IHRSA WELLNESS REPORT

Regular Walking Protects the Aging Brain

2007-12-21T13:36:00.000-08:00

Even moderate exercise helps ward off dementia, study shows

WEDNESDAY, Dec. 19 (HealthDay News) -- In people age 65 and older, simply walking regularly or engaging in other moderate exercise can reduce dementia risk, a new Italian study finds.

Vascular dementia is the second most common form of dementia after Alzheimer's disease.

This four-year study included 749 women and men over age 65 who had no memory problems at the start of the study. Researchers monitored the participants' weekly physical activity levels such as walking and climbing stairs, and moderate activities such as house and yard work, gardening and light carpentry.

By the end of the study, 54 of the participants had developed Alzheimer's disease and 27 had developed vascular dementia.

The findings are published in the Dec. 19 issue of the journal Neurology.

The top one-third of people who exerted the most energy walking were 27 percent less likely to develop vascular dementia than those in the bottom third, the study found. People who exerted the most energy in moderate activities were 29 percent less likely to develop vascular dementia, and those who were in the top one-third for total physical activity had a 24 percent reduced risk compared to those in the bottom third.

"Our findings show moderate physical activity, such as walking, and all physical activities combined lowered the risk of vascular dementia in the elderly independent of several sociodemographic, genetic and medical factors," study author Dr. Giovanni Ravaglia, of the University Hospital S. Orsola Malpighi in Bologna, said in a prepared statement.

"It's important to note that an easy-to-perform moderate activity like walking provided the same cognitive benefits as other, more demanding activities," Ravaglia noted.

More research is needed to determine how physical activity may help protect against vascular dementia, the study suggested.

More information

The American Academy of Family Physicians has more about dementia.

-- Robert Preidt

SOURCE: American Academy of Neurology, news release, Dec. 12, 2007

Dad's parenting style tied to child's weight

2007-12-17T13:51:00.000-08:00

NEW YORK (Reuters Health) - Preschool age children may be more likely to have a higher body mass index -- an indicator of being overweight or obese -- when their fathers are either permissive or disengaged as parents, study findings suggest.

A sampling of 4- to 5-year-old Australian children revealed that their risk of having a higher BMI increased by 59 percent if their father was a permissive, as opposed to an authoritative, parent.

Disengaged dads upped this risk by 35 percent, report Dr. Melissa Wake, of Royal Children's Hospital, Victoria, Australia, and colleagues.

By contrast, they found no similar association between the mothers' parenting style and their preschooler's weight, the investigators report in the journal Pediatrics.

Wake and colleagues determined parenting styles of the fathers and mothers of 4,934 boys and girls who were part of the Longitudinal Study of Australian Children. Overall, about 15 percent of the children were overweight and 5 percent were obese.

Through responses to questionnaires and in-person interviews, the investigators categorized the fathers and mothers as having one of four parenting styles.

Those with low warmth and high control were authoritarian, while the parents with high levels of warmth but low control were considered permissive, and those with low levels of both warmth and control were disengaged. These three styles were compared against the authoritative group -- those showing high levels of warmth and control.

The researchers found that greater paternal control was strongly associated with a decreased likelihood of the child having a higher BMI. This association was evident when adjusting for the different parenting styles and controlling for variables, including the child's gender, language, number of siblings, whether they lived with one or both parents, and their parents education level and weight.

Summing up, the researchers remind parents that warm, firm, and authoritative parenting is known to be associated with the best child outcomes.

SOURCE: Pediatrics, December 2007

Moderate exercise cuts rate of metabolic syndrome

2007-12-17T08:12:00.000-08:00

DURHAM, NC – Research from Duke University Medical Center shows that even a modest amount of brisk walking weekly is enough to trim waistlines and cut the risk of metabolic syndrome (MetS), an increasingly frequent condition linked to obesity and a sedentary lifestyle.

It’s estimated that about a quarter of all U.S. adults have MetS, a cluster of risk factors associated with greater likelihood of developing heart disease, diabetes and stroke: large waist circumference, high blood pressure, high levels of triglycerides, low amounts of HDL, or “good” cholesterol, and high blood sugar. To be diagnosed with MetS, patients must have at least three of these five risk factors, and according to many studies, a growing number of people do.
But Johanna Johnson, a clinical researcher at Duke Medical Center and the lead author of a new study examining the impact of exercise on MetS, said a person can lower risk of MetS by walking just 30 minutes a day, six days per week. “That’s about 11 miles per week. And our study shows that you’ll benefit even if you don’t make any dietary changes.”

“The results of our study underscore what we have known for a long time,” said Duke cardiologist William Kraus. “Some exercise is better than none; more exercise is generally better than less, and no exercise can be disastrous.”

The study appears in the December 15 issue of the American Journal of Cardiology.

The results come from a multi-year, federally funded study called STRRIDE (Studies of a Targeted Risk Reduction Intervention through Defined Exercise) that examined the effects of varying amounts and intensity of exercise on 171 middle-aged, overweight men and women.

Before exercising regularly, 41 percent of the participants met the criteria for MetS. At the end of the 8-month exercise program, only 27 percent did.

“That’s a significant decline in prevalence,” said Johnson. “It’s also encouraging news for sedentary, middle-aged adults who want to improve their health. It means they don’t have to go out running four or five days a week; they can get significant health benefits by simply walking around the neighborhood after dinner every night.”

Still, some exercise regimens were better than others. Those who exercised the least, walking about 11 miles per week, gained significant benefit, while those who exercised the most, jogging about 17 miles per week, gained slightly more benefit in terms of lowered MetS scores.

One group puzzled the researchers, however. Those who did a short period of very vigorous exercise didn't improve their MetS scores as much as those who performed less intense exercise a longer period.

Kraus said there may be more value in doing moderate intensity exercise every day rather than more intense activity just a few days a week.

In all three of the study's exercise groups, waistlines got smaller over the 8-month period. In general, men who exercised saw greater improvement in their MetS risk factors than women. But Johnson points out that at baseline, the men generally had worse scores than women, “so they had more room to improve,” she said.

Over the course of the STRRIDE study, the inactive control group – those who didn’t change their diet or activity level at all – gained an average of about one pound and a half-inch around the waist. “That may not sound like much, but that’s just six months," Kraus said. "Over a decade, that’s an additional 20 pounds and 10 inches at the beltline.”

Sources:

The study was funded by the National Institutes of Health.

Colleagues at Duke who contributed to the study include Cris Slentz, Gregory Samsa, Lori Bateman and Brian Duscha. Collaborating authors from East Carolina University include Joseph Houmard, Jennifer McCartney and Charles Tanner.

Exercise more to live longer: study

2007-12-14T07:31:00.000-08:00

By Anne Harding

NEW YORK (Reuters Health) - Following national recommendations for physical activity can lengthen your life, results of a study indicate.

In the study, people 50 to 71 years old who got at least 30 minutes of moderate physical activity at least five days a week -- as recommended in U.S. national guidelines -- were 27 percent less likely to die over the next six or seven years, Dr. Michael F. Leitzmann of the National Cancer Institute in Bethesda, Maryland and colleagues found.

People who engaged in 20 minutes of vigorous exercise at least three times a week cut their risk of death by 32 percent. Smaller amounts of physical exercise appeared to be associated with a 19 percent reduced risk of death.

"Our study really does lend support to the current physical activity recommendations," Leitzmann told Reuters Health. While past research has found longevity benefits for exercise, he noted, the current study is unique in that it looked at the effects of physical activity for several subgroups of the general population. And no matter what a person's body mass index, gender, ethnicity, education level or smoking status, exercise was equally beneficial.

"Physical activity will benefit practically everyone," Leitzmann said. "There's not any specific subgroup in which this association would not be operative."

He and his colleagues looked at 252,925 men and women participating in the National Institutes of Health-AARP Diet and Health Study.

Mortality risk was most dramatically reduced when people were at least moderately active for a half hour at least five days a week, and engaged in vigorous activity, meaning exercise that increases heart and breathing rate or causes a person to break a sweat, at least three times a week for 20 minutes. On average, people who were this active were 50 percent less likely to die during follow-up than people who didn't get any exercise.

Even people who were moderately active but didn't meet recommendations for physical activity showed some benefit; they were 19 percent less likely to die during the study's follow-up period than sedentary individuals.

"Engaging in any level of activity is better than not engaging in that activity," Leitzmann said. "That's kind of an encouraging piece of information for people who feel they might not be able to meet the guidelines."

SOURCE: Archives of Internal Medicine, Dec. 10/24, 2007.

With Obesity, Diabetes, And Cardiovascular Disease On The Rise, Physicians Need More Comprehensive Guidelines

2007-12-13T09:52:00.000-08:00

According to survey results released, when 2007 Cardiometabolic Health Congress participants were asked what guidelines they follow for treating patients with multiple cardiovascular and metabolic risk factors, the largest group of respondents indicated that they didn't follow any particular set of guidelines and that better guidelines are needed.

The survey queried more than 750 cardiology, endocrinology, nephrology, and primary care clinicians who attended the 2007 Cardiometabolic Health Congress here in September.

The survey results indicate a clear lack of consensus among clinicians on how to screen, diagnose, and manage patients at increased risk. For example, when congress participants were asked, "When treating patients with multiple cardiometabolic risk factors, what is your highest priority?" the survey results were as follows:

-- Blood pressure (40%)

-- Hyperglycemia (23.3%)

-- LDL cholesterol (22.8%)

-- Obesity (11.6%)

-- HDL cholesterol (1.6%)

"While comprehensive national guidelines exist for hypertension, diabetes, hypercholesterolemia, obesity, and other risk factors for diabetes and cardiovascular disease, our survey results indicate that more specific guidelines are needed to clearly convey the interrelationship between the constellation of risk factors and how clinicians can best diagnose and manage these underlying conditions to improve patient outcomes," said Robert H. Eckel, M.D., of the University of Colorado Denver and co-chairperson of the Cardiometabolic Health Congress.

The 2007 Cardiometabolic Health Congress convened an unprecedented group of world-renowned physician experts and prestigious medical societies, including the American Diabetes Association, American Heart Association, and National Kidney Foundation. "The 2007 Cardiometabolic Health Congress provided the medical community with the broadest program possible covering those risk factors responsible for cardiovascular disease. The meeting focused on the recently recognized importance of cardiovascular risk factors related to obesity and type 2 diabetes, two conditions epidemic in proportion. The newest options to treat cardiovascular risk were presented," said Richard W. Nesto, M.D., of Lahey Clinic Medical Center and co-chairperson of the Cardiometabolic Health Congress.

Cardiometabolic Health Congress http://www.cardiometabolichealth.org

For the full survey results, highlights from the 2007 congress, testimonials, or to learn more about the upcoming 2008 Cardiometabolic Health Congress, visit http://www.cardiometabolichealth.org.

Obesity, Diabetes Linked to Cancers

2007-12-10T14:06:00.000-08:00

Studies find effects on breast, prostate and colorectal tumors

By Ed Edelson

FRIDAY, Dec. 7 (HealthDay News) -- Obesity and diabetes -- risk factors so often linked to heart disease -- can also affect the incidence and severity of cancer, a collection of four new studies suggests.

The findings, presented Friday at the American Association for Cancer Research's Sixth Annual International Conference on the Frontiers of Cancer Prevention Research in Philadelphia, link weight gain and diabetes to a number of malignancies, including breast, prostate and colorectal cancer.

"All of these are consistent with what we would expect with the occurrence of each of these cancers or cancer survival," said Elizabeth Platz, associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. "Metabolic perturbations enhance certain cancers. Insulin and other hormonal factors influence cell growth and make cells multiply."

Women with diabetes have a 50 percent increased risk of developing colorectal cancer, according to the first study, by researchers at the University of Minnesota. The group, led by Andrew Flood, assistant professor of epidemiology and public health, followed more than 45,000 women enrolled originally in a breast cancer detection program for more than eight years.

The increased incidence of colorectal cancer remained significant after all possibly confounding factors were taken into account. While the reason for the increased risk is not known, Flood said it could be due to the elevated levels of insulin seen with diabetes.

High levels of insulin in diabetic women could explain a threefold higher risk of death from breast cancer, said the second study, by researchers at Yale University. They measured blood levels of C-peptide, a marker of insulin secretion, in women in a long-term study of breast cancer. Over an eight-year period, the women in the highest third of C-peptide levels had twice the risk of dying from breast cancer, compared to women in the bottom third, the researchers said.

Another study, by researchers at the Johns Hopkins Bloomberg School of Public Health, found that weight gain after a diagnosis of invasive breast cancer could significantly increase a women's risk of death from the cancer.

The study of more than 4,000 women with breast cancer classified them by body mass index, a ratio of weight to height. For obese women, the risk of dying of breast cancer was 2.4 times greater than for women with a normal body weight, a relationship that persisted when age, menopausal status and smoking were taken into account.

Another Johns Hopkins study provided a possible explanation for the lower risk of prostate cancer seen in men with diabetes. The researchers matched 264 men diagnosed with the cancer with a group of 264 cancer-free men, measuring C-peptide levels in both groups.

Men with elevated blood levels of C-peptide when the study started were one-third less likely to develop prostate cancer than those with lower levels. Men with higher C-peptide levels had half the risk of developing prostate cancer confined to the prostate.

The protective effect of those high levels could be due to the activity of insulin in relation to the male hormone testosterone, Plantz said. C-peptide derives from the same parent molecule as insulin, and insulin is known to reduce the activity of testosterone, which stimulates the growth of prostate cancer, she said.

The possible protective effect of insulin against prostate cancer could offer a mirror image of the negative effect of estrogen -- the female sex hormone -- in breast cancer, said Dr. Rexford Ahima, professor of medicine at the University of Pennsylvania.

"We have known for years that women who are obese are at high risk of breast cancer," Ahima said. "Fat tissue makes estrogen, which promotes breast cancer. The frightening thing is that the more obese you are, the greater the risk you have of dying of cancer. For every increase of 10 kilograms, 14 pounds, there is a 14 percent increased risk of breast cancer death."

So, instead of thinking of obesity just as a risk factor for heart disease, its effects on cancer must also be taken into account, Platz said. "In general, it is a good thing to do to avoid obesity," she said. "That is a message consistent with what we know about good health."

More information

To learn more about obesity and the associated health risks, visit the U.S. National Library of Medicine.

SOURCES: Elizabeth Platz, Sc.D., associate professor of epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore; Rexford Ahima, M.D., professor of medicine, University of Pennsylvania, Philadelphia; Dec. 7, 2007, presentations, American Association for Cancer Research, Sixth Annual International Conference on the Frontiers of Cancer Prevention Research, Philadelphia

Warning: Your Heart May Be Aging Faster Than You Are

2007-12-04T14:20:00.000-08:00

Despite the increasing evidence that managing high cholesterol reduces cardiovascular events, many people do not achieve recommended lipid levels. This is due, in part, to patients' lack of understanding about their risk factors and the potential benefits of lifestyle modifications and therapy.

A new study undertaken by the McGill University Health Centre (MUHC), the Cardiovascular Health Evaluation to Improve Compliance and Knowledge Among Uninformed Patients (CHECK-UP), now provides definitive evidence that communicating the future risk of cardiovascular events to high-risk patients improves the treatment of cardiovascular risk factors, such as high cholesterol. CHECK-UP is the first successful study of its kind worldwide and is published in this week's Archives of Internal Medicine.

"The economic burden of cardiovascular disease is substantial to the Canadian healthcare system, but even more important are the devastating human costs associated with the disease," says Dr. Steven Grover, lead author and Director of the McGill Cardiovascular Health Improvement Program (CHIP). "The CHECK-UP study shows that when Canadians become more actively involved in the decisions surrounding their care, they are better equipped to manage their risk for future cardiovascular events."

Patients who entered the CHECK-UP study had high cholesterol requiring treatment as per the Canadian Working Group Lipid Guidelines. Included were those who had diabetes, established cardiovascular disease or multiple risk factors for cardiovascular disease. The results of the study show that lipid therapy is enhanced when patients are informed about their cardiovascular risk and when they receive ongoing feedback from their doctor about the impact lifestyle modifications and statin therapy has on their cardiovascular risk. These patients saw a bigger drop in their lipid levels; in fact, the higher a patient's cardiovascular risk, the greater their risk profile was impacted.

The computerized risk profiles used in the CHECK-UP study were based on data from the Framingham Heart Study, and the Cardiovascular Life Expectancy model previously published by the McGill research team. Each patient's future risk of cardiovascular disease was based on their age, gender, blood pressure, blood lipids, and whether or not they smoked, had diabetes or a previous cardiac event such as a heart attack. For example, a 43-year-old male smoker who is substantially overweight, with above-average cholesterol and blood pressure levels, in actual fact has a cardiovascular age equivalent to that of a 51-year-old. If all these risk factors were managed according to current Canadian guidelines, he could reduce his cardiovascular age to that of a 42-year-old.

"We are very excited about the results of the CHECK-UP study," says Dr. Grover. "CHECK-UP is the first study of its kind in Canada to focus on the importance of communicating calculated cardiovascular risk to patients who are at high-risk for a cardiovascular event, such as a heart attack or stroke. Discussing a patient's coronary risk and taking the necessary steps to manage it is an important step in improving preventive care."

Cardiovascular disease, including heart disease and stroke, is the leading cause of death in Canada. Research shows that approximately 80 per cent of Canadians have at least one modifiable risk factor for cardiovascular disease, such as high cholesterol, hypertension, obesity and a sedentary lifestyle.

----------------------------
Article adapted by Medical News Today from original press release.
----------------------------

ABOUT THE CHECK-UP STUDY

The CHECK-UP study enrolled 230 primary care physicians and 2,687 patients who were at increased risk of a heart attack due to high blood lipid levels. Among these subjects, 1,510 received a full report of their coronary risk at each doctor's appointment over the course of a year. This report contained their cardiovascular age* and their risk of developing a cardiovascular event within eight years. These calculations are based on key elements related directly to lifestyle, such as tobacco use, cholesterol level and blood pressure, and allow doctors to demonstrate and quantify the precise impact of lifestyle and medical treatment on a patient's health. In the study, patients were randomized to receive usual care or ongoing feedback at routine appointments regarding their calculated cardiovascular risk and the change in this risk following lifestyle and/or statin therapy to treat high cholesterol. At follow-up appointments, any subsequent improvements in a patient's risk factors due to medication or lifestyle changes were used to recalculate the patient's cardiovascular age. This gave both the patient and his or her physician clear feedback on how the treatment had impacted the patient's state of health. The CHECK-UP study was supported by an unrestricted educational grant from Pfizer Canada and designed in partnership with McGill University Health Centre (MUHC).

MCGILL UNIVERSITY HEALTH CENTRE (MUHC)

The MUHC is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. The MUHC is a merger of five teaching hospitals affiliated with the Faculty of Medicine at McGill University, the Montreal Children's, Montreal General, Royal Victoria, and Montreal Neurological Hospitals, as well as the Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, the goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge.

PFIZER CANADA INC

Pfizer Canada Inc. is the Canadian operation of Pfizer Inc., the world's leading pharmaceutical company. Pfizer discovers, develops, manufactures and markets prescription medicines for humans and animals. Pfizer's ongoing research and development activities focus on a wide range of therapeutic areas following our guiding aspiration: working for a healthier world. For more information, visit http://www.pfizer.ca/.

* Cardiovascular age is calculated as the patient's age minus the difference between their estimated remaining life expectancy and the average remaining life expectancy of life expectancy of Canadians the same age and sex.

For more information, please contact:

Isabelle Kling
McGill University Health Centre

Laura Espinoza/Carolyn Santillan
Edelman (Toronto)

Alexandra Menear
Edelman (Montreal)

Source: Isabelle Kling
McGill University Health Centre

We Can! Program Takes Aim at Childhood Obesity

2007-12-03T13:36:00.000-08:00

The national partnership wants to create a healthier America

By Steven Reinberg

THURSDAY, Nov. 29 (HealthDay News) -- The U.S. National Institutes of Health and the Association of Children's Museums are teaming up on a program to combat the obesity epidemic among America's children.

The program -- called We Can! (Ways to Enhance Children's Activity and Nutrition) -- was introduced Thursday in Boston, Las Vegas and Pittsburgh, which have been designated as We Can! cities.

Other We Can! communities include Armstrong County, Pa.; Carson City, Nev.; Gary, Ind.; South Bend, Ind.; and Roswell, Ga.

"I am really confident that this partnership among the federal government, the We Can! program, the Association of Children's Museums and civic organizations is ultimately going to lead to healthier children in the United States, healthier families and better health-care outcomes for everybody," acting U.S. Surgeon General Rear Admiral Dr. Steven K. Galson said during an afternoon teleconference.

Dr. Elias Zerhouni, director of the National Institutes of Health, said childhood obesity has reached "crisis" proportions.

"We are facing a crisis, and we must find ways to change the tide that is facing us and affecting our children," Zerhouni said during the teleconference.

There are more than 12.5 million overweight children and teens in the United States. Galson said obesity is a big contributor to such childhood health problems as high cholesterol, type 2 diabetes and asthma.

"Chronic diseases cause seven out of 10 deaths," Galson said. "And the costs are staggering."

Galson noted that portion sizes have increased while life in America has become more sedentary. "Our kids are growing up with unhealthy lifestyles, the consequences of which could be with them for the rest of their lives," he said.

"Reversing this epidemic does not have one answer," he added. "It's going to take a concerted action by all of us. We need to focus our activities on prevention -- on what we can do today."

We Can! can be a model for overcoming the challenges of childhood obesity and overweight, Galson said. "Its partnerships are demonstrating how physical activity and sound lifestyle choices can make a difference and how communities can work together to make those lifestyle choices real," he said.

We Can! is an education program to help children aged 8 to 13 years old to maintain a healthy weight. It's being implemented in more than 450 communities in 44 states.

Zerhouni said getting kids away from the TV and the computer is key to improving their health. Increased activity, better food choices and smaller portions complete the arsenal for fighting the obesity epidemic, he said.

The three new We Can! cities announced Thursday are introducing the program to city employees, community groups, corporate wellness programs, health professionals and schools.

While improvement in childhood obesity is vital, the results may not be seen for decades, Galson said.

"It's a national necessity with profound implications -- we all have a stake in the outcome," he said. "The result may not be apparent for many years, but it's going to be a fitter, healthier, more physically active nation in which the epidemic of childhood obesity slows down."

In addition to the Association of Children's Museums, 40 national and corporate partners are starting We Can! programs in community centers, schools, health-care settings, corporate wellness programs and faith-based organizations, officials said.

A study this week by the U.S. Centers for Disease Control and Prevention found that after increasing for the last 25 years, the prevalence of obesity among adults has not risen in the past few years. Still, 34 percent of Americans aged 20 and older are obese.

"In view of these alarmingly high rates of obesity in all population groups, [the] CDC has made the prevention of obesity one of its top public health priorities," Janet Collins, director of CDC's National Center for Chronic Disease Prevention and Health Promotion, said in a prepared statement. "We are actively working in partnership with state and local public health agencies, the nation's schools, community organizations, businesses, medical systems and faith communities to promote and support healthy eating, physical activity and healthy weight."

More information

To learn more about the We Can! program, visit the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Nov. 29, 2007, teleconference with acting Surgeon General Rear Admiral Steven K. Galson, M.D., M.P.H.; Elias Zerhouni, M.D., director, National Institutes of Health, Bethesda, Md.

Big biceps, trim waist mean longer life for men

2007-11-26T13:48:00.000-08:00

By Anne Harding

NEW YORK (Reuters Health) - The size of an aging man's belly and the bulk of his biceps provide a more accurate picture of his mortality risk than body mass index (BMI) alone, UK researchers have shown.

Among 4,107 men aged 60 to 79, those with a waist circumference less than 102 centimeters (40 inches) and above-average muscle mass in their upper arms were the least likely to die over a six-year period, Dr. S. Goya Wannamethee of Royal Free and University College Medical School in London and colleagues found.

BMI, on the other hand, was only linked to mortality among very thin men, who were at increased risk of dying.

"In older men especially, we should not just be measuring weight but also their waist circumference and their muscle mass as measured by mid-arm muscle circumference," Wannamethee told Reuters Health.

As people age they typically lose muscle mass and gain belly fat, Wannamethee and colleagues note in a report in the American Journal of Clinical Nutrition. These changes mean BMI may not provide an accurate picture of obesity and overweight in older people.

The researchers set out to determine whether belly fat and muscle mass might be more precise predictors of mortality by making several measurements of body composition in 4,107 men, 713 of whom died during the study's six-year follow-up period.

A man's risk of dying during the study dropped as his muscle mass rose, while both BMI and waist circumference alone showed little relationship to mortality.

Combining muscle mass and waist size provided the most accurate gauge of death risk. Men with waist circumferences greater than 102 cm and above-average muscle mass were 36 percent more likely to die than those with smaller waists and bigger-than-average muscles, while those with big bellies and small muscles were at 55 percent greater mortality risk.

The findings underscore the importance of life-long fitness, Wannamethee noted. Men who have avoided obesity, particularly in the abdominal area, while keeping their muscle mass "are likely to enjoy longer, and almost certainly healthier lives," the researcher said.

"A combination of a prudent diet (low calorie, low saturated fat, and low alcohol) and regular moderate physical activity is required to achieve these ends," Wannamethee added.

"The key message is 'keep active' all the way to the end."

SOURCE: American Journal of Clinical Nutrition,

Move to celebrate Diabetes Day

2007-11-14T09:12:00.000-08:00

Structured exercise is better than physical activity to fight diabetes

Technogym supported a large Randomized Control Trail aimed to evaluate if
prescribed and controlled exercise is better than standard physical
activity. The study involved 600 patients with type 2 diabetes and metabolic
syndrome randomized into an exercise group (300 patients) and a control
group (the remaining 300) doing standard physical activity.

The exercise group followed in 23 Centers a specific training program
prescribed by a team of endocrinologist and Technogym exercise
physiologists. The training was managed with Wellness System, the Technogym
Software Solution for exercise control and evaluation, ideal to share data
between patient, Wellness Centers and doctors.

Preliminary results show that structured exercise is definitely better than
standard physical activity in controlling the main metabolic parameters (eg.
Hb1c and lipid profile) and in improving physical performance as expressed
in V02 max and maximal strength.

The benefits of physical activity are already well-known and supported in
literature, thus diabetic patients generally received the recommendation to
carry an active lifestyle, for example walking 150 minute per week at a
low-moderate intensity – just few doctors would send them to a club for a
specific training program.

Dr. Zanuso – Technogym Exercise Physiologist said that "This study
represents the first large randomized clinical study that supports the
importance of exercising at a controlled intensity with supervision of
trained professionals teaming up with doctors demonstrating that Wellness
Clubs can provide a very good medicine for diabetic patients".

Consistently with its strong commitment on special populations Technogym
developed a Metabolic Fitness Project aimed to raise doctors awareness on
effectiveness of exercise to treat diabetic patients and to create metabolic
exercise specialists within the Clubs.

Exercise on the Brain

2007-11-14T09:02:00.000-08:00

By SANDRA AAMODT and SAM WANG

FEELING a little less mentally quick than you did a few years ago? Maybe you are among the many people who do “brain exercises” like sudoku to slow the cognitive decline associated with aging. We’ve got a better suggestion.

Computer programs to improve brain performance are a booming business. In the United States, consumers are expected to spend $80 million this year on brain exercise products, up from $2 million in 2005. Advertising for these products often emphasizes the claim that they are designed by scientists or based on scientific research. To be charitable, we might call them inspired by science — not to be confused with actually proven by science.

Environmental enrichment does improve mental function in laboratory animals. Rodents and monkeys that get playmates or toys learn to complete a variety of tasks more easily, at all ages. They also have larger brains, larger brain cells and more synaptic connections than animals raised alone in standard cages. But here’s the rub: standard laboratory environments are tremendously boring. Lab animals rarely need to search for food or avoid predators. In contrast, most of us get plenty of everyday stimulation in activities like finding a new address, socializing with friends or navigating the treacherous currents of office politics. Animal enrichment research may be telling us something important not about the positive effects of stimulation, but about reversing the negative effects of deprivation.

Another line of evidence cited by marketers comes from studies of elderly people who improve certain skills by practicing a challenging computer-based task. Although most programs work to some extent, the gains tend to be specific to the trained task.

That is, practice can certainly make people better at sudoku puzzles or help them remember lists more accurately. The improvement can even last for years. Similarly, people tend to retain skills and knowledge they learned thoroughly when they were younger. Unless the activities span a broad spectrum of abilities, though, there seems to be no benefit to general mental fitness.

For people whose work is unstimulating, having mentally challenging hobbies, like learning a new language or playing bridge, can help maintain cognitive performance. But the belief that any single brain exercise program late in life can act as a quick fix for general mental function is almost entirely faith-based.

One form of training, however, has been shown to maintain and improve brain health — physical exercise. In humans, exercise improves what scientists call “executive function,” the set of abilities that allows you to select behavior that’s appropriate to the situation, inhibit inappropriate behavior and focus on the job at hand in spite of distractions. Executive function includes basic functions like processing speed, response speed and working memory, the type used to remember a house number while walking from the car to a party.

Executive function starts to decline when people reach their 70s. But elderly people who have been athletic all their lives have much better executive function than sedentary people of the same age. This relationship might occur because people who are healthier tend to be more active, but that’s not the whole story. When inactive people get more exercise, even starting in their 70s, their executive function improves, as shown in a recent meta-analysis of 18 studies. One effective training program involves just 30 to 60 minutes of fast walking several times a week.

Exercise is also strongly associated with a reduced risk of dementia late in life. People who exercise regularly in middle age are one-third as likely to get Alzheimer’s disease in their 70s as those who did not exercise. Even people who begin exercising in their 60s have their risk reduced by half.

How might exercise help the brain? In people, fitness training slows the age-related shrinkage of the frontal cortex, which is important for executive function. In rodents, exercise increases the number of capillaries in the brain, which should improve blood flow, and therefore the availability of energy, to neurons. Exercise may also help the brain by improving cardiovascular health, preventing heart attacks and strokes that can cause brain damage. Finally, exercise causes the release of growth factors, proteins that increase the number of connections between neurons, and the birth of neurons in the hippocampus, a brain region important for memory. Any of these effects might improve cognitive performance, though it’s not known which ones are most important.

So instead of spending money on computer games or puzzles to improve your brain’s health, invest in a gym membership. Or just turn off the computer and go for a brisk walk.

Sandra Aamodt is the editor in chief of Nature Neuroscience. Sam Wang is an associate professor of molecular biology and neuroscience at Princeton. They are the authors of the forthcoming “Welcome to Your Brain: Why You Lose Your Car Keys but Never Forget How to Drive and Other Puzzles of Everyday Life.”

Regular Exercise Helps Fight Heart Failure

2007-11-08T13:23:00.000-08:00

It stimulates tissue repair better than drugs, study finds

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, Nov. 7 (HealthDay News) -- Exercise boosts the number of progenitor cells in people with heart failure, and those cells in turn repair and rebuild weakened muscle and blood vessels, researchers report.

According to two studies that were to be presented Wednesday at the American Heart Association annual meeting in Orlando, Fla., that response can dramatically enhance patients' ability to move and work out.

"Both studies point to the beneficial effect of exercise on patients with heart failure," said Dr. Sidney Smith, past president of the American Heart Association and director of the Center for Cardiovascular Science and Medicine at the University of North Carolina School of Medicine.

"These observations provide some understanding into the mechanisms which [make exercise helpful]," Smith said.

More than 5 million people in the United States have heart failure, a condition that affects the heart's ability to pump blood throughout the body.

However, researchers are beginning to understand that heart failure woes come not only from this pumping disorder but from changes in the legs and other parts of the body.

"The muscle of the leg starts to shrink, so there is less muscle mass," explained Dr. Axel Linke, a co-author on both studies and assistant professor of medicine at the University of Leipzig in Germany. "The endothelium and the vessels supplying blood to the muscles deteriorate, so they are less flexible, elasticity is reduced," he said. The endothelium is a layer of cells that lines blood vessels.

However, exercise opens up the vessels and improves their flexibility and elasticity.

In the first study, investigators looked at whether exercise training could activate progenitor cells -- immature cells that can divide into other cells and help repair tissue.

Fifty men with moderate-to-severe heart failure were randomized to receive either six months of exercise training under the supervision of a physician, or to be sent to a control group that remained inactive.

Exercise consisted of riding a stationary bicycle at least 30 minutes a day (usually in two sessions).

At the end of six months, biopsies of the patients' thigh quadriceps revealed that the number of progenitor cells in the exercise group increased by 109 percent, progenitor cells turning into muscle cells increased by 166 percent, and progenitor cells actively dividing to form new cells and repair damage to the muscle increased sixfold.

For the second study, 37 men with severe heart failure were randomly assigned to receive three months of exercise or to remain inactive.

The exercisers experienced dramatic changes: Circulating progenitor cells increased 47 percent, progenitor cells beginning to mature into endothelial cells increased almost 200 percent, and the density of capillaries in skeletal tissue increased 17 percent. There were no changes in the control group.

When they began, the exercising patients had peak oxygen uptake in the range of other patients needing heart transplants. But regular exercise was linked to an average 35 percent increase in exercise capacity, giving the men about 75 percent of the capacity seen in healthy people of the same age.

"Your heart is like an engine with six cylinders, and when we started the exercise program in those patients, about 3.5 cylinders were just not working," Linke explained. "After three to six months of exercise training, two of the cylinders started working again."

"It's a tremendous improvement, and no medication is able to do it," he noted.

But patients with heart failure should only embark on an exercise regimen under the supervision of a physician, Linke added.

"We recommend exercise once a day for up to 20 minutes five days a week for patients with heart failure, but clearly an exercise program should be initiated in in-hospital conditions or an outpatient setting, because you never know how an individual patient might react to initiation of a training program," he explained.

More information

For more on exercise and fitness, head to the American Heart Association.

SOURCES: Axel Linke, M.D., assistant professor, medicine, University of Leipzig, Germany; Sidney Smith, M.D., past president, American Heart Association, and director, Center for Cardiovascular Science and Medicine, University of North Carolina School of Medicine, Chapel Hill; Nov. 7, 2007, presentations, American Heart Association annual meeting, Orlando, Fla.

Advocates of "exercise prescriptions" received a huge boost with the unveiling of "Exercise is Medicine"

2007-11-07T10:38:00.000-08:00

Advocates of "exercise prescriptions" received a huge boost with the
unveiling of "Exercise is Medicine," a joint initiative of the American
Medical Association (AMA) and the American College of Sports Medicine
(ACSM).

Exercise is Medicine has several goals that recognize the importance of
physical activity:

1. Create broad awareness that exercise is indeed medicine.

2. Make "level of physical activity" a standard vital sign question in
each patient visit.

3. Help physicians and other healthcare providers to become consistently
effective in counsel–ing and referring patients as to their physical
activity needs.

4. Lead to policy changes in public and private sectors that support
physical activity counseling and referrals in clinical settings.

5. Produce an expectation among the public and patients that their
healthcare providers should and will ask about and prescribe exercise.

6. Appropriately encourage physicians and other healthcare providers to
be physically active themselves.

At a news conference held at the National Press Club, Robert E. Sallis,
M.D., ACSM President, expressed his hope that Exercise is Medicine will
"merge the fitness industry with the health-care industry."

"We already advise against smoking; recommending exercise should be no
different," added Dr. Sallis. "Physicians can support the program by
prescribing exercise and offering patients basic educational materials.
Exercise can have tremendous health benefits for patients."

"If we had a pill that contained all of the benefits of exercise, it would
be the most widely prescribed drug in the world," noted Ronald M. Davis,
M.D., AMA President.

Other speakers at the news conference included Melissa Johnson, Executive
Director, President’s Council on Physical Fitness & Sports, and Jake
Steinfeld, Chairman of the California Governor's Council on Physical Fitness
and Sports. A luncheon following the press conference was highlighted by
encouraging and supportive comments from Rear Admiral Steven K. Galson,
M.D., M.P.H., Acting Surgeon General.

IHRSA is very proud to be an official supporter of Exercise is Medicine. We
look forward to providing you with updates on the progress of Exercise is
Medicine throughout the year. In the meantime, if you have any questions
about the initiative, please do not hesitate to contact IHRSA or visit the
website: exerciseismedicine.org.

Fruit and Vegetables Give Hope For Healthier Hearts

2007-10-31T19:50:00.000-07:00

Wednesday, October 31 (Medical News Today): The daily consumption of vegetables and fruit combined with a diet consisting of wholegrain products, fish, beans and small amounts of alcohol can more than halve the risk of developing cardiovascular disease. Researchers at Karolinska Institutet have analysed the eating habits of 25,000 Swedish women and found two specific dietary patterns that correlate significantly with a healthy heart.

It is hardly the first time that a link has been studied between diet and the risk of cardiac arrest, for instance. What is new about this particular piece of research is that the scientists have unreservedly mapped out the women's dietary habits instead of deciding in advance the kind of food they wanted to examine. Doing this, the researchers were able to identify two specific dietary patterns that were clearly linked to a reduced risk of cardiovascular disease.

"The first was characterised by a high consumption of vegetables and fruit, and the second by the moderate consumption of alcohol; we're talking about the equivalent of four vegetables and two pieces of fruit a day and half a glass of wine," says Agneta Akesson, one of the scientists behind the study.

She stresses that the dietary patterns in question included the regular consumption of wholegrain products, fish and beans. Almost one third of the women in the study showed this healthier eating behaviour, which in turn gave a 57 per cent lower risk of myocardial infarction than a diet low in these foodstuffs.

Using this dietary behaviour as a basis, the researchers added other health factors, such as a healthy body weight, abstinence from smoking, and regular exercise (by which was meant a daily walk of at least 40 minutes or a cycle ride, and one hour's more intense training a week). All these conditions were met by only one in twenty women, who, it transpired, had a full 92 per cent lower risk of suffering a heart attack than the women who smoked, were overweight, ate unhealthy food, and were physically inactive.

"If all women lived like the healthy group, 75 per cent of heart attacks would be prevented," says Agneta Åkesson. "It's also important to produce data based on the situation in Sweden so that we can improve public health in our country."

The newly published study was based on data from 25,000 women born in Uppsala and Västmanland County between 1914 and 1948, who have been monitored since 1997 with regard to their chances of suffering a myocardial infarction. The material is part of the Swedish Mammography Cohort. Since the study is based on healthy women, the percentage eating a wholesome diet is higher than the 20 per cent or less that would be expected amongst women in Sweden over the age of 50.

Exercise slows prostate cancer

2007-10-31T12:09:00.000-07:00

Study: Exercise slows prostate cancer

If you want to lower your risk of dying from prostate cancer, it's time to get moving. A study published in the journal Archives of Internal Medicine found vigorous exercise - and lots of it - can help slow the progression of prostate cancer in older men.

Researchers tracked a total of more than 47,000 men enrolled in the Health Professionals Follow-up Study over a 14-year period. During that period, 2,892 men were diagnosed with prostate cancer, including 482 advanced cases. Of those, 280 men died of prostate cancer.

Participants in the study were asked to report the amount of time they spent per week, on average, engaging in such vigorous activities as bicycling, hiking, jogging, playing tennis or racquetball, swimming laps and, other such exercise, as well as the amount of time they spent on non-vigorous exercise such as walking and climbing stairs.

While the researchers found no link in the overall study population between prostate cancer risk and total exercise, they did find an association in men above the age of 65 who engaged in three or more hours per week of vigorous exercise. In fact, these men face a 67% lower risk of being diagnosed with advanced prostate cancer and a 74% lower risk of dying of prostate cancer than their less active counterparts. Younger men did not share this association.

"Although the mechanisms are not yet understood, these findings suggest that regular vigorous activity could slow the progression of prostate cancer and might be recommended to reduce mortality from prostate cancer, particularly given the many other documented benefits of exercise," the researchers write.

Other research is also pointing to the benefits of exercise for colon cancer survivors. In a study presented at the annual meeting of the American Society of Clinical Oncology, researchers looked at the effects of physical activity on more than 800 people who were still alive a year after undergoing surgery and chemotherapy to treat colon cancer.

Participants were asked to complete surveys detailing their physical activity, including type of exercise, duration, and intensity. More than two years after completing chemotherapy, participants who reported the most exercise - 3 to 4 hours a week of jogging or a daily brisk walk at a speed of about 5 to 6 km per hour - were 35% less likely than the least active participants to have their cancer come back.

Earlier studies have pointed to the benefits of exercise for decreasing the risk of developing colon cancer in the first place, but this is the first study to show its effect on people who have already undergone treatment, the researchers said.

Consult your doctor before beginning any new or strenuous exercise routine.

Obesity Can Hurt Kids' Hearts

2007-10-25T11:34:00.000-07:00

Early signs of cardiovascular disease are there, researchers say

WEDNESDAY, Oct. 24 (HealthDay News) -- Obese children and those at risk for obesity show early signs of heart disease -- similar to that seen in obese adults, U.S. researchers say.

The study, by a team at Washington University School of Medicine, St. Louis, included 168 children ages 10 to 18. All of the children had undergone cardiac ultrasound to check on symptoms such as heart murmur, chest pain, acid reflux or high blood cholesterol. Of the children, 33 were obese, 20 were at risk for obesity, and 115 were normal weight.

The researchers used a new tissue Doppler imaging technique called "vector velocity imaging" that can track the movement of the heart's muscular wall.

"In the patients who are obese, the rate of motion of heart muscle changed," Dr. Angela Sharkey, an associate professor of pediatrics at Washington University School of Medicine and a pediatric cardiologist at St. Louis Children's Hospital, said in a prepared statement. "As a child's BMIA (body mass index for age) increases, we see alterations in both the relaxation and contraction phase of the heartbeat. Many of these changes that have been seen in adults were assumed to be from long-standing obesity, but it may be that these changes start much earlier in life than we thought."

"Based on this study, these subtle markers can help us predict who could be at risk for heart disease and heart attacks," Sharkey said.

The findings were published in the winter issue of the Journal of Cardiometabolic Syndrome.

Vector velocity imaging could help doctors follow obese children to see if these changes in the heart progress and to determine if interventions -- such as dietary changes, increased exercise, and the use of cholesterol-lowering statin drugs -- have any effect, Sharkey said.

About 19 percent of American children ages 6 to 11 and 17 percent of those ages 12 to 19 are overweight, according to the U.S. Centers for Disease Control and Prevention.

More information

The Nemours Foundation has more about overweight and obese children.

-- Robert Preidt

SOURCE: Washington University School of Medicine, St. Louis, news release, Oct. 16, 2007

Study Shows How Exercise Helps Women's Hearts

2007-10-24T08:00:00.001-07:00

Much of the benefit comes from changes in blood pressure, inflammation

MONDAY, Oct. 22 (HealthDay News) -- About 60 percent of the protection provided to women by exercise against heart disease and stroke comes from its effect on a few specific risk factors, says a U.S. study in the journal Circulation.

Researchers assessed cardiovascular risk factors and exercise levels in more than 27,000 women, ages 45-90 (average age 55) enrolled in the Women's Health Study who were followed for more than 11 years for new diagnosis of heart attack and stroke.

Women who exercised the most were 40 percent less likely to have a heart attack or stroke than those who did the least amount of exercise.

"Regular physical activity is enormously beneficial in preventing heart attack and stroke," lead author Dr. Samia Mora, instructor of medicine at Harvard Medical School in the divisions of preventive and cardiovascular medicine at Brigham and Women's Hospital in Boston, said in a prepared statement.

"We found that even modest changes in risk factors for heart disease and stroke, especially those related to inflammation/hemostasis and blood pressure, can have a profound impact on preventing clinical events. This study is the first to examine the importance of a variety of known risk factors in explaining how physical activity prevents heart disease and stroke," Mora said.

The Harvard team found that exercise-related changes in inflammatory and hemostatic biomarkers -- fibrinogen, C-reactive protein and intracellular adhesion molecule-1 -- had the largest impact, lowering heart attack and stroke risk by 33 percent.

"Inflammatory and hemostatic factors as a group have overlapping functions and roles and, in our study, had the biggest effect in mediating exercise-related cardioprotection, more so than blood pressure or body weight," Mora said.

Exercise-related improvement in blood pressure was the second most important (a 27 percent reduced risk), followed by lipids (blood fats), body mass index, glucose abnormalities, kidney function, and homocysteine.

Due to a lack of clinical evidence, the inclusion of inflammatory and hemostatic biomarkers as risk factors in assessing cardiovascular disease isn't yet recognized by the American Heart Association.

More information

The American Academy of Family Physicians has more about exercise.

SOURCE: American Heart Association, news release, Oct. 22, 2007

Exercise Helps Older Adults Improve Balance

2007-10-22T13:40:00.000-07:00

Newswise — According to a new review of research, exercise helps people stay steady on their feet in later years, when diminished balance can put older adults at risk for falls.

The review shows gains in balancing ability across different groups of adults who participated in a variety of exercises including walking, strength and balance training, dancing and tai chi.

Some of the balance exercises included rising from a chair and training on one leg.

“Our message is that some form of exercise will improve balance and it’s never too late to exercise. Specifically, exercise that challenges your balance is best,” said lead review author Tracey Howe.

The analysis gathered evidence from 34 studies, which collectively included more than 2,800 participants. On average the study participants were over age 75, generally healthy, and the majority were women.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

After engaging in an exercise program, study participants achieved improvements in different kinds of balance measures including walking speed, standing on one leg and reaching forward without tipping over.

Health researchers want to learn more about balance because they suspect it relates to an individual’s risk for falls. In old age, falls can lead to disability and a loss of independence. Howe said the review did not gauge the effect of exercise on falls, so there is no way to tell from the review if balance improvements led to fall prevention.

Still, Howe said, the balance gains documented in the study are significant because balance is involved in almost everything we do.

“You use it every time you move positions, even walking. Walking is nothing more than movement without falling — controlled falling,” said Howe, director of HealthQWest, a research consortium based at Glasgow Caledonian University in Scotland.

“Good balance allows you to react to change. As they get older, some people have problems with their muscles being rigid. Think of the wind blowing through a tree. If the tree sways too much, or if it is rigid, the tree will fall over. If you can sway with the wind, by responding to the subtle changes in everyday life you are more stable and less likely to fall,” she said.

The American College of Sports Medicine recently revised its guidelines for older adults. The recommendations include balance exercise for people who are at risk for falls, but the Cochrane review did not find that one kind of exercise outperformed any other.

Healthy aging researcher Debra Rose said health professionals need more information on how the risk of falls interacts with different types of exercise.

“The type of physical activity or exercise that’s appropriate is really going to be determined by a person’s level of risk for falls,” said Rose, professor of kinesiology and co-director of the Center for Successful Aging and Fall Prevention at California State University, Fullerton.

“When you are at low risk for falls, there are lots of exercise options, but the choices narrow as balance diminishes and fall risk increases,” Rose said.

The reviewers’ analysis could not determine if the balance gains for older adults were long lasting.

“I agree with the summary that there isn’t sufficient evidence of the efficacy of exercise over the long term,” said Rose. “There’s a notion that exercise is a quick fix — it isn’t. It has to be incorporated into an overall lifestyle change.”

Howe, TE et al. Exercise for improving balance in older people (Review). Cochrane Database of Systematic Reviews 2007, Issue 4.

The Cochrane Collaboration is an international non-profit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

Obesity epidemic 'could bankrupt the NHS'

2007-10-16T12:37:00.000-07:00

By Rebecca Smith

Tackling Britain’s obesity epidemic could bankrupt the NHS, a leading expert has warned.

It is anticipated that obesity could cost as much as £45 billion a year by 2050, to pay for growing incidents of diabetes, strokes and heart disease as well as the loss of earnings by those too heavy to work, a conference was warned.

Dr Colin Waine, chairman of the National Obesity Forum (NOF), said the financial implications of obesity were "huge" and claimed the Government would have to confront the food industry to tackle the problem.

The obesity crisis is currently thought to cost the NHS £1 billion a year to treat but with half the population expected to be obese by 2050, the bill is due to rise much higher.

Dr Waine’s warning comes as the Government was accused of shelving its target to stop the rise in childhood obesity by 2010.

The British Heart Foundation said even this modest target has been replaced, quietly, with a longer-term goal to give ministers time to "get their act together".

The new target to reduce childhood obesity to 2000 levels by 2020 was hidden in the Comprehensive Spending Review published last week.

Peter Hollins, chief executive of the British Heart Foundation, said: "Setting new targets for 2020 is presumably a tactic to buy the Government more time to get its act together.

"It’s not as if this crisis is new – we have been warning of its severity and urgency for years but no coordinated cross-Government strategy has been formed. The pace of change needs to be quickened."

At the National Obesity Forum conference in London yesterday, experts said the Government needs a co-ordinated approach across all aspects of life.

Dr Waine said there had been a tendency for the obesity problem to be heaped on the individual, whereas the situation was more complex than that.

"It may need Government to confront the food industry... it also means governments rethinking environments to plan them around the pedestrian, not the motor car.

"It does require a large amount of political courage to do it.

"I’m cautiously optimistic that the Health Secretary seems to have appreciated the sheer size of the problem.

"I hope he influences his colleagues to come up with the right policies."

Dr Waine estimated it could take five to 10 years before such action would really produce results. He said: "It means the sooner we start, the better.

"Even with the very generous funding that we have had, the problem is escalating so quickly we are not just going to get an epidemic of obesity, we are going to have an epidemic of type II diabetes.

"The complications of that are very costly."

He warned the financial cost of obesity would have "huge implications". "It could bankrupt the NHS," he said.

Health Secretary Alan Johnson said at the weekend that the obesity epidemic could lead to a public health crisis on the "scale of climate change".

He said efforts to promote exercise and healthy eating had to go "further and faster" in response to the stark findings of the new Government Foresight study

Obesity 'fuelling cancer timebomb'

2007-10-09T13:37:00.000-07:00

By Caroline Gammell

The growing obesity epidemic is fuelling a cancer timebomb, cancer research experts warn today.

One in three primary-school leavers overweight

Ten ways to stay thin

Being overweight increases the risk of developing a number of cancers, including breast, womb and prostate.

According to a study by Cancer Research the number of men and women under the age of 45 who are morbidly obese has doubled in the past decade. This increase in obesity means more people are at risk of developing cancer.

Professor Jane Wardle, the director of Cancer Research UK's health behaviour unit, said slim people stayed roughly the same size over the 10 years, but the weight of heavier people dramatically increased.

The charity said a more sedentary lifestyle – often sitting at a computer – takeaway meals and snacking were all contributory factors.

Prof Wardle said two cancers that claimed most lives in Britain – breast and colorectal – were among those that had been linked with obesity. "We are seeing evidence of a rise in the number of cancers that can be caused by obesity just when we are seeing a reduction in those caused by smoking," she said.

Being overweight or obese upsets the metabolic environment and accelerates cell damage as well as the fat secreting hormones that could trigger tumours, she went on.

Obese people are at a greater risk of getting cancers of the womb, gall bladder and kidney and could also increase the risk of prostate and pancreatic cancers. "The biological link between obesity and cancer is complicated but maintaining a healthy body weight will reduce cancer risk.

"We need to continue raising awareness of the dangers of obesity and offer information to help people lose those extra pounds."

Dr Lesley Walker, of Cancer Research UK, said: "This research adds to the evidence that the UK is in the grip of an obesity epidemic.

"We know that high body weight increases the risk of a number of cancers and it is important we get this message to as many people as possible. A healthy diet with plenty of fibre, fruit and vegetables as well as regular exercise can help people to lose weight and reduce their risk of cancer."

Obesity growth in England was measured by taking the weight and waist measurements of 12,000 people in 1993-94 and contrasting them with a similar group 10 years later.

The number of men classed as obese rose from 13.4 per cent to 22.7 per cent, while the level of obese women increased from 15.8 per cent to 22.4 per cent. Men's waist circumference expanded by 1.37in (3.48cms) and women's by 1.71in (4.35cms).

The study also looked at a person's Body Mass Index (BMI), which is calculated by dividing weight in kilograms by the square of a person's height in metres. To be considered morbidly obese, a person must have a BMI of 35 or more. Between 1994 and 2004, the number of women with a BMI of more than 40 doubled.

Research has shown that 12,000 cases of cancer could be prevented each year if a person's BMI did not exceed 25 – classed as overweight.

Obesity Driving Rising U.S. Health Costs

2007-10-04T08:20:00.000-07:00

Americans outspend Europeans when it comes to chronic disease care, study finds

By Steven Reinberg
HealthDay Reporter

TUESDAY, Oct. 2 (HealthDay News) -- Obesity is a big factor driving soaring rates of chronic disease in the United States, with many more Americans chronically ill than their European counterparts, a new study finds.

It's an expensive problem, too: According to researchers, chronic illnesses such as diabetes and heart disease account for some $100 to $150 billion in health-care spending in the United States each year.

"The United States spends twice as much as European countries on health care," noted lead researcher Kenneth Thorpe, chairman of the department of health policy and management at Emory University's Rollins School of Public Health in Atlanta. "Seventy-five percent of what we spend in this country is associated with patients that have one or more chronic conditions and most of the growth is due to obesity."

"We have got to find more effective means to reduce, and at the worst, stabilize this persistent rise in obesity among adults and kids in this country," he said.

In addition, experts must find better and less expensive ways of managing chronic health-care problems, Thorpe said.

"That's where all the money is being spent," he said. "We are not going to control costs until we get the level and growth in chronic disease prevalence down."

The report appears in the Oct. 2 online edition of Health Affairs.

In the study, Thorpe's team compared 2004 data on the prevalence and treatment of diseases among adults aged 50 and older in the United States and Austria, Denmark, France, Germany, Greece, Italy, Netherlands, Spain, Sweden and Switzerland.

They report that about 17 percent of European adults are obese, compared with around a third of American adults. In addition, 53 percent of adult Americans are either former or current smokers, compared with 43 percent of those in Europe. American adults were also more likely than Europeans to have heart disease, cancer, diabetes and chronic lung disease -- all associated with obesity and/or smoking.

"The United States spends more on health care than any country in Europe," Thorpe said. In the United States, in 2004 the per capita spending on health care was $6,102 -- about twice as much as in the Netherlands and Germany, and almost twice that of France.

If the prevalence of obesity could be reduced (and along with it, chronic disease), Thorpe's team estimates that health spending could be cut by $100 billion to $150 billion per year, trimming up to 18.7 percent off the nation's total health-care budget.

There are several reasons for the costs of chronic disease in the United States, Thorpe's group notes. In addition to high rates of obesity and smoking, these include more aggressive cancer screening in the United States than in Europe, and more intensive drug treatment for chronic disease than in Europe, further driving up costs.

Thorpe believes the only way to get health-care costs under control is to find ways to reduce obesity. "There is a lack of an effective primary-care system in this country," he said. "We have to manage patients with chronic conditions more effectively, and we have got to find a way to prevent this rise in obesity."

One expert agreed with the scope of the problem, but said solutions remain elusive.

"There are two reasons why the U.S. might spend more of our total economy on health care than any other country -- treatment here costs more, and more of us need treatment," said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine.

That Americans are fatter than Europeans comes as no surprise, Katz said, but that more Americans smoke is surprising. "This finding does make me question the reliability of the data to some degree. But even if we know for sure that Americans have more chronic disease risk factors than populations abroad, it doesn't necessarily tell us how to fix the problem," he said.

Obesity rates in Europe are rising fast, so "we are exporting our bad example and higher health-care costs may well follow [there]," Katz said. "Without a doubt, the high costs of health care are best reduced by the propagation of health. Defining how best to get there from here is as yet a challenge inadequately met."

Another health-care cost expert agreed.

"I'm not sure obesity is a medical condition that lends itself to medical treatment," said Greg Scandlen, the founder of Consumers for Health Care Choices, a health-care lobbying group. "Certainly, it does suggest the need for more exercise and better diets, but that is a grandmother's advice. Do we need highly trained and expensive professionals telling people what grandmothers have told them for free for generations?"

"I'm just not sure this information is of much use to the health-care system, though it may be for the education system," Scandlen said. His suggestions? "Bring back P.E. classes, [use the] transportation system, use more bicycles and fewer cars, and urban design, get rid of escalators so people will walk up stairs," he said.

More information

For more information on the cost of health care, visit the Kaiser Family Foundation.

SOURCES: Kenneth Thorpe, Ph.D., chairman, department of health policy and management, Emory University Rollins School of Public Health, Atlanta; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Greg Scandlen, founder, Consumers for Health Care Choices, Hagerstown, Md.; Oct. 2, 2007, Health Affairs online

Heart-Healthy Exercise May Also Be Knee-Healthy Exercise

2007-10-02T11:57:00.000-07:00

The world's most common joint disease, osteoarthritis (OA) is a major cause of disability among adults over the age of 50. Whether physical activity is beneficial or detrimental to weight-bearing joints, knees in particular, has been open to debate. Some studies implicate physical activity in provoking knee OA, while others suggest that physical activity may actually protect the knee joint from the disease. Confounding the matter is the fact that knee injury is a known risk factor for knee OA. Then, there's the unclear role of osteophytes in knee OA progression, compounded by the limitations of radiographs for monitoring small yet significant changes in joint structure.

For a clearer picture of the impact of physical activity on the knee joint, a team of researchers in Australia turned to magnetic resonance imaging (MRI). This highly accurate high-tech tool makes it possible to directly visualize joint structures, detect early and pre-disease states of OA, and assess the influence of potential risk factors. Taking advantage of this novel methodology, the researchers studied the effect of physical activity, in various degrees of intensity, frequency, and duration, on knee structures in a total of 257 healthy adults between the ages of 50 and 79, with no history of knee injury or OA. Their findings, presented in the October 2007 issue of Arthritis Care & Research , suggest that exercise that is good for the heart is also good for the knee.

Recruited from an established community-based research population, the Melbourne Collaborative Cohort Study, subjects all underwent MRI exams on the tibia bone and tibiofemoral joint of their dominant knee -- the one on the leg they first step forward when walking. MRI was used to assess cartilage defects and bone marrow lesions, as well as measure cartilage volume, an indicator of cartilage health and strength. Loss of knee cartilage is linked to worsening knee symptoms in OA sufferers. Subjects also answered specific questions regarding their exercise and walking habits, as well as routine activity at home and at work, to determine their level of physical activity in both the 6 months and 7 days prior to the study. To create a baseline for each subject, past information on weight, height, body mass index, and physical activity, from questionnaires completed between 1990 and 1994, was obtained. Then, the team performed a series of analyses and comparisons.

Among the notable findings, both baseline and current vigorous physical activity -- exercise that gets the heart pumping and the body sweating -- were associated with an increase in tibial cartilage volume, free from cartilage defects. What's more, tibial cartilage volume increased with frequency and duration of vigorous activity. Recent weight-bearing exercise was also linked to increased tibial cartilage volume and reduced cartilage defects. Finally, moderate physical activity, including regular walking, was associated with a lower incidence of bone marrow lesions.

"This is the first study to demonstrate a potentially beneficial effect of walking on the reduction in the risk of bone marrow lesions in the knee," notes the study's leading author, Dr. Flavia M. Cicuttini. "Bone marrow lesions have been associated with pain and radiograph-defined progression of osteoarthritis, type II collagen degradation, and loss of cartilage volume."

Demonstrating a protective effect of past and current vigorous physical activity on knee cartilage in healthy adults, this study strongly supports the benefits of exercise for older individuals at risk for OA. Though both the intensity and duration of physical activity had a significant positive impact on cartilage, the ideal amount of physical activity for joint health remains unclear. "Our data suggest that at least 20 minutes once per week of activity sufficient to result in sweating or some shortness of breath might be adequate. This is similar to, if not somewhat less than, the recommendations for cardiovascular health," Dr. Cicuttini observes.

###

Article: "Effect of Physical Activity on Articular Knee Joint Structures in Community-Based Adults," Tina L. Racunica, Andrew J. Teichtahl, Yuanyuan Wang, Anita E. Wluka, Dallas R. English, Graham G. Giles, Richard O'Sullivan, and Flavia M. Cicuttini, Arthritis Care & Research, October 2007; (DOI: 10.1002/art.22990).

Take Care of Your Heart Before and After Problems

2007-09-25T15:37:00.000-07:00

Healthy blood pressure and weight can help avoid heart failure; rehab can aid recovery

By Steven Reinberg
HealthDay Reporter

MONDAY, Sept. 24 (HealthDay News) -- People need to take care of their heart both before and after heart trouble starts, two new studies suggest.

In the first study, researchers said that to avoid heart failure when you're 70 or 80, you must begin by keeping your blood pressure and weight under control when you're 50.

"We tested the hypothesis that higher levels of blood pressure and body mass index (BMI) in midlife would be powerful determinants of heart failure risk in later life, and that the risk posed by preceding measurements would remain even after accounting for these risk factors measured later in life," said lead researcher Dr. Ramachandran S. Vasan.

"This is exactly what we found," added Vasan, a senior investigator with the Framingham Heart Study and a professor of medicine at Boston University School of Medicine.

An increase of about 20 mm Hg in systolic blood pressure at age 50 was associated with a 36 percent higher risk of heart failure up to 20 years later. Every 2.2 pound increase in BMI (a ratio of weight to height) at age 50 was associated with a 6 percent increase in the risk of heart failure, Vasan said.

"The study highlights the importance of maintaining an ideal BMI and blood pressure over the life course of individuals," Vasan said.

For the study, Vasan's team collected data on 3,362 people who were part of the Framingham Heart Study who had routine examinations between 1969 and 1994. During follow-up, 518 people developed heart failure.

"The prevention of heart failure should begin early in life and should include screening for elevated blood pressure and BMI," Vasan said. "Failure to identify or treat such modifiable risk factors in early and mid-adulthood may result in the loss of opportunities to reduce the incidence of heart failure in later life."

The findings are published in the November issue of the journal Hypertension.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said he agrees that keeping both your weight and blood pressure down will help you avoid the ravages of heart failure.

"The lifetime risk for developing heart failure in both men and women is one in five," said Fonarow. "However, heart failure can be prevented, and there are a number of modifiable risk factors for heart failure, including hypertension, obesity, and diabetes.

"Maintaining a healthy blood pressure and body weight is essential to reduce the risk of heart failure," he said.

The second study found that fewer than 20 percent of patients seek cardiac rehabilitation after a heart attack or coronary bypass surgery.

"It has been shown by many trials that cardiac rehabilitation reduced the risk for new coronary events, re-hospitalization and mortality. The main advantage of cardiac rehabilitation is to reduce mortality," said study leader Dr. Jose A. Suaya, a lecturer and scientist at the Brandeis University Schneider Institutes for Health Policy, Heller School, in Waltham, Mass.

Cardiac rehabilitation also improves functional capacity, Suaya said. "Patients can walk more without pain and improve their quality of life," he said.

For the study, Suaya's group collected data on 267,427 men and women, 65 and older, who had survived a heart attack or bypass surgery. The data were drawn from 1997 Medicare claims records.

In the year after hospital discharge, only 18.7 percent of the patients had at least one session of cardiac rehabilitation. Patients who underwent bypass surgery were more likely to seek rehabilitation -- 31 percent -- compared with heart attack patients -- 13.9 percent.

More men had cardiac rehabilitation (22.1 percent) than women (14.3 percent). Age also played a role -- patients 75 to 85 were less likely to go for rehabilitation, the researchers found.

In addition, patients with other medical conditions, such as diabetes, a previous stroke, congestive heart failure or cancer, were significantly less likely to seek cardiac rehabilitation, Suaya's group found.

The study results are published in the Oct. 9 issue of the journal Circulation.

There are many reasons why patients don't seek rehabilitation, the researchers said.

"Many doctors may be reluctant to refer patients to cardiac rehabilitation," said study co-author Donald S. Shepard, a research professor at Brandeis' Heller School. "In addition, patients may not know or ask about it."

Shepard also noted that many medical institutions don't promote the service, which typically includes exercise and advice on diet. "It's not glamorous and, from the data we have, it is not very profitable," he said.

It may also be difficult for people to get to rehabilitation centers, Shepard said. "One of the findings in the study was that the closer you are, the more likely you are to use the service," he said. "Travel time and travel expense are things that reduce the use of the service."

Fonarow said "more needs to be done to ensure that eligible patients are effectively enrolled in supervised cardiac rehabilitation. The American Heart Association's 'Get With The Guidelines Program' is one example of a highly successful initiative to improve referral to cardiac rehabilitation after hospitalization for cardiovascular event or surgery."

More information

For more on heart health, visit the American Heart Association.

SOURCES: Ramachandran S. Vasan, M.D., senior investigator of the Framingham Heart Study, professor of medicine, Boston University School of Medicine; Jose A. Suaya, M.D., Ph.D., lecturer and scientist, the Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, Mass; Donald S. Shepard, Ph.D., research professor at the Heller School for Social Policy and Management, Brandeis University, Waltham, Mass.; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; early release, November 2007, Hypertension; Oct. 9, 2007, Circulation

Childhood Obesity Epidemic a Long-Term Challenge

2007-09-24T13:15:00.000-07:00

It may take decades to reverse the health threats, experts say

By Karen Pallarito
HealthDay Reporter

THURSDAY, Sept. 20 (HealthDay News) -- In the 1980s and '90s, Americans tried to control their weight by watching their cholesterol by cutting dietary fat and substituting carbohydrates. They paid little mind to total calories and physical activity. And guess what happened to their waistlines -- and their children's?

"It was just an end run around the issue of health maintenance," said Dr. Henry C. McGill Jr., senior scientist emeritus at the Southwest Foundation for Biomedical Research in San Antonio, Texas. "And, of course, it crept over into kids, especially kids subjected to all of the advertising and offerings of high-density caloric food -- opportunities to avoid physical activity, attractions to television viewing and net surfing."

Today, more than one in three children and adolescents in the United States -- some 25 million kids -- are overweight or obese, according to the Robert Wood Johnson Foundation, which recently announced an unprecedented effort to reverse the childhood obesity epidemic by 2015. The Princeton, N.J.-based philanthropy said it plans to spend at least $500 million over the next five years on public health efforts focusing on kids and families in underserved communities.

It's the foundation's largest commitment ever. While the foundation has spent roughly as much in the area of tobacco over the years, "we never made the scale of that commitment up-front and public like we have with this," said Dr. James S. Marks, senior vice president and director of the foundation's health group.

"If we don't deal with children," he added, "this could be the first generation that will live sicker and die younger than its parents."

Scientists, physicians and public health advocates know that efforts to prevent obesity must start in childhood, because the problem leads to increased risk of coronary heart disease and other health hazards in adulthood. In fact, there's substantial evidence that obesity and related diseases, including diabetes and hypertension, can begin to exact damage during the teenage years.

In one landmark study, a group of researchers from across the United States analyzed post-mortem blood samples and evaluated atherosclerosis in coronary artery and aorta specimens from roughly 3,000 15- to 34-year-old men and women who died from causes such as accidents, homicide or suicide. One of the surprising results of the study, according to McGill, was that an elevated blood sugar -- as measured by levels of "glycohemoglobin" -- was associated in the late 20s and early 30s with about an 8-fold increase in advanced lesions in the coronary arteries. "It was a whopper of an effect," he said.

In another study, published in the Journal of the American Medical Association, researchers documented a significant upward shift over the past 16 years in blood pressure levels of children and teens aged 8 to 18. Lead author Paul Muntner, an epidemiologist at Tulane University School of Medicine, and colleagues said the increase in blood pressure levels is partially due to the increased prevalence of overweight in the United States.

And British researchers recently reported that children who are overweight at age 11 continue to have weight problems through their teenage years. Rates of overweight and obesity were highest among girls and children from lower socioeconomic backgrounds. The authors said the study highlights the need to target efforts to prevent obesity in the early years.

But even as more money and manpower are devoted to obesity prevention, McGill said it may take many years to erase the epidemic. And, he added, it will take action on many different fronts, from educating children and physicians to improving the health-care financing system to include more preventive medicine.

"It was 1964 when the first U.S. Surgeon General's report came out, and just now, there's talk about the tide turning on cigarette smoking," he observed. "Obesity's perhaps going to take that long to get the tide turned."

More information

For more on childhood obesity, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Henry C. McGill Jr., M.D., senior scientist emeritus, Southwest Foundation for Biomedical Research, San Antonio, Texas; James S. Marks, M.D., M.P.H., senior vice president, director, health group, Robert Wood Johnson Foundation, Princeton, N.J.; Feb. 24, 1999, May 5, 2004, and April 25, 2005, Journal of the American Medical Association; May 5, 2006, British Medical Journal

Physical Fitness Improves Asthma Management In Children

2007-09-20T09:59:00.000-07:00

Children with asthma who improve their physical fitness are likely to experience beneficial effects on disease control and quality of life, according to a study published recently in Medicine & Science in Sports & Exercise , the official journal of the American College of Sports Medicine (ACSM). The results show aerobic training to be effective in improving cardiopulmonary fitness and decreasing daily use of inhaled steroids in asthmatic children, outcomes that should have positive implications for disease management in a group that tends to have lower cardiorespiratory fitness than their healthy counterparts.

"Children who experience breathing restrictions caused by asthma sometimes fear inducing breathlessness by exercise, which can cause physical deconditioning over time," said Celso Carvalho, Ph.D., an author on the study. "This is where we often see patients with asthma having lower fitness levels. Physical training, properly supervised, is not only a possibility for this group, but also a management strategy for their symptoms."

The study enrolled 38 children with moderate-to-severe persistent asthma, randomly assigned to either a training group or a control group. Exercise performance and exercise-induced bronchoconstriction was evaluated 16 weeks apart, while daily doses of inhaled steroids and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) scores also were recorded.

Asthmatic children, even with moderate to severe disease, showed significant improvements in their aerobic capacity after the training program and a reduction in exercise induced-bronchoconstriction, which induces breathlessness and is a characteristic response to exercise present in most patients. Daily doses of inhaled steroids were reduced in trained patients by 52 percent, but remained unchanged or increased in the control (untrained) group. When compared to controls, these children also reported a significant improvement in health-related quality of life.

The authors emphasize that training should be supervised and performed in children properly medicated, and the actual impact of physical training on clinical indicators of disease control is unknown. While these data suggest an adjunct role of physical conditioning on clinical management of patients with more advanced disease, additional research is warranted to discover the contribution of exercise on asthma symptoms and its manifestations.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 20,000 international, national, and regional members are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

Medicine & Science in Sports & Exercise is the official journal of the American College of Sports Medicine, and is available from Lippincott Williams & Wilkins at 1-800-638-6423.

American College of Sports Medicine

Aerobic, Weight Training Combo Best Against Diabetes

2007-09-19T07:29:00.000-07:00

Exercise is always good, but combining two approaches brings better results, study finds

By Kathleen Doheny
HealthDay Reporter

MONDAY, Sept. 17 (HealthDay News) -- Most people know that exercise can help beat type 2 diabetes, but one type of fitness regimen might work best, a new study shows.

Specifically, workouts that combine aerobic and resistance training exercises appear better at controlling blood sugar than either type of activity alone, researchers say.

The finding is new, because "most other studies have looked at just one kind of exercise, either aerobic or resistance," noted lead researcher Dr. Ronald J. Sigal, an associate professor of medicine and cardiac sciences at the University of Calgary, in Alberta, Canada.

The study is published in the Sept. 18 issue of the Annals of Internal Medicine.

As part of their research, Sigal's team evaluated 251 adults, ages 39 to 70, all with type 2 diabetes and not regular exercisers at the start of the study.

The participants were assigned to one of four groups: those who did 45 minutes of aerobic training three times a week, those who did 45 minutes of resistance (i.e., weight) training three times a week, those who did 45 minutes each of both forms of exercise three times a week, and those who did no exercise at all.

The aerobic group worked out on a treadmill or a bike at the gym; memberships were provided. The resistance group also worked out at the gym, with memberships provided, doing seven different exercises on weight machines.

Sigal's team evaluated changes in A1c values -- a measurement reflecting blood sugar concentrations -- over the previous two to three months. A1c is expressed as a percentage. A decline of 1.0 percent in A1c value would be linked to a 15 percent to 20 percent decrease in risk of heart attack or stroke, the researchers explained, and a 25 percent to 40 percent decline in risk of complications linked to diabetes, such as eye disease or kidney disease.

As expected, blood sugar control improved in all the exercise groups. In those who did either aerobic or resistance, the A1c value declined by about 0.5 percent compared to the non-exercisers. Those who did both kinds of exercise had double that level of success, with their A1c value dropping by 0.97 percent compared to the non-exercising group. Non-exercisers experienced no change in their A1c values over the 26-week study.

The bottom line: "There is additional value to doing both resistance and aerobic exercise," according to Sigal.

He said the decrease of nearly one percent of A1c seen in the study "translates to a 15 to 20 percent reduction in risk of heart attack or stroke and a 25 to 40 percent reduced risk of other complications, such as retinopathy," an eye problem related to diabetes.

How does physical activity fight type 2 diabetes, the most common and obesity-linked form of the disease? According to Sigal, "exercise decreases insulin resistance. It makes the transport of glucose [blood sugar] more efficient."

Another expert said the study adds gives new information for people hoping to beat back diabetes.

"Basically, aerobic and resistance training both do very well, and the combination does even better," said Cathy Nonas, director of physical activity and nutrition for the New York City Department of Health and Mental Hygiene and a registered dietitian and certified diabetes educator.

But she said couch potatoes often need to ease into exercise to maintain a fitness regimen over time.

The study participants built up to their 45-minute fitness sessions, Nonas noted, and the combination group ended up doing about 4.5 hours of exercise a week -- an amount some might find daunting.

"I would never talk about 4.5 hours a week to someone who doesn't exercise at all," Nonas said. Rather, she encourages physical activity in any amount to start. "Anything you do is good," she said. Then, she encourages people to slowly build up their time.

"I think this is a very uplifting study," she added. "It says whatever you do will have an effect, and the more you do, the better the effect."

More information

To learn more about the benefits of exercise for diabetes, visit the American Diabetes Association.

SOURCES: Ronald J. Sigal, M.D., associate professor, medicine and cardiac sciences, University of Calgary, Alberta, Canada; Cathy Nonas, R.D., director, physical activity and nutrition, New York City Department of Health and Mental Hygiene, and certified diabetes educator; Sept. 18, 2007, Annals of Internal Medicine

Lifestyle disease deaths may double by 2015, WHO warns

2007-09-14T11:58:00.000-07:00

SEOUL (AFP) — World deaths from "lifestyle" diseases will double by 2015 unless all-out efforts are taken to combat them, the World Health Organization (WHO) warned Friday.

It said about 17 million people die prematurely each year as a result of the global epidemic of largely preventable chronic diseases -- the leading cause of death in the world today.

High on the list are cardiovascular diseases -- mainly heart disease and stroke -- cancer, chronic respiratory diseases, diabetes and obesity.

"Unless national interventions are urgently taken to reduce the prevalence of chronic diseases, 36 million people will die of these diseases by 2015, nearly half of them before they turn 70," said Shigeru Omi, director of the WHO regional committee for the Western Pacific.

The committee Friday was winding up a five-day meeting in the southern South Korean island of Jeju.

In 2005 the WHO set a global goal of reducing the projected trend of chronic disease death rates by two percent each year until 2015.

The vast majority of cases are caused by a small number of known and preventable risk factors. Three of the most important are unhealthy diet, physical inactivity and tobacco use, the WHO said.

Omi called for a "whole-of-society" approach to prevention. "All sectors, from government to private enterprises, civil society and communities, will have to work together," he said.

Regional health ministers urged national leaders to be role models for healthy lifestyles, including encouraging people to eat nutritious local food.

The ministers also called for better strategies to reduce non-communicable diseases.

Strengthening health services that are under pressure from the growing burden of non-communicable diseases is also part of the "whole-of-society" approach, the WHO said.

In line with this, regional health leaders will meet in Singapore in November to identify solutions.

Exercise may generate new blood vessels

2007-09-05T13:27:00.000-07:00

By MARIA CHENG, AP Medical Writer

VIENNA, Austria - Having a bad heart doesn't mean you can skip exercise, doctors said Wednesday. In fact, it may even help your heart to repair itself. Research presented at the European Society of Cardiology meeting showed that exercise sparks the creation of new heart vessels.

In a small study of 37 people at Leipzig University in Germany, Dr. Robert Hollriegel found that people with serious heart failure who rode a bike for up to 30 minutes a day for four months produced new stem cells in their bones.

They also had more small blood vessels in their muscles. Those who didn't exercise had no change in their vessels or muscles.

Most patients with heart failure are over 70 years old, and some can barely walk a few steps without stopping for rest. Doctors think that even these patients would benefit from light exercise such as walking or cycling. To ensure that patients will be able to handle a certain level of physical activity, doctors conduct a test first to determine their maximum limits and to ensure they would not be exceeded. Some exercise regimens also are supervised by health professionals.

"We're not talking about patients with acute heart problems," said Dr. John Cleland, a heart failure specialist at the University of Hull in Britain who is spokesman for the European Society of Cardiology. Cleland was not involved in Hollriegel's research.

"This is to prevent people from getting into a cycle of deterioration where they're afraid to exercise and they just avoid any activity that leaves them out of breath," he said.

Physical activity strains the heart's arteries and muscles by sending 10 times the normal amount of blood to the muscles being used. Stem cells then are dispatched to relieve this stress and may repair any damaged parts. If you continue to exercise, these stem cells help the body adapt to the stress, by building new blood vessels and strengthening muscles. But to maintain such benefits, you must exercise regularly.

Cleland said that people with heart failure should exercise to a state where they're breathless at least once a day. Pushing the limits of their heart's capabilities should help make it stronger.

"People think that if they have heart failure, then they're at the end of the road and they can't exercise," said Dr. Freek Verheugt, a cardiologist at the University of Nymegen in the Netherlands. "But this study shows that exercise can work to produce new blood vessels, even in patients with serious heart disease."

Because no drugs exist to produce new stem cells, exercise may be the only method for some patients to rebuild their hearts.

"We are not saying that patients should run marathons, but there is no other way to augment your arteries," said Dr. Francois Carre of Rennes University Hospital in France. "Patients have to exercise if they want that."

Previous studies have shown that people who do physical therapy after a heart attack live longer than those who don't. Experimental studies in rats have also suggested that exercise can even be more effective than statins, drugs that are commonly used to treat heart disease.

Though doctors routinely recommend that patients exercise, it is not an actual treatment. Carre thinks that should change. "We need to write patients prescriptions to exercise the same way we write prescriptions for drugs," he said.

"People have been trying for years to create a polypill to treat many different parts of heart disease," Carre said. "But that already exists. It's exercise."

B.C. kids will be required to exercise

2007-09-05T13:07:00.000-07:00

VANCOUVER -- School children in B.C. will be required to do 30 minutes of exercise a day starting next September, Education Minister Shirley Bond announced yesterday.

"This is not about mandatory P.E., this is about daily physical activity," said Bond after making the first-day-of-school announcement in Vancouver.

Students will be able to sweat out their mandatory minutes either during or outside of school hours, said Bond, so walking to school, extracurricular sports and classroom calisthenics will all be on the list of acceptable activities.

"This is not adding to a student's curricular course load, but in fact (high school students) already are required to do 80 minutes of physical activity (per week) to graduate. We are going to increase that to 150 (minutes for all students)."

Bond said her ministry will take the next year to write the fine print of the policy, so she doesn't know yet how students' activity levels will be recorded or monitored. But come next fall, she said, schools will have to offer at least 30 minutes of physical activity programs each day, whether during class or recess.

Bond also announced the provincial government is about to fast-track its two-year-old promise to remove junk food from schools by 2009. The ban on unhealthy snacks will be implemented in elementary schools this January and in middle and secondary schools by September 2008.

Statistics Canada says one in four B.C. children and youth is obese or overweight.

Health Canada recommends children and youth do at least 30 minutes of moderate to vigorous physical exercise per day, which could be anything from brisk walking, skating, and bike riding to running, weight training, and team sports.

For Health Info, Women Often Turn to the Web

2007-08-27T13:07:00.000-07:00

They're much more likely to do so than men, survey finds

TUESDAY, Aug. 21 (HealthDay News) -- Women are more likely than men to search for health information on the Internet, according to researchers who analyzed four years of U.S. national survey data.

A team at Bryant University in Smithfield, R.I., also found that:

women are more likely than men to seek online support groups for medical problems;
women are more likely than men to seek health care information for others;
women visit more health sites than men;
men are more likely than women to go online for sensitive health information that may be difficult to talk about.

According to the researchers, health care is one of the few areas where women use the Internet much more than men. The other two areas are religion and driving directions.

Men were much more likely to use the Internet to find information in seven areas: research on products and services; weather; news; do-it-yourself; sports scores; financial information; and work-related research.

The findings were to have been presented Sunday at the American Psychological Association's annual meeting, in San Francisco.

More information

The U.S. Food and Drug Administration offers advice about evaluating health information on the Internet.

Even a little exercise has health benefits

2007-08-24T09:16:00.000-07:00

NEW YORK (Reuters Health) - A new study shows that even low levels of weekly exercise - below currently recommended levels -- has major health benefits. In the study, 30 minutes of brisk walking three days per week was enough to drive down blood pressure and improve overall fitness in a group of healthy sedentary adults.

For optimum health, adults are currently recommended to engage in 30 minutes of moderately strenuous exercise on at least five days of the week. But few people achieve this level of weekly activity, often citing lack of time as the reason.

Dr. Mark A. Tully, of University of Ulster, Northern Ireland, and colleagues designed a study to see if exercising at a level lower than currently recommended would boost overall fitness and heart health.

A total of 106 healthy but sedentary adults between the ages of 40 and 61 years participated in the 12-week study. The subjects were randomly assigned to a brisk 30-minute walk 3 days per week (44 subjects); a brisk 30-minute walk 5 days per week (42 subjects); and the remainder did not change their lifestyle (the non-walking control group).

After 12 weeks, Tully's team found that blood pressure and waist and hip girth fell significantly in both the 3-day walkers and 5-day walkers. Overall fitness also increased in both walking groups. In contrast, no changes occurred in the non-walking control group.

The findings of the study appear in the September edition of the Journal of Epidemiology and Community Health.

The authors note that the degree of positive change in blood pressure and waist and hip size seen in the 3- and 5-day walkers is enough to make a difference to an individual's risk of heart disease.

"These results may encourage people who feel they do not have time to exercise on 5 days each week to consider finding time to commit to a lower weekly target of exercise," Tully and colleagues conclude.

SOURCE: Journal of Epidemiology and Community Health, September 2007.

Healthy Diet Guards Against Return of Colon Cancer

2007-08-15T14:36:00.000-07:00

Patients who ate high-fat foods were three times more likely to see recurrence of disease, study finds

By Amanda Gardner
HealthDay Reporter

TUESDAY, Aug. 14 (HealthDay News) -- Colon cancer patients who eat a diet rich in fruits, vegetables, poultry and fish can significantly lower the risk of their cancer returning, new research suggests.

"We know a lot about how certain dietary things affect the risk of developing colon cancer in the first place but we didn't know, before this study, how diet affected persons who already have cancer," explained study author Dr. Jeffrey A. Meyerhardt, an assistant professor of medicine at the Dana-Farber Cancer Institute in Boston.

Although the findings, which appear in the Aug. 15 issue of the Journal of the American Medical Association, need confirmation, colon cancer patients might want to consider improving their eating habits.

"This is not a substitute for standard therapy, but it's not unreasonable for oncologists to use this data to start talking about diet," Meyerhardt said. "There are benefits in other regards, such as benefits for heart disease, and it does give us some initial information that may affect people's outcome."

"Maybe the message is it's never too late to change your diet," added Dr. Andrejs Avots-Avotins, an associate professor of internal medicine at Texas A&M Health Science Center College of Medicine and a gastroenterologist with Scott & White Hospital in Temple, Texas. "A healthy diet is going to be so helpful in so many different ways that even if you do end up with a cancer that may or may not have been related to your diet, this may be of benefit in prolonging your survival."

Diet and other lifestyle factors have been strongly implicated in the risk of developing colon cancer. It's been less clear what effect diet has on the course of established colon cancer.

The authors asked 1,009 patients with stage III colon cancer (cancer that had spread to the lymph nodes) who were participating in a chemotherapy trial to answer dietary questionnaires during and after the time they received treatment. All participants had already undergone surgery to remove the cancer.

The study was funded partially by the U.S. National Cancer Institute and Pfizer Oncology.

Two major dietary patterns were identified: Western (high intakes of meat, fat, refined grains and dessert) and prudent (lots of fruits and vegetables, poultry and fish).

A Western diet was associated with a significantly worst prognosis, both in terms of recurrence and death, than a prudent diet.

Compared with patients ranked in the lowest 20 percent of a Western dietary pattern, those in the highest 20 percent had almost three-and-a-half times the risk of recurrence or death. Those in the highest 20 percent of a Western diet were also 2.9 times more likely to see their cancer recur than those in the lower 20 percent.

"There's a biological basis for this. The Western type of diet affects insulin levels and insulin-like growth factors that help promote cancer's growth and metastases," Meyerhardt explained. "The magnitude of the effect was surprising, however."

More information

Visit the U.S. National Cancer Institute for more on colon and rectal cancer.

SOURCES: Jeffrey A. Meyerhardt, M.D., assistant professor, medicine, Dana Farber Cancer Institute, Boston; Andrejs Avots-Avotins, M.D., Ph.D., associate professor, internal medicine, Texas A&M Health Science Center College of Medicine, and gastroenterologist, Scott & White Hospital, Temple; Aug. 15, 2007, Journal of the American Medical Association

Tape measure, not scale, key to knowing heart risk

2007-08-15T09:13:00.000-07:00

WASHINGTON (Reuters) -- A quick check around the waist with a tape measure may be a better way of telling if you are at risk of heart disease than stepping on a scale, researchers said Monday.

Even if people are not overweight, those with larger waistlines are more likely to show the early signs of heart disease than those with smaller waists, the team at University of Texas Southwestern Medical Center in Dallas reported.

"Inches are as important as pounds," Dr. James de Lemos, a cardiologist who led the study, said in a telephone interview.

Writing in the Journal of the American College of Cardiology, the researchers said they have started a long-term study of 2,744 people with a median age of 45.

They used magnetic resonance imaging and electron beam computed tomography scans to look for early signs of clogged arteries and found a direct relationship between waist size and early indications of heart disease, regardless of the patients' overall weight.

"It's a straight-line relationship all the way down to the lowest levels," de Lemos said.

"This isn't the kind of thing that is only relevant if you are one of the obese people."

Several studies have shown waist size is clearly linked with heart attack, stroke and heart disease risk. U.S. government guidelines now say men should aim to have a waist 40 inches in circumference or less -- 35 inches for a woman.

The Dallas researchers found no absolute cutoff. They simply found that the smaller a person's waist, the clearer his or her arteries were observed to be.

"Our study was the first really large study to dig in the preclinical stage. So we are looking at people who haven't yet had a heart attack or stoke, and people at earlier ages," de Lemos said.

After accounting for high cholesterol, high blood pressure and other known heart factors, the researchers found that weight alone did not predict a person's chances of having early artery clogging.

Waist size, however, did.

"As a young adult, you have got to make some serious lifelong choices about maintaining your body shape," de Lemos said. "You have to fight, every day, this middle age creep in terms of belt size. Food is plentiful, it's cheap and it is high caloric and most of us work sedentary jobs."

"It's a day-to-day, meal-to-meal battle, but it's worth fighting. Even a small pot belly puts us at higher risk when compared to a flat tummy," de Lemos said.

Study links women's obesity, birth defects risk

2007-08-09T13:15:00.000-07:00

CHICAGO, Illinois (AP) -- Women who are obese before pregnancy face a higher risk of having babies with a variety of birth defects than women with a healthy weight, a new study suggests.

The results involving nearly 15,000 women from eight states found abnormalities of the spine, heart, arms, legs and abdomen, building on previous research that showed heart and spine defects. The greatest risk was for spina bifida.

"Obese women should not be overly alarmed by these findings because their absolute risk of having a child with a birth defect is low, and the cause of the majority of birth defects is unknown," said University of Texas researcher Kim Waller, the study's lead author.

Still, the results underline yet another reason for women to maintain a healthy weight, Waller said.

The findings suggest that about 4 percent of women who are obese before pregnancy will have babies with major birth defects, versus 3 percent for healthy-weight women, Waller said.

Obese women faced double the risk of having babies with spina bifida than women of healthy weight. With spina bifida, the most common disabling birth defect in the United States, the spinal column fails to close properly. That often leads to leg paralysis, learning difficulties and other serious problems.

Very heavy women also were 60 percent more likely to have babies born with a rare defect in which abdominal organs protrude through the belly button; 40 percent more likely to have heart defects; 36 percent more likely to have shortened arms or legs; and at least 20 percent more likely to have any of several gastrointestinal deformities.

The study was released Monday in the August edition of Archives of Pediatrics & Adolescent Medicine. It was funded by the federal Centers for Disease Control and Prevention.

"This is probably an under-recognized finding which I suspect will be corroborated by other research in the future and something we will need to talk to our patients about," said Dr. Alan Peaceman, a high-risk pregnancy specialist and professor at Northwestern University.

Dr. Michael Katz, acting medical director for the March of Dimes, said, "It's important because if it is true," it suggests that rising obesity rates might be triggering increases in birth defects.

The research is part of the National Birth Defects Prevention Study, involving women who were pregnant between October 1997 and December 2002.

Participants included 10,249 women whose babies were born with at least one birth defect. They were compared with 4,065 women with healthy babies.

Women were asked what their height and weight had been just before they got pregnant. Based on those responses, the researchers calculated that 2,312 women were obese pre-pregnancy.

Reasons for the potential link between obesity and birth defects are unclear, Waller said. It's possible that some women had undiagnosed diabetes, which also is linked to birth defects, she said.

While the study didn't examine weight during pregnancy, it's also possible that some women tried potentially dangerous weight-loss techniques right before conception or during early pregnancy, when most birth defects occur, the researcher said.

She urged obese pregnant women, however, not to try diet pills, fasting or other aggressive methods which also might contribute to risks for birth defects.

Schizophrenia Improved By Mental And Physical Exercise

2007-08-08T06:03:00.000-07:00

Science Daily — Scientists at Melbourne's Howard Florey Institute have shown that mental and physical exercise can improve behavioural deficits in schizophrenia and repair damaged chemical transmitter pathways in the brain.

Dr Anthony Hannan, along with Dr Caitlin McOmish, Emma Burrows and colleagues, characterised a genetically altered mouse and discovered that it had schizophrenia-like behaviours, including learning and memory problems, the inability to process complex information, and abnormal responses to particular sensory stimuli.

The scientists found the mouse's condition significantly improved by simply giving them enhanced mental and physical exercise -- putting running wheels in their cages, plus interesting items to smell, see and touch.

Not only did the mouse's schizophrenia-like symptoms ease through this environmental enrichment, but a specific chemical transmitter pathway found to be abnormal in the cerebral cortex of the mice was selectively rescued.

An anti-psychotic drug used by humans also improved the mouse's condition, indicating that this mouse is a valid model for schizophrenia in humans. Dr Hannan said this discovery could pave the way for the development of better treatments for schizophrenia.

"Through our research, and that of others, we hope a new class of therapeutic drugs will be developed that mimic the effects of environmental enrichment in the brain to treat various brain disorders, possibly including schizophrenia," Dr Hannan said.

"Pharmaceutical approaches may not be the sole answer for a given brain disease. People may still need optimal levels of physical and mental activity, as well as a healthy diet, plus the right drugs.

"We have already identified specific molecules that could be targets for what I call 'enviromimetics' and these may have relevance for other brain diseases. "However, there are obviously major differences between mice and men, and large-scale clinical trials are needed to identify the most beneficial drugs," he said. Schizophrenia is a brain disorder that is brought on through a complex and largely unknown interaction of genes and environment.

There is a nature-nurture aspect to schizophrenia because in human identical twins, if one twin develops schizophrenia, there is only a 50% chance the other twin, who has identical genes, will develop the illness.

Dr Anthony Hannan's ground-breaking environmental enrichment studies have previously shown that a combination of mental and physical exercise could delay the onset and progression of Huntington's disease. As well as movement problems (e.g. chorea) and cognitive deficits (culminating in dementia) this disease has psychiatric symptoms, which can include depression and psychosis.

This research, which also involved collaboration with scientists from the Mental Health Research Institute of Victoria, was published online in the journal Molecular Psychiatry.

Note: This story has been adapted from a news release issued by Howard Florey Institute.

Physicians Unlikely to Document Obesity in Patient Records

2007-08-06T07:22:00.000-07:00

By Peggy Peck

ROCHESTER, Minn., Aug. 2 -- Obesity is more than twice as likely to be treated seriously if physicians jot the formal diagnosis down in medical records -- a relatively uncommon act by clinicians here.

Only about one in five obese patients have a diagnosis of obesity documented, according to a review of the records of almost 10,000 patients, Aditya Bardia, M.D., of the Mayo Clinic, and colleagues, reported in the August issue of Mayo Clinic Proceedings.

Of 2,543 patients who met a standard criterion for obesity -- a body mass index of 30 or more -- only 505 had obesity listed by Mayo physicians as a diagnosis, they wrote.

Mayo staff physicians were 45% less likely to diagnose obesity than residents (P<0.001),>

A BMI of more than 35, obstructive sleep apnea, and/or a diagnosis of diabetes increased the likelihood that obesity would be noted in patients' charts (P<0.001> 35 and obstructive sleep apnea, P=0.007 for diabetes).

Nonetheless, patients who did have that diagnosis were 2.39 times more likely to have an obesity management plan documented in the charts (P<0.001).

Dr. Bardia and colleagues used the clinic's primary care database to identify 9,827 patients who had general medical examinations from Nov. 1, 2004 to Oct. 31, 2005. Patient files included demographic information, BMI, and comorbidities, as well as documentation of obesity diagnosis and management plans.

Among the findings:

Among the 2,543 obese patients, 40% were men and the median age was 58.
The mean BMI of obese patients was 35.4 (±10.6).
Most of the obese patients -- 1,717 -- were seen by staff physicians.
Men were about 40% less likely to be diagnosed with obesity and the likelihood of diagnosis declined about 3% per year for every year over 58 (P<0.001>

The authors acknowledged it was "possible that physicians discussed obesity with their patients but did not document it," a possibility that could explain why some patients had documentation of an obesity management plan with no notation of obesity in their records.

The study was limited by its single-institution design, as well as by the lack full evaluation of a number of variables including race, education, and income. Finally, they said they did not "directly evaluate" whether documented obesity management plans resulted in weight loss.

The new face of fitness is getting older

2007-08-06T06:05:00.000-07:00

By David Williams

(CNN) -- Sixty used to be old -- or at least it seemed to be.

In the '80s, seniors had TV role models like the Golden Girls, Matlock and "Murder She Wrote's" mystery-writing sleuth, Jessica Fletcher.

Now baby boomers can look to Goldie Hawn, Diane Sawyer and Harrison Ford for inspiration as they near retirement age.

Today's seniors also have a much different view of fitness than their parents, said Colin Milner, CEO of the International Council on Active Aging.

"Exercise was actually a bad word," Milner said. "The term exercise meant hard work. It was what you did in the military or body builders did at Muscle Beach and women were told that if they did it they weren't womanly or it would hurt their reproductive organs."

Baby boomers like Jane Fonda, jogging pioneer Jim Fixx and aerobics inventor Ken Cooper helped create the modern fitness movement, according to Milner.

He said 37 percent of health club members are 55 or older, and that doesn't count people who work out at retirement homes -- an area he said is exploding.

"Nine out of the 10 top builders in the U.S. are building active adult communities and they will typically put in anywhere between a 20,000- and 40,000-square-foot fitness center."

The average age of personal training clients also is going up, from 36.5 in 1998 to 42.4 in 2006, according to Robyn Stuhr of the American Council on Exercise.

The council certifies fitness professionals and has partnered with the AARP to help match the group's 38 million members with personal trainers.

"Our trainers say they're starting to see more middle-age and older clients and we've actually been looking at developing more curriculum about working with those groups," she said.

Stuhr said older clients are at higher risk of diabetes and cardiovascular disease and also may have problems like arthritis, back pain or muscle tears.

"That probably means you need to exercise even more, but the trainer has to understand how to work with that population and make exercise a safe experience," she said.

She recommends getting a good physical before starting an exercise program and says people need to realize that their bodies aren't the same as they were when they were 20.

"Exercise can be a fountain of youth, in that it can help slow down aging changes and help you maintain a level of vitality and energy that you might not otherwise have. But you just have to do it smarter, because your body is more vulnerable because of the aging process," she said.

Milner says he's spoken to many physical therapists whose patients are pushing themselves too hard.

"What's happening is more of the boomers are going out and beating the heck out of themselves as a weekend warrior and spending the rest of the week in therapy," he said.

"Some wonder what kind of therapy they should be in," Milner said jokingly.

But that doesn't mean seniors have to take it easy.

Dr. Walter Bortz, author of the books "Dare to be 100" and "Living Longer for Dummies" is 77 years old, but he has run a marathon every year for the last 35 years.

"You're supposed to be a little bit tired," he said, but people should avoid "undue fatigue."

"Obviously, pain is nature's signal, but you can't be a pantywaist about pain," said Bortz.

Better stretching, going a little slower and investing in new shoes are just a few tips he offered, but he also encourages boomers not to give up.

"Fitness for young people is an option, fitness for old people is an imperative," Bortz said.

The government's National Institute on Aging says regular activity can help seniors maintain their strength and be more independent, have more energy and better balance. Exercise can also help reduce depression and fight diseases such as heart disease, diabetes and cancer.

It recommends that seniors focus on four types of exercise:

Endurance: Seniors should try to get at least 30 minutes of activity that causes heavy breathing almost every day.

Strength: Lifting weights can help build muscle strength so you can get up from a chair by yourself or pick up your grandchildren. You don't have to be a bodybuilder though -- light weights or even using your own body weight for resistance is enough for beginners.

Balance: Standing on one foot, walking heel-to-toe and standing up without using your arms can help improve balance.

Stretch: Stretching exercises make muscles more flexible and help you move more freely. Be sure to warm up before stretching and don't stretch so far that it hurts.

The bottom line is people can benefit from exercise no matter how old they are, according to the International Council on Active Aging.

"In the fitness industry, there's the old saying 'use it or lose it,' " Milner said. "But even if you've lost it, you can still find it again, no matter how old you are."

Exercise, caffeine can fight skin cancer

2007-07-31T13:47:00.000-07:00

By RANDOLPH E. SCHMID, AP Science Writer

WASHINGTON - Can adding a cup or two of coffee to the exercise routine increase protection from skin cancer? New research indicates that just might be the case.

The combination of exercise and caffeine increased destruction of precancerous cells that had been damaged by the sun's ultraviolet-B radiation, according to a team of researchers at Rutgers University.

Americans suffer a million new cases of skin cancer every year, according to the National Cancer Institute.

In mice there is a protective effect from both caffeine and voluntary exercise, and when both are combined the protection is even more than the sum of the two, said Dr. Allan H. Conney of the laboratory for cancer research at Rutgers.

"We think it likely that this will extrapolate to humans, but that has to be tested," Conney said in a telephone interview.

Nonetheless, he added, people should continue to use sunscreen.

Exposing the mice to ultraviolet-B light causes some skin cells to become precancerous.

Cells with damaged DNA are programmed to self-destruct, a process called apoptosis, but not all do that, and damaged cells can become cancerous.

The researchers report in Tuesday's issue of Proceedings of the National Academy of Sciences that they studied hairless mice in four groups. Some were fed water containing caffeine, some had wheels on which they could run, some had both and a control group had neither.

"The most dramatic and obvious difference between the groups came from the caffeine-drinking runners, a difference that can likely be attributed to some kind of synergy," Conney said.

Compared with the control animals, those drinking caffeine had a 95 percent increase in apoptosis in damaged cells. The exercisers showed a 120 percent increase, and the mice that were both drinking and running showed a nearly 400 percent increase.

Just what is causing that to happen is not yet clear, though the researchers have several theories.

"We need to dig deeper into how the combination of caffeine and exercise is exerting its influence at the cellular and molecular levels, identifying the underlying mechanisms," Conney said.

"With an understanding of these mechanisms we can then take this to the next level, going beyond mice in the lab to human trials," he said. "With the stronger levels of UVB radiation evident today and an upward trend in the incidence of skin cancer among Americans, there is a premium on finding novel ways to protect our bodies from sun damage."

Conney said the researchers were originally interested in the effects of green tea in preventing skin cancer and were doing tests on regular and decaffeinated teas.

They found the regular tea had an effect, but not the decaffeinated brew.

And, he said, researchers also observed that mice drinking caffeine were more active than those that didn't get it, so they decided to study the effects of exercise too.

They put running wheels into some of the cages. The mice "love to go on it," he said, and will jump on the wheels and run for several minutes, then get off for a while, and then get on and run some more.

And they found that both caffeine and exercise helped eliminate damaged skin cells, but the combination worked better than either alone.

"What we would like to see next is a clinical trial in people," Conney said.

Dr. Michael H. Gold, a Nashville, Tenn., dermatologist and a spokesman for the Skin Cancer Foundation, said he believes "the concept of systemic caffeine should be addressed further."

"I think the concept potentially has a lot of merit," he said in a telephone interview. But mice and humans are different and studies need to be done to be sure this also applies to people.

In the meantime, he said: "If you go outside, you have to wear a sunscreen ... it has to be caffeine and exercise with your sunscreen."

WHO: Urban planning should promote active lifestyle

2007-07-25T11:01:00.000-07:00

As obesity rates in Europe increase, the World Health Organization (WHO) deplores that only a few residential environment currently meet the recommended criteria to promote an active lifestyle.

A new WHO report identifies the determinants that may encourage or impede physical activity in a residential environment and thereby have an impact on obesity. The study, published in June 2007, comes after two separate WHO reports, which highlighted evidence of the link between physical activity and health and the need to create opportunities for active living in urban environments (see EurActiv 16/11/06).

Even if the importance of the residential environment in promoting an active lifestyle is increasingly recognised, there is still a lack of integration of such concerns in urban planning. This is why WHO is now seeking to support this process by providing recommendations based on various case-studies.

The study argues that several characteristics of the residential environment - access to physical activity facilities, land-use mix, active transport opportunities and perceived safety in the neighbourhood - have an impact on people's physical activity level.

The WHO's recommendations with regard to urban planning differ according to the targeted population. Access to sport facilities close to home is, for example, a major prerequisite for promoting children's physical activity, whereas for older people it is important that public facilities are at walking distance. According to the report, national and local-level political commitment is crucial for successful and sustainable implementation.

Increasing obesity rates are a serious public health concern in Europe and lack of physical activity is a major determinant of this modern disease. The EU obesity White Paper, adopted in May 2007, highlights the importance of developing physical and social environments that are conducive to physical activity. The White Paper on Sport, adopted on 11 July 2007, includes proposals to enhance public health and tackle obesity through physical activity (see EurActiv 11/07/07).

Simple Lifestyles Changes Can Produce Big Payoffs

2007-07-23T10:12:00.000-07:00

The path to a better, longer life may be shorter than you think

By Kathleen Doheny
HealthDay Reporter

FRIDAY, July 20 (HealthDay News) -- By now, everyone knows the drill: Quit smoking, eat better, exercise, and you'll get healthier.

Now, two new studies uncover the wisdom in that tried-and-true advice. And they find that success may come quicker than most people realize.

In one study, Christian Roberts and colleagues at the University of California, Los Angeles, found that lifestyle changes helped reverse serious heart disease risk factors in less than one month among 31 obese men they studied. That study was published online Jan. 10 in the Journal of Applied Physiology.

A second report -- this time by Stephanie Chiuve and colleagues at Harvard University -- found that men who followed five healthy habits had an 87 percent lower risk of getting heart disease than men who ignore these behaviors. The health habits included eating a prudent diet, exercising regularly, controlling weight, not smoking and drinking in moderation.

That study, which tracked more than 51,000 men for over 16 years, was published in the July 3 online edition of the journal Circulation

While both studies were done in men, the findings are expected to apply to women, said Chiuve. She noted that a separate study of women, published about five years ago, found that healthy behavior quickly reduced their risk of heart disease.

Following all five healthy habits is best, she says, but even if you change one or two habits, that's good, Chiuve said. The most important one to change: smoking.

"Not smoking was associated with the lowest risk for heart disease," Chiuve said. Next up was maintaining a healthy body weight -- that means sticking to a body mass index (BMI) below 25. For reference, a person 5 feet 5 inches tall who weighs 145 pounds has a BMI of 24, for instance. Statistical overweight begins at a BMI over 25.

"The other three [factors] -- exercise, eating a healthy diet, drinking in moderation were all equal," Chiuve said, in terms of reducing heart disease risks.

Some changes can reduce risks particularly quickly, she said. "Within two weeks, eating a healthy diet can reduce blood pressure."

Roberts' group found relatively speedy results from healthy changes, too. In his study, he followed men who had recently entered a residential program for improving their health. They ate a high-fiber, low-fat diet, taking in more than 40 grams a day and less than 15 percent of total calories from fat. They also walked for about 60 minutes a day.

After just three weeks of this behavior, about half the men reversed their tendency to type 2 diabetes or a cluster of other heart risk factors -- such as elevated blood pressure, insulin levels or high cholesterol -- that together are called the metabolic syndrome.

"We measured 15 or 20 different things," he said. "The lipids [such as cholesterol] tend to change very quickly," he said.

"Body weight [reduction] has a much longer course," he said. While many people focus on body weight reduction, thinking it's the prime factor driving health-related changes, that's not always so, Roberts said.

"Some people think the body weight [change] causes the cholesterol to drop. It's not the body weight per se, but many other mechanisms. The cholesterol can drop independent of body weight," he said.

Simply adding more fiber to the diet and taking out saturated fat, he said, could be beneficial for your lipid profile, as can regular exercise.

"An editorial written in concert with this paper suggests the concept that you have to change for several months is erroneous," he said.

What is needed, he said, is to consider the changes a new life plan, not a temporary fix.

More information

For more on heart-healthy lifestyles, visit the American Heart Association.

SOURCES: Stephanie Chiuve, Sc.D., research fellow, Harvard School of Public Health, Boston; Christian Roberts, Ph.D., adjunct assistant professor, physiological science, University of California, Los Angeles; July 3, 2006, online edition, Circulation; Jan. 10, 2006, online edition, Journal of Applied Physiology

Losing Weight After Pregnancy: Diet And Exercise Better Than Diet Alone

2007-07-18T13:48:00.000-07:00

Science Daily — Preliminary evidence suggests that a combination of dieting and exercise is a more effective way of losing weight after pregnancy than dieting alone, concludes a Cochrane Systematic Review.

Women naturally gain weight during pregnancy and many gradually lose it afterwards, but some women find it difficult to lose this additional weight. This retained body weight may be one factor that contributes to obesity among women. Many women are keen to find ways of returning to, and maintaining, pre-pregnant weights, and there is plenty of competing advice on offer.

By studying data from six different trials that involved a total of 245 women, a group of Cochrane Researchers found that women who did exercise did not lose significantly more than women who have a standard post-natal lifestyle. However, women who combined exercise and dieting did lose more weight than those with normal care.

Returning to body weight gradually after giving birth seems to be important, because women who regain their pre-pregnancy weight within six months have a lower risk of being overweight ten years later.

"As well as helping reduce body weight, exercise has the added advantage of improving the women's cardiovascular fitness and preserves fat-free mass -- dieting alone reduces fat-free mass," says Amanda Amorim, an epidemiologist working in Rio de Janeiro, Brazil.

Overweight kids face early stigma, long-term problems

2007-07-17T13:53:00.000-07:00

NEW HAVEN, Connecticut (AP) -- Overweight children are stigmatized by their peers as early as age 3 and even face bias from their parents and teachers, giving them a quality of life comparable to people with cancer, a new analysis concludes.

Youngsters who report teasing, rejection, bullying and other types of abuse because of their weight are two to three times more likely to report suicidal thoughts as well as to suffer from other health issues such as high blood pressure and eating disorders, researchers said.

"The stigmatization directed at obese children by their peers, parents, educators and others is pervasive and often unrelenting," researchers with Yale University and the University of Hawaii at Manatoa wrote in the July issue of Psychological Bulletin.

The paper was based on a review of all research on youth weight bias over the past 40 years, said lead author Rebecca M. Puhl of Yale's Rudd Center for Food Policy and Obesity.

It comes amid a growing worldwide epidemic of child obesity. By 2010, almost 50 percent of children in North America and 38 percent of children in the European Union will be overweight, the researchers said.

While programs to prevent childhood obesity are growing, more efforts are needed to protect overweight children from abuse, Puhl said.

"The quality of life for kids who are obese is comparable to the quality of life of kids who have cancer," Puhl said, citing one study. "These kids are facing stigma from everywhere they look in society, whether it's media, school or at home."

Even with a growing percentage of overweight people, the stigma shows no signs of subsiding, according to Puhl. She said television and other media continue to reinforce negative stereotypes.

"This is a form of bias that is very socially acceptable," Puhl said. "It is rarely challenged; it's often ignored."

The stigmatization of overweight children has been documented for decades. When children were asked to rank photos of children as friends in a 1961 study, the overweight child was ranked last.

Children as young as 3 are more likely to consider overweight peers to be mean, stupid, ugly and sloppy.

A growing body of research shows that parents and educators are also biased against heavy children. In a 1999 study of 115 middle and high school teachers, 20 percent said they believed obese people are untidy, less likely to succeed and more emotional.

"Perhaps the most surprising source of weight stigma toward youths is parents," the report says.

Several studies showed that overweight girls got less college financial support from their parents than average weight girls. Other studies showed teasing by parents was common.

"It is possible that parents may take out their frustration, anger and guilt on their overweight child by adopting stigmatizing attitudes and behavior, such as making critical and negative comments toward their child," the authors wrote, suggesting further research is needed.

Lynn McAfee, 58, of Stowe, Pennsylvania, said that as an overweight child she faced troubles on all fronts.

"It was constantly impressed upon me that I wasn't going to get anywhere in the world if I was fat," McAfee said. "You hear it so often, it becomes the truth."

Her mother, who also was overweight, offered to buy her a mink coat when she was 8 to try to get her to lose weight even though her family was poor.

"I felt I was letting everybody down," she said.

Other children would try to run her down on bikes to see if she would bounce. She had a hard time getting on teams in the playground.

"Teachers did not stand up for me when I was teased," McAfee said.

A study in 2003 found that obese children had much lower quality of life scores on issues such as health, emotional and social well-being, and school functioning.

"An alarming finding of this research was that obese children had (quality of life) scores comparable with those of children with cancer," the researchers reported.

Sylvia Rimm, author of "Rescuing the Emotional Lives of Overweight Children," said her surveys of more than 5,000 middle school children reached similar conclusions.

"The overweight children felt less intelligent," Rimm said. "They felt less popular. They struggled from early on. They feel they are a different species."

Parents should emphasize a child's strengths, she said, and teachers should pair up students for activities instead of letting children pick their partners.

McAfee, who now works for the Council on Size and Weight Discrimination, said her childhood experiences even made her reluctant to see a doctor when she needed one. She recalled one doctor who said she looked like a gorilla and another who gave her painkillers and diet pills for what turned out to be mononucleosis.

"The amount of cruelty I've seen in people has changed me forever," McAfee said.

The Yale-Hawaii research report recommends more research to determine whether negative stereotypes lead to discriminatory behavior, citing evidence that overweight adults face discrimination. It also calls for studying ways to reduce stigma and negative attitudes toward overweight children.

"Weight-based discrimination is as important a problem as racial discrimination or discrimination against children with physical disabilities," the report concludes. "Remedying it needs to be taken equally seriously..."

Exercise may help delay inflammation

2007-07-13T13:54:00.000-07:00

CHAMPAIGN, Ill., July 5 (UPI) -- A study may offer insight into whether regular exercise can fend off the onset of heart disease or diabetes, University of Illinois researchers said.

The researchers, in a news release, said this could lead to a better understanding of the link between exercise and inflammation, a condition predictive of cardiovascular conditions or other diseases.

Researchers examined parasympathetic tone and sympathetic tone on C-reactive protein -- a biomarker for inflammation -- by assessing heart-rate recovery after exercise. The sympathetic nervous system speeds things up during exercise and the parasympathetic nervous system slows things down when the exercise is finished.

"(When) you're exercising, your sympathetic nervous system will be on, increasing your heart rate, your respiration, etc. Once you stop ... the parasympathetic nervous system kicks in to get everything back down to baseline levels," said Victoria Vieira, a pre-doctoral fellow and the study's primary author and designer.

A notable finding related to post-exercise, heart-rate recovery, researchers said.

"The quicker the individuals were able to get back to their resting heart rate after a strenuous exercise test was inversely related to their CRP," Vieira said. "(Individuals) who had better parasympathetic tone had lower levels of inflammation."

Scientists discover stress-obesity switch

2007-07-03T08:41:00.000-07:00

By Rob Stein

WASHINGTON — Scientists reported Sunday that they have uncovered a biological switch by which stress can promote obesity, a discovery that could help explain the world's growing weight problem and lead to new ways to melt flab and manipulate fat for cosmetic purposes.

In a series of experiments on mice, researchers showed that the neurochemical pathway they identified promotes fat growth in chronically stressed animals that eat the equivalent of a junk-food diet.

The international team also showed that blocking those signals can prevent fat accumulation and shrink fat deposits, while stimulating the pathway can strategically create new ones, possibly offering new ways to remove fat as well as to mold youthful faces, firmer buttocks and bigger breasts.

"It's very exciting," said Zofia Zukowska of Georgetown University, who led the research published online by the journal Nature Medicine. "This could be revolutionary."

While cautioning that the safety and effectiveness of the approach remains to be proven in people, other researchers said the findings reveal new clues about the basic biology of fat and why obesity has been increasing so quickly, particularly in Western countries.

"There is a lot of uncontrollable stress right now in our societies. There's also a lot of inexpensive high-fat food," said Mary Dallman of the University of California, San Francisco, who co-wrote a commentary accompanying the research. "This could help explain the obesity epidemic."

The researchers have applied for a patent and begun negotiating with drug companies to license the technology. They predicted studies in people could begin within two years.

Previous studies have indicated that while acute stress can make some people lose weight, chronic stress, such as long-term job insecurity, might cause some to put on pounds.

To explore this, Zukowska and her colleagues subjected mice to chronic stress — either standing in cold water an hour a day or being caged with a more aggressive alpha mouse for 10 minutes a day — and then gave them standard feed or a high-fat, high-sugar diet similar to the junk-food fare that many people consume.

"By treating the mice the way humans are treated, which is introducing a chronic stress from which they cannot escape and introducing this abundance of food, we mimicked what happens in American society," Zukowska said.

After two weeks, only the mice that were both stressed and fed the junk-food diet gained a significant amount of weight, accumulating about twice as much fat in their bellies as non-stressed mice that consumed the same diet.

"This tells me it's not just the stress. It's the combination of stress and the high-fat, high-sugary rich diet ... There is some kind of interaction going on."

Moreover, the stressed-out junk-food eaters put on the worst kind of fat — deposited around their abdomens and laced with hormones and other chemical signals that promote illness. After three months, the animals developed the constellation of health problems obese humans often get: high blood pressure, early diabetes and high cholesterol.

When the researchers examined the animals' fat tissue, they discovered sharply elevated concentrations of a substance called neuropeptide Y (NPY), a chemical messenger produced by the nervous system. They also had far higher levels of a molecular partner that NPY needs to work, known as the neuropeptide Y2R receptor.

NPY induces the growth of immature fat cells, coaxes mature fat cells to get bigger, and promotes blood vessels necessary to sustain fat tissue.

Scientists also showed injecting a substance that blocks NPY prevented mice from accumulating fat even if they were stressed and ate a high-fat diet, and could shrink fat deposits by 40 percent to 50 percent within two weeks.

The technique could offer an alternative or supplement to liposuction, Zukowska said.

On the flip side, when the researchers inserted pellets containing NPY under the skin of mice and three monkeys, they were able to stimulate localized fat growth, suggesting the approach could replace skin fillers and other cosmetic and reconstructive surgical techniques.

"This has tremendous potential applications for both cosmetic and reconstructive surgery," said Stephen Baker, a Georgetown professor of plastic surgery who helped conduct the research.

Others cautioned that much more research would be needed to confirm that the same system works in people, and to learn whether blocking or stimulating NPY receptors is safe.

And they warned that it is unlikely that anything will ever be a panacea for weight gain or replace eating well and exercising regularly.

"I wouldn't want people to not to make an effort to control their weight or lose weight while waiting for this magical solution to fix the whole thing," said Louis Aronne of the Weill Medical College of Cornell University. "This is very promising, but the average person shouldn't say, 'I can eat whatever I want and wait for that shot to take it all away.' "

Exercise key in control of type 2 diabetes

2007-07-03T08:20:00.000-07:00

NEW YORK (Reuters Health) - People with type 2 diabetes may go a long way in managing their condition if they take up regular exercise, a new research review shows.

Researchers found that when they combined the results from 103 studies, there was clear evidence that lifestyle changes helped people with type 2 diabetes gain better control over their blood sugar.

But while diet, exercise and medication are all vital to diabetes management, exercise alone was effective in these studies.

In fact, the review found, studies that focused only on boosting exercise levels yielded greater benefits than those that tried to change patients' diets, exercise habits and medication adherence all at once.

The findings "could mean that it is easier for people to focus on one thing at a time," lead study author Dr. Vicki Conn said in a statement. "It is easy for people to get overwhelmed when asked to make too many changes."

Conn and her colleagues at the University of Missouri-Columbia report the findings in the journal Diabetologia.

For their study, the researchers combined the results of 103 studies that involved a total of 10,455 adults with type 2 diabetes, a disorder in which the body cannot properly use the blood-sugar-regulating hormone insulin.

Type 2 diabetes is closely linked to obesity, and diet, exercise and adherence to medication are the cornerstones of managing the disease. But Conn's team found that blood sugar improvements were twice as great in studies that focused on exercise alone than in those that tried to improve diet, exercise and medication adherence.

Importantly, the researchers point out, exercise helped study participants regardless of their weight or how poor their blood sugar control had been in the past.

"The improvements from exercise," Conn said, "were equal across the board."

SOURCE: Diabetologia May 2007.

Exercise Grows New Brain Cells

2007-07-02T11:01:00.000-07:00

Jeanna Bryner
LiveScience Staff Writer

Exercise stimulates the growth of new brain cells, a new study on rats finds. The new cells could be the key to why working out relieves depression.

Previous research showed physical exercise can have antidepressant effects, but until now scientists didn’t fully understand how it worked.

Astrid Bjornebekk of the Karolinska Institute in Sweden and her colleagues studied rats that had been genetically tweaked to show depressive behaviors, plus a second group of control rats. For 30 days, some of the rats had free access to running wheels and others did not.

Then, to figure out if running turned the down-and-out rats into happy campers, the scientists used a standard “swim test.” They measured the amount of time the rats spent immobile in the water and the time they spent swimming around in active mode. When depressed, rats spend most of the time not moving.

“In the depressed rats, running had an antidepressant-like effect after running for 30 days,” Bjornebekk told LiveScience. The once-slothful rodents spent much more time in active swimming compared with the non-running depressed rats.

The researchers also examined the hippocampus region of the brain, involved in learning and memory. Neurons there increased dramatically in the depressed rats after wheel-running.

Past studies have found that the human brain’s hippocampus shrinks in depressed individuals, a phenomenon thought to cause some of the mental problems often linked with depression.

“The hippocampus formation is one of the regions they have actually seen structural changes in depressed patients,” Bjornebekk said.

Running had a similar effect as common antidepressants called selective serotonin reuptake inhibitors (SSRIs) on lifting depression.

The research is published in the International Journal of Neuropsychopharmacology.

It's Never Too Late to Get Healthy

2007-06-29T10:43:00.000-07:00

Even starting in middle age reduces risk of heart disease and death, study shows

By Steven Reinberg
HealthDay Reporter

THURSDAY, June 28 (HealthDay News) -- Adopting a heart-healthy lifestyle makes a difference, even if the change doesn't come until middle age.

In fact, people who eat right and exercise more can substantially reduce their risk for cardiovascular disease and death even if they're in their 50s or 60s, researchers from the Medical University of South Carolina report.

Consuming at least five fruits and vegetables daily, exercising at least 2.5 hours per week, maintaining a healthy weight and not smoking can lessen your chances of heart trouble by 35 percent, and your risk of dying by 40 percent, compared to people with less healthy lifestyles, according to the report in the July issue of the American Journal of Medicine.

"We call this the turning-back-the-clock study," said lead researcher Dr. Dana E. King. "We want to emphasize that it's not too late change, and the benefits of a healthy lifestyle don't accrue only to people who have been doing this all along, but you can make changes in your 50s and 60s and have a healthier longer life because of it."

King said his team wanted to test if, once you reach middle age, it's too late to adopt healthy habits and improve your health. "We found that it's not too late," he said. "The benefits were dramatic and immediate, even at age 65."

"Some people in middle age don't change, because they think the damage is done," King said. "In fact, in this study, the chances of dying or having a heart attack were reduced by a third after just four years of living a healthy lifestyle."

In the study, King's team collected data on 15,792 men and women aged 45 to 64 who took part in the Atherosclerosis Risk in Communities Study.

The researchers found that during four years of follow-up, the benefit of switching to a healthy lifestyle after age 45 became apparent. In addition, the benefit happened even with modest changes in health habits.

Moreover, a healthy lifestyle was beneficial when compared with people with three or fewer healthy habits, not just compared to people with no healthy habits or only one of the healthy habits, King's group found. While people with only three healthy habits had lower mortality, they did not reduce their risk for cardiovascular disease.

Unfortunately, only 8.5 percent of people in the study practiced these four healthy behaviors, and only 8.4 percent adopted these lifestyle changes after age 45.

King noted that men, blacks, those without a college education, those with lower income, or those with a history of high blood pressure or diabetes were all less likely to adopt a healthy lifestyle past age 45.

One expert noted that living healthy reduces your risk of other diseases, too.

"Most experts agree that a health-promoting lifestyle -- eating well, being active, not smoking -- can cut overall risk of heart disease by 80 percent, cancer risk by 60 percent, and diabetes risk by 90 percent," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine.

King and his colleagues show that it may never be too late to start over, Katz said. "Healthy living is the most powerful medicine of all. It requires no prescription, and all of the side effects are beneficial, too. It can, admittedly, be tough at times to get there from here, but it's well worth it, and anytime is a good time to start."

Another expert agreed.

"These are very encouraging results," said Alice H. Lichtenstein, director of the Cardiovascular Nutrition Lab and Gershoff Professor of Nutrition at the USDA Human Nutrition Research Center at Tufts University.

"They confirm that adopting heart-healthy behaviors, regardless of age, can lead to clear benefits," Lichtenstein said. "Additionally, by identifying individuals who are more likely to adopt heart-healthy behaviors and who is not, more targeted programs to help the more unlikely ones to change can be developed."

More information

For more information on healthy living, visit the American Heart Association.

SOURCES: Dana E. King, M.D., Medical University of South Carolina, Charleston; David Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Alice H. Lichtenstein, D.Sc., director, Cardiovascular Nutrition Lab, Gershoff Professor of Nutrition, USDA Human Nutrition Research Center, Tufts University, Boston, and vice chairwoman, nutrition committee, American Heart Association; July 2007, American Journal of Medicine

Exercise: The best medicine

2007-06-28T11:30:00.000-07:00

By Sally Squires/ The Lean Plate Club

“Walk two miles and call me in the morning.”

That’s what doctors could soon prescribe if the new leaders of two major medical groups have their way.

“We’re trying to get every physician to prescribe exercise,” says Robert Sallis, a California physician who recently became president of the American College of Sports Medicine. “Physicians have a moral responsibility to inform patients of the danger of inactivity and the health benefits of being more active.”

That’s also the message from the new head of the American Medical Association.

“We are in lockstep with them on that concept,” says incoming AMA President Ronald M. Davis, who is also the director of the Henry Ford Health System’s Center for Health Promotion and Disease Prevention in Detroit. “We need to get doctors to prescribe exercise more and we need to get patients to follow that advice.”

More than half of Americans fail to get the 30 minutes of physical activity recommended daily to provide health benefits, according to the Centers for Disease Control and Prevention.

So many Americans are inactive that some experts have coined a new term for it: sedentary death syndrome. The condition helps cut short an estimated 250,000 lives annually, according to Frank Booth, professor of physiology at the University of Missouri. Research suggests that people who are sedentary spend about $1,500 more annually on medical bills than do their more active counterparts.

“There are also studies to show that they miss more work and are not as productive,” says Sallis. Research shows that regular physical activity improves health by cutting the risk of heart disease, stroke, colon cancer, diabetes and high blood pressure. Even brief bouts of activity several times a day can help control weight and relieve arthritis, anxiety and depression.

“Exercise is medicine,” Sallis says. “We know that it works very well. We just don’t have the proper way to administer it.”

That’s where the doctors come in. Sallis is leading the charge to get doctors and other health professionals to ask every patient at every office visit about their exercise habits.

It isn’t just activity that doctors are being asked to encourage. Harvard Medical School and the Culinary Institute of America recently teamed up to teach physicians to cook more healthfully for their own personal consumption.

The theory is that by teaching doctors how to cook, they may be more likely to encourage their patients to do the same. Harvard also is considering establishing teaching kitchens in hospitals. The goal would be to take patients who have recently been diagnosed with diabetes, heart disease or other nutritionally related conditions, and show them how to make healthier meals.

Fitness level predicts heart problems

2007-06-22T13:39:00.000-07:00

By Amy Norton

NEW YORK (Reuters Health) - Cardiovascular fitness may predict the odds of a future heart attack in men and women with no apparent signs of heart disease, a large study suggests.

Researchers found that of more than 26,000 adults with no symptoms of heart disease, those who showed the greatest endurance on exercise tests had the lowest risk of suffering a heart attack or stroke over the next 10 years.

Men with the highest fitness levels were 31 percent less likely than their least-fit counterparts to have a non-fatal heart attack or stroke, or to require an invasive procedure for heart artery blockages. The risk for men with moderate fitness levels fell between the highest and lowest fitness groups.

A similar pattern emerged among women, the study authors report in the American Journal of Epidemiology.

By now, most people may have heard the familiar advice to get 30 minutes of moderate exercise each day for the sake of their health. The new findings underscore how important fitness -- and, therefore, regular exercise -- is in heart health, according to Dr. Xuemei Sui, the study's lead author.

Other findings in this same study group, she told Reuters Health, have shown "again and again" the benefits of boosting fitness through exercise.

This includes not only a lower risk of death from cardiovascular disease, but also a lower likelihood of premature death from a range of causes, noted Sui, a research associate at the University of South Carolina in Columbia.

The current findings are based on 20,728 men and 5,909 women who had no symptoms of heart disease when they entered the study, somewhere between 1971 and 2001. At that time, they underwent a treadmill test to gauge their fitness levels, had physical exams and completed questionnaires on their lifestyle habits.

They were then followed for an average of 10 years, during which time 1,512 men and 159 women had a non-fatal heart attack or stroke, or underwent an artery-clearing procedure.

Sui's team found that, even when several other factors were accounted for -- such as age, smoking and weight -- higher fitness levels seemed to protect against heart problems.

The findings, according to the researchers, argue for the value of more routine exercise testing of people with no symptoms of heart disease. Those test results, they say, could be used along with traditional risk factor assessment -- like measuring blood pressure and cholesterol -- to help predict a person's odds of heart trouble down the road.

Right now, however, it's not standard practice for people without heart disease symptoms to undergo exercise testing. The test is generally reserved for people who have symptoms, such as chest pain, or a high risk of heart disease, Sui noted.

SOURCE: American Journal of Epidemiology, June 15, 2007.

Health costs of aging workers imperil state

2007-06-18T12:57:00.001-07:00

Study cites trends in population, obesity, medical expenses

By Jeffrey Krasner

An aging workforce, combined with the growing obesity epidemic and the high cost of medical care, could result in an epidemic of preventable illness that might cripple the region's economy, according to a study being released this morning by the New England Health Care Institute and the Boston Foundation.

Wendy Everett , president of the not-for-profit healthcare institute which seeks to improve patient care, said population and cost trends could conspire to make the Boston area the first in the United States to be severely affected by the intersection of demographics and disease. She warned that unless action is taken quickly, within the next eight years companies and municipalities will be hit with rising healthcare costs that make today's annual double-digit increases seem modest by comparison.

"The message of the report is, here we are in paradise, with the best teaching hospitals and physicians and the lowest number of uninsured of any state in the country, and a creative and ambitious health reform program, but if we don't act now our economy is going to be dead in the water," Everett said.

Massachusetts residents have already been coping with hefty annual insurance-premium increases. For the past seven years, premiums have increased an average of 10 percent annually.

But the report highlights some little-noticed population trends that could precipitate a financial crisis.

For instance, its authors say the high cost of living is forcing many residents ages 34 to 44 to leave the state. As a result, the state's workforce is getting older while population growth stagnates. Older workers, and immigrants -- who account for many of the state's new workers -- are more vulnerable to developing chronic illnesses, including obesity, which has led to increases in conditions such as heart disease and high blood pressure. The incidence of adult obesity in Massachusetts doubled from 10 percent 1990 to 20 percent in 2005, according to the Department of Public Health.

"Obesity is the elephant in the room," said Everett. "We are getting fatter and fatter, and that's one of the root causes of chronic illness."

The rise of such preventable conditions will greatly increase treatments costs, driving up healthcare premiums and making it more difficult for local companies to compete with those in less expensive states.

The report also predicts the start of a vicious cycle that could put the Boston area at a greater disadvantage than many other parts of the country: As chronic diseases become more prevalent, state government will have to divert money and other resources from preventive programs to those that treat existing conditions.

"We should view this as a call to action," said Andrew Dreyfus , executive vice president of healthcare services at Blue Cross Blue Shield of Massachusetts, the state's largest health insurer, who has been briefed on the report.

"We need to work now to significantly improve our public health and prevention programs in the state. We need to do a lot in the physician's office, in the workplace, and in the hospital to intervene earlier with people suffering from chronic illness."

Dr. JudyAnn Bigby , secretary of health and human services, downplayed the report's finding, saying some of the apparent increase in chronic disease might be attributable to a rise in the earlier diagnosis of conditions.

"I don't see anything in this report that hasn't been known," she said. "The report makes very clear that Massachusetts is one of the healthiest states in the nation."

The report was funded by the Boston Foundation, a community charity that last year made grants of $70 million to nonprofit organizations. Its title, "The Boston Paradox," refers to the irony that an area with some of the country's top medical research and academic institutions could experience such a serious increase in preventable illness.

Despite the report's grim predictions, Boston now ranks high in measures of public health. For example, in 2004 the life expectancy for someone born in Massachusetts was 79.5 years, well above the US average of 77.9 years, according to the Organisation for Economic Cooperation and Development.

But such statistics are not reason for complacency, according to the report's authors.

"It is now imperative for Greater Boston to become as innovative in public health as we have been in medical technologies," said Paul S. Grogan , chief executive of the Boston Foundation, in an introduction to the report. The foundation is also funding a second study, to be completed in December, that will focus on regulation, legislation, and action strategies that it says could help.

Others involved in state healthcare issues say they are optimistic about finding ways to head off the healthcare problems predicted by the report.

"I don't think this is written in stone yet," said Rick Lord , chief executive of Associated Industries of Massachusetts. "There are opportunities for employers and insurers to prevent this from developing."

Women's midlife weight key to future diabetes risk

2007-06-13T12:05:00.000-07:00

NEW YORK (Reuters Health) - People carrying excess weight who aim to ward off diabetes should try to lose the pounds before they reach middle age, Australian researchers suggest.

A woman's body mass index (BMI) in her late 40s was the strongest predictor of her risk of developing diabetes over the next eight years, Dr. Gita D. Mishra of the University of Queensland and her colleagues found.

On the other hand, there was no link between weight change in subsequent years and the likelihood of becoming diabetic.

While excess weight is understood to boost the risk of developing type 2 diabetes, the effects of shorter-term weight gain or loss are not as clear, Mishra and her team note in the journal Diabetes Care. To investigate, the researchers followed 7,239 women for 8 years. Study participants were 45 to 50 years old when the study began, and they completed surveys on their health at the study's outset in 1996 and in 1998, 2001 and 2004.

Those with BMIs of 25 or greater, indicating they were overweight or obese, in 1996 were at the highest risk of developing type 2 diabetes by 2004, the researchers found. Very obese women with BMIs of 35 or above were 12 times more likely than their normal-weight peers to become diabetic.

Weight gain or loss during the course of the study had no influence on a woman's risk of developing diabetes, while physical activity only reduced risk for the most active women.

"Because women's risk of developing type 2 diabetes in midlife is more closely related to their initial BMI (when aged 45-50 years) than to subsequent short-term weight-change, public health initiatives should target the prevention of weight gain before and during early adulthood," the researchers conclude.

They note that only small changes in physical activity and calorie intake are needed to stop from becoming overweight or obese, and that it is particularly important to "inspire people" to make those changes while they are young adults.

SOURCE: Diabetes Care, June 2007.

Exercise plus good food can halve breast cancer deaths

2007-06-11T08:27:00.000-07:00

Eating healthily and taking regular exercise can slash a breast cancer
victim's risk of dying, according to scientists.

They found that walking briskly for half an hour and eating five portions of
fruit and vegetables a day halved the chances of dying from the disease,
even if a woman was obese.

In the first study to look at the impact of both diet and physical activity
on breast cancer survival, a team from the University of California at San
Diego studied 1,490 women with an average age of 50.

The women, who had all undergone primary therapy for early-stage breast
cancer, were taking part in the Women's Healthy Eating and Living study,
looking at the effects of lifestyle on health.

The researchers found that women who were both physically active and had a
healthy diet were much more likely to survive for between five and 11 years
than the rest of the group.

Only around 7 per cent of the 'healthyliving' women died within 11 years -
about half that seen for the others taking part in the study.

Dr John Pierce, from the university's Moores Cancer Centre, said: "We
demonstrate in this study of breast cancer survivors that even if a woman is
overweight, if she eats at least five servings of vegetables and fruits a
day and walks briskly for 30 minutes, six days a week, her risk of death
from her disease goes down by 50 per cent. The key is that you must do
both."

The findings are published in the latest issue of the Journal of Clinical
Oncology.

Because of the strength of the findings, the scientists now want to see if
taking steps to change diet and physical activity affects breast cancer
survival.

They suggest that a healthy lifestyle should be routinely prescribed as part
of breast cancer treatment.

The findings were welcomed by cancer charities yesterday.

Dr Sarah Cant of Breakthrough Breast Cancer said: "This initial study is
encouraging - breast cancer patients tell us that they would like more
information about beneficial lifestyle changes can make, and we look forward
to further research in this

"We also know that regular exercise helps to reduce the risk of developing
breast cancer, so Breakthrough Breast Cancer encourages all women to lead a
healthy lifestyle, which includes taking regular exercise and eating a
balanced diet."

Liz Caroll, head of clinical services at Breast Cancer Care, said: "More and
more evidence is emerging clearly pointing to the potential benefits
exercise and a healthy diet may have in improving breast cancer survival
rates.

"It is important to stress that regular exercise and a healthy diet are
always beneficial in maintaining good health."

Henry Scowcroft of Cancer Research UK, said: "The results of this study add
to mounting evidence that adopting a healthy lifestyle might also play a
role in cancer survival, as well as helping to prevent the disease.

"It is really interesting that the effects observed in this study only
occurred when the women both exercised and ate healthily.

"We still need to find out more about exactly how lifestyle changes can
influence breast cancer survival.

"What we do know is that maintaining a healthy bodyweight, eating sensibly
and taking regular exercise is the key to a healthy life, as it can help
reduce your risk of several types of cancer, as well as many other disease

Many Americans do maintain weight loss

2007-06-07T14:40:00.001-07:00

By Amy Norton

NEW YORK (Reuters Health) - Though dieters often see their weight "yo-yo," a new national survey suggests that many Americans do fairly well at keeping the pounds off.

Government researchers found that of 1,310 U.S. adults who'd ever lost a substantial amount of weight, the majority had managed to keep at least some of the weight off.

Overall, 59 percent were still close to their weight of a year before -- which in all cases was at least 10 percent lower than their heaviest all-time weight. Another 8 percent weighed less than they did a year earlier.

However, one third of the subjects had regained a significant amount of weight over the year, the researchers report in the American Journal of Preventive Medicine.

Lost pounds are notorious for finding their way back again. So it's "encouraging" to see that so many people in this study were keeping their weight stable, lead study author Dr. Edward Weiss told Reuters Health.

Still, weight maintenance remains a "challenge" in a culture that encourages sitting and eating, according to Weiss and his colleagues at the Centers for Disease Control and Prevention in Atlanta.

Several past studies have shown that overweight people in clinical weight-loss programs regain the weight when the program ends. Individuals treated with lifestyle modification, like calorie-cutting and exercise, generally regain about one third of their lost weight over the next year. By the fifth year, they've regained most of the weight, on average.

But much of the research on weight regain has focused on people in clinical weight-loss programs. To get a better idea of how the average American fares, Weiss's team used data from a federal health survey that questioned a nationally representative sample of U.S. adults.

The researchers focused on 1,310 men and women who, 1 year before the survey, weighed at least 10 percent less than their all-time high. They then compared respondents' current weight with their weight 1 year earlier.

While relatively few people kept losing weight over the year, the study found, a majority managed to stay within 5 percent of their weight from the year before.

Exercise seemed to be one of the factors that separated the regainers from the maintainers. The odds of weight regain were twice as high among sedentary men and women than among those who met public health recommendations for exercise -- moderate physical activity for at least 30 minutes a day on most, and preferably all, days of the week.

The risk also climbed in tandem with the number of hours survey respondents spent in front of the TV or computer each day.

Exercise, Weiss said, has consistently been associated with long-term weight-loss maintenance. So staying active after the pounds are off may be one key to keeping them off.

But he pointed out that exercise has to be accompanied by continuing calorie control.

It's also important for people to focus on more than the number on the scale, according to the researcher. Even if the weight loss is not as substantial as you'd like, eating well and exercising will bring significant health benefits, like lower risks of diabetes and heart disease.

SOURCE: American Journal of Preventive Medicine, July 2007.

Study spots gaps in Americans' diet, health IQ

2007-06-04T06:44:00.000-07:00

NEW YORK (Reuters) -- Ninety percent of Americans say breakfast is an important part of a healthy diet, but just 49 percent manage to eat breakfast every day, a new survey shows.

And only 11 percent know the amount of calories they should consume daily to maintain a healthy weight, according to the International Food Information Council Foundation's second annual Food & Health Survey. "The only good thing is more people tried to guess than last year," Susan Borra, the president of the Washington, DC-based IFIC Foundation, told Reuters.

IFIC commissioned a survey of 1,000 U.S. adults, this March to better understand people's beliefs and behaviors regarding healthy eating. The survey identified a number of "diet disconnects" between what people intend to do and their actual habits, according to Borra and her team.

Among the most striking "disconnects," Borra said, concerned knowledge about good and bad fats. While current guidelines recommend people consume more polyunsaturated fats, found in fish and some whole grain foods, and monounsaturated fats, found in nuts, avocados and vegetable oils, she noted, 42 percent of those surveyed said they were trying to eat fewer polyunsaturated fats and 38 percent reported trying to cut down on monounsaturated fats.

However, 70 percent of people said they were trying to cut down on saturated fat, more than last year's 57 percent. Saturated fats are found in meats, dairy foods, and coconut and palm oils, among other sources, and have been tied to an increased risk off heart disease and stroke.

While 84 percent said they were physically active at least once a week for health benefits, only 44 percent said they "balanced diet and physical activity" for weight management. "That concept of calories in, calories out isn't quite making the consumer radar screen," Borra said. "That's another big disconnect."

And while most people surveyed knew about the benefits of functional foods; for example, 80 percent knew such foods could benefit the heart, just 42 percent actually ate such heart-healthy foods.

"Consumers are interested in health, they want to have a healthy lifestyle, but they're just having a tremendous difficulty achieving it," Borra said, adding that people's "hectic, crazy lifestyles" and the confusing mix of information out there don't help matters.

Borra recommends people stick to good sources of information on diet and health, such as IFIC's Web site; the federal government's mypyramid.gov; the American Dietetic Association; and the American Heart Association .

She also urges people to make incremental changes in their lifestyle habits, rather than trying to do everything all at once, and recommends IFIC's "Your Personal Path to Health: Steps to a Healthier You" as a good source for identifying ways to make these small changes.

"If you just make a couple of small steps a day, you're doing a lot to achieving a healthy lifestyle in the long run," Borra said.

Boomers Must Take Extra Steps To Prevent Sports And Exercise-related Injuries

2007-05-31T12:21:00.000-07:00

While exercise and playing sports can be lots of fun, aging puts some limits on the intensity and duration of that activity. Growing older also makes us more prone to injuries ourselves during physical activity. "Baby boomers" tend to be at risk, since they may just be discovering their bodies are not as young as they used to be. The American Academy of Orthopaedic Surgeons (AAOS) recommends that "boomers" take special cautions to help prevent injuries as they exercise to keep their bodies in top condition.

According to the U.S. Consumer Products Safety Commission, in 2005:

-- More than 128,000 people between the ages of 45 and 64 were treated in hospital emergency rooms, doctors' offices, clinics and other medical settings for injuries related to exercise and exercise equipment.

"When you are 50, your body is more prone to injury than it was when you were 20," says Emmett McEleney, MD, orthopaedic surgeon and AAOS Leadership Fellows Program member. "Joints, tissues and muscles may not be as flexible as they used to be. So as you get older, you need to take extra steps to protect yourself from injuries when you exercise."

The Academy offers the following strategies to help baby boomers prevent exercise-related injuries:

-- Check with your doctor first. Before beginning an exercise program, a physician can make sure your heart is in good condition, and make recommendations based on your current fitness level. This is especially important if you have had a previous injury.
-- Always warm up and stretch before exercising. Cold muscles are more likely to get injured, so warm up with some light exercise for at least 3 to 5 minutes.
-- Don't be a "weekend warrior." Moderate exercise every day is healthier and less likely to result in injury than heavy activity only on weekends.
-- Take lessons. An instructor can help ensure that you are using the proper form, which can prevent overuse injuries such as tendonitis and stress fractures.
-- Develop a balanced fitness program. Incorporate cardio, strength training, and flexibility training to get a total body workout and prevent overuse injuries. Also, introduce new exercises gradually, so you don't take on too much at once.
-- Take calcium and vitamin D daily.
-- Listen to your body. As you age, you may not be able to do some of the activities that you did years ago. Pay attention to your body's needs and abilities and modify your workout accordingly.

Obesity bad for the bones

2007-05-29T13:23:00.000-07:00

NEW YORK (Reuters) -- New research does not support the general belief that obesity increases bone mass and is therefore good for bone health. A study, in which investigators corrected for the mechanical loading effect of increasing body weight, suggests the opposite.

"Our study found that increasing body fat mass decreases bone mass, for people of similar weight," Dr. Hong-Wen Deng from University of Missouri-Kansas City told Reuters. "Therefore, increasing obesity (fat mass) is not good for bone health."

The finding is "important," Deng and colleagues say, because it suggests that interventions or treatments aimed at reducing obesity may increase bone mass and thus protect against osteoporosis.

Past studies on the relationship between obesity and osteoporosis did not control for the "mechanical loading effects" of a person's total body weight on bone mass, the investigators note in a report published this month.

Deng's team reevaluated the relationship between obesity and osteoporosis taking into account mechanical loading effects of total body weight on bone mass in more than 6,400 healthy adults.

According to the investigators, when the mechanical loading effect of body weight on bone mass was adjusted for, fat mass was negatively associated with bone mass; that is, in general, the greater the fat mass, the lower the bone mass.

The results of their study, the researchers say, also "reaffirm the beneficial effects of appropriate weight-bearing and mechanical loading on a healthy skeletal system."

Strength training may reverse muscle aging

2007-05-24T07:20:00.000-07:00

By Amy Norton

NEW YORK (Reuters Health) - Strength training may not only make older adults' muscles stronger, but younger as well, a small study suggests.

It's well known that resistance exercises improve muscle strength and function in young and old alike, but the new research suggests that strength training also affects older muscles on the level of gene expression -- essentially turning back the clock on muscle aging.

The study, published in the online journal PLoS One, looked at whether strength training affects the "gene expression profile" in older adults' muscle. Genes hold the instructions from which the body manufactures proteins; gene expression refers to the processes that translate these instructions into proteins.

Analyzing small samples of muscle tissue from a group of healthy young and older adults, researchers found that older and younger muscle tissues differed significantly in their gene expression profiles. The difference indicated that older muscle tissue had impaired functioning in mitochondria -- structures within cells that act as the cell's "powerhouse."

That impairment was reversible, however. After 14 of the older adults underwent 6 months of strength training, the gene expression profile in their muscles showed a more youthful appearance.

"In a very real sense, the muscle was younger," said lead study author Dr. Simon Melov of the Buck Institute for Age Research in Novato, California.

Experts have long known that exercise is good for younger and older adults alike, Melov told Reuters Health, but the new findings suggest that it can "actually rejuvenate muscle" in older individuals.

The study included 25 healthy men and women older than 65, and 26 healthy adults ages 20 to 35 who had diet and exercise habits similar to the older group. By analyzing muscle tissue from each volunteer, Melov's team found age-related differences in the expression of hundreds of genes -- such that mitochondrial function in older adults appeared "dramatically impaired."

Fourteen of the older adults then went through a strength training program, working out two days a week for 6 months.

As expected, the researchers found that these volunteers boosted their muscle strength, coming closer to their younger counterparts' performance. But their muscle also showed a turnaround in gene expression that Melov described as surprisingly stark.

He said more studies are needed to see whether aerobic exercise, like walking or cycling, has similar effects on muscle -- and whether exercise might reverse molecular aging in other types of body tissue.

For now, the researchers say, their findings show that it's never too late to start exercising.

SOURCE: PLoS One, online May 23, 2007.

Individuals Who Conduct Regular Exercise Achieve Lower Health Care Costs Says New Study by Medica and Life Time Fitness

2007-05-22T08:46:00.000-07:00

Participants in Groundbreaking Medica - Life Time Fitness Program Realize More Than 33% Decrease in Per Member Per Month Health Care Claims Costs After Two Years in Program

MINNEAPOLIS--(BUSINESS WIRE)--A new study released by Medica and Life Time Fitness (NYSE:LTM) demonstrates that Medica members who began a new, regular program of exercise at Life Time Fitness centers saw a decrease in claim costs after just two years in the program. The members, who received a financial incentive to exercise regularly, saw an average claim cost decrease of more than 33 percent on a per member per month basis during the period.

The study involved 3,249 participants in the Fit Choices^SM by Medica program, which offers a $20 monthly credit from Medica toward the payment of members’ monthly dues if they exercise at least eight days per month at their chosen Life Time Fitness center. To ensure comparability with regard to health care expenditures before and after participating in the Fit Choices program, a control group of equivalent size, demographics, health status, and health care consumption habits also was established. Health care costs examined included facility claims, physician claims and RX claims, which were summed to derive total expenditures.

According to the study’s results, new Life Time Fitness members who exercised at least eight days per month after joining the Fit Choices program achieved an overall 33.6 percent per member per month average claim cost decrease as compared with the comparison test group in their second year of program participation. These participants also realized the following claims cost decreases relative to the control group:

A 64.3% decrease in facility claims.
A 13.0% decrease in physician claims.
A 9.2% decrease in RX claims.

The study also revealed dramatic differences in visits to inpatient, emergency room and outpatient health care service providers among the same comparison groups. Non-program participant control group members realized an average of:

63.6% more visits to inpatient facilities.
105.0% more visits to emergency room facilities.
43.3% more visits to outpatient facilities.

“Fit Choices is all about helping people make better decisions about their health,” said Charles Fazio, M.D, chief medical officer at Medica. “When we formalized our partnership with Life Time Fitness in 2003, we began making an investment in peoples’ health and, in doing so, we expected to see it pay dividends by way of controlled health care costs. Via the study, we found that offering a financial incentive is effective in motivating people to exercise. We also validated that health care cost reductions occur when participants exercise at least eight days per month and participants experienced improvement in their health status based upon self-reported survey results.”

“We are highly encouraged by the study’s findings,” said Glen Gunderson, vice president of the Business-to-Business division at Life Time Fitness, Inc. “Life Time Fitness’ centers, programs and services have been specifically designed to allow individuals to take charge of their own health and wellbeing by adopting healthy-way-of-life habits in their everyday lives. Through the innovative partnership we started with Medica in 1999, we have demonstrated that people who decide to make a positive change in their lives through regular exercise and sound nutrition not only are healthier, but also, achieve real, quantifiable financial benefits, both as a result of the membership dues credit they receive and through reduced health care costs paid either by their insurer or out of their own pockets.”

In addition to monthly membership dues reimbursement, Fit Choices participants also receive preferred Life Time Fitness membership enrollment fees and may take advantage of a comprehensive personal fitness screening, development of an individualized health and wellness action plan, any many other unique programs and services.

Fit Choices is a standard component of Medica’s offerings to fully insured customers and is offered as an option for self-insured groups.

Keeping people healthy not only saves lives, it saves money. Studies show an estimated 70 percent of all illnesses are due to lifestyle-related causes such as obesity and physical inactivity, and one-half of all medical costs are attributable to illnesses that could be prevented. Within this environment, Medica estimates that it spends $80 million a year in health care costs for overweight and obesity-related illnesses among its commercial fully insured members – customers that account for approximately a third of all Medica members.

About Medica

Serving more than 1.3 million members, Medica is a health insurance company headquartered in Minneapolis and active in the Upper Midwest. The non-profit company provides health care coverage in the employer, individual, Medicaid, Medicare and Medicare Part D markets in Minnesota and a growing number of counties in North Dakota, South Dakota and Wisconsin. Medica also offers national network coverage to employers who also have employees outside the Medica regional network. Medica has the highest accreditation status, Excellent, from the National Committee for Quality Assurance (NCQA®) for its Minnesota Medicaid HMO plans and commercial health plans in Minnesota and North Dakota. Medica’s vision is to become the community’s health plan of choice, trusted for its integrity, respected for its service, and admired for its commitment to innovation and efficiency.

About Life Time Fitness, Inc.

Life Time Fitness, Inc. (NYSE:LTM) operates distinctive and large sports and athletic, professional fitness, family recreation and resort/spa centers. As of May 21, 2007 the Company operated 62 centers in 14 states, including Arizona, Florida, Georgia, Illinois, Indiana, Kansas, Maryland, Michigan, Minnesota, North Carolina, Ohio, Texas, Utah and Virginia. The Company also operates two satellite facilities and five preview locations in existing and new markets. Additionally, Life Time Fitness provides consumers with personal training consultation, full-service spas and cafes, corporate wellness programs, health and nutrition education, the healthy lifestyle magazine - Experience Life, athletic events, and nutritional products and supplements. Life Time Fitness is headquartered in Eden Prairie, Minnesota, and may be accessed on the Web at www.lifetimefitness.com. LIFE TIME FITNESS, the LIFE TIME FITNESS logo, and EXPERIENCE LIFE are registered trademarks of Life Time Fitness, Inc. All other trademarks or registered trademarks are the property of their respective owners.

Contacts

Medica
Greg Bury, 952-992-8437
greg.bury@medica.com
or
Larry Bussey, 952-992-8013
larry.bussey@medica.com
or
Life Time Fitness
Kent Wipf, 952-229-7211
kwipf@lifetimefitness.com
or
Jason Thunstrom, 952-229-7435
jthunstrom@lifetimefitness.com

DIET: Thin people may be fat inside

2007-05-16T06:38:00.000-07:00

By MARIA CHENG, AP Medical Writer

LONDON - If it really is what's on the inside that counts, then a lot of thin people might be in trouble. Some doctors now think that the internal fat surrounding vital organs like the heart, liver or pancreas — invisible to the naked eye — could be as dangerous as the more obvious external fat that bulges underneath the skin.

"Being thin doesn't automatically mean you're not fat," said Dr. Jimmy Bell, a professor of molecular imaging at Imperial College, London. Since 1994, Bell and his team have scanned nearly 800 people with MRI machines to create "fat maps" showing where people store fat.

According to the data, people who maintain their weight through diet rather than exercise are likely to have major deposits of internal fat, even if they are otherwise slim. "The whole concept of being fat needs to be redefined," said Bell, whose research is funded by Britain's Medical Research Council.

Without a clear warning signal — like a rounder middle — doctors worry that thin people may be lulled into falsely assuming that because they're not overweight, they're healthy.

"Just because someone is lean doesn't make them immune to diabetes or other risk factors for heart disease," said Dr. Louis Teichholz, chief of cardiology at Hackensack Hospital in New Jersey, who was not involved in Bell's research.

Even people with normal Body Mass Index scores — a standard obesity measure that divides your weight by the square of your height — can have surprising levels of fat deposits inside.

Of the women scanned by Bell and his colleagues, as many as 45 percent of those with normal BMI scores (20 to 25) actually had excessive levels of internal fat. Among men, the percentage was nearly 60 percent.

Relating the news to what Bell calls "TOFIs" — people who are "thin outside, fat inside" — is rarely uneventful. "The thinner people are, the bigger the surprise," he said, adding the researchers even found TOFIs among people who are professional models.

According to Bell, people who are fat on the inside are essentially on the threshold of being obese. They eat too many fatty, sugary foods — and exercise too little to work it off — but they are not eating enough to actually be fat. Scientists believe we naturally accumulate fat around the belly first, but at some point, the body may start storing it elsewhere.

Still, most experts believe that being of normal weight is an indicator of good health, and that BMI is a reliable measurement.

"BMI won't give you the exact indication of where fat is, but it's a useful clinical tool," said Dr. Toni Steer, a nutritionist at Britain's Medical Research Council.

Doctors are unsure about the exact dangers of internal fat, but some suspect it contributes to the risk of heart disease and diabetes. They theorize that internal fat disrupts the body's communication systems. The fat enveloping internal organs might be sending the body mistaken chemical signals to store fat inside organs like the liver or pancreas. This could ultimately lead to insulin resistance, type 2 diabetes, or heart disease.

Experts have long known that fat, active people can be healthier than their skinny, inactive counterparts. "Normal-weight persons who are sedentary and unfit are at much higher risk for mortality than obese persons who are active and fit," said Dr. Steven Blair, an obesity expert at the University of South Carolina.

For example, despite their ripples of fat, super-sized Sumo wrestlers probably have a better metabolic profile than some of their slim, sedentary spectators, Bell said. That's because the wrestlers' fat is primarily stored under the skin, not streaking throughout their vital organs and muscles.

The good news is that internal fat can be easily burned off through exercise or even by improving your diet. "Even if you don't see it on your bathroom scale, caloric restriction and physical exercise have an aggressive effect on visceral fat," said Dr. Bob Ross, an obesity expert at Queen's University in Canada.

Because many factors contribute to heart disease, Teichholz says it's difficult to determine the precise danger of internal fat — though it certainly doesn't help.

"Obesity is a risk factor, but it's lower down on the totem pole of risk factors," he said, explaining that whether or not people smoke, their family histories and blood pressure and cholesterol rates are more important determinants than both external and internal fat.

When it comes to being fit, experts say there is no short-cut. "If you just want to look thin, then maybe dieting is enough," Bell said. "But if you want to actually be healthy, then exercise has to be an important component of your lifestyle."

Pediatricians Not Tracking Kids' BMI

2007-05-10T12:10:00.000-07:00

Surveys find most failing to measure patients' body weight

By Randy Dotinga
HealthDay Reporter

TUESDAY, May 8 (HealthDay News) -- Despite recommendations that came out years ago, two new studies suggest that many pediatricians are failing to properly track the body weight of their young patients.

Ideally, pediatricians take note of a child's height and weight and then perform a calculation to get a number that reveals whether the child has a weight problem, said Dr. Jennifer Hillman of Cincinnati Children's Hospital Medical Center, lead author of one of the studies.

But Hillman and her colleagues found that 42 Cincinnati pediatricians correctly measured and tracked the body-mass index (BMI) of only 5.5 percent of the 500 children studied.

Obesity is a growing problem in children, Hillman said, causing "secondary complications like diabetes and high blood pressure and cardiac problems. We're seeing those things earlier and earlier."

The results of the 2004 study were released Monday at the Pediatric Academic Societies' annual meeting, in Toronto.

BMI, a number derived from a person's height and weight, measures whether someone is underweight, of normal weight or overweight.

Why not just eyeball a kid?

That doesn't work, according to Hillman. When kids are between toddler-age and adolescence, she said, "it's very difficult to look at a child and actually know by appearance" whether they're at risk for being underweight or overweight.

But even just the BMI doesn't present the entire picture for kids, as it does in adults. The growth of children throws off the BMI, so pediatricians who track it look at charts that tell them the proper BMI for children of specific ages and genders.

The American Academy of Pediatrics has recommended since 2003 that pediatricians track BMI; federal growth charts have included BMI since 2000.

Why isn't there more consideration of BMI?

"One reason may be a lack of knowledge about the recommendations, about what the BMI means in children and how to use it," Hillman said. "We also wonder if there's some resistance in terms of how it takes a lot of extra time to explain this to families, and there's resistance from the family's perspective about a diagnosis of obesity and overweight."

A second study to be presented at the pediatric meeting found that a higher number -- 52 percent -- of 1,662 pediatricians surveyed in 2006 report assessing the BMI of patients over the age of 2.

That survey found that 92 percent of pediatricians felt comfortable talking to patients about weight issues, but only 38 percent thought such counseling would be effective. About two-thirds said they didn't have enough time to talk about the topic of weight.

Ninety-six percent of pediatricians want to do more about obesity, but "the barriers to being able to do this are both time and the doctor's expertise," in addition to health insurance companies that probably don't pay for weight and nutrition management, said study author Dr. Jonathan Klein, an associate professor of pediatrics at the University of Rochester.

What to do?

Parents "need to start prompting their physicians about BMI and learning about it," said Hillman. "That will push pediatricians to become more savvy and address the issue. It may also send a message to physicians that there may not be as much resistance as we think. Most parents just want their kids to be healthy, even if that means talking about something that's particularly sensitive."

More information

Learn more about BMI and kids from the U.S. Centers for Disease Control and Prevention.

SOURCES: Jennifer Hillman, M.D., clinical fellow in adolescent medicine, Cincinnati Children's Hospital Medical Center; Jonathan Klein, M.D., associate professor, pediatrics, University of Rochester, New York; May 7, 2007, presentation, Pediatric Academic Societies meeting, Toronto

Exercising harder keeps weight off longer

2007-05-10T11:23:00.000-07:00

NEW YORK (Reuters) -- People who consistently engage in high levels of exercise over the long haul are the most successful at losing weight and keeping it off, a new study shows.

Among a group of overweight men and women participating in an 18-month weight loss program, those who were still getting 75 minutes of exercise daily a year after the program ended had lost 26 pounds, compared with 1.8 pounds for people who were exercising less.

But only 13 of the 154 people who completed the study were able to sustain this level of activity, Dr. Deborah F. Tate of the University of North Carolina in Chapel Hill and her colleagues found. "Strategies are needed to help participants maintain high levels of activity over the long-term," she and her colleagues conclude in a report in the American Journal of Clinical Nutrition.

The researchers initially assigned 202 people to either a high physical activity group who aimed to burn 2,500 calories per week (equivalent to a 75-minute walk daily) or standard behavioral treatment, including 30 minutes of exercise daily, equivalent to 1,000 calories per week.

Twelve and 18 months later, people in the high activity group had lost significantly more weight than those in the lower activity group.

Although the participants in the high activity group were able to sustain the 2,500 calorie per week exercise goal during the 18-month study, their activity level declined once treatment ended, which resulted in no between-group differences in activity or weight loss at 2.5 years.

However, a small subgroup of people who stuck to the 2,500 calorie per week exercise regimen after the 18-month treatment period ended maintained a significantly larger weight loss than those who didn't exercise as much.

People who maintained high levels of exercise were also eating fewer calories and less fat.

The researchers believe that their e-mails, mailings and phone calls to study participants for the initial 18 months of the study were successful in helping them to reach exercise goals; continuing to stay in touch may have helped them sustain this level of activity.

"It is also possible that sustaining the long-term behavior changes that are needed for behaviors such as physical activity will require changes in the larger social and environmental context in which these behaviors occur," they conclude.

IHRSA To Help Kickoff National Women's Health Week

2007-05-10T09:24:00.000-07:00

As reported by Billings News, the eighth annual National Women’s Health
Week, coordinated by the U.S. Department of Health and Human Services’
Office on Women’s Health, begins on Mother’s Day, May 13.

More than 1,000 health-related events around the country, ranging from
health fairs and screenings to spa days, will encourage women to incorporate
preventive health measures into their everyday lives and take time to focus
on their health.

National Women’s Health Week is a nationwide initiative that calls attention
to the importance of women’s health. During the week, families, health
organizations, businesses, communities, the government and individuals come
together to raise awareness about women’s health issues and educate women
about simple steps they can take for a longer, healthier and happier life.

Organizations participating include the National Association of Chain Drug
Stores, the International Health, Racquet and Sportsclub Association
(IHRSA), National Stroke Association, Screening for Mental Health Inc.,
Better Sleep Council and more. For information, visit
www.womenshealth.gov/whw

HHS Secretary Announces Physical Activity Guidelines Advisory Committee Members, USA

2007-05-08T12:29:00.000-07:00

HHS Secretary Mike Leavitt announced today the members of the advisory committee that will make recommendations pertaining to the development of the first federal guidelines to focus on physical activity.

The Physical Activity Guidelines for Americans is to be issued in late 2008. The report will provide science-based recommendations on the latest knowledge about activity and health, with depth and flexibility to target specific population subgroups, such as seniors, children, and persons with disabilities. Secretary Leavitt announced the initiative in October.

"These experts have a broad array of knowledge of the health value of physical activity," Secretary Leavitt said. "I look forward to working with them to develop evidence-based guidelines on physical activity levels."

The advisory committee will hold its first meeting June 28 and 29, 2007. The committee will survey the history of physical activity guidelines in the U.S., and be introduced to the systematic evidence review process that will form the basis of the deliberations. The committee will also examine and summarize research that can be used as the basis of the guidelines and make suggestions on what should be included. The department will consider the research and the committee's recommendations as it develops guidelines.

Members of the Physical Activity Guidelines Advisory Committee are:

Rod K. Dishman, Ph.D., professor of exercise science and director, Exercise Psychology Laboratory, Department of Kinesiology, University of Georgia, Athens, Ga. Dr. Dishman is an expert in the area of mental health benefits of physical activity. Internationally recognized for his research on the determinants of physical activity and related neurobiological adaptations, Dr. Dishman has authored seminal reviews of the research literature, 125 refereed articles, 35 invited book chapters, three textbooks, and two edited books on exercise and public health. He was a contributing author of the Recommended Quality and Quantity of Exercise for Healthy Adults published in 1998 by the American College of Sports Medicine (ACSM) and Physical Activity and Health: a Report of the U.S. Surgeon General.

William Haskell, Ph.D., professor of medicine (active emeritus), Stanford University School of Medicine, Stanford, Calif., has been appointed as chair of the Committee. Professor Haskell has spent 40 years researching the effects of habitual physical activity on health and performance, especially in chronic disease prevention, cardiac rehabilitation, and assessment of physical activity in free-living populations. He is an expert in physiology with extensive knowledge of current recommendations for adults. He has participated in committees that have developed guidelines for physical activity and health for the ACSM, American Heart Association (AHA), American College of Cardiology, the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). He is actively involved in physical activity and health research and development and distribution of educational materials to health professionals and the public.

Edward Howley, Ph.D., professor emeritus, Department of Exercise, Sport, and Leisure Studies, University of Tennessee, Knoxville, Tenn. Dr. Howley has 35 years of experience teaching and conducting research in exercise physiology and fitness. He is a past president of the ACSM and currently serves as editor-in-chief of the ACSM Health & Fitness Journal and as a member of the Science Board of the President's Council on Physical Fitness and Sports. Dr. Howley is an expert in metabolism and energy expenditure, fitness guidelines, and fitness assessment. He recently helped to develop the East Tennessee 2-Step Healthy Weight Initiative, a collaboration between the University of Tennessee, the Knox County Health Department and the East Tennessee Regional Health Office.

Wendy Kohrt, Ph.D., professor of medicine, Division of Geriatric Medicine, University of Colorado at Denver and Health Sciences Center, Denver, Colo. Dr. Kohrt has conducted clinical intervention studies toward understanding the health benefits of physical activity in older people for more than 20 years. Her research focuses on reducing risk for chronic diseases and conditions like osteoporosis, type 2 diabetes, abdominal obesity, and physical disability. She chaired the writing committee for the 2004 ACSM Position Stand on Physical Activity and Bone Health. Dr. Kohrt established the Investigations in Metabolism, Aging, Gender, and Exercise research group at the University of Colorado, which has the goal to be a national leader in aging research focused on the prevention of disease and the maintenance of functional independence in old age.

William Kraus, M.D., professor, Division of Cardiovascular Medicine, Department of Medicine, Duke University School of Medicine, Durham, N.C. Dr. Kraus is an attending cardiologist and researcher at Duke University Medical Center and serves as Medical Director for Cardiac Rehabilitation and Director for Clinical Research at the Duke University Center for Living. Dr. Kraus was the principal investigator on Studies of Targeted Risk Reduction Interventions through Defined Exercise, one of the first large, randomized, controlled trials to investigate the effects of different amounts and intensities of exercise on cardiovascular disease risk factors. He is currently leading another trial to examine the effects of resistance training alone, aerobic training alone and both together on cardiovascular disease risk factors. He is the vice chair of the Physical Activity Committee of the AHA Council on Nutrition, Physical Activity and Metabolism.

I-Min Lee, M.D., Sc.D., associate professor of medicine, Harvard Medical School and Associate Professor of Epidemiology, Harvard School of Public Health, Boston, Mass. Dr. Lee provides expertise in the epidemiology of chronic diseases related to physical activity. Her research focuses on the role of physical activity in preventing disease, promoting health and well-being, and enhancing longevity. Dr. Lee has investigated the association of physical activity with risks of several chronic diseases, mechanisms through which physical activity reduces risk of cardiovascular disease, epidemiological methods for studies of physical activity and health, and public health questions of how much physical activity is required for health. She contributed to Physical Activity and Health: a Report of the U.S. Surgeon General, and served on the expert panel of the NIH Consensus Development Conference on Physical Activity and Cardiovascular Health.

Anne McTiernan, M.D., Ph.D., director, Prevention Center, Fred Hutchinson Cancer Research Center, Seattle, Wash. Dr. McTiernan is an expert on the association of physical activity and cancer risk, and the effect of exercise on biological precursors of cancer and other diseases. She is principal investigator of a National Cancer Institute-funded center that focuses on the mechanisms linking energy balance, physical activity, and obesity with cancer risk and prognosis, and has led several other studies assessing the effect of physical activity on cancer and obesity. She served on several advisory and guidelines committees, including the American Cancer Society Nutrition and Physical Activity Guidelines Advisory Committee, Nutrition and Physical Activity for Cancer Survivors, Guidelines on Nutrition and Physical Activity for Cancer Prevention, and the ACSM Specialty Certification for Cancer Survivors. She was editor of the 2005 volume Cancer Prevention and Management Through Exercise and Weight Control, the first text to cover the role of physical activity and weight on cancer incidence and rehabilitation.

Miriam Nelson, Ph.D., director, John Hancock Center for Physical Activity and Nutrition Science and Policy, Tufts University, Boston, Mass., has been appointed as vice-chair of the committee. Dr. Nelson is an expert in the relationship of physical activity to health in midlife and older populations, with an emphasis on women. She has directed and collaborated on studies examining the effects of strength training, endurance exercise, and balance training on reducing risks and symptoms of chronic disease and functional decline. Outcomes studied include bone health, arthritis, frailty, type 2 diabetes, and muscle loss. Dr. Nelson also has a strong educational and research background in nutrition, which will contribute to consideration of chronic diseases and conditions that are influenced by physical activity and nutrition.

Russell Pate, Ph.D., associate vice president for health sciences, Office of Research and Health Sciences and Professor, Department of Exercise Science, University of South Carolina, Columbia, S.C. Dr. Pate is an expert on the overall health implications of physical activity and youth physical activity. He has published over 170 scholarly papers and authored or edited five books. Dr. Pate coordinated the effort that led to the CDC/ACSM recommendations on Physical Activity and Public Health in 1995. He served on an Institute of Medicine panel to develop guidelines on the prevention of childhood obesity and on the 2005 Dietary Guidelines Advisory Committee. He is a former member of the Science Board of the President's Council on Physical Fitness and Sports and a former president of ACSM. He has held leadership positions with the National Coalition on Promoting Physical Activity, the American Academy of Kinesiology and Physical Education, and the American Heart Association. Dr. Pate ran three U.S. Olympic Trials marathons and twice finished in the top ten in the Boston Marathon.

Kenneth Powell, M.D., M.P.H., public health and epidemiologic consultant, Atlanta, Ga. Dr. Powell is an expert on adverse events and injury risk and protection related to physical activity. He has been working in physical activity and public health with the CDC and Georgia state health department for more than 20 years. From 1999-2005, He was Chief of the Chronic Disease, Injury, and Environmental Epidemiology Section in the Georgia Division of Public Health. He planned, chaired and edited the papers from the first national workshop on the epidemiologic and public health aspects of physical activity and exercise in 1985. He authored over 50 scientific articles on physical activity, with many addressing injury prevention and risk of injury due to physical activity. Dr. Powell is a member of the Coordinating Team on Physical Activity for the Task Force on Community Preventive Services, Guide to Community Preventive Services.

Judith Regensteiner, Ph.D., professor, Department of Medicine, Section of Vascular Medicine, Divisions of General Internal Medicine and Cardiology, and director, Center for Women's Health Research, University of Colorado Health Sciences Center, Denver, Colo. Dr. Regensteiner is an expert in metabolic health considerations of diabetes and peripheral arterial disease. Her research focuses on the role of exercise and physical activity in preventing and treating diabetes. She also has an international reputation for research on the role of exercise training in preventing and treating peripheral arterial disease. In addition to research on older individuals, she has recently been studying exercise in adolescents with type 2 diabetes. She has received funding for completed and ongoing studies to assess exercise capacity, the effects of exercise training, and gender differences on cardiovascular function and peripheral arterial disease in persons with type 2 diabetes. She has authored over 100 scientific articles and presented over 60 invited lectures.

James Rimmer, Ph.D., professor and director, National Center on Physical Activity and Disability, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, Ill. Dr. Rimmer has been developing and directing physical activity and health promotion programs for people with disabilities for 26 years. He has published over 85 manuscripts and book chapters and given over 100 invited presentations to national and international audiences on topics related to physical activity, health promotion, secondary conditions and disability. He directs two centers related to physical activity and disability, one funded by CDC and the other funded by the National Institute on Disability and Rehabilitation Research. Dr. Rimmer was recently asked to serve as one of 15 experts on a National Academy of Sciences Aging and Longevity Initiative to represent people with disabilities.

Antronette Yancey, M.D., M.P.H., professor, Department of Health Services, University of California, Los Angeles School of Public Health, Los Angeles, Calif. Dr. Yancey co-directs the UCLA School of Public Health Center to Eliminate Health Disparities. She served as Director of Public Health for Richmond, Virginia from 1996-98 and was the inaugural director of Chronic Disease Prevention and Health Promotion in Los Angeles. In Los Angeles, Dr. Yancey created one of the first physical activity programs in a local health department. She specializes in the design, implementation and evaluation of community-based health promotion interventions, focusing on high risk, underserved communities and on prevention especially through physical activity. She has published extensively on changing social and cultural environments to promote physical activity; requirements for successful intervention research; and ways to recruit minority participants in chronic disease prevention trials and interventions.

Weight loss results in a reduction of both fat and muscle

2007-05-07T13:54:00.000-07:00

(HealthDay News) -- Older, overweight women who diet do not experience
reduced physical function and should feel free to try to lose weight by
reducing their calorie intake, U.S. research shows.

"Our results suggest that losing weight through calorie cutting won't lead
to increased disability in older women," lead researcher Dr. Jamehl Demons
of Wake Forest University Baptist Medical Center, said in a prepared
statement.

When older, overweight women diet they may often gain back some of the
weight. But they are still better off than before, noted Dr. Mary F. Lyles,
also at Wake Forest and the lead investigator of a second project that
examined how dieting affects body composition.

The findings of the two projects -- both part of the larger Diet, Exercise
and Metabolism in Older Women (DEMO) study -- were to be presented Friday at
the annual meeting of the American Geriatrics Society in Seattle.

Weight loss results in a reduction of both fat and muscle, and people
naturally lose muscle mass and physical function as they age. This has led
to questions about the safety of older adults dieting in order to lose
weight.

Demons' project looked at 23 obese, postmenopausal women, average age 58,
who were put on a calorie-reduced diet for five months. They lost an average
of 25 pounds, with muscle representing about 35 percent of that weight loss.

"Despite the large amount of muscle loss, their aerobic fitness and their
ability to rise from a chair showed a trend toward improvement," said
Demons, an assistant professor of internal medicine-gerontology.
Furthermore, "Their strength and walking speed did not change. This suggests
that their weight loss through dieting wouldn't be expected to lead to
increased disability," the researcher said.

Lyles' project looked at body composition before and after 30 women were on
a five-month calorie-reduced diet. During that time, the women lost an
average of 25 pounds (about 68 percent fat and 32 percent muscle). A year
later, the women had regained an average of 11 pounds (about 73 percent fat
and 27 percent muscle).

People who consistently engage in high levels of exercise are the most successful at losing weight and keeping it off

2007-05-02T14:24:00.000-07:00

NEW YORK (Reuters) -- People who consistently engage in high levels of
exercise over the long haul are the most successful at losing weight and
keeping it off, a new study shows.

Among a group of overweight men and women participating in an 18-month
weight loss program, those who were still getting 75 minutes of exercise
daily a year after the program ended had lost 26 pounds, compared with 1.8
pounds for people who were exercising less.

But only 13 of the 154 people who completed the study were able to sustain
this level of activity, Dr. Deborah F. Tate of the University of North
Carolina in Chapel Hill and her colleagues found. "Strategies are needed to
help participants maintain high levels of activity over the long-term," she
and her colleagues conclude in a report in the American Journal of Clinical
Nutrition.

The researchers initially assigned 202 people to either a high physical
activity group who aimed to burn 2,500 calories per week (equivalent to a
75-minute walk daily) or standard behavioral treatment, including 30 minutes
of exercise daily, equivalent to 1,000 calories per week.

Twelve and 18 months later, people in the high activity group had lost
significantly more weight than those in the lower activity group.

Although the participants in the high activity group were able to sustain
the 2,500 calorie per week exercise goal during the 18-month study, their
activity level declined once treatment ended, which resulted in no
between-group differences in activity or weight loss at 2.5 years.

However, a small subgroup of people who stuck to the 2,500 calorie per week
exercise regimen after the 18-month treatment period ended maintained a
significantly larger weight loss than those who didn't exercise as much.

People who maintained high levels of exercise were also eating fewer
calories and less fat.

The researchers believe that their e-mails, mailings and phone calls to
study participants for the initial 18 months of the study were successful in
helping them to reach exercise goals; continuing to stay in touch may have
helped them sustain this level of activity.

"It is also possible that sustaining the long-term behavior changes that are
needed for behaviors such as physical activity will require changes in the
larger social and environmental context in which these behaviors occur,

Nutrition standards urged for foods sold in school

2007-04-30T11:16:00.000-07:00

WASHINGTON (AP) -- Millions of children soon could be saying goodbye to regular colas, candy and salty snacks during school hours.

Concerned about the rise of obesity in young people, Congress asked the Institute of Medicine to develop a set of standards for foods that would be available in schools.

The Institute responded Wednesday with a two-tier system designed to encourage youngsters to eat more fruits, vegetables and whole grains and to avoid added sugars, salt and saturated fats.(Check out a list of recommended foods.)

"The alarming increase in childhood obesity rates has galvanized parents and schools across the nation to find ways to improve children's diets and health, and we hope our report will assist that effort," said Virginia A. Stallings, head of the committee that prepared the report.

"Making sure that all foods and drinks available in schools meet nutrition standards is one more way schools can help children establish lifelong healthy eating habits," said Stallings, director of the nutrition center at Children's Hospital of Philadelphia, Pennsylvania.

"Foods and beverages should not be used to reward or to discipline for academic activities or behavior," she added.

And don't think their recommendation applies only to children. The committee also urged that Parent Teacher Associations adhere to the same standards, as should food items sold at school fund raisers.

Bag lunches not affected

Foods sold in school cafeterias under federally assisted lunch programs already must meet nutritional standards. The IOM recommendation covers items considered competitive with those foods, such as items sold in vending machines and other food and drinks sold in the school but not under the federal program, an area often profitable for the schools.

The standards would not apply to bag lunches that students bring from home.

The report now goes to Congress for consideration. Copies will also go to the Departments of Agriculture, Health and Human Services and Education and it will be available for state and local school boards and administrators and the food and beverage industry. Putting the recommendations into practice would involve federal, state or local laws and setting school standards and policies.

The report drew prompt praise and criticism.

Sen. Tom Harkin, D-Iowa, said: "For the first time, we have gold-standard recommendations for school nutrition standards from one of America's most distinguished scientific bodies. And as it turns out, they are also just common sense -- promoting fruit and vegetable consumption, and also seeking to reduce things like calories, fat, and sodium."

Harkin, chairman of the Senate Agriculture Committee, said the "recommendations offer a tool kit for local, state, and federal policy-makers who already know that we need to do more much more -- to promote sound child nutrition and prevent childhood obesity."

The School Nutrition Association, which represents school food service directors, applauded the report but said it believes "it will be ineffective in making change happen.

"Any voluntary guidelines, such as those of this report, are unenforceable and present a major challenge for schools to incorporate," the Association said.

The Center for Consumer Freedom worried that the report could lead to a government "no child with a fat behind" program.

Response is mixed

The growing rate of obesity is caused by lack of physical activity rather than overeating, argued the group, which describes itself as representing restaurants, food companies and individuals.

"These decrees may seem surreal, but many schools have already implemented similar measures. Birthday celebrations are a thing of the past with cupcakes banned in classrooms across the nation. Many schools forbid parents from bringing their kids fast food," the Center said in a statement.

On the other hand the Center for Science in the Public Interest, which describes itself as promoting nutrition, food safety and a healthy lifestyle, welcomed the report.

"Congress should support parents and protect kids by having USDA bring its disco-era standards into line with modern science," said CSPI nutrition director Margo C. Wootan.

The American Beverage Association, which represents companies that make and sell nonalcoholic beverages, said it is already working with schools to "improve the product mix" sold in schools by reformulating products, changing packaging, retrofitting vending machines and working with school districts.

This is a time-consuming process which should be complete by the 2009-2010 school year, the Association said.

Foods listed as Tier 1 would be allowed at all grade levels during the school day and during after-school activities.

These foods would have to provide at least one serving of fruits, vegetables, whole grains or nonfat or low-fat dairy, would be limited to 200 calories for snacks and would have limits for fat, sugar and salt.

Examples of Tier 1 snacks were whole fruit, raisins, carrot sticks, whole-grain low-sugar cereals, some multigrain tortilla chips, some granola bars and nonfat yogurt with no more than 30 grams of added sugars. Entrees could include such items as fruit salad with yogurt or a turkey sandwich. Beverages would be limited to plain water, skim or 1 percent milk, soy beverages and 100 percent fruit or vegetable juice.

The IOM recommended that, because of their calorie content, juices be limited to 4-ounce servings for elementary and middle-school students and 8-ounce portions for high school students.

Tier 2 foods would be available only to high school students and only after school hours.

These foods would also be limited in calories, salt, sugar and fat and the drinks could have just have five or fewer calories per portion and no caffeine; they are not vitamin- or mineral-fortified, but may be carbonated and may contain flavoring or a sugar substitute.

Examples include single servings of baked potato chips, low-sodium whole wheat crackers, graham crackers, pretzels, caffeine-free diet soda and seltzer water.

Sports drinks would be available to students engaged in an hour or more of vigorous athletic activity, at the discretion of coaches.

The committee said fortified water should not be available in either tier.

The Institute of Medicine is a branch of the National Academy of Sciences, an independent organization chartered by Congress to advise

Weighing in on weights

2007-04-30T10:49:00.000-07:00

Jessica Belasco
Express-News

The clients at Tracey Keller's gym work hard. Leg presses, seated dips, shoulder presses, lat pulldowns. It's a workout that would make an adult sweat.

But most of Keller's clients are in still in elementary school.

"We want them to come in, have fun, knowing (exercise) doesn't have to be something they dread. It can be fun and hopefully change their life," says Keller of Kids Get Fit, a small gym for kids ages 5-15 on Blanco Road.

Gyms for kids are nothing new — the Little Gym, for example, offers gymnastic instruction to young children. But Kids Get Fit, opened by Keller and her business partner, Tracy Chaco, in November, may be the only gym in San Antonio that offers gym-style strength training for prepubescent kids. The kids do a weight circuit (a la Curves) on machines manufactured especially for children by Hoist Fitness Systems.

It was once believed that pumping iron could hurt the growth plates in young children's bones. But the American College of Sports Medicine, the National Strength and Conditioning Association and the American Academy of Pediatrics have given it the green light.

The latter states that "strength training programs for preadolescents and adolescents can be safe and effective if proper resistance training techniques and safety precautions are followed." But, AAP warns, children should "avoid competitive weight lifting, power lifting, body building and maximal lifts until they reach physical and skeletal maturity."

Despite the proven safety, weight training for kids remains controversial. Some experts think machines and free weights are for adults only.

Kids' fitness is a growing trend, and children younger than 18 represent the second-fastest-growing demographic of health-club membership, according to the International Health, Racquet & Sportsclub Association. The trade group estimates that one-third of health clubs in the country offer children's programs, some of which include weight training.

Sarah Kennington brings her home-schooled daughters, 9-year-old Hannah and 10-year-old Hope, to Kids Get Fit three or four days per week. Kennington likes the organized circuit program. "For homeschooling purposes, we needed P.E., and this is perfect," she says.

Her daughters were all smiles as they followed other kids to machine after machine.

"The circuit is fun. Sometimes it's easy, sometimes it's hard," Hannah said after her workout — which Keller monitored, as she monitors every kid's workout.

"Under supervision, it's probably the safest activity a child can do, at least according to the results of the injury data," says Wayne Westcott, Ph.D., senior fitness/research director at the South Shore YMCA in Quincy, Mass.

Westcott, who served on the President's Council on Physical Fitness and Sports during the Reagan administration and has studied the effects of strength training on kids for more than 20 years, says it can improve strength, strengthen bones, raise metabolism to burn more calories and boost self-confidence, especially among obese children, who don't do well in competitive sports.

Westcott's program, implemented at the YMCA and many school districts in Massachusetts, consists of 15 to 20 minutes of strength training twice a week paired with aerobic conditioning. The kids do one set each of 8-10 basic exercises, focused on the major muscle groups. He recommends that kids be at least 7 years old so they can follow directions.

CATZ Sports San Antonio, a new training center for athletes up to age 17, offers sports-specific weight training and emphasizes building strong muscles and joints to prevent injuries from overuse.

At the facility, part of a national chain, kids use different methods of resistance training. They use their own body weight while doing sit-ups, pushups, lunges and squats. Or they step up on high boxes to work their lower body muscles and roll on an Ab Dolly to increase core strength. They also play with weighted balls. The goal is increasing endurance as well as strength.

"Strength training isn't necessarily bulking up," says Dr. Shaylon Rettig, president of CATZ Sports San Antonio. "If you want to make your muscles work for longer periods of time, that is a form of strength training."

Dr. David Schmidt endorses sports-specific training for kids, but otherwise he doesn't think the effort of weight training is worth it.

"The effectiveness of weight training at a young age is not very high, particularly in males, until their testosterone levels get up a little higher," say Schmidt, team physician for the San Antonio Spurs and doctor at Sports Medicine Associates of San Antonio. "The work they put in is not as efficient."

Stevan Falk has his own concerns with strength training for kids.

"It's not that it's dangerous, it's just totally unnecessary and stupid," says Falk, owner of Bikram Yoga San Antonio and strength conditioning coach at Trinity University. "You're asking them to do something very boring and totally unnecessary. Kids need to be outside playing leapfrog and climbing trees."

Instead of sending their kids to a gym, Falk says, parents should send them outside to get fit the old-fashioned way: playing like kids. It's lack of activity and unhealthy eating habits that have caused the rise in childhood obesity, he says, not lack of weight training.

"The fact that we're even discussing whether a kid should be doing strength training is a tremendous comment on what's going on in our society today," he says.

Overweight and Overlooked: A Hidden Heart Risk for Kids

2007-04-27T13:41:00.000-07:00

Ron Winslow, Wall Street Journal

Heart researchers say they have uncovered a surprising development in the
obesity epidemic: Overweight children who go undiagnosed at the doctor's
office but who are in fact in the early stages of heart disease.

At Cincinnati Children's Hospital Medical Center, researchers found that a
number of kids viewed as normal, healthy children by their parents and even
the medical staff at the hospital were later found to have enlarged hearts
-- a thickening in the wall of the main pumping chamber. Even some children
under 10 years old showed signs of the condition, known as left ventricular
hypertrophy, or LVH.

When researchers went back later to look for clues, they calculated these
children's body mass indexes and found that many were actually overweight.
Research has previously detected enlarged hearts in children, but generally
in those who were clearly obese. What surprised the Cincinnati Children's
researchers is that they found LVH in children whom doctors hadn't initially
deemed overweight.

Given the attention on childhood obesity today, how could doctors not notice
that these kids were heavy? One argument is that there are so many of them.

"We've grown so accustomed to an overweight child walking into the exam room
that we've lost our visual representation of what a normal child is supposed
to look like," says Tom Kimball, a pediatric cardiologist at the hospital.
In short, overweight is the new "normal."

Doctors rarely look for enlarged hearts in kids. But in adults, LVH is an
important sign of heightened risk of cardiovascular disease. The worry in
kids is that, left unmanaged, these early physical changes to the heart
could set children on a life course for premature coronary artery disease
and heart attacks.

"We found that kids we consider 'normal' actually are not, from a
cardiovascular standpoint," says Sandy Witt, a cardiac sonographer at
Cincinnati Children's. "But no one is alerting the children or the families.
Even for the physician, it is going under the radar."

Spurred by the concerns about overlooked obesity in kids, Ms. Witt and her
colleagues conducted further research that showed an overall rise in
children's BMIs in recent years, and linked high BMI with risk for an
enlarged heart.

The report, which researchers presented at the recent American College of
Cardiology meeting in New Orleans, is based on a comparison of children that
doctors viewed as normal during the past three years with a similar group
from the late 1980s.

The findings heighten the stakes in an already intense struggle under way in
homes, schools and communities over how to encourage kids and their families
to change eating, exercise and other habits to promote better health.

Dr. Kimball says fewer cases of overweight children would be missed if
doctors routinely calculated their patients' body mass index -- a ratio
based on height and weight. Both the American Academy of Pediatrics and the
U.S. Centers for Disease Control and Prevention recommend doctors chart and
track BMI for children, but the indicator isn't perfect and for a variety of
reasons, not widely used, Dr. Kimball says. For one, muscle mass can vary
widely in kids.

Though there are exceptions, those whose BMI is above the 95th percentile
for their age are generally considered overweight; above the 85th percentile
is at risk of being overweight.

Dr. Kimball and his colleagues conducted the study after making a curious
observation among some 50 seemingly normal children who were recruited to
serve as a control group for a clinical study. The trial was to look at the
effect of high blood pressure on children's hearts. As part of the
assessment, researchers took the kids' height, weight and blood pressure,
but didn't calculate their BMI or otherwise identify them as overweight.
They didn't look overweight, says Ms. Witt, the sonographer.

But when the researchers performed an echocardiogram -- an ultrasound image
of the heart -- they found that in many of the kids their hearts were
enlarged. "None of these kids seemed to be somebody who would have that,"
she says. In trying to understand why the children's hearts were enlarged,
researchers calculated the BMIs. "They all seemed like normal, healthy kids,
but when we calculated their BMI, they weren't normal."

Many of these recruits were children of doctors and other staff at the
hospital. When they were told about the echocardiogram findings, "it came as
a surprise to them," says Ms. Witt.

The researchers figured that a look at a previous generation of the
hospital's patients might offer an answer, she says.

Using the hospital's database, they culled data on 465 children between the
ages of 2 and 17 who had undergone echocardiogram exams between 1984 and
1990 -- a period shortly before the sharp rise in childhood obesity began --
and 548 kids of similar age from the current era, 2004 to 2006. All told,
the study included 559 boys and 444 girls.

The kids had all been deemed healthy from a cardiovascular standpoint. Kids
in each group had been evaluated for heart murmurs or chest pain that turned
out not to have a cardiac cause and they had been found to be free of any
signs of heart disease. The researchers compared them on both BMI and what
their echocardiograms revealed about thickening in their left ventricles.

Body mass index among kids in the most recent group was 18.8 on average,
compared with 17.9 in the group from the 1980s. The echocardiograms revealed
a 10% increase in left ventricular mass in the current group compared with
their earlier counterparts.

While body mass in children is influenced by numerous factors, the
researchers said that even after accounting for two prominent ones -- male
gender and age -- the higher body mass index among the kids in the study
correlated significantly with enlarged hearts. "The higher your BMI, the
worse your hypertrophy," Dr. Kimball says.

Exactly what impact that has on future risk isn't clear. "I don't think
anybody has data on how this would translate into cardiovascular issues as
adults," Dr. Kimball says. But it was enough to prompt him to change his
practice. He now carefully charts his patients' BMI and counsels them and
their parents about weight-losing strategies.

The study has limitations. For one, it looked at a limited, nonrandom group
of kids -- all treated at Cincinnati Children's and mostly from southwestern
Ohio and northern Kentucky.

But Christopher Bolling, medical director of the hospital's
weight-management center who was in private practice until 18 months ago,
believes many kids aren't getting appropriate advice in community doctors'
offices either.

"Pediatricians don't know how to bring it up with parents," Dr. Bolling
says. "They're afraid to alienate them or they don't know where to send
them" for help.

The good news is that other research indicates that by losing weight, kids
can reverse the deleterious physical effects on the heart as well as other
weight-related risks for cardiovascular disease.

In a recent study of extremely obese adolescents who underwent bariatric
surgery to treat their condition, weight loss led to a shrinking of the
hypertrophy, says Holly Ippisch, a pediatric cardiologist also at Cincinnati
Children's. She says such benefits would occur regardless of how children
shed weight.

"The important thing is to lose the weight," she says.

People who exercise regularly may be less likely to develop Parkinson's disease

2007-04-24T10:39:00.000-07:00

People who exercise regularly may be less likely to develop Parkinson's
disease -- but leisurely strolls may not be enough.

That news comes from a study of more than 143,300 U.S. men and women who
were followed from 1992-2001.

When the study started, participants were 63 years old, on average. They
reported their weekly hours of light exercise (walking or dancing) and
moderate to vigorous exercise (jogging, running, swimming, bicycling,
playing tennis or racquetball, or doing aerobics or calisthenics).

A total of 413 participants were diagnosed with Parkinson's disease by the
end of the study.

The most active participants were the least likely to develop Parkinson's
disease in the next decade, according to the researchers, who included Evan
Thacker, SM, of Harvard School of Public Health.

Exercise and Parkinson's

"The most important thing we learned from this study was that high levels of
moderate to vigorous recreational physical activity (like biking, swimming,
aerobics, etc.) were associated with lower Parkinson's disease risk,"
Thacker tells WebMD.

"Those with the highest levels of recreational physical activity at the
beginning of the study had a lower risk of getting Parkinson's disease over
the next 10 years, compared to the people with low levels of recreational
physical activity or none at all," says Thacker.

Thacker will present the study in Boston on May 1, 2007 at the American
Academy of Neurology's 59th annual meeting. How Much Exercise?

The drop in Parkinson's disease risk was only seen in people who got a lot
of moderate to vigorous exercise.

"People who reported the highest levels of recreational physical activity in
the study were doing about the equivalent of 5-6 hours of aerobics or 3-4
hours of lap swimming each week ," says Thacker.

"Their Parkinson's disease risk was 40% lower than the people who reported
zero physical activity, or only light activities like walking," he says.

Exercise Intensity Mattered

"Light physical activity such as walking or dancing was not related to
Parkinson's disease risk at all," says Thacker.

"On the other hand," he says, "higher participation in moderate to vigorous
activities such as biking, lap swimming, jogging, etc., was associated with
lower Parkinson's disease risk."

No particular form of moderate to vigorous exercise stood out as being best.

"The amount of time spent and the overall level of intensity were more
important than the specific activity," says Thacker.

Study's Limits

The study was purely observational. That is, participants weren't asked to
exercise.

The researchers considered participants' age, gender, and smoking -- but
they can't rule out the possibility that other factors influenced the
results.

Thacker and colleagues aren't blaming Parkinson's disease on insufficient
exercise. Their study also doesn't promise that exercise will prevent
Parkinson's disease.

Many factors may affect the odds of developing Parkinson's disease, and
doctors often don't know precisely why someone develops Parkinson's disease.

"Our study is just one piece in a complicated puzzle of discovering what
might prevent Parkinson's disease," says Thacker.

SOURCES: American Academy of Neurology's 59th Annual Meeting, Boston, April
28-May 5, 2007. Evan Thacker, SM, Harvard School of Public Health.

"Glycemic load" of diet has no effect on weight loss

2007-04-20T12:27:00.000-07:00

NEW YORK (Reuters Health) - When it comes to losing weight, the number of
calories you eat, rather than the type of carbohydrates, may be what matters
most, according to a new study.

The findings, published in the American Journal of Clinical Nutrition,
suggest that diets low in "glycemic load" are no better at taking the pounds
off than more traditional -- and more carbohydrate-friendly -- approaches to
calorie-cutting.

The concept of glycemic load is based on the fact that different
carbohydrates have different effects on blood sugar. White bread and
potatoes, for example, have a high glycemic index, which means they tend to
cause a rapid surge in blood sugar. Other carbs, such as high-fiber cereals
or beans, create a more gradual change and are considered to have a low
glycemic index.

The measurement of glycemic load takes things a step further by considering
not only an individual food's glycemic index, but its total number of
carbohydrates. A sweet juicy piece of fruit might have a high glycemic
index, but is low in calories and grams of carbohydrate. Therefore, it can
fit into a diet low in glycemic load.

However, the effort of figuring out what's an allowable carb might not be
worth it, if the new study is any indication.

Principal investigator Dr. Susan B. Roberts, of Tufts University, Boston,
and colleagues found that a reduced-calorie diet, whether glycemic load was
high or low, was effective in helping 34 overweight adults shed pounds over
one year.

Study participants who followed a low-glycemic-load diet ended up losing
roughly 8 percent of their initial weight, as did those who followed a
high-glycemic-load diet.

"The bottom line is that in this study we don't see one single way to eat
that is better for weight loss on average," Roberts told Reuters Health. Of
course, that doesn't mean "anything goes" as long as you're cutting
calories."

A super-sized serving of French fries won't do any dieter any good, she
noted.

Both diets her team used in the study were carefully controlled. For the
first 6 months, participants were provided with all the food they needed,
and both diets were designed to cut their calories by 30 percent while
providing the recommended amount of fiber, limiting fat and encouraging
healthy foods like fruits and vegetables.

The comparable outcomes suggest that, among healthy diets, no single one
stands out as better, according to Roberts. So the focus should be on
calories, rather than specific foods to avoid or include.

"Focusing on calories is something we need more of, especially when portion
sizes are so absurd," Roberts said, referring to the portions served at so
many U.S. restaurants.

This doesn't mean, however, that there's no place for diets that focus on
glycemic load, according to the researcher. Some studies, for example, have
found that low-glycemic index foods might help control blood sugar in people
with type 2 diabetes.

And in their own research, Roberts said she and her colleagues have found
that low-glycemic index diets do seem more effective for overweight people
who naturally secrete high levels of the hormone insulin, which regulates
blood sugar.

SOURCE: American Journal of Clinical Nutrition, April 2007.

CDC Data Says Number Of Severely Obese People Highest In Last Few Years

2007-04-13T12:53:00.000-07:00

Nidhi Sharma - All Headline News Staff Writer

Washington D.C. (AHN) - A recent study by the Centers for Disease Control and Prevention has found that there has been a sudden increase in the proportion of extremely obese Americans, whose body mass index is 40 or more.

Recent data by CDC says that extremely overweight people have increased by 50 percent from 2000 to 2005, twice as fast as the increase in moderate obesity. Also during the same time, the proportion of overweight people (BMI of 30 or more) increased by 24 percent, and the proportion of those with a BMI of 50 or more increased by 75 percent.

In the past 20 years, this has been the highest percentage increase ever to have occurred in the heaviest weight groups.

According to experts, a body mass index, or BMI, is a ratio of weight to height and those men who weigh 300 pounds at a height of 5 feet 10 inches are considered morbidly obese. However a severely obese woman is described as the one who weighs 250 pounds at a height of 5 feet 4 inches.

Experts have expressed their concern over the sudden increase of people whose BMI are higher than normal despite increased public awareness on the risks of obesity and the increased use of drastic weight loss strategies.

CDC data also added that nearly three percent of Americans are severely obese and health officials are worried over the health costs for severely obese people that are expected to be double that of normal weight people. In comparison, health costs for moderately obese people are expected to be 25 percent more.

People who are very obese are at increased risks for diabetes, heart disease, cancer and many other diseases. The total economic costs of obesity in the nation is pegged at more than $100 billion annually.

'Fat' gene found by scientists

2007-04-13T10:33:00.000-07:00

A gene that contributes to obesity has been identified for the first time, promising to explain why some people easily put on weight while others with similar lifestyles stay slim.

People who inherit one version of the gene rather than another are 70 per cent more likely to be obese, British scientists have discovered. One in six people has the most vulnerable genetic make-up and weighs an average 3kg more than those with the lowest risk. They also have 15 per cent more body fat.

The findings provide the first robust link between a common gene and obesity, and could eventually lead to new ways of tackling one of the most significant causes of ill health in the developed world. One in four British adults is classified as obese, and half of men and a third of women are overweight.

Obesity is a main cause of heart disease, cancer and type 2 diabetes. An adviser to the Government’s health spending watchdog said recently that the condition was a bigger national danger than smoking, alcohol or poverty.

If the biological function of the gene, known as FTO, can now be understood, it could become possible to design drugs that manipulate it to help people to control their weight. “Even though we have yet to fully understand the role played by the FTO gene in obesity, our findings are a source of great excitement,” Mark McCarthy, of the University of Oxford, who led the research, said.

“By identifying this genetic link it should be possible to improve our understanding of why some people are more obese, with all the associated implications such as increased risk of diabetes and heart disease. New insights will hopefully pave the way for us to explore novel ways of treating this condition.”

While it has long been understood from family studies that obesity is heavily influenced by genetics, scientists have struggled to pin down individual genes that are involved.

A handful of serious genetic mutations that cause rare obesity disorders such as Prader-Willi Syndrome have been found, but the search for common genes that affect an ordinary person’s risk of becoming obese or overweight has remained elusive.

The effect of FTO emerged from a key study of the genetic origins of disease funded by the Wellcome Trust known as the Case Control Consortium, in which 2,000 people with type 2 diabetes had their genomes compared to 3,000 healthy controls.

Scientists from Oxford and the University of Exeter first found that certain versions of the FTO gene were more common among people with type 2 diabetes, but that the effect disappeared when the data were adjusted for obesity. This led them to wonder whether FTO really influenced obesity instead, and they followed up their theory in a further 37,000 people.

FTO comes in two varieties, and everyone inherits two copies of the gene. The team found that those who inherit two copies of one variant — 16 per cent of white Europeans — were 70 per cent more likely to be obese than those who inherited two copies of the other variant. The 50 per cent of subjects who inherited one copy of each FTO variant had a 30 per cent higher risk of obesity.

Those in the highest risk group weighed an average of 3kg (7lb) more and those at medium risk were an average of 1.2kg heavier. In each case the extra weight was entirely accounted for by more body fat, not greater muscle or extra height. The results, published in the journal Science, apply to men and women, and to children as young as 7.

FTO will not be the only gene that influences obesity, and inheriting a particular variant will not necessarily make anyone fat. “This is not a gene for obesity, it is a gene that contributes to risk,” Professor McCarthy said.

The research involved too many people to control for exercise and diet, so it is not yet known whether FTO affects how much people eat or how active they are. But it may explain how people with apparently similar lifestyles differ in propensity to put on weight.

Independent experts called the discovery highly significant. Susan Jebb, of the MRC Human Nutrition Unit, said: “This research provides clear evidence of a biological mechanism which makes some people more susceptible to gaining weight in a world where food is plentiful and sedentary lifestyles the norm.”

Genetic trigger

— The FTO gene comes in two varieties. 16% of people have two copies of the high-risk variant, 50% have one high-risk and one low-risk, and 34% of people have two low-risk variants

— Those with two high-risk copies have a 70% greater risk of obesity than those with two low-risk copies. They weigh an average of 3kg more

— Those with one high-risk copy have a 30% greater risk of obesity. They weigh an average of 1.2kg more

Small Steps Lead to Healthier Hearts for Women

2007-04-09T13:32:00.000-07:00

But many still don't know cardiovascular disease is their biggest enemy

By Dennis Thompson
HealthDay Reporter

SUNDAY, April 8 (HealthDay News) -- For years, doctors have been fighting the perception that heart disease is a mainly male affliction.

But, in fact, cardiovascular disease is the number one killer of both men and women in the United States, according to the National Institutes of Health. Two of every five women who die are taken by heart disease or stroke, more than from all forms of cancer combined.

Now, health officials are broadening their push to educate more women about their heart risks. The renewed campaign follows an American Heart Association study, initially done in 1997, that found that only 30 percent of women were aware that heart disease and stroke were their greatest health threats. A follow-up survey released last year found that number had climbed to 55 percent.

"The problem I see is that, yes, women are much more knowledgeable, but they aren't translating that knowledge into action," said Dr. Jennifer Mieres, director of nuclear cardiology and associate professor of clinical medicine at New York University School of Medicine, and a national spokeswoman for the American Heart Association. "That's where the disconnect is."

The heart association continues to push its "Go Red for Women" campaign, which includes an online self-survey to evaluate an individual woman's specific risk factors.

"That way, women can increase their thought process about their risk factors," said Dr. Nieca Goldberg, a cardiologist and associate professor of medicine at New York University, and medical director of the university's Women's Heart Program. "We still have to get women to take the plunge to personalize it. If you ask the average woman on the street, she will not say, 'It's going to affect me.' "

A big part of the problem is that women often don't experience a heart attack the same way men do.

"Women's symptoms can be more subtle," Goldberg said. "It can be shortness of breath without any chest pain. Some suddenly feel very exhausted with minimal activity. Pain often is felt lower in the chest and mistaken for a stomach problem."

Because the symptoms are less obvious, women often wait too long to get treatment.

"If you look at statistics of women who've died suddenly of heart attack, two-thirds died before they could reach the hospital," Goldberg said.

Heart disease also often takes place in women differently than it does in men, Goldberg added.

In men, plaque forms on the walls of blood vessels in specific places, eventually causing a "kink" in the vessel that stops blood flow. To treat it, doctors implant a stent -- an artery-opening mesh tube -- at the point of blockage, which reopens the blood vessel.

But as many as 30 percent of women suffer from micro-vascular coronary disease, Goldberg said. The plaque distributes more evenly throughout the blood vessels, slowing blood flow without creating a flow-stopping kink.

In those cases, arteries have difficulty dilating during exercise or exertion, causing extreme fatigue in women.

"When women go to have an angiogram, there have been situations where doctors don't see any blockages, even though the patient has symptoms and a bad stress test," she said.

Since there's no specific blockage, treating micro-vascular coronary disease is much harder.

"When doctors go in to look, there are no kinks, so they can't be stented," Goldberg said. "Women are given drugs to thin the blood and take care of symptoms, as well as reduce cholesterol levels."

Since heart disease is often harder to detect and harder to treat in women, prevention is the key to saving most women's lives. Women need to take a hard look at their risk factors, Mieres and Goldberg said.

"If they can't recite their cholesterol levels or blood pressure, they need to schedule a visit with their doctor because that shows those probably haven't been checked in a while," Goldberg said.

Women also should consider whether or not a relative has had heart disease. There is a genetic risk involved, and family members often share the same lifestyle risks, such as drinking, smoking or eating unhealthy foods.

Once that risk is known, women can take steps to improve their health, Mieres said.

Mieres recommends taking small steps that lead to big ones -- walking 10 minutes a day and increasing that to 30 minutes, or eating an apple for a snack instead of a candy bar.

"Everyone thinks it's so overwhelming in terms of making lifestyle changes," Mieres said. "Doctors want women to realize that simple steps can make a world of difference in terms of your heart health."

More information

For more information on the "Go Red for Women" campaign, visit the American Heart Association.

SOURCES: Nieca Goldberg, M.D., cardiologist and associate professor of medicine, New York University, medical director of the university's Women's Heart Program, and author of The Women's Healthy Heart Program; Jennifer Mieres, M.D., director of nuclear cardiology, and associate professor of clinical medicine, New York University School of Medicine, New York City, and a national spokeswoman, American Heart Association

Obesity Doubles Odds of Prostate Cancer Mortality

2007-03-21T08:16:00.000-07:00

SEATTLE, March 15 -- Obese men diagnosed with prostate cancer in middle age are at a 2.6-fold higher risk of dying from the disease than are patients of normal weight, according to a case-control study.

Surprisingly, the increased prostate-cancer-specific mortality risk was independent of treatment and key prognostic factors at diagnosis, including disease grade and stage, reported Alan R. Kristal, Dr.P.H., of the Fred Hutchinson Cancer Research Center here, and colleagues, in the March 15 issue of Cancer.

Epidemiology data has consistently indicated a modest increase in prostate cancer mortality among men with a body mass index (BMI) of 30 kg/m² or greater. However, it was unclear whether the effect was due to poor prognostic factors or an effect on progression after treatment.

So, the researchers looked at 752 men ages 40 to 64 with newly diagnosed, histologically confirmed prostate cancer in the Seattle-Puget Sound Surveillance, Epidemiology, and End Results (SEER) cancer registry.

The men reported their pre-diagnosis height and weight in a baseline interview and were followed through the registry for an average of 9.5 years.

The mean BMI was 26.7 kg/m², and 17.0% of the men were obese. About a quarter had regional- or distant-stage prostate cancer at diagnosis (27%), and 14% had Gleason scores of 7 or higher. Most underwent radical prostatectomy as the primary treatment (63%).

During follow-up, 50 men died of prostate cancer, 64 died of other causes, and 36 developed metastases.

The researchers found that obesity at diagnosis significantly increased risk of prostate-cancer-specific mortality (hazard ratio 2.64, 95% confidence interval 1.18 to 5.92, P=0.03 for trend) after controlling for age, race, smoking status, and clinical prognostic factors at baseline. Mortality from other causes was not linked to BMI (P=0.40).

The prostate-cancer-specific mortality rates were:

6.5 per 1,000 person-years for normal or underweight men (BMI less than 25 kg/m²).
5.4 per 1,000 person-years for overweight men (BMI 25 to 29.9 kg/m²).
13.0 per 1,000 person-years for obese men.

When the researchers stratified mortality by BMI categories, the adjusted findings were:

No significant associations between obesity and Gleason score (P=0.72 for interaction), cancer stage (P=0.78 for interaction), or serum prostate specific antigen level at diagnosis (P=0.11).
No significant trend for higher mortality with higher BMI whether the primary treatment was radical prostatectomy (P=0.26 for trend) or androgen-deprivation therapy only (P=0.07 for trend).
No significant association between mortality and androgen-deprivation therapy use (P=0.32 for interaction) though there was a suggestion that the risk was higher among those that did not receive it (HR 15.92, 95% CI 1.37 to 85.18).

Obesity also significantly increased the risk of metastasis for men diagnosed with local- or regional-stage disease (HR 3.61, 95% CI 1.73 to 7.51, P=0.0006 for trend). This finding did not vary significantly across BMI strata with Gleason score, cancer stage, or primary treatment.

Mechanisms by which obesity could affect cancer outcomes may include altered steroid hormone concentrations, high levels of leptin and other adipokines, and inflammation, Dr. Kristal and colleagues suggested.

They said their findings were unlikely to be biased by the effects of treatment or diagnosis on weight since men reported their pre-diagnosis weight and androgen-deprivation treatment showed no interaction with reported BMI.

However, they noted that such self-reports may have introduced error.

While it is unknown whether weight reduction post-diagnosis could affect prostate cancer outcomes, the researchers said the study suggests that this avenue should be studied.

"Although a randomized clinical trial would be needed to definitively determine whether weight reduction would be an effective adjunct treatment for men diagnosed with prostate cancer," they wrote, "these results provide yet one more important reason for men to adopt healthful patterns of diet and physical activity to achieve and maintain a normal weight."

Study shows why exercise boosts brainpower

2007-03-16T13:27:00.000-07:00

WASHINGTON (Reuters) -- Exercise boosts brainpower by building new brain cells in a brain region linked with memory and memory loss, U.S. researchers reported Monday.

Tests on mice showed they grew new brain cells in a brain region called the dentate gyrus, a part of the hippocampus that is known to be affected in the age-related memory decline that begins around age 30 for most humans.

The researchers used magnetic resonance imaging scans to help document the process in mice -- and then used MRIs to look at the brains of people before and after exercise.

They found the same patterns, which suggests that people also grow new brain cells when they exercise.

"No previous research has systematically examined the different regions of the hippocampus and identified which region is most affected by exercise," Dr. Scott Small, a neurologist at Columbia University Medical Center in New York who led the study, said in a statement.

Writing in the Proceedings of the National Academy of Sciences, the researchers said they first tested mice.

Brain expert Fred Gage, of the Salk Institute in La Jolla, California, had shown that exercise can cause the development of new brain cells in the mouse equivalent of the dentate gyrus.

The teams worked together to find a way to measure this using MRI, by tracking cerebral blood volume.

"Once these findings were established in mice, we were interested in determining how exercise affects the hippocampal cerebral blood volume maps of humans," they wrote.

They of course could not dissect the brains of people to see if new neurons grew, but they could use MRI to have a peek.

They recruited 11 healthy adults and made them undergo a three-month aerobic exercise regimen.

They did MRIs of their brains before and after. They also measured the fitness of each volunteer by measuring oxygen volume before and after the training program.

Exercise generated blood flow to the dentate gyrus of the people, and the more fit a person got, the more blood flow the MRI detected, the researchers found.

"The remarkable similarities between the exercise-induced cerebral blood volume changes in the hippocampal formation of mice and humans suggest that the effect is mediated by similar mechanisms," they wrote.

"Our next step is to identify the exercise regimen that is most beneficial to improve cognition and reduce normal memory loss, so that physicians may be able to prescribe specific types of exercise to improve memory," Small said.

Health costs will surge without better prevention

2007-03-09T12:48:00.000-08:00

The cost of caring for aging Americans will add 25 percent to the nation's
health care bill by 2030 unless people act now to stay healthy, the U.S.
Centers for Disease Control and Prevention said on Thursday.

Currently, 80 percent of Americans 65 or older have at least one chronic
disease that could lead to premature death and disability, CDC researchers
said.

The report, The State of Aging and Health in America 2007, projects that by
2030, 71 million Americans will be over 65, accounting for 20 percent of the
U.S. population, up from 10 to 11 percent now.

With the cost of caring for older Americans at three- to five-times greater
than care for younger adults, CDC researchers believe policymakers and
individuals should take steps to help aging adults forestall chronic
disease.

"Given the demographics ... the economic impact on healthcare will be
enormous," said Dr. Richard Murray, a vice president at Merck & Co. Inc.,
whose foundation funded the study.

If people adopt healthier lifestyles, they will not develop the expensive,
chronic diseases that raise health costs sharply, such as diabetes, cancer
and heart disease.

"We are going to see an increase in health care costs, but the goal has to
be to restrain the rate of increase. Prevention is the key to that," said
Bill Benson, a health care benefits and policy analyst who advised the CDC
on the report.

The report noted that three behaviors -- smoking, poor diet and physical
inactivity -- caused almost 35 percent of U.S. deaths in 2000.

SHARP REGIONAL VARIATION

Those three behaviors often lead to the development of the nation's leading
chronic diseases: heart disease, cancer, stroke and diabetes, they said.

"Having a chronic disease that's well managed doesn't necessarily put a
person at risk for functional decline, but when someone starts developing
problems, they are much more at risk," said Lynda Anderson, a chronic
disease and aging expert at the CDC.

The report looks at how states are faring in terms of elderly health and
providing preventive care such as immunizations and health screenings and
taking steps to prevent falls, a major risk for the elderly.

"You have some regions that are doing extremely well in a lot of areas and
others that are struggling to get these services to older adults," she said.

Elderly people in Hawaii, for example, are likely to fare better in many key
measures of health. The state ranked best in overall health, mental health,
and disability and had the lowest percent of obese elderly. But Hawaii
ranked last in terms of screening for colorectal cancer.

West Virginia ranked worst in terms of overall health, oral health and
disability, while Kentucky had the highest level of elderly people reporting
mental health problems. Louisiana reported the highest levels of obesity,
with more than 25 percent of the elderly population considered obese.

"There are certainly areas that we need to really pay attention to,"
Anderson said.

She hopes the data will give state policymakers the right tools to start
building prevention programs now, before chronic disease begins.

"We have the opportunity for prevention," Merck's Murray said. "We need to
be serious about it."

Exercise Helps Slow Smokers' Lung Function Decline

2007-03-06T09:05:00.000-08:00

Activity levels tied to 21% drop in new cases of chronic obstructive pulmonary disease

THURSDAY, March 1 (HealthDay News) -- Moderate to high levels of regular exercise may help slow lung function decline in smokers and lower their risk of developing chronic obstructive pulmonary disease (COPD), a Spanish study suggests.

Researchers publishing in the March issue of the American Journal of Respiratory and Critical Care Medicine examined the physical activity, smoking history and lung function of nearly 6,800 people over 11 years. None of them had COPD at the start of the trial, but 928 of the participants developed the lung disease during the study.

The researchers found that moderate to high levels of exercise among smokers in the study were associated with a 21 percent decline in potential new cases of COPD. They believe that regular exercise suppresses the production of inflammatory markers in the lungs caused by smoking.

It had been believed that quitting smoking and reducing occupational exposure to smoke were smokers' only options for slowing lung function decline. This study showed that exercise may provide another important option, the study authors said.

"The interaction between physical activity and smoking should be taken into account when projecting the future burden of this respiratory disease," researcher Dr. Judith Garcia-Aymerich, of the Center for Research in Environmental Epidemiology at the Institut Municipal d'Ivestigacio Medica in Barcelona, said in a prepared statement.

COPD, the fourth leading cause of death in the United States, results from chronic bronchitis and emphysema. Smoking is the primary cause of COPD.

Obesity May Trigger Earlier Puberty for Girls

2007-03-06T08:52:00.000-08:00

Breast development at 9 linked to weight gain in younger years, study finds

MONDAY, March 5 (HealthDay News) -- Childhood obesity may lead to earlier onset of puberty for girls, a U.S. study concludes.

The study of 354 girls from 10 different regions in the United States found that increased body fat in girls as young as age 3 and large increases in body fat between the age of 3 and the start of first grade were associated with earlier puberty, defined as the presence of breast development by age 9.

"Our finding that increased body fatness is associated with the earlier onset of puberty provides additional evidence that growing rates of obesity among children in this country may be contributing to the trend of early maturation in girls," study lead author Dr. Joyce Lee, a pediatric endocrinologist at the University of Michigan, said in a prepared statement.

Her team published the findings in the March issue of Pediatrics.

Lee noted that girls in the United States are entering puberty at younger ages than they were 30 years ago. Over that same time, there's been a significant increase in obesity rates among American children.

"Previous studies had found that girls who have earlier puberty tend to have higher body mass index (BMI), but it was unclear whether puberty led to the weight gain or weight gain led to the earlier onset of puberty. Our study offers evidence that it is the latter," said Lee, who is also assistant professor in the department of pediatrics and communicable diseases at the U-M Medical School.

"Beyond identifying how obesity causes early puberty, it's also important to determine whether weight control interventions at an early age have the potential to slow the progression of puberty," she noted.

BabyCenter, LLC, is the leading online resource for new and expectant parents

2007-03-02T08:14:00.000-08:00

SAN FRANCISCO, Feb. 22 /PRNewswire/ -- According to BabyCenter, LLC,
("BabyCenter") the leading online resource for new and expectant parents, a
majority of women increase their focus on health, fitness and nutrition once
they become a mother, than before they planned to conceive and/or had a
child. New research shows approximately 65 percent of women exercise more or
try to exercise more since becoming mothers, and 82 percent reported eating
healthier since becoming a mom.

"We found that becoming a mom is a catalyst for getting healthy. Women begin
making diet and exercise changes during pregnancy and those changes stay
with them long after the baby is born. In our survey, three out of four
women say they change their eating habits during pregnancy and after their
kids are born, and more than half say they exercise more since becoming
moms," said Linda Murray, editor in chief, BabyCenter. "Motherhood is good
for your health."

BabyCenter(R) recently surveyed approximately 600 members looking for
greater insight on the role of health and nutrition in women in the
preconception and pregnancy stages. The research, conducted in partnership
with AVEENO(R) Baby, a Johnson & Johnson Consumer Products Company brand and
leader in ACTIVE NATURALS(R) technology, found of the 40 percent of members
planning to begin or expand their family in 2007, there was an overall
commitment to healthier lifestyles whether trying to conceive, while
pregnant, or while caring for a baby or toddler.

More than 75 percent of the women in the survey reported that being
physically fit is somewhat or very important. Most moms, 57 percent,
exercise on a weekly basis, with the majority walking to stay in shape.
Nearly a quarter of pregnant moms say they plan to take yoga.

"Walking is one of the best exercises for moms-to-be. It's safe throughout
pregnancy and easy to start doing even if you've never exercised before.
Regular strolls are also a great stress reliever," said Murray.

Since becoming pregnant, 14 percent of moms increased their amount of
exercise, while 43 percent exercised less often. At least 55 percent of
pregnant moms exercised on their own while their child was occupied or in
the care of others, while 41 percent exercised with their child in or out of
the home. Only eight percent belonged to parent/child interactive exercise
groups...

Watching television disrupts children's' normal response to food

2007-02-26T08:32:00.000-08:00

NEW YORK (Reuters Health) - Watching television disrupts children's' normal
response to food -- they will eat more while they're sitting in front of the
tube, whether or not they're really hungry.

"These data, combined with those from other studies, support recommendations
to reduce television watching and restrict eating while watching television
as part of a healthy lifestyle," Dr. Jennifer L. Temple and colleagues from
the University at Buffalo, New York, conclude.

Temple and her team looked at how television affected "habituation to food
cues." Habituation is the phenomenon that occurs when a person repeatedly
provided with a food will eventually lose interest and stop eating it once
they are full. Providing a new, unfamiliar food can disrupt this process,
and a person will start eating again even if they're not hungry. Non-food
stimuli may also disrupt habituation if a person's attention is distracted.

In the first experiment, the researchers had 30 normal-weight kids ranging
in age from 9 to 12 perform a computer task to earn points to eat food. The
task consisted of 10 two-minute time blocks. For the first 7 blocks, kids
worked for points to eat half a junior cheeseburger. For the final 3, some
children continued to work for pieces of cheeseburger, others worked for
French fries, and the third group worked for cheeseburgers while watching
television.

While the kids who didn't watch television and were continually offered
cheeseburgers as rewards eventually lost interest in the food, the children
offered French fries and those who finished the task while watching
television started eating again, the researchers found.

The television group and the French fry group spent more time responding to
the computer task and consumed more calories than the third group confined
to the same food without the distraction of television.

In the second experiment, researchers provided children with 1,000 calories
worth of a favorite snack food and told them they could eat as much or as
little as they wanted. Some of the children watched a 23-minute television
show, others watched a 1.5-minute repeating loop of a television show, and
the rest didn't watch television.

The researchers theorized that the repeating television loop would not
require the children's constant attention.

The children watching the continuous television show consumed more calories
(500) and spent more time eating (21 minutes) than the television-loop and
the no-television groups combined, the researchers found.

Given that kids tend to eat high-calorie foods when watching television,
snacks in front of the tube have the potential to "profoundly" affect how
many calories children consume, even if the time they spend snacking is
short, the researchers note.

They call for additional research to determine whether television's effect
on habituation is different for normal-weight and overweight kids.

SOURCE: American Journal of Clinical Nutrition, 2007.

U.S. Health-Care Costs to Top $4 Trillion By 2016

2007-02-22T06:57:00.000-08:00

That's a doubling of expenditure in 10 years, according to a new report

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, Feb. 21 (HealthDay News) -- Federal forecasters predict that U.S. health-care spending will double by 2016, to $4.1 trillion per year.

That's one-fifth of the nation's gross domestic product (GDP).

Health spending in 2006 was projected at $2.1 trillion, or 16 percent of the GDP.

"There is a relatively modest and stable projection for 2006 to 2016, with an average growth rate of 6.9 percent," John Poisal, deputy director of the National Health Statistics Group at the Centers for Medicare and Medicaid Services (CMS), said during a Tuesday teleconference. He noted that with projected growth rates falling slightly in 2006 and 2007, "that would result in five consecutive years of slowing growth."

But the projected decelerations didn't impress outside experts.

"We haven't solved the health-care cost problem," stated Karen Davis, president of the Commonwealth Fund. "There was a lot of feeling when the 2006 numbers came out and we were growing at about 7 percent a year, that maybe it wasn't a continuing problem. But, I think even growing at 7 percent a year you see that by 2016 we are going to be spending 20 percent of the nation's economy on health care. I think it says we've got to get serious about doing something that really improves the efficiency of the health-care system and not just shifting money."

Here are other highlights from the report, prepared by CMS actuaries and Medicaid Services and appearing in today's online edition of Health Affairs:

Medicaid spending is expected to reach $313.5 billion in 2006, about the same as in 2005.
Medicaid drug spending is projected to drop 36 percent between 2005 and 2006 as low-income recipients who also are eligible for Medicare start receiving drug coverage through the new Part D program.
With the addition of Part D, total Medicare spending growth is expected to reach $417.6 billion in 2006, up from $342 billion the year before. Medicare spending growth is expected to slow to 6.5 percent in 2007, partly due to legislated cuts in payments to managed-care plans and to physicians. By 2016, Medicare spending is expected to more than double, reaching $862.7 billion.
U.S. prescription drug spending should reach $497.5 billion by 2016, more than double the expected level for 2006. Prescription drug spending will grow at an average annual rate of 8.6 percent until 2016.
The cost of hospital care is expected to climb to more than $1.2 trillion by 2016, vs. $651.8 billion expected for 2006. The growth rate for hospital spending is expected to slow, from 7.9 percent in 2005 to 6.6 percent in 2006.
In 2006, consumers are expected to spend slightly less than 1 percent more in out-of-pocket ($250.6 billion) health-care costs. The total spent will reach $440.8 billion by 2016, however. In 2005, an individual spent an average of $850.02 on health care and in 2006 they are projected to spend $846.50. In 2016, the average spent will be $1,405.73, although that number is not adjusted for inflation, officials said.
Private health insurance premiums are expected to grow 4.4 percent in 2006, down from a high of 11 percent in 2002.
Growth in total physician and clinical spending is expected to slow from 7 percent in 2005, to 6.1 percent in 2006.
Growth in nursing home spending is also expected to slow, from 6 percent in 2005 to 3.4 percent in 2006, largely as a result of slowing Medicaid and Medicare spending.
Home health spending is likely to rise 1.4 percentage points to 12.5 percent in 2006, or $53.4 billion. This would make it the fastest growing area of health care.

Many of the changes reflect cost shifting, Davis said.

"They're trying to deflect costs onto other parties," she said. "What we really need is a transformation of the health-care system that gives us value for the money we're spending. We clearly have to do something about the underlying rising health costs that affect everyone."

More information

There's more on health-care costs at the National Coalition on Health Care.

SOURCES: Karen Davis, Ph.D., president, Commonwealth Fund, New York City; Feb. 20, 2007, teleconference with John Poisal, deputy director, National Health Statistics Group, CMS; Feb. 21, 2007, Health Affairs online

Experts Issue New Heart Disease Guidelines for Women

2007-02-21T14:13:00.000-08:00

American Heart Association recommendations now focus on a woman's lifetime risk

By Amanda Gardner
HealthDay Reporter

MONDAY, Feb. 19 (HealthDay News) -- The American Heart Association has updated and sharpened its guidelines for preventing heart disease in women.

The focus now is on a woman's lifetime risk for heart disease, not just her short-term risk, as was the case in the 2004 guidelines.

The 2007 Guidelines for Preventing Cardiovascular Disease in Women are published this week in a special issue of the journal Circulation devoted to women's health, and were outlined at an AHA press conference Tuesday.

Among other things, the guidelines refresh recommendations on aspirin use, hormone replacement therapy and vitamin and mineral supplementation.

"The new updated guidelines are extremely exciting, because they advance our science quite a bit and our ability to provide guidance to physicians and other health care providers on the best practices for prevention for women," said Dr. Lori Mosca, chair of the American Heart Association's (AHA) expert panel that devised the guidelines. She is also director of preventive cardiology at New York-Presbyterian Hospital in New York City.

Heart disease among women is practically epidemic, accounting for one in three female deaths.

"Cardiovascular disease is the leading cause of death among women," Mosca said. "The rate of awareness among women has increased from 30 to almost 60 percent, but we still need to work on the confusion around preventive strategies. We are very encouraged that the release of these new guidelines can help clear up some of this confusion and help our women engage in more conversations with physicians and health care providers as to what are the best strategies to reduce the burden of the number-one killer of women."

Here are the high points of the new guidelines, which incorporate the latest science from recent randomized, controlled trials:

Where once women were classified as being at high, intermediate or low (optimal) risk for heart disease, they are now considered high, at-risk or optimal (the latter group representing probably no more than 10 percent of women). The new stratification incorporates, but does not rely solely on, the conventional Framingham Score that doctors use to assess cardiovascular risk. It also takes into account lifetime risk, not just short-term risk. "We wanted to align more with clinical trial evidence and acknowledge that cardiovascular disease is so ubiquitous in women," Mosca said.
Expanded lifestyle interventions include a continued emphasis on quitting smoking and avoiding secondhand smoke. This time, the guidelines also recommend counseling, nicotine replacement or other forms of smoking cessation therapy.
All women are still urged to exercise a minimum of 30 minutes per day, but women who need to lose weight or maintain weight loss are now advised to engage in 60 to 90 minutes of moderate-intensity activity on most, or preferably all, days of the week.
A heart-healthy diet should still be rich in fruits, whole grains and fiber foods with a limited intake of alcohol and sodium.
Saturated fat should now be reduced to less than 7 percent of calories (the previous guidelines stated 10 percent).
Women should eat oily fish, a source of omega-3 fatty acids, at least twice a week. "This is not recommended for all women but can be considered a balance of benefit and risk for women at high risk," Mosca said.
Women at very high risk for heart disease should try to lower their LDL ("bad") cholesterol to less than 70 mg/dL. Otherwise, high-risk women are still encouraged to lower their LDL to less than 100 mg/dL.
Women aged 65 and over should consider taking low-dose aspirin on a routine basis, regardless of their risk. Aspirin has been shown to prevent both heart attacks and stroke in this age group.
Women under 65 should not be taking aspirin routinely, as it has been shown only to have a benefit for stroke prevention.
The upper dose of aspirin for high-risk women is now 325 mg per day, up from 162 mg.
As stated in the previous guidelines, neither hormone replacement therapy, selective estrogen receptor modulators or antioxidant supplements such as vitamins C and E should be used to prevent heart disease.
Folic acid should also not be used to prevent cardiovascular disease, a major change from the last set of recommendations.

The current issue of Circulation also included heart information from several other studies:

Age, rather than health care disparities, seems to explain why more women than men die in the hospital after a heart attack. "The differences in death rates are largely due to differences in age when the heart attack occurred and not due to differences in treatment," said Dr. Alice Jacobs, professor of medicine at Boston University School of Medicine, who was also involved with the new guidelines.
Differences in an estrogen gene (ESR1) do not appear to affect the risk of heart attack and stroke in response to hormone replacement therapy, as was previously thought. The gene may, however, be associated with an elevated risk of breast cancer.
Some 40 percent of postmenopausal women have "pre-hypertension," associated with a 58 percent higher risk of cardiovascular death, said researchers from the Women's Health Initiative. It's unclear if intervening in this group will reduce cardiovascular problems, Jacobs said.
Supplementation with calcium/vitamin D had no effect on heart disease and stroke risk in postmenopausal women who were generally healthy.
Estrogen, when delivered by patch or gel, does not seem to increase the risk of blood clots in the vein (venous thromboembolism or VTE). Only estrogen taken orally seems to increase this risk.

More information

There's more on women and heart disease at the American Heart Association.

SOURCES: Feb. 15, 2007, teleconference with Lori Mosca, M.D., Ph.D., director of preventive cardiology, New York-Presbyterian Hospital, and Alice Jacobs, professor of medicine, Boston University School of Medicine; Circulation

Unique Twin Study Shows Increased Cardiometabolic Risk In Obesity

2007-02-20T14:08:00.000-08:00

Science Daily — Obesity and its many related health hazards have become a serious and growing problem worldwide. While environmental and lifestyle factors play a key role in the development of obesity, genetic variation may determine an individual's susceptibility to weight gain and to the rise of obesity-related health risks. Obesity increases the risk of cardiovascular diseases and diabetes especially when the extra fat is accumulated to central and intra-abdominal depots and when obesity is accompanied by an atherogenic dyslipidemia.

A Finnish team from the Finnish Twin Cohort, Helsinki University Central Hospital, and VTT Technical Research Centre of Finland performed a metabolomic analysis of lipids in 14 monozygous twins highly discordant for obesity, and 10 control pairs concordant for weight. They found that acquired obesity, independent of genetic influences, primarily relates to increases in lysophosphatidylcholines, constituents of an atherogenic lipid profile and decreases in ether phospholipids, lipids with anti-oxidative properties.

The origin of obesity and related dyslipidemias is multifactorial, involving complex genetic and environmental networks. Not all obese individuals develop dyslipidemia and not all dyslipidemic patients are obese. Cross-sectional studies comparing lipid profiles in obese vs. non-obese humans do not permit unequivocal distinction between genetic versus environmental and life-style effects. This can best be done by studying monozygotic (MZ) twins discordant for obesity. MZ twins are genetically identical at the sequence level and any differences between the co-twins are thus attributable to environmental factors. The co-twin design controls for age, gender, childhood socioeconomic background and other environmental experiences and exposures.

Serum patterns of small molecules such as lipids reflect the homeostasis of the organism. However, classical measurements of lipids in the clinical setting are unable to detect early changes and abnormalities in specific metabolites. Recent advances have made broad screening of metabolites, i.e. metabolomics, feasible, therefore opening new possibilities for discoveries of sensitive biomarkers for different diseases.

The study convincingly demonstrates the sensitivity of the metabolomics platforms since subtle pathophysiological changes were detected well prior to changes in commonly utilized clinical measures. Of special interest and clinical relevance is the finding that the atherogenic lipid profile of the obese co-twins was associated with whole body insulin resistance, something that could not be detected using classical lipid measures only.

This study will be published on February 14, 2007 in PLoS ONE, the international, peer-reviewed, open-access, online publication from the Public Library of Science (PLoS).

Citation: Pietiläinen KH, Sysi-Aho M, Rissanen A, Seppänen-Laakso T, Yki-Järvinen H et al (2007) Acquired obesity is associated with changes in the serum lipidomic profile independent of genetic effects -- a monozygotic twin study. PLoS ONE 2(2): e218. doi:10.1371/journal.pone.0000218 (http://dx.doi.org/10.1371/journal.pone.0000218)

Strength Training Before Receiving Flu Vaccine Consistently Increases the Immune Response

2007-02-15T12:33:00.000-08:00

As reported by the New York Times, exercise before having a flu shot may
make the vaccine more effective, British researchers have found.

Eccentric Exercise as an Adjuvant to Influenza Vaccination in Humans (Brain,
Behavior and Immunity)

A small study, published in the February issue of Brain, Behavior and
Immunity, found that lifting weights before a vaccination increased antibody
response in women, while reducing it in men. In men, cell-mediated response
— the activation of white blood cells and other kinds of cellular defenses —
was increased.

The scientists randomly divided 60 healthy men and women into two groups. A
group of 40 exercised by lifting weights for about 25 minutes before
receiving their flu shot. The remaining 20 rested for 25 minutes and then
got their shot. The scientists took blood samples from all of the
participants, then tested their blood again 6, 8 and 20 weeks later. They
found a consistently increased immune response in the exercisers.

Kate M. Edwards, the lead author, said that it could do no harm if everyone
exercised before being vaccinated.

“We don’t know for sure how this will work, but I think that if people go
out and exercise before a shot, that might be a good idea,” said Dr.
Edwards, a researcher in exercise immunology at the University of Birmingham
in England.

The authors suggest that exercise increases the number of immune cells that
arrive at the muscle tissue, which increases activity in the lymph nodes,
leading to a more efficient immune response.

Diabetics urged to get exercise

2007-02-13T12:58:00.000-08:00

DENVER (AP) -- Bad news when it comes to diabetics and exercise: Most people with Type 2 diabetes or at risk for it apparently ignore their doctors' advice to be active.

Fewer than 40 per cent get exercise, a new study found, and the more in danger the patients are, the less likely they are to be active.

That's despite an earlier study that found nearly three-quarters of diabetics said their doctors had advised them to exercise. The patients who got the strongest warnings to get moving were the least likely to listen, according to research being released Friday.

"People should exercise more, that story is out," said Dr. Elaine Morrato, who led both studies. "What we're saying is, 'Here's a high-risk population that can benefit from exercise, and they're even less likely to exercise."'

Without exercise, Type 2 diabetics face complications ranging from nerve damage to high blood pressure.

Morrato, an assistant professor at the University of Colorado Denver with a doctorate in public health and epidemiology, said researchers surveyed more than 22,000 patients for the new survey. Results of the study appear in the February edition of the American Diabetes Association's journal Diabetes Care.

The federal Centers for Disease Control and Prevention estimates more than 20 million Americans have diabetes, about 90 per cent of them Type 2, which is linked with obesity.

Dr. Larry Deeb, president of medicine and science at the American Diabetes Association, said by the time patients have Type 2 diabetes or are at risk of getting it, the deck is stacked against them. They may already have problems with mobility as a result of obesity or foot and circulatory disorders that make exercise difficult.

"We have to be careful not to blame the victims," he said. "There's a difference between being unable and being unwilling."

Even for the most disabled, there's hope, said author and fitness expert Charlotte Hayes, but health professionals must do more.

Hayes, who wrote The I Hate to Exercise Book For People With Diabetes, said telling patients to exercise is different from telling them how.

Every step of exercise is important, she said. For those who can walk, a few steps a day helps. For those who can't, there are alternatives.

"We take a small-steps approach," she said.

The American Diabetes Association recommends people get at least 30 minutes of aerobic exercise, such as brisk walking, five times a week. But the association says for those who can't, there are benefits from even five minutes a day, along with everyday activities such as gardening or walking to work.

Morrato said she doesn't know the answer, only that the results of her study are disappointing.

"It is difficult to be optimistic about addressing the twin epidemics of obesity and diabetes without success in increasing physical activity in the population," her study concludes. "The results of this study provide very pessimistic data."

Deeb, who specializes in pediatrics, said the next generation is off to a better start. Children, he said, are taught nutrition and the benefits of physical activity. Now, families, local governments and school boards need to take action, while doctors need to follow up and find out if at-risk patients know where to get help.