DIABETES DRUG SHOULD BE PULLED OVER HEART RISKS, FDA SCIENTIST SAYS
Monday,  July 30, 2007 8:26 AM

WASHINGTON (AP) — The widely used diabetes drug Avandia should be pulled from the market because of heart risks, a federal scientist said Monday.
    Those risks, combined with no unique short-term benefits in helping diabetics control blood-sugar levels, fail to justify keeping Avandia on the market, according to a copy of a slide presentation by Food and Drug Administration scientist Dr. David Graham.
    The document was distributed at the onset of a daylong meeting of a joint panel of outside experts convened to consider whether the drug should restricted to use in select patients and branded with prominent warnings or removed altogether from sale. Previously, the FDA said information from dozens of studies of the GlaxoSmithKline PLC drug points to an increased risk of heart attack.
    Glaxo officials, meanwhile, disputed that conclusion, according to copies of company presentations to be given later Monday.
    The FDA isn't required to follow the advice of its advisory committees but usually does.
    The FDA moved up the date of Monday's meeting following the May publication of a study by The New England Journal of Medicine that generated new concerns about Avandia's safety. The pooled analysis of 42 studies revealed a 43 percent higher risk of heart attack for those taking Avandia compared with people taking other diabetes drugs or no diabetes medication.
    Glaxo, meanwhile, says its own data show no increase in heart risks with Avandia compared with other diabetes drugs, including Actos.
    About 1 million Americans with Type 2 diabetes use Avandia to control blood sugar by increasing the body's sensitivity to insulin. That sort of treatment has long been presumed to lessen the heart risks already associated with the disease, which is linked to obesity. News that Avandia, also called rosiglitazone, might actually increase those risks would represent a “serious limitation” of the drug's benefit, according to the FDA.

 

STUDY: MANY LOW-INCOME KIDS OBESE BY AGE 3

Friday, December 29, 2006
Lauran Neergaard
ASSOCIATED PRESS

WASHINGTON — Far too many kids are fat by preschool, and Latino youngsters are most at risk, according to new research that’s among the first to focus on children growing up in poverty.
    The study couldn’t explain the disparity: White, black and Latino youngsters alike watched a lot of TV, and researchers spotted no other big differences between families.
    But one important predictor of a pudgy preschooler was whether the child was still using a bottle at the age of 3, concluded the study published online yesterday by the American Journal of Public Health.
    "These children are already disadvantaged because their families are poor, and by age 3 they are on track for a lifetime of health problems related to obesity," said lead researcher Rachel Kimbro, of the University of Wisconsin-Madison.
    About 17 percent of U.S. youngsters are obese, and millions more are overweight. Overweight preschoolers are five times more likely than lean preschoolers to be fat at age 12, scientists reported last fall.
    Kimbro culled data on more than 2,000 3-year-olds from a study that tracks children born to low-income families in 20 large U.S. cities.
    Thirty-two percent of the white and black tots were either overweight or obese, versus 44 percent of Latino kids.
    Nothing researchers checked could fully explain the racial difference, Kimbro said.
    Children were particularly at risk if their mothers were obese. So were those who still took a bottle at age 3, as did 14 percent of the Latino youngsters, 6 percent of the whites and 4 percent of the blacks.
    Pediatricians say that children should start drinking from a cup around age 1.

 

TEACHING TRIM

In some schools, sweating in gym class isn’t just for students
Monday, October 30, 2006
Charlie Roduta
THE COLUMBUS DISPATCH

    Teaching students how to make healthful choices is one thing. But some schools have taken the charge personally. Across Franklin County, teachers have organized their own workout groups. Administrators and teachers in Marysville, Pickerington and Westerville have joined schoolwide weight-loss competitions, modeled after TV’s Biggest Loser. And bus drivers, secretaries and others on the support staff are taking advantage of school weight rooms.
    "It’s a good support system for education," said Kelly Magnacca, a language-arts teacher at Heritage and Blendon middle schools who also teaches an hourlong step aerobics class three times a week at Westerville Central High School.
    "You’ll have a better classroom performance for teachers, which translates into better performance with students," she said.
    Educators have spent the previous year fine-tuning policies to make schools more healthful for students as part of a 2004 reauthorization of the Child Nutrition and Women Infants and Children Act.
    Now, some administrators are adding teachers and other staff members to the mix.
    "It’s up to us as teachers, secretaries and staff to help students develop healthy habits," said Rachel Coldwell, a physical-education teacher at High Point Elementary in Gahanna who leads the district’s fitness program.
    There, the staff can walk, lift weights or perform jumping jacks and other aerobic activities twice a week at High Point. Gahanna Lincoln High School offers yoga classes for its staff members.
    At Westerville, four schools host staff exercise classes that include aerobics, kickboxing and yoga. The district plans to start offering staff sessions with a nutrition expert this school year.
    Marysville holds a districtwide health fair where staff members can receive a variety of free screenings.
    Administrators nationwide are beginning to pay more attention to the health of their staff, said JoAnne Owens-Nauslar, a wellness expert in Illinois.
    "All faculty and staff need to strive for a peak-performance body so a child who has a need at 2:10 gets the same energy, focus, coping and critical-thinking skills from teachers as when they were fresh at 9:30 in the morning," Owens-Nauslar said.
    Research shows that companies with fitness programs have decreased absenteeism, reduced health-care costs and increased productivity.
    Teachers and staff members say fitness and wellness programs ease stress, boost morale and deepen connections among coworkers.
    Officials in New Albany and Upper Arlington schools say they are looking at what they can do to make fitness and nutrition programs available to their staff members.
    Hamilton and Whitehall keep weight rooms open to teachers. Groveport plans to resurrect districtwide volleyball matches that pit schools against the administration.
    Coldwell said she hopes Gahanna’s program will inspire staff members to make more healthful choices throughout life.
    "I’m not into diets and the latest exercise fad," she said. "It’s all about making it a lifestyle and what works for you."

 
DAILY EXERCISE MAY KEEP THE COMMON COLD AT BAY
Friday, October 27, 2006
Lee Bowman
SCRIPPS HOWARD NEWS SERVICE

    Older women who regularly engaged in exercise had about half the risk of coming down with a cold as similar women who didn’t get a regular workout, a new study shows.
    Writing in the November issue of the American Journal of Medicine, researchers at the Fred Hutchinson Cancer Center in Seattle report that even by getting about 30 minutes of exercise five days a week, the previously sedentary women were able to achieve an immune-system boost.
    "This adds another good reason to put exercise on your to-do list, especially now that cold season is here," said Cornelia Ulrich, senior author of the study, which involved 115 overweight, postmenopausal women in the Seattle area.
    Americans come down with a billion colds a year, making the viruses a leading cause of doctor visits and lost days from work and school, according to the National Institute of Allergy and Infectious Diseases. Adults report suffering two to four colds a year, on average.
    In the study, women were randomly assigned to either the moderate exercise program (45 minutes a day, five days a week) or a once-weekly 45-minute stretching session.
    Overall, the stretchers experienced about twice as many colds during a 12-month period as did the exercisers, and among women who reported at least one cold, the stretchers tended to report colds more frequently. However, there was no significant difference between the two groups in the frequency of other types of upper-respiratory infection, such as flu, or episodes of allergies.
    "The enhanced immunity was strongest in the final quarter of the yearlong exercise intervention," Ulrich said. "This suggests that when it comes to preventing colds, it’s really important to stick with exercise long-term."
    However, she also emphasized that exercise in moderation — such as 30 to 45 minutes of brisk walking each day — is key. Other studies have shown that excessive, exhaustive exercise can deplete the immune system and increase the risk of colds and other infections.
    Walking was the most common form of exercise for the women, accounting for about half their workout time at gyms and three-quarters of homebased exercise.
    And even though the women didn’t do quite as much as suggested, the average of 30 minutes they did put in "was enough activity to boost immune function in the long run," Ulrich said.
    "It’s been shown that just a 30-minute walk can increase levels of leukocytes, which are part of the family of immune cells that fight infection."
    The main goal of the study, funded by the National Cancer Institute, wasn’t focused on colds but sought to assess the effect of physical activity on breast-cancer risk factors. And in fact, the women in the exercise group did achieve significant reductions in weight, total-body fat and abdominal fat.
    The researchers also note that while their yearlong look was the longest known to have been done yet on the impact of exercise on resistance to infections, it may actually take people longer than a year before their immune systems fully respond to a workout program.

WARNING TO WOMEN: DISEASES MIGHT BE SNEAKING UP

America’s weight gain fueling ‘pre-diabetes’ fears
Wednesday, September 27, 2006
Linda A . Johnson
ASSOCIATED PRESS

TRENTON, N.J. — Getting fatter around the middle? Have a family history of heart disease or diabetes? You could be headed for the same trouble, especially if you’re a woman older than 40.
    There are no obvious symptoms from high blood sugar or a condition called insulin resistance, so few people realize it is creeping up and putting them on the path to diabetes, heart disease or both.
    But insulin resistance, a type of pre-diabetes, is a growing national problem: Some experts think half of all overweight or obese American adults are insulin-resistant.
    Yet, even many women with a family history of heart disease or diabetes don’t know they need to eat a healthier diet and get more exercise to avoid those problems — two of the nation’s top killers.
    "We think this is a very important new issue for women," said Audrey Sheppard, chief executive of the National Women’s Health Resource Center. "There’s very little awareness."
    As women enter the years leading to menopause, the hormonal changes that trigger hot flashes and end menstruation make women more likely to add fat around the waistline than in other places. A key tip-off of looming trouble is a waistline more than 34 inches, according to one expert. For men, it’s 40 inches.
    Fat also builds up in the liver and other vital organs, predisposing them to insulin resistance, a condition in which insulin no longer can inject enough glucose into the body’s cells for fuel, said Dr. David Katz, co-founder of the Yale Prevention Research Center and author of several books on weight control.
    The body’s compensatory mecha- nisms eventually fail, and blood pressure rises along with levels of blood sugar and blood fat — making cells even more resistant to insulin. Diabetes, heart disease or both often follow.
    "That’s the sequence that’s occurring in tens of millions of American adults" and an increasing number of children amid the country’s obesity epidemic, Katz said. "It’s an enormous problem. We’re just starting to get doctors’ attention."
    Besides a family history of heart disease or diabetes, women who had diabetes during pregnancy or who had a baby 9 pounds or heavier are at higher risk of insulin resistance.
    Frequent fatigue and cravings for sweets, bread and pasta also might be linked to the problem. But Dr. Henry Kahn, a chronic-disease epidemiologist with the U.S. Centers for Disease Control and Prevention, said those are vague symptoms that could have other causes.
    The women’s resource center, based in Red Bank, N.J., has just begun a public-health campaign targeting women aged 40 to 65 because they are at greater risk than others and often hold of the role of Dr. Mom, serving as monitor for the whole family’s health.
    Besides explaining on its Web site how uncontrolled blood sugar harms the body, the center offers tips for a healthy blood-sugar level and suggests questions that patients can ask a doctor.
    Among research showing the benefits of a healthy lifestyle is a recent CDC study that found modestly overweight adults who worked with nutrition and exercise experts reduced their risk of diabetes by nearly 60 percent over several years, compared with a group that made no changes, Kahn said.
    Lalita Kaul, an American Dietetic Association spokeswoman and professor of nutrition at Howard University Medical School, said over the past 25 years, about 70 percent of her patients at risk of diabetes have been able to control their blood sugar with diet and lifestyle changes.
    The key diet changes, she said, include eating at least five servings of fruits and vegetables daily; cutting down on sugar and desserts while eating more whole grains; eating less saturated fat and using healthier cooking oils; eating salmon and other fish rich in essential fatty acids a few times a week; and avoiding prepared foods high in sodium, which pushes up blood pressure.

 

U.S. SLOW TO TACKLE CHILDHOOD OBESITY

Experts pushing for more programs that get kids exercising
Thursday, September 14, 2006
Lauran Neergaard
ASSOCIATED PRESS

WASHINGTON — One-fifth of children are likely to be obese by 2010, but efforts to turn that tide are scattershot and underfunded, and the government killed one of the few programs that worked, experts said yesterday.
    Programs aimed at reducing youngsters’ growing waistlines are sprouting nationwide, an encouraging sign that the threat to children’s health is being taken seriously, said the report by the Institute of Medicine.
    But no one knows which programs really help kids slim down, the institute said in calling for research to identify the best methods.
    More troubling, the country lacks the national leadership needed to speed change, lamented an expert panel convened by the scientific group.
    "Is this as important as stockpiling antibiotics or buying vaccines? I think it is," said Dr. Jeffrey Koplan of Emory University, who led the institute’s panel. "This is a major health problem. It’s of a different nature than acute infectious threats, but it needs to be taken just as seriously."
    To reinforce that point, yesterday’s report spotlighted the government’s VERB campaign, a program once promoted as spurring a 30 percent increase in exercise among the preteens it reached. It ended this year with Bush administration budget cuts.
    VERB encouraged 9- to 13-year-olds to take part in physical activities, such as bike riding or skateboarding. Slick ads, at a cost of $59 million last year, portrayed exercise as cool at an age when outdoor play typically winds down and adolescent slothfulness sets in.
    The program’s demise "calls into question the commitment to obesity prevention within government," the panel concluded.
    Koplan, a former CDC director, called it a waste of taxpayer money to develop a program that works and end it.
    The report cites other examples of promising federal programs that have yet to reach their potential. Kids gobbled fruits and vegetables in an Agriculture Department schoolsnack program, but it only reaches 14 states. And the main anti-obesity initiative of the Centers for Disease Control and Prevention had enough money this year for only 28 states to start childhood nutrition and exercise programs.
    The report also praised some creative state and local efforts, including:

• A California program, started in Marin County, to build new sidewalks and bike paths so that more children can walk or bike to school.

• A community garden project in New York City’s Harlem neighborhood to increase youngsters’ access to healthful food and safe recreation.

• An effort by Arkansas schools to notify parents when students are overweight. Combined with new school menus and physical-activity programs, the initiative recently reported a leveling off of the state’s child obesity rate.

 

NUMBER OF OBESE U.S. ADULTS CONTINUES TO CREEP UP

Wednesday, August 30, 2006
Kevin Freking
ASSOCIATED PRESS

WASHINGTON — Americans’ waistlines expanded a bit more in 2005 as 31 states registered an increase in obesity among adults.
    The findings led some healthcare experts yesterday to dispute the notion that obesity is simply a personal choice. They say that finding ways to improve fitness needs more attention from the government, employers and the food and beverage industry.
    The organization that tracked obesity state by state, Trust for America’s Health, said better information and access are the keys to improving health.
    "If we’re urging people to walk more, and their streets are not safe, that’s an unrealistic expectation," said Jeff Levi, the group’s executive director. "If we’re urging people to eat more fresh fruits and vegetables, and they don’t have access to a supermarket or the cost is beyond their capacity, then we’re not asking them to take responsibility for something they have control over."
    Levi’s organization found that nine of the 10 states with the highest obesity rates are in the South. Mississippi continued to lead the way with an estimated 29.5 percent of adults considered obese. It’s followed by Alabama and West Virginia.
    Obesity now exceeds 25 percent in 13 states, Levi said. Ohio isn’t one of those states, but just barely. It ranked 15 th, with an obesity rate of 24. 9 percent.
    Colorado remains the leanest state, at 16.9 percent. The only state that saw a decrease in obese adults was Nevada
    Trust for America’s Health made recommendations for reducing obesity. For example:

• Employers should offer benefits such as nutrition counseling and subsidized healthclub memberships.

• The government should mandate routine screenings that measure the fitness of Medicaid beneficiaries.

• Local governments should approve zoning and land-use laws that give people more chances to walk or bike.

• The food and beverage industry should be clearer about calories and fat content. The industry should estimate based on the size of the product, which often contains two or three servings.
    Citing a 2004 report, the advocacy group said $5.6 billion could be saved if just one-tenth of Americans began a regular walking program.

 

REPORT LINKS SUGARY DRINKS TO RISE IN OBESITY

Wednesday, August 09, 2006
Marilynn Marchione
ASSOCIATED PRESS

    Americans have sipped and slurped their way to fatness by drinking far more soda and other sugary drinks during the past four decades, a new scientific review concludes.
    An extra can of soda a day can pile on 15 pounds in a year, and the evidence strongly suggests that such increased consumption is a key reason why more people have gained weight, the researchers say.
    The findings justify publichealth efforts to limit sugarsweetened beverages, said Dr. Frank Hu, who led the study published yesterday in the American Journal of Clinical Nutrition.
    He and others at the Harvard School of Public Health reviewed 30 studies on nutrition dating back 40 years that met strict standards for relevance and scientific muster. The work was funded by grants from the federal government and the American Heart Association.
    The American Beverage Association faulted the new analysis for ignoring some studies that would have discounted such a link.
    "Blaming one specific product or ingredient as the root cause of obesity defies common sense. Instead, there are many contributing factors, including regular physical activity," said a statement from the beverage association.
    However, Dr. David Ludwig, director of the obesity program at Children’s Hospital in Boston and a longtime advocate of curbs on soda, said blaming other factors misses the point.
    "Could you imagine somebody saying we should ignore the contribution of hypertension to heart attack because there are many causes? It’s ludicrous. Yet this argument resurfaces with regard to obesity," Ludwig said.
    "There’s an overwhelmingly strong case to be made for a causal relationship" between beverage trends and obesity, he said.
    Although all the studies do not show harm, they collectively suggest that soda and sugary drinks "should be discouraged," the authors wrote.
    Federal dietary guidelines recommend beverages without added sugars, and the World Health Organization advises that added sugars should provide no more than 10 percent of total calories.

 

YOUNG OR OLD, FAT OR FIT, EXERCISE CAN HELP

Monday, July 24, 2006
Katherine Hobson
TRIBUNE MEDIA SERVICES

    When it comes to exercise, everybody’s got an excuse. Or 10.
    "I had a list," says Farai Chideya, a 36-year-old Los Angeles journalist who recently began lifting weights and taking dance classes. "I’m too busy. Maybe I’ll hurt myself. Shouldn’t I be out meeting new people instead? "
    Despite the well-documented health benefits of exercise, less than half of adults in the United States get the minimum amount necessary for those rewards: 30 minutes of aerobic activity, most days a week. A quarter of Americans are sedentary. And the older people get, the less likely they are to exercise.
    The U.S. Centers for Disease Control and Prevention recommends moderate-intensity exercise, which means your heart rate gets going but not so much that you’re huffing and puffing and unable to carry on a conversation.
    Think biking, inline skating, using an elliptical trainer and swimming. Strength training such as lifting weights can help prevent bone and muscle loss and shore up joints stressed by arthritis or pain.
    "There is so much evidence that allows us to really prescribe exercise for someone," says Paul Ribisl, chairman of health and exercise science at Wake Forest University in Winston-Salem, N.C. "The most difficult issue challenging us is how to change (people’s) physical activity and eating patterns."
    The overall message is clear: Get moving.
    Experts say the "life is too hectic" excuse is by far the most common one. Trying to cram in an exercise regimen with work, relationships, friends, family and errands might seem futile.
    But people who exercise are busy, too. They just make working out a priority.
    "Anything that is important to you, you’ll find the time for," says Chris Imbo, managing director of health-lifestyle company Welldome and a personal trainer.
    Working out might not take as much time as you think.
    "You can spend a relatively minimal amount of time —30 minutes on most days — and it will give you such a big return," says Cedric Bryant, chief science officer with the American Council on Exercise.
    People can accumulate exercise throughout the day, say, by taking the dog for a brisk 15-minute walk in the morning and again after dinner.
    Almost no one is too old or too frail to exercise. Because of the natural decline in muscle mass —about 10 percent per decade starting around age 50 — and dwindling aerobic capacity, the need to stay active might be more apparent in old age than at any other life stage, says Kerry Stewart, director of clinical and research exercise physiology at Johns Hopkins University School of Medicine in Baltimore.
    "It’s really important for young people to stay active to maintain health," Stewart says, "but for older people, it may be even more important to stay active to have some way of fighting off the natural processes of aging and to resist chronic diseases."
    The American College of Sports Medicine recommends that older adults follow the same 30-minutes-a-day routine, including aerobic activity and strength training. For the homebound, strength training can be done using a chair.
    The first key to workout dedication is to find an appealing exercise.
    "I fell in love with the act of running the very first time I went out," says John Bingham, a columnist at Runner’s World.
    The technology-obsessed can take advantage of newer computerized gadgets to spice up a workout. There are fitness videos online and numerous cycling and running workouts for MP3 players.
    Unless you are severely obese, excess girth isn’t a good reason to remain sedentary. Anyone with a body-mass index (a measure of body fat taking into account height and weight) between 25 and 30, considered overweight, should be able to exercise, says Ribisl.
    As the BMI climbs above the 40 mark deemed morbidly obese, there are increasing risks, he says, such as strain on joints or the heart.
    "The key word is individualization," Ribisl says. For obese people, "the intensity would have to be lower, the duration would have to be shorter."
    A small study in the Archives of Internal Medicine in April revealed that elderly and frail people who were obese benefited from six months of regular exercise and a healthier diet. The group lost an average of 8.4 percent of body weight and improved strength, walking speed, and balance.
    The point is, any physical activity is better than none for the overweight crowd, though some people might need to work up to an hour or more per day.

 

PUBLIC SCHOOLS TAKE NEW FEDERAL WELLNESS LAW TO HEART

Friday, July 14, 2006
Brian Bakst
ASSOCIATED PRESS

ST. PAUL, Minn. — They’re promising to keep closer tabs on student lunch trays, pull sugary treats from vending machines and classroom celebrations, and encourage more pulse-raising activities during the school day.
    The nation’s public schools are under orders to adopt nutrition and exercise goals before classes resume in the fall. The written wellness policies are required by a federal law that took effect July 1.
    "Some school districts and school buildings have already made a lot of these changes, and some have done nothing just because they’ve never been required to," said Alicia Moag-Stahlberg, executive director of Action for Healthy Kids, a 50-state nonprofit network. "Frankly, schools that have never had this conversation are having it."
    The primary objective is straightforward: combating rising childhood-obesity rates. Overweight children miss more school than their averageweight counterparts, according to the National School Boards Association. Supporters also argue that reducing sugar in students’ diets leads to improved focus in the classroom.
    Some states are making similar efforts through new laws and policies, and the federal law gives school boards wide latitude, causing vast differences in their approaches.
    In Tennessee’s Williamson County, for instance, the broadly worded policy runs 23 lines; in Hampton, N.H., the five-page plan is so detailed that it suggests elementary students have "at least two colors other than white and brown as part of their lunch meal."
    Some districts are looking beyond the cafeteria.
    In St. Paul, students will find water, fruit juice and milk in vending machines that used to dispense soda. In Farmington, Utah, schools are holding recess before lunch so kids don’t give short shrift to their meals in the race to the playground.
    Teachers in Cape Girardeau, Mo., will encounter restrictions on goodies they can give out in their classrooms.
    Rhonda Dunham, an elementary-school principal in the district, will try rewards other than sweets for students who meet homework goals or display good behavior. One plan is to set up elegant lunches, where kids get specially prepared meals at tables with linen cloths, china and glassware.
    "They feel a bit more grownup that way," she said.
    Classroom candy also has lost favor in the Perham Dent school district in northwestern Minnesota.
    "The truth is, one Jolly Rancher isn’t bad, but 13 years of several Jolly Ranchers a day is a bad habit to learn," said Superintendent Tamara Uselman.
    Her district is incorporating more movement into the school day as well. One geography teacher is setting up stations in her classroom so students are on the move every 20 minutes.

 

REPORT CONDEMNS SECOND HAND SMOKE

Just a little bit is harmful, surgeon general says
Wednesday, June 28, 2006
Misti Crane
THE COLUMBUS DISPATCH

    Smoke tendrils wafting across the bar from a lone cigarette are enough to hurt nonsmokers, the nation’s top doctor said today.
    Yesterday, U.S. Surgeon General Richard Carmona delivered the first secondhand-smoke report from his office in 20 years and the strongest condemnation of tobacco’s impact on those who don’t smoke.
    He at once buoyed petition carriers, public-health workers and others pushing smoking bans and angered those who argue that studies showing the harm of secondhand smoke are bunk and that smoking is a right.
    Secondhand smoke harms nonsmokers even in small amounts and for a short duration, Carmona said.
    It causes heart disease and lung cancer in nonsmoking adults and sudden infant death syndrome, respiratory problems, ear infections and asthma attacks in children, the report concludes.
    Dr. Thomas Houston, who directs OhioHealth’s nicotine-dependence program at the McConnell Heart Health Center, was one of about 40 experts who reviewed the report and its studies before publication.
    "The tobacco industry over the years has been trying to say that there’s doubt, that there’s just not enough evidence … I think this really puts that to rest," Houston said yesterday.
    Not if foes of smoking bans have anything to do with it.
    "The suggestion is that just a few minutes of exposure is deadly and they make some really nonsense conclusions here that don’t hold up," said Gary Nolan, former talkshow host and head of the Small Business Coalition in Cleveland.
    "It is not the poison, it’s the dose. I don’t believe that it’s deadly."
    Nolan, whose family owns a Cleveland bar, questioned the report’s aim, saying that pharmaceutical companies will make money from medications that help people stop smoking.
    "It’s going to strengthen the hand of the anti-tobacco extremists," he said. "At the end of the day, it’s going to hurt businesses."
    Nolan believes those who are allergic suffer, but he compared banning smoking for their sake to banning peanuts because they’re an allergen.
    "They’re not telling Dairy Queen they can’t sell a Peanut Buster Parfait," he said.
    Columbus already bars smoking in restaurants and watering holes and SmokeFree Ohio circulates petitions to put a statewide smoking ban on the November ballot.
    The surgeon general validated what other groups have been saying for years and may help convince the public and lawmakers that they should stop people from smoking in places where they expose others, said Dr. Doug Teske, a Children’s Hospital cardiologist and petition carrier.
    Teske said he hopes the message will reach parents and grandparents, not just voters and politicians.
    Sometimes he struggles to convince adults to stop smoking in homes and cars to protect kids with heart disease.
    "There’s still a lot of work to do, but you’ve got to take baby steps."
    Because of efforts to reduce secondhand smoke, including the elimination of smoking in airplanes and most workplaces, exposure has dropped significantly, said Michael Leavitt, secretary of Health and Human Services.
    From 1988 to 1991, 88 percent of nonsmokers 4 years old and older showed signs of exposure based on blood tests showing the presence of cotinine, a chemical the body makes from nicotine.
    In 2001 and 2002, that number dropped to 43 percent.
    Still, an estimated 126 million nonsmoking Americans 3 and older are exposed, he said.
    Houston commended Carmona’s approach and said policy changes should follow.
    "Establishing smoke-free workplaces is the only way to ensure that secondhand smoke exposure does not occur," he said."We really are being put on notice."
    As for that cigarette burning as you grab a brew in a bar, Houston says it’s not going to stop anyone’s healthy heart.
    But, it’s putting carbon monoxide in your blood stream, blocking oxygen from attaching to your red-blood cells, and making your heart work harder. Meanwhile, the lining of the blood vessels stiffens.
    If you are "healthy as a horse, it’s not going to give you a heart attack in 30 minutes," said Houston, a professor at Ohio State University.
    "The exposure over time is what we worry about."
    Houston called fears that business will drop with a statewide ban unfounded.
    And, he said, many smokers — the ones who want to quit — would appreciate it.
    "It gives them another reason not to smoke. They can go into a bar and have a glass of beer and not have that trigger, that craving."
    To read the entire report, go to www.surgeongeneral.gov/ library/secondhand.

CUT TRANS FATS, GET MORE EXERCISE, HEART EXPERTS SAY

Tuesday, June 20, 2006
Marilynn Marchione
ASSOCIATED PRESS

    The American Heart Association has become the first big health group to urge a specific limit on trans fats in the diet — less than 1 percent of total calories — in guidelines released yesterday.
    Also for the first time, the organization’s dietary guidelines include lifestyle recommendations, including an emphasis on exercising and not smoking.
    A panel of specialists in nutrition and heart disease reviewed more than 90 studies to update the dietary advice the association released in 2000. The guidelines are for healthy Americans ages 2 or older.
    Rather than slavishly counting calories, people should try something simpler: cooking with healthier oils and balancing calories consumed with calories burned through exercise, said Alice Lichtenstein, the Tufts University nutrition expert who chaired the panel.
    Trans fats, or trans fatty acids such as partially hydrogenated oils, are in many cookies, crackers, breads, cakes and fried foods. They contribute to heart-disease risk by raising LDL, or the bad cholesterol.
    Avoiding them and keeping a healthy diet is hard while eating out as much as Americans do, panel members noted.
    Last week, a consumer group sued KFC to try to get the company to stop frying its chicken in trans fats, and other fast food chains have been pressured to lower such fats as well.
    "Total fat reduction alone is not the only answer. It is important what kind of fat you eat," said Linda Van Horn, a Northwestern University dietitian who helped draft the guidelines.
    Among the panel’s other recommendations:

• Limiting saturated fats to 7 percent of daily calories, down from the 11 percent most Americans consume.

• Getting at least half an hour of exercise a day.

• Eating fruits and vegetables (not fruit juices) that are deep in color, such as spinach, carrots, peaches and berries.

• Choosing whole-grain, high-fiber foods.

• Eating fish, especially oily fish like salmon and trout, at least twice a week. (Children and pregnant women should follow federal guidelines for avoiding mercury in fish.)

• Consuming low-fat dairy products.

• Avoiding beverages with added sugars.

• Adding little or no salt to foods.

• Drinking alcohol in moderation.
    The guidelines were published in the association’s journal Circulation. For a free brochure, visit www.americanheart.org or call 1-800-AHAUSA1.

 

FAST FOOD FATTIER IN U.S. THAN IN EUROPE

While experts blame cheap oil, firms say it’s all about taste
Thursday, April 13, 2006
Linda A . Johnson
ASSOCIATED PRESS

    Order french fries or hot wings at a McDonald’s or a KFC in the United States and you’re more likely to get a super-size helping of artery-clogging trans fats than you would be at their restaurants in some other countries.
    A study of the fast-food chains’ products around the world found remarkably wide variations in trans-fat content from country to country, from city to city within the same nation, and from restaurant to restaurant in the same city.
    The researchers said the differences had to do with the type of frying oil used, and the main culprit appeared to be partially hydrogenated vegetable oil, which is high in trans fats.
    "I was very surprised to see a difference in trans fatty acids in these uniform products," said one of the researchers, Dr. Steen Stender, a cardiologist at Gentofte University Hospital in Hellerup, Denmark, and former head of the Danish Nutrition Council. "It’s such an easy risk factor to remove."
    McDonald’s Corp., which promised in September 2002 to cut trans fat in half, and KFC parent Yum! Brands Inc. said the explanation is local taste preferences. But nutrition experts and consumer activists said it is about money: Frying oil high in trans fats costs less.
    The Danish researchers tested products from the chains’ outlets in dozens of countries in 2004 and 2005, analyzing McDonald’s chicken nuggets, KFC hot wings, and the two chains’ fried potatoes. The findings were reported in yesterday’s New England Journal of Medicine.
    At a New York City McDonald’s, a large fries-and-chicken-nuggets combo was found to contain 10.2 grams of trans fat, compared with 0.33 grams in Denmark and about 3 grams in Spain, Russia and the Czech Republic.
    At KFCs in Poland and Hungary, a large hot wings-and-fries order had 19 grams of trans fats or more, versus 5.5 grams for wings and fried potato wedges in New York. But in Germany, Russia, Denmark and Aberdeen, Scotland, the same meal had less than a gram.
    A large order of french fries at a New York City McDonald’s contained 30 percent more trans fat than the same order from an Atlanta McDonald’s.
    Partially hydrogenated vegetable oil is cooking oil that has been injected with hydrogen to harden it and give it a longer shelf life.
    Switching to liquid vegetable oils such as canola, corn, olive or soy eliminates the trans fat, as has been done in Denmark under a 2004 law allowing only a minuscule amount of trans fat in foods.
    Trans fat raises bad cholesterol and lowers good cholesterol. Eating just 5 grams of it per day increases the risk of heart disease 25 percent, research shows.
    Stender and other experts said many restaurants still use partially hydrogenated vegetable oil to save money because it does not spoil and can be used over and over for frying.
    Michael F. Jacobson, executive director of the Center for Science in the Public Interest, said his group has petitioned the Food and Drug Administration to drastically limit the use of trans fats and require restaurant menus to note foods containing trans fat.
    Harvard School of Public Health cardiologist Dr. Dariush Mozaffarian and colleagues wrote in the journal that other countries have replaced partially hydrogenated with unsaturated fats without raising costs or reducing quality.
    Jacobsen said the cost might be a penny per order of fries or nuggets, and that the taste difference would be minimal.
    "I don’t think people would mind paying a penny more or getting one less french fry to avoid heart disease," he said.

 

TWO STUDIES WARP VIEW OF HOW WOMEN CAN STAY HEALTHY

Value of low-fat diet, calcium supplements called into question
Sunday, February 19, 2006
Denise Grady
THE NEW YORK TIMES

    So what do women do now? The results of two major studies during the past two weeks have questioned the value of two widely recommended measures: taking calcium pills and vitamin D to prevent broken bones and maintaining low-fat diets to prevent heart disease and breast and colon cancer.
    Should women shed guilt and assume that diet makes no difference or muddle on with salad and supplements, just in case?
    The studies have prompted a new look at the regimens that many have been following. Researchers are debating how far scientific rules can be stretched when measuring results and searching for evidence in smaller groups of patients within a large study.
    The researchers admit that the findings were a challenge to firmly held beliefs about nutrition and health. And though some experts said the results mean women should look for other ways to prevent heart disease, cancer and bone loss, the study’s researchers said their findings are not a signal to binge on bacon cheeseburgers.
    "I was a little uncomfortable with some of the reactions," said Dr. Jacques Rossouw, project officer for the Women’s Health Initiative, the program that has created the stir. It worries him, he said, that some people think the studies mean dietary fat and calcium do not matter.
    "It’s not what we say, and I don’t think it’s what the papers say," Rossouw said.
    "For folks who are on a lowfat diet, by all means continue," he said. "If you’re on a high-fat diet, certainly get it down. That’s the message we would like to send."
    As for calcium and vitamin D, he said, the recent study had "enough hints" of benefit that women whose diets do not provide adequate amounts should take supplements.
    In the diet study, the difference in breast-cancer rates was not statistically different. But Rossouw said it was so close — a 9 percent reduction in risk, when 10 percent would have been significant — that if the study had continued, it might have become significant.
    In the calcium study, researchers noticed intriguing differences in certain subgroups. The ones who took most of their calcium, 80 percent of the pills, had a 29 percent reduction in hip fractures. Women older than 60 also had a reduction, 21 percent.

BONE-BREAK STUDY SAYS SUPPLEMENTS WORK, BUT RESULTS INCLUDE SURPRISES

Thursday, February 16, 2006
Misti Crane
THE COLUMBUS DISPATCH

    The leader of a major study of calcium and vitamin D’s benefits in preventing fractures in older women says the results confirm that supplements can help ward off broken hips.
    But the research, part of the national Women’s Health Initiative, showed only modest benefits in post-menopausal women as a whole. It is published in today’s New England Journal of Medicine.
    The study of 36,282 women 50 to 79 years old found that those who took supplements had a 1 percent higher hip-bone density, considered significant, but did not have a lower rate of broken bones.
    However, women older than 60 (those more likely to break a hip) and those who did the best job taking their supplements had better protection against broken hips.
    Taking supplements also increased a woman’s chances of developing kidney stones.
    The potential for lowering the risk of hip fracture later in life is an important finding and reinforces conventional wisdom that all women should shoot for 1,200 milligrams of elemental calcium and 400 to 600 units of vitamin D, said endocrinologist Rebecca Jackson, lead author of the article and an osteoporosis expert at Ohio State University Medical Center.
    Most people do not naturally get the recommended calcium, nor vitamin D, which is made by the body and fueled by exposure to sunlight.
    Drinking adequate fluids can help prevent kidney stones, Dr. Jackson said.
    Some reasons the supplements may not have shown more dramatic results in the group as a whole:

• The test group included many middle-aged women. Women generally break hips later in life.

• The women in the study started with an average daily intake of 1,100 milligrams of calcium. That’s short of the recommended daily allowance of 1,200 milligrams and is much higher than most people get in their diet, said Andrea LaCroix, who led the study with Jackson and works as an epidemiology professor at Seattle’s Fred Hutchinson Cancer Research Center.

    Women who take in little natural calcium in a day may have seen significantly more benefit from supplements, she said.

• The women suffered half of the number of hip fractures the researchers would have expected in the general population.

"These women were so healthy," La-Croix said.

• The women as a whole didn’t take all the supplements they were supposed to. Among those who took 80 percent or more of the recommended amounts, there was a 29 percent reduction in hip fracture.

    "Many women believe that they are completely protected against the development of osteoporosis if they are taking these supplements," Dr. Joel S. Finkelstein, of Massachusetts General Hospital, wrote in an editorial accompanying the research. "Calcium with vitamin D supplementation is akin to the ante for a poker game: it is where everyone starts."
    Women and doctors should be aware that even those taking supplements may be at risk for fractures and may need medication, he wrote.
    "I say, don’t overemphasize supplements. I think women should take calcium and vitamin D in the recommended amounts," he said in an interview.
    But, "clearly they’re not enough to prevent osteoporosis in many women."
    Bone-density tests should be done to reveal which women may need medication. There are seven FDA-approved osteoporosis drugs, he said.
    Finkelstein said the benefits from supplements outweigh the risk of kidney stones.
    "You’re probably preventing a lot more fractures than you’re inducing kidney stones."

SHEDDING OLD HABITS, EXCUSES IS A FIRST STEP TO SUCCESS

Monday, January 09, 2006
By Eugenie Jones SCRIPPS HOWARD NEWS SERVICE

    Perhaps you have a habit or two that make your fitness goals much harder to achieve.
    If you do, consider how you can tackle two of the most fundamental changes that getting fit requires:
Dietary — A lot of people dream of one day getting into better shape, but only if it doesn’t mean cutting back on fried foods, super-sized orders or daily quotas of chocolate.
    Rather than trying to preserve your sacred-cow dietary habits, be willing to change the old favorites for something new.
    Buying, cooking and eating differently might seem awkward, take great effort and require more determination, but your efforts will be rewarded every time you look in the mirror or have a physical.
Activity — The change is obvious. If you’re like many Americans, you simply need more of it. And contrary to fears of unfit folks everywhere, you don’t have to train like a professional athlete to benefit from exercise.
    You simply have to let go of the excuses — "too busy, too hard, too inconvenient" — and make time for consistent, moderate exercise.
    Just 30 minutes of walking, swimming, jogging or other aerobic activity four to six days a week will give your body the pulse-raising, fat-burning, endurance building, cardio conditioning it needs.

 

AS MEN AGE, THEY MUST CHANGE WORKOUTS, TOO

Thursday, January 05, 2006
Jeannine Stein
LOS ANGELES TIMES

    Drew Woodmansee prides himself on being in shape.
    The San Diego lawyer played baseball in college and stays fit by running and cycling. But as he eases into his mid-30s, Woodmansee is noticing minor "knots and aches and pains," he says.
    As men age, their fitness needs change. The all-out basketball games played at 20 aren’t so painless at 36. During middle age, weight begins to creep up as metabolism slows, and the fat that puddles around the midsection threatens the heart and other organs. Elderly men discover the importance of flexibility and muscle strength as the simplest tasks, such as getting in and out of chairs, can become a challenge.
    It’s vital for men to keep exercising to maintain good health. One study, published last year in the Journal of Applied Physiology, found that men 65 to 79 who did regular physical activity had far stronger immune systems than those of a sedentary control group.
    A Canadian study of 19,000 men discovered that those who exercised and were fit cut their risk of death by heart disease in half.
    Men in their 20s are at the peak of their strength. That’s why many head for the gym and load up on weights, sometimes neglecting the cardiovascular exercise.
    Throughout their 20s and early 30s, men also aren’t giving much thought to things such as warming up and stretching, says Dr. Jordan Metzl, a sports-medicine physician at the Hospital for Special Surgery in New York City.
    "They’re not seeing as much in terms of body decay," he says, "so they’re not as good about doing preparation and cross-training — even though they should — because they don’t feel they need it."
    At this stage, men should incorporate a variety of sports and activities into their cardio and weight routines, says Justin Price, a trainer in San Diego. "Variety is important for cardio and weight-bearing exercises," he explains, so the body doesn’t get used to the same repetitive movements. He advocates sports such as basketball or soccer, or activities such as kickboxing, all of which involve explosive movements as well as body rotation.
    A sedentary lifestyle can creep up on guys in their 20s and 30s. If competitive sports become too strenuous or even dangerous, experts recommend segueing to less demanding activities such as exercise classes, running or cycling.
    "This is a time when I hope a man’s underlying motivation for exercise might start to be a bit more mature," says Cedric Bryant, chief exercise physiologist for the American Council on Exercise. "Think about why you exercise and start to look at the overall health benefits of being physically active."
    Developing a consistent workout that includes cardiovascular and strength training should be paramount, he says, to keep weight down and muscles strong. Men typically gain abdominal weight, which puts them at higher risk for heart disease and diabetes. Maintaining flexibility is vital, as well.
    Workouts for men in their 60s and 70s should be geared toward functional fitness or training the body to handle real-life situations such as getting in and out of chairs or climbing stairs. That means relying less on weight machines and more on the body itself to maintain strength and balance, as by lifting weights while on a stability ball.