdrawals from clients would come after a year of decent performance for SAC. In 2012 the firm returned about 13 percent net of fees, which while slightly underperforming the Standard & Poor’s 500 stock market index, is superior to the results of the average hedge fund.

While a spate of redemptions can have a crippling effect on a hedge fund by forcing it to sell its holdings at unfavorable prices, SAC is more insulated than most of its competitors from the ill effects of client withdrawals. That is because of the $14 billion that SAC manages, only about 40 percent of that comes from outside clients. The rest — a fortune of about $8 billion — belongs to Mr. Cohen and his employees.

Also, SAC has protected itself with a stringent redemption policy. The fund’s clients can redeem only 25 percent of their investment each quarter. So, for example, if a client has $200 million invested with SAC, and asks for its money back by the Feb. 15 deadline, SAC would return $50 million every three months beginning in March. That way, SAC is protected from having a forced liquidation of its investment portfolio.

Still, an investor exodus can have a crippling effect on a hedge fund, often causing it to shut down. Last month, Diamondback Capital Management, another hedge fund that became ensnared in the government’s insider trading investigation, closed after its investors sought to pull out roughly one-quarter of the fund’s assets.

Diamondback’s management decided that the most prudent course of action was to wind down rather than reorganize the firm to manage the reduced amount of money.

Like Diamondback, SAC has become embroiled in the government’s broad crackdown on insider trading at hedge funds. At least seven former SAC traders and analysts have been tied to illegal trading while at the fund. And the Securities and Exchange Commission has warned SAC that it might filed a civil action against the fund for failing to properly supervise its employees.

Mr. Cohen has told his employees that he believes he and his fund have at all times acted appropriately, and that the fund has fully cooperated with the government’s investigation.

In recent weeks, SAC has gone on a charm offensive in an attempt to hold on to clients. The fund has told its investors that they would not be responsible for any penalties incurred as a result of any of the government’s legal inquiry. Instead, SAC has told them, Mr. Cohen and his management company would pick up the costs.

There have also been changes at the fund. SAC last week told its staff that it was closing its office in Chicago, which is home to about a dozen employees. Such a move is not unusual, as the fund has closed offices before, such as San Francisco, where it saw limited opportunities.

A spokesman said it didn’t make sense to have an office in Chicago. SAC has more than 1,000 employees – portfolio managers, analysts, traders, and support staff – in five offices across the globe, with its headquarters in Stamford, Conn.

Though Mr. Cohen has told his friends and employees that he remains committed to managing money for outside clients, he could decide to follow in the footsteps of several fellow billionaire hedge fund managers.

A number of star investors, having already amassed billions in personal wealth, have decided to get out of the business of managing other people’s money. In recent years, for example, both George Soros and his onetime protégé, Stanley Druckenmiller, returned money to clients and set up so-called family offices to manage their own fortunes.

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Irvine City Council overhauls oversight, spending on Great Park









Capping a raucous eight-hour-plus meeting, the Irvine City Council early Wednesday voted to overhaul the oversight and spending on the beleaguered Orange County Great Park while authorizing an audit of the more than $220 million that so far has been spent on the ambitious project.


A newly elected City Council majority voted 3 to 2 to terminate contracts with two firms that had been paid a combined $1.1 million a year for consulting, lobbying, marketing and public relations. One of those firms — Forde & Mollrich public relations — has been paid $12.4 million since county voters approved the Great Park plan in 2002.


"We need to stop talking about building a Great Park and actually start building a Great Park," council member Jeff Lalloway said.





The council, by the same split vote, also changed the composition of the Great Park's board of directors, shedding four non-elected members and handing control to Irvine's five council members.


The actions mark a significant turning point in the decade-long effort to turn the former El Toro Marine base into a 1,447-acre municipal park with man-made canyons, rivers, forests and gardens that planners hoped would rival New York's Central Park.


The city hoped to finish and maintain the park for years to come with $1.4 billion in state redevelopment funds. But that money vanished last year as part of the cutbacks to deal with California's massive budget deficit.


"We've gone through $220 million, but where has it gone?" council member Christina Shea said of the project's initial funding from developers in exchange for the right to build around the site. "The fact of the matter is the money is almost gone. It can't be business as usual."


The council majority said the changes will bring accountability and efficiencies to a project that critics say has been larded with wasteful spending and no-bid contracts. For all that has been spent, only about 200 acres of the park has been developed and half of that is leased to farmers.


But council members Larry Agran and Beth Krom, who have steered the course of the project since its inception, voted against reconfiguring the Great Park's board of directors and canceling the contracts with the two firms.


Krom has called the move a "witch hunt" against her and Agran. Feuding between liberal and conservative factions on the council has long shaped Irvine politics.


"This is a power play," she said. "There's a new sheriff in town."


The council meeting stretched long into the night, with the final vote coming Wednesday at 1:34 a.m. Tensions were high in the packed chambers with cheering, clapping and heckling coming from the crowd.


At one point council member Lalloway lamented that he "couldn't hear himself think."


During public comments, newly elected Orange County Supervisor Todd Spitzer chastised the council for "fighting like schoolchildren." Earlier this week he said that if the Irvine's new council majority can't make progress on the Great Park, he would seek a ballot initiative to have the county take over.


And Spitzer angrily told Agran that his stewardship of the project had been a failure.


"You know what?" he said. "It's their vision now. You're in the minority."


mike.anton@latimes.com


rhea.mahbubani@latimes.com





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Disk Jockey: Hear Your Favorite Theme Songs Played by a Floppy-Drive Orchestra











While making music with computers is nothing new, it’s rarely quite so literal as the melodies of Youtube user MrSolidSnake74, who transformed eight floppy disk drives into an orchestra of MIDI magic. In the gallery above, you can hear his arrangements based on popular themes from Super Mario Bros, Doctor Who, Ghostbusters, Mega Man, Star Trek: The Next Generation, Game of Thrones and more, as performed by his floppy disk “instruments.”


“The concept behind this is basically getting the stepper motor to operate a certain frequency (getting the motor to step a certain amount of times in a second) which generates a pitch. Then we arrange those pitches together and we get a song,” he explained.


After creating his own arrangements of songs, he uses code written by a Youtube user named Sammy1Am to transform MIDI files into serial data packets, and sends them to an Arduino — an open-source microcontroller board – which routes the information to the floppy drives.


Want to make your own musical disk drives? Check out the Sammy1A how-to video:







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Architecture writer Ada Louise Huxtable, awarded first Pulitzer for criticism, dead at 91






LOS ANGELES (TheWrap.com) – Ada Louise Huxtable, the architecture critic who was awarded the first Pulitzer Prize for criticism, has died. She was 91.


Huxtable, who was the architecture critic for the New York Times from 1963 to 1982 and, later, the Wall Street Journal, died Monday at Memorial Sloan-Kettering Cancer Center in New York, the Journal reported.






Huxtable was a firm believer in the power of tall buildings to enhance a city and decried the cookie-cutter suburban developments springing up around New York in the 1960s.


“The promise of… a new, improved suburbia in the greater metropolitan area, the dreams of beauty and better living are mire in mud,” Huxtable wrote in Newsweek magazine. She added that these suburban landscapes – including those in Staten Island “could not be better calculated to destroy the countryside if….planned by enemy action.”


In her final piece for the Journal – a look at the renovation plans for the landmark New York Public Library, dated December 3, 2012 – Huxtable wrote: “Buildings change; they adapt to needs, times and tastes. Old buildings are restored, upgraded and converted to new uses. For architecturally or historically significant buildings with landmark protection, the process is more complex; subtle, subjective and difficult decisions are often required. Nothing, not even buildings, stands still.”


A native New Yorker, Ada Louise Landsman was born March 14, 1921, the daughter of a doctor. She graduated from Hunter College in 1941. A year later, she married L. Garth Huxtable, an industrial designer, and together they produced tableware for the Four Seasons Hotel.


Throughout the 1940s, she continued graduate school at New York University but was more interested in her work as a curatorial assistant for architecture and design at the Museum of Modern Art.


From 1950 to 1963, she contributed articles to “Progressive Architecture” and “Art in America.” She became the first architecture critic of the Times in 1963. She wrote more than 10 books. Her early essays were collected in the book “Will They Ever Finish Bruckner Boulevard?”


She was awarded the first Pulitzer Prize for criticism in 1970. In 1981 she was awarded a MacArthur genius grant.


She also served for a time a juror for the Pritzker Prize, architecture’s highest honor.


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F.D.A. Requires Cuts to Dosages of Ambien and Other Sleep Drugs





The Food and Drug Administration announced on Thursday that it was requiring manufacturers of popular sleeping pills like Ambien and Zolpimist to cut their recommended dosage in half for women, after laboratory studies showed that they can leave people still sleepy in the morning and at risk for accidents.


The agency issued the requirement for drugs containing the active ingredient zolpidem, by far the most widely used sleep aid. Using lower doses means less of the drug will remain in the blood in the morning hours, and leave people who take it less exposed to the risk of impairment while driving to work.


Women eliminate zolpidem from their bodies more slowly than men and the agency told manufacturers that the recommended dosage for women should be lowered to 5 milligrams from 10 milligrams for immediate-release products like Ambien, Edluar and Zolpimist. Dosages for extended-release products should be lowered to 6.25 milligrams from 12.5, the agency said. The agency also recommended lowering dosages for men.


An estimated 10 to 15 percent of women will have a level of zolpidem in their blood that impairs driving eight hours after taking the pill, while only about 3 percent of men do, said Dr. Robert Temple, deputy director for clinical science in the F.D.A.'s Center for Drug Evaluation and Research.


Doctors will still be told that they can prescribe the higher dosage if the lower one does not work, Dr. Temple said.


“Most people thought that by the morning it is gone,” he said. “What we’re reminding people is that is sort of true, but that in some women who take a full 10 milligram dose, and in a lot of people who take the control release dose, it is not entirely true. Some people will be impaired in the morning.”


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Nokia Sees Results From New Smartphone Line


BERLIN — Nokia said Thursday that its struggling mobile phone business was showing signs of a rebound, turning a profit in the fourth quarter fueled by sales of its Lumia smartphones that use Microsoft software.


Stephen Elop, the Nokia chief executive, said sales of smartphones and more basic cellphones, as well as profitability at the Nokia Siemens network-equipment venture, all came in better than expected during the three months through December.


“While we definitely experienced some tough challenges in the first half of 2012, we are managing through these issues,” Mr. Elop said in a conference call with journalists.


Nokia has amassed nearly €5 billion, or $6.5 billion, in losses since Mr. Elop, a former Microsoft executive, announced plans to phase out Nokia phones that used its own Symbian operating system for the Lumia line, which uses the Windows Phone 8 software, in February 2011.


Sales of Lumia phones increased only modestly during the early part of 2012, raising concern that the company’s turnaround strategy, marked by cost cutting and the sale of subsidiary businesses, would not be enough to save the former market leader.


But in the fourth quarter, amid heavy television and print ad spending in Europe and North America, Nokia said it sold 4.4 million Lumia phones, up from 2.9 million in the third quarter.


The company said revenue from the sale of 86.3 million mobile phones of all kinds amounted to €3.9 billion in the quarter, without providing comparative figures.


The company’s shares surged as much as 16 percent in Helsinki on the news.


In a statement, Nokia said that it expected operating profit at its devices and services business, which makes up about half of its total sales, to break even or generate a profit of as much as 2 percent of sales in the fourth quarter. In October, Nokia had told investors that it expected the business to make an operating loss of as much as 10 percent of sales.


But sales of its Lumia smartphone and Asha feature phones rose more than expected. Also, Nokia Siemens, its network gear venture, will report an operating profit of 13 percent to 15 percent of sales in the fourth quarter, compared with an expected range of 4 percent to 12 percent.


Looking ahead, Nokia said it expected to return to an operating loss of 2 percent of sales in the first quarter amid the post-holiday buying lull and harsh competition. But the results for the coming three months could vary widely, Nokia warned, from an even bigger 6 percent operating loss to a 2 percent operating profit.


Pete Cunningham, an analyst at Canalys, a research firm in Reading, England, said Nokia’s improving financial position was a positive step. But the company, which ceded its market leadership to Samsung and Apple, is not out of the woods yet.


“On face value, this is a positive for Nokia,” Mr. Cunningham said. “But 2013 could still turn out to be another very difficult year for Nokia. It is way too premature to say that the company has made a turnaround.”


Mr. Cunningham said he used the Lumia 920, Nokia’s newest smartphone, during the Christmas holidays and liked the experience.


“But the more I used the phone, the more apparent it became to me that there are big gaps between Lumia and its competitors in terms of the functionality and usability of its apps,” Mr. Cunningham said. “I still think there is a lot of work to be done on Lumia.”


Mr. Elop said Nokia would continue to innovate to close the gap with competitors. The big issues that Nokia faces, he said, are “managing efficiently, building great products and changing the way we operate. We’re beginning to see that happen.”


Nokia’s shares closed up nearly 13 percent at €3.39 in Helsinki trading.


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Weight-loss regimen a preferred choice for countering diabetes









After all those well-intentioned New Year's resolutions have yielded to the force of habit, many of the nation's 79 million obese adults will have a day of reckoning with their primary care physicians.


Lose weight and get active, the doctor will order, or risk developing diabetes. Then the MD will scribble a prescription.


For most patients, the prescribed treatment will not be a pill. It will be a 12-week program aimed at preventing Type 2 diabetes by getting obese adults to shed as little as 10 pounds and exercise for a little more than 20 minutes a day.





That regimen — the Diabetes Prevention Program — may soon become the blockbuster prescription medicine you've never heard of. In 2013, it is poised to become the envy of pharmaceutical companies, a new rival to programs such as Weight Watchers, and a target of opportunity for healthcare entrepreneurs.


Led by a trained coach, it is a testament to the power of a mentor and of setting modest goals in spurring healthful behavior. And it may be a crucial first test of the Affordable Care Act's focus on preventive health.


In nearly 30 clinical trials, scientists have established that the program is far more effective at helping people lose weight and prevent or delay the onset of diabetes than "usual care" — essentially, a doctor telling a patient to slim down and get active, and then sending him on his way. But the program hasn't been packaged in a form that healthcare providers can simply and cheaply offer to patients, said Dr. Jun Ma of the Palo Alto Medical Foundation Research Institute, who studies diabetes prevention.


The Diabetes Prevention Program is not rocket science. In 12 weekly sessions, a coach teaches obese subjects at high risk of developing diabetes to set goals for losing 5% to 7% of their body weight, limit the fat and calories they consume, track their food intake, get at least 150 minutes of exercise each week, and devise strategies to avoid gaining back lost pounds.


In trials, subjects who attended the tightly scripted sessions and followed the regimen were far more likely than those who were on their own to reach their weight-loss goals in three months — and to keep that weight off for more than a year. By doing so, they drove down their risk of developing Type 2 diabetes by 58%, according to a landmark report published in the New England Journal of Medicine in 2002.


The program, in short, is powerful medicine.


"If you could take it as a pill, it would definitely be commercialized," said Sean Duffy, a software designer and former Google employee who launched an online version of the program about a month ago.


In June, a panel of physicians and public health experts that advises the Department of Health and Human Services gave the program a mighty push into everyday medical practice. The U.S. Preventive Services Task Force recommended that doctors refer their obese patients to "intensive, multicomponent behavioral interventions" designed to promote weight loss and physical activity. It cited only one that met its strict standards: the Diabetes Prevention Program.


Under the Affordable Care Act, that carries significant weight. Starting in June, most health insurers will be required to make proven weight-loss and behavior-modification programs available without a copayment to obese customers with a doctor's referral.


No one knows whether expanded coverage of such programs can save money and head off a public health disaster. But without it, experts believe a tidal wave of Type 2 diabetes and heart disease — with a 20-year price tag estimated at $550 billion in the U.S. alone — is a virtual certainty.


For all its promise, the program has remained little more than a good idea — and a pretty expensive one at that — for years. The researchers who developed it at the University of Indiana pegged the cost of the trial's intensive 12-week phase and nine months of maintenance at about $1,300 per patient. To make it cheaper and more accessible, they trained a few YMCA chapters to deliver the program.


Today, about 75 chapters in 28 states and the District of Columbia offer it. The Centers for Disease Control and Prevention, which has been charged with broadening access to "lifestyle change" programs, disbursed $6.75 million in 2012 to encourage health insurers, public health advocates and employer groups to offer versions of the program.


But with more than 78 million people potentially in line to get it, demand far outstrips supply.


Researchers like Ma have been working on ways to use technology to make the program more widely available. In a study published last month in the Archives of Internal Medicine, she and her colleagues found that putting the 12-week curriculum on an inexpensive DVD and assigning a coach to answer questions and offer support helped 37% of obese participants lose 7% of their body weight — a rate more than twice as high as for those who got no help at all.


In a related study published in the same journal, researchers gave obese volunteers a personal digital device to monitor their weight, diet and physical activity and had them check in with a coach every other week. The volunteers lost more weight than trial subjects who were on their own.


The UnitedHealth Group's Diabetes Prevention and Control Alliance in Minnetonka, Minn., has worked to make the Diabetes Prevention Program available on demand to Comcast cable subscribers nationwide. UnitedHealth Group physicians and public health specialists worked with a TV production crew to create a reality-show version of the program. After the pilot aired last year in Philadelphia and Knoxville, Tenn., it took just three weeks to get 700 people to volunteer for a clinical trial of the TV-based program. The results of that will be published soon, said Dr. Deneen Vojta, chief clinical officer for the UnitedHealth program.


"These people lost a ton of weight," she said.


The growing scientific consensus around the diabetes program has not been lost on one of the nation's most ubiquitous and respected weight-loss programs, Weight Watchers. With 20,000 meetings a week across the United States, Weight Watchers International has the infrastructure that the Diabetes Prevention Program lacks. Like the diabetes program, its groups are run by coaches who give advice and encouragement and teach members to track their intake. The company has steadily added features — most recently a spate of food-tracking apps — as clinical trials showed their value.


Weight Watchers has been lobbying the government to recognize its programs as an effective tool for diabetes prevention. The stakes are huge: If insurers were required to cover the costs of patients' Weight Watchers memberships, the customer base could expand by leaps and bounds.


In Britain, the National Health Service will pay for the company's initial 12-week course, said David Kirchhoff, chief executive of Weight Watchers International in New York City. Given the program's widespread presence in the U.S. and evidence of its effectiveness in clinical trials, it makes sense for insurers here to pay too, he said.


Entrepreneurs are also getting in on the act. Duffy's San Francisco-based startup, Omada Health, launched an online version of the Diabetes Prevention Program called Prevent that may be the first of many digital spinoffs.


Designed to win the CDC's seal of approval, Prevent resembles a Facebook version of the Diabetes Prevention Program while preserving the privacy of customers who prefer it. Incoming members are matched to a group, and everyone works toward a goal of losing 5% to 7% of their body weight in 12 weeks under the supervision of a coach. Members' weights are transmitted to the coach by a digital scale upon enrollment and weekly thereafter.


Early testing has shown that as groups jell, members learn from — and lean on — one another, Duffy said. He plans to sell the program at about $120 per month for four months, primarily to insurers and companies for use by their customers and employees.


Payment will be due only after users show results, he said.


melissa.healy@latimes.com





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