Regular Walking Protects the Aging Brain

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

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Dad's parenting style tied to child's weight

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

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Moderate exercise cuts rate of metabolic syndrome

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.

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Exercise more to live longer: study

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.

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

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.

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Obesity, Diabetes Linked to Cancers

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

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Warning: Your Heart May Be Aging Faster Than You Are

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.
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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

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We Can! Program Takes Aim at Childhood Obesity

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.

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