The San Francisco Chronicle reports a study in Nature showing that irisin, “a hormone naturally found in muscle cells … rises during exercise, converting white fat into brown fat, a substance whose primary function is to generate body heat.” Continue reading
ABC World News reported, “And we have a red flag to tell you about tonight about the most popular prescription drug in the world: statins.” Investigators “at Harvard Medical School” found that “people who take statins to reduce their cholesterol are at slightly higher risk of diabetes.” Sounds scary, right? Not to worry … it isn’t! Continue reading
The Los Angeles Times “Booster Shots” blog reports, “Fat kids often turn into fat adults with a host of related health problems: diabetes, high blood pressure, clogged arteries.” However, a study published in the New England Journal of Medicine “finds that if those heavy kids lose weight, they may be on a par with people who were never overweight.” Continue reading
In the past I’ve told you that children younger than two years of age should have NO screen time, while children over two should have less than two hours per day. Now we may have to extend this advice to adults. Continue reading
In my book, SuperSized Kids: How to protect your child from the obesity threat, I warn that the childhood obesity epidemic was leading to dramatic increases in the number of kids with diabetes and cardiovascular disease and could shorten their life expectancy. Now we’re beginning to see this come true. Continue reading
Most doctors (81 percent) fall short when it comes to comparing what they do for colon cancer screening with what they should be doing. And, we docs fall off both sides of the balance beam, either ordering tests too frequently or too seldom. Here are the details from HealthDay News:
Only one in five doctors in the United States follows all the recommended colon cancer screening guidelines, a new report finds. Some 40 percent of doctors follow guidelines for some tests, while the remaining 40 percent don’t follow guidelines for any colon cancer screens, the researchers said.
“There’s more work to be done to understand how to improve colorectal cancer screening,” concluded lead researcher Robin Yabroff, an epidemiologist at the U.S. National Cancer Institute.
Most doctors also don’t adhere to guideline recommendations about when people should start screening and how often they should be screened, she added. The report is published in the online edition of the Journal of General Internal Medicine.
In the study, the researchers looked at the recommendations for various tests to find colon cancer, including colonoscopy, flexible sigmoidoscopy, fecal occult blood test (stool-based testing) and double-contrast barium enema.
For the study, Yabroff’s team questioned almost 1,300 doctors who participated in a National Cancer Institute survey. The researchers compared the survey answers against expert guidelines for the various screening tests.
They found that while most doctors correctly recommended beginning screening for adults at average risk for colon cancer at age 50, and correctly recommended how often screening was needed, only 19 percent followed the guidelines for the different types of tests they recommended.
Doctors who followed screening guidelines tended to be younger and board-certified, Yabroff’s group noted.
In addition, they were more likely to use electronic medical records and take patient preferences into account. They were also likely to be influenced by the clinical evidence behind the screening guidelines, the researchers found.
Moreover, many doctors either overused or underused certain tests, Yabroff’s team found. For example, colonoscopy was the test many doctors recommended more frequently than the guidelines called for.
Colonoscopy is the most expensive screening test and the most commonly recommended, the researchers found. They note that overuse of screening can result in unnecessary follow-up testing and an increased risk of complications.
On the other hand, some doctors recommended starting colon cancer screening in patients older than age 50, or at intervals that are less frequent than guidelines recommend. Underuse of screening can result in fewer cancers being found at an early stage when they are more likely to respond to treatment, Yabroff’s group says.
Commenting on the study, Dr. Durado Brooks, director of colorectal cancer at the American Cancer Society, said that “the good news is that most of these physicians do recommend colorectal cancer screening. The concern is how inexact their recommendations are.”
Brooks noted that the knowledge gap around the guidelines is occurring mostly in older doctors. They often continue to practice as they have since they were trained and aren’t keeping up with the latest recommendations, he said.
“We need to figure out how to disseminate that information effectively to people once they have been out in practice,” he said. But as the number of doctors using electronic health records increases, adherence to guidelines will also increase, Brooks believes.
Patients also have a role to play in cancer screening, Brooks said.
- First, they should be aware of the need for screening and
- Second, they should know which tests are available, when screening should start, and how often it’s needed, he said.
“As much as we can get people to take responsibility for their personal health and the health of their family members, the greater the likelihood that care can be given appropriately,” Brooks said.
What the Experts Recommend on Colon Cancer Screening
Here are the American Cancer Society’s current guidelines on checking for colorectal cancer and polyps (often precursors to cancer). Starting at age 50, men and women should follow one of these testing schedules:
To detect both polyps and cancer (preferred) :
- A flexible sigmoidoscopy every five years or a colonoscopy every 10 years (sigmoidoscopy examines the lower part of the colon, colonoscopy is more extensive)
- double-contrast barium enema once every five years
- or CT (“virtual”) colonoscopy once every five years
To primarily detect a cancer:
- Fecal occult blood test (gFOBT) or fecal immunochemical test (FIT) every year
- Stool DNA test (SDNA), interval as yet uncertain
Some people may require a different screening schedule due to personal or family history; the cancer society recommends that you talk with your doctor to determine which schedule is best for you.
For more information on colon cancer, visit the U.S. National Cancer Institute here.
An easy-to-remember formula for good health (0, 5, 10, 30, 150) is proposed in a wonderful editorial in American Family Physician titled “Preventive Health: Time for Change.” The author suggests this formula to physicians to “help patients achieve healthy lifestyle goals”:
- 0 = no cigarettes or tobacco products
- 5 = five servings of fruits and vegetables per day
- 10 = ten minutes of silence, relaxation, prayer, or meditation per day
- 30 = keep your BMI (body mass index) below 30
- 150 = number of minutes of exercise per week (e.g., brisk walking or equivalent)
The editorial is penned y Colin Kopes-Kerr, MD, from the Santa Rosa Family Medicine Residency in Santa Rosa, California:
It is time to make a decision. Which will be our health promotion strategy—primary prevention or secondary prevention?
Traditionally, the only one available to us was secondary prevention. Medicine consisted of a one-on-one physician-patient relationship, and taking care of patients meant minimizing the impact of any diseases the patient had. We did not have the time or tools to do anything else. More recently, we have been able to reduce a patient’s mortality by 20 to 30 percent by treating heart disease with a statin or beta blocker. These two medications have had the most dramatic effects in secondary prevention.
But now, the way we practice medicine has changed. We have a real choice to make. According to recent literature, primary prevention appears to work better than any other strategy in medicine. So why do some physicians not implement primary prevention? Despite the literature, maybe physicians are not getting the news. We need to keep repeating the message to physicians and patients that primary prevention is simple and effective. Next, we need to take a look at our own behavior as physicians and determine if it makes sense in the context of primary prevention.
There are 10 major studies on the effects of primary prevention.(1–15) These studies demonstrate very large correlations between specific healthy lifestyle behaviors and decreases in major chronic diseases (e.g., diabetes mellitus, heart disease, stroke, cancer) and all-cause mortality.
Although these studies offer a complex array of data to sift through, the elements of a healthy lifestyle are clear: not smoking, regular exercise, healthy diet, healthy body weight, and reduced stress.
Although exercise guidelines vary, I ascribe to the U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans, which recommends at least 150 minutes of brisk walking or the equivalent per week.(16) For the diet criterion, the Atherosclerosis Risk in Communities study illustrates that merely consuming five servings of fruits and vegetables per day is associated with the same benefits as consumption of a Mediterranean-style diet.(11) A standard of five servings of fruits and vegetables is much easier to remember and adhere to.
There is strong support for at least one weight-related variable in a healthy lifestyle. This may include body weight, body mass index (BMI), waist circumference, or waist:hip ratio. The INTERHEART study showed waist:hip ratio to be the most predictive of cardiovascular disease.(6) However, unlike BMI calculation, measurement of weight:hip ratio has not yet become standard in U.S. practices. I use BMI as the metric, and a value less than 30 kg per m2 as the cutoff between a healthy and unhealthy lifestyle. The goal is to move away from this outer limit toward a more ideal parameter, such as less than 25 kg per m2.
The final variable of a healthy lifestyle, which has strong support from the INTERHEART study, is stress reduction.(7) The INTERHEART study offers useful suggestions for measuring stress—perception of severe stress at home or at work, financial stress, or major life events.(7)
The minimal lifestyle intervention that would be beneficial is not defined. However, 15 to 20 minutes of silence, relaxation, or meditation appears to be a common interval.(17) To be more inclusive of patients, I set the criterion to an even less restrictive amount, about 10 minutes per day.(17) This is enough time to produce a change in biorhythms and is achievable for most patients.
Information alone does not lead to behavior change, however. Motivational interviewing or brief negotiation is a new framework that can close the gap between knowledge of available lifestyle interventions and changing behaviors. The framework has already been proven markedly effective for tobacco, drug, and alcohol addiction.(18) Few physicians have received the training necessary to implement motivational interviewing or brief negotiation. Resources for learning about these skills include the Kaiser Permanente Medical Group Web site and the book Motivational Interviewing in Health Care: Helping Patients Change Behavior.(18)
In terms of health, we can have it all. We have the requisite tools to convert knowledge into healthy behaviors. This newfound power to reduce diabetes, heart disease, stroke, cancer, and all-cause mortality with primary prevention strategies should impel us to change how we counsel patients. Research is needed to explore why some physicians are not making this change.
Address correspondence to Colin Kopes-Kerr, MD, at firstname.lastname@example.org. Reprints are not available from the author.
Author disclosure: Nothing to disclose.
- Stampfer MJ, Hu FB, Manson JE, et al. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000;343(1):16–22. View here
- Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001;345(11):790–797. View here
- Forman JP, Stampfer MJ, Curhan GC. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009;302(4):401–411. View here
- Knowler WC, Barrett-Connor E, Fowler SE, et al.; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403. View here
- Knoops KT, de Groot LC, Kromhout D, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA. 2004;292(12):1433–1439. View here
- Yusuf S, Hawken S, Ounpuu S, et al.; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infraction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–952. View here
- Rosengren A, Hawken S, Ounpuu S, et al.; INTERHEART Investigators. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):953–962. View here
- Chiuve SE, McCullough ML, Sacks FM, et al. Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation. 2006;114(2):160–167. View here
- Chiuve SE, Rexrode KM, Spiegelman D, et al. Primary prevention of stroke by healthy lifestyle. Circulation. 2008;118(9):947–954. View here
- Kurth T, Moore SC, Gaziano JM, et al. Healthy lifestyle and the risk of stroke in women. Arch Intern Med. 2006;166(13):1403–1409. View here
- King DE, Mainous AG III, Geesey ME. Turning back the clock: adopting a healthy lifestyle in middle age. Am J Med. 2007;120(7):598–603. View here
- Khaw KT, Wareham N, Bingham S, et al. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study [published correction appears in PLoS Med. 2008;5(3):e70]. PLoS Med. 2008;5(1):e12. View here
- Ford ES, Bergmann MM, Kröger J, et al. Healthy living is the best revenge: findings from the European Prospective Investigation into Cancer and nutrition–Potsdam study. Arch Intern Med. 2009;169(15):1355–1362. View here
- Lee CD, Sui X, Blair SN. Combined effects of cardiorespiratory fitness, not smoking, and normal waist girth on morbidity and mortality in men. Arch Intern Med. 2009;169(22):2096–2101. View here
- Djoussé L, Driver JA, Gaziano JM. Relation between modifiable lifestyle factors and lifetime risk of heart failure. JAMA. 2009;302(4):394–400. View here
- U.S. Department of Health and Human Services. 2008 physical activity guidelines for Americans. View here.
- Dialogue Partner. View here
- Rollnick S, Miller WR, Butler CC. Motivational Interviewing in Health Care: Helping Patients Change Behavior. New York, NY: Guilford Press; 2008. View here
Most of us are aware of the many, many benefits to the baby when the mom chooses to breastfeed … especially when mom exclusively breastfeeds for at least six months. But, did you know that there are benefits for the breastfeeding mom? And, it’s not just psychological. Here’s a study showing that breastfeeding your baby for only one month may help prevent diabetes in the mom in the future — and this may be especially helpful information for moms with gestational diabetes, as they are more likely to develop diabetes later in life. Here are the details from WebMD:
Breastfeeding for a month or longer appears to reduce a woman’s risk of getting diabetes later in life, according to a new study.
The breastfeeding and diabetes link has been reported in other studies, according to researcher Eleanor Bimla Schwarz, MD, assistant professor of medicine at the University of Pittsburgh School of Medicine.
Her study lends more credence to the link, she says. “Moms who had ever breastfed were much less likely to develop diabetes,” Schwarz tells WebMD. ”Moms who had never breastfed had almost twice the risk of developing diabetes as moms who had.”
The study is published in The American Journal of Medicine. It was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Child Health and Development.
Breastfeeding and Diabetes: A Closer Look
Schwarz and colleagues looked at data gathered for another study on risk factors for incontinence, evaluating information given for that study on breastfeeding practices and whether the women later developed diabetes. The women were ages 40 to 78 and all members of a large health maintenance organization in California.
The researchers evaluated data on 2,233 women. Of those, 405 were not mothers, 1,125 were mothers who breastfed for at least a month, and 703 were mothers who had never breastfed.
The risk of getting a diagnosis of type 2 diabetes for women who breastfed all their children for a month or longer was similar to that of women who had not given birth.
But mothers who had never breastfed were nearly twice as likely to develop diabetes as women who had never given birth.
Moms who never exclusively breastfed were about 1.4 times as likely to develop diabetes as women who breastfed exclusively for one to three months, Schwarz found.
Later in life, here is the breakdown of who developed diabetes:
- 17.5% of the women who hadn’t given birth.
- 17% of the women who breastfed all their children for a month or longer.
- 20.3% of those who breastfed, but not all children for a month or longer.
- 26.7% of moms who didn’t breastfeed.
Overweight and obesity were common among the participants, with 68% having a body mass index of 25 or more, considered outside the healthy weight range.
The link held, Schwarz says, even after controlling for factors such as weight, physical activity, and family history of diabetes.
While one month of breastfeeding appears to make a difference, Schwarz says even longer is better. “Previous studies have shown the longer the mom breastfeeds, the more benefit for your body.”
Many experts recommend exclusive breastfeeding for six months and continuing [supplemented by food] for a year,” she says. “Clearly it’s hard for moms to always negotiate breastfeeding given the constraints of their work environment,” she tells WebMD.
Breastfeeding and Diabetes: Explaining the Link
The diabetes-breastfeeding link is probably explained by belly fat, Schwarz says. Moms who don’t breastfeed, as they get older, may have more belly fat, she says, as breastfeeding helps new mothers take off weight. “Belly fat increases the risk of diabetes as you get older.”
Some research has shown that breastfeeding may increase sensitivity to insulin, in turn reducing diabetes risk. But that may be short-term — while the breastfeeding is occurring, Schwarz says. “The real problem may be the belly fat.”
The finding that breastfeeding lowers the risk of diabetes later isn’t surprising at all, says Kimberly D. Gregory, MD, MPH, vice-chair of Women’s Healthcare Quality and Performance Improvement at Cedars-Sinai Medical Center, Los Angeles, who reviewed the study findings for WebMD.
She often counsels women who get gestational diabetes (occurring during pregnancy) that they are at risk for later getting type 2 diabetes and suggests they breastfeed.
The new findings, Gregory tells WebMD, will probably inspire her to add to the advice she gives moms-to-be about the benefits of breastfeeding. She often focuses on the benefits to the baby during that discussion, says Gregory, a professor of obstetrics and gynecology at the University of California Los Angeles School of Public Health.
But with the new research, she says, she may expand on that discussion. “I think it would make me say, ‘Oh by the way, breastfeeding would also help you lose your weight faster and could possibly decrease your likelihood of becoming diabetic later in life.”
The Wall Street Journal reports that, according to a study published in the journal Archives of Internal Medicine, substituting white rice with brown rice may decrease the chances of developing type 2 diabetes. Substituting other whole grains in place of white rice may reduce the risk even further.
CNN reports that researchers from the Harvard School of Public Health estimate that if people “eat a little more than two servings of white rice (about 12 ounces) per week, switching to brown rice will lower” the “risk of developing type 2 diabetes by 16 percent.”
By replacing “those servings of white rice with whole grains in general, they estimate, your diabetes risk will decline … by 36 percent.”
To reach those conclusions, researchers “mined data from three large, long-term trials – the Health Professionals Follow-up Study and the Nurses’ Health Study I and II – for a combined study population of 157,463 women and 39,765 men, ranging in age from 26 to 87,” the Time magazine “Wellness” blog reported.
“The participants were followed for 14 to 22 years, and asked periodically to fill out comprehensive questionnaires about their eating habits.”
Today, I have three blogs to encourage all of you who, when you wake up at the crack of dawn each day need your coffee. Some of you think it’s healthy. Some of you worry it may not be. So, I hope these blogs will bring you the latest “medical news that you can use” on the health benefits and risks of a beverage that’s chock full of antioxidants … coffee. This first blog report is an excellent review of the published data published in USA Today:
“I’m up every morning by 5 o’clock. Coffee gets the energy going,” says the owner of Natalia’s Elegant Creations in Falls Church, Va.
Kost-Lupichuk is among 56% of American adults who drink coffee regularly, the National Coffee Association says.
Though many refer to their java habit as an unhealthy indulgence, experts say that in moderation, a cup or two of joe a day actually has numerous health perks.
“People always talk about it as if it’s a little bad for you. That’s not necessarily true,” says Donald Hensrud, associate professor of Preventive Medicine and Nutrition at the Mayo Clinic. “Coffee contains over 2,000 different chemical components, including cancer-fighting anti-oxidants.”
Some studies suggest coffee can boost vision and heart health, says registered dietitian Elisa Zied, author of Nutrition at Your Fingertips. Research also has suggested coffee helps people with liver disease, but it has had mixed results when it comes to diabetes.
But be aware of how much caffeine you’re consuming, because it varies among coffee drinks, says Mary Rosser, assistant professor of obstetrics and gynecology at Montefiore Medical Center in the Bronx, N.Y.
Loading up on cream and sugar is a bad idea, Hensrud says. A Starbucks venti 24-ounce double chocolate chip frappucino has 520 calories, 14 grams of saturated fat and 75 grams of carbohydrates. Pregnant women and people with anxiety and sleep problems should especially watch their intake, he says.
Also, people metabolize caffeine differently — the result of genetic differences, Hensrud says.
Caffeine’s influence can last for 10 hours or more, says researcher Jim Lane, a professor of medical psychology at Duke. He recommends pacing yourself throughout the day: “It’s nice to have places to meet friends that aren’t alcohol-related, but it does sort of encourage people to ignore the drug effects of caffeine.”
More on coffee’s perks and pitfalls:
Recent research suggests caffeine could help protect against cognitive decline, including Alzheimer’s disease and other dementia, says Mayo’s Hensrud. Large clinical trials are still needed, though, says Duke aging expert Murali Doraiswamy. “We still don’t know the right dose for seniors,” Doraiswamy says. “Bottom line: I would not recommend caffeine solely as a preventive strategy for dementia.”
Convinced you need a morning cup to wake up? Research online this month in Neuropsychopharmacology suggests frequent coffee drinkers develop a tolerance to the anxiety-producing and stimulatory effects of caffeine. A study last month suggests those who consume caffeine perform better on the job.
Coffee exacerbates bad breath, Zied says. It also can give teeth a yellow tinge.
Although research suggests drinking five or six cups a day might reduce the risk of developing type 2 diabetes, other studies show caffeine can exaggerate blood sugar problems in people who already have it, says Duke’s Lane.
High levels of caffeine can exert a laxative effect in some people but constipate others, Zied says. Heartburn and peptic ulcer patients should steer clear, too.
Too much coffee at once can increase blood pressure, but a cup or two a day generally does no harm to heart health, says Carl Lavie, medical director of Cardiac Rehabilitation and Prevention at John Ochsner Heart and Vascular Institute in New Orleans. Rarely, overindulgence can increase heart rate and cause heart rhythm disturbances, he says.
See more information about how coffee may prevent heart disease in my other blogs on the topic.
“Coffee intake is associated with a reduced risk of cirrhosis and liver cancer,” Hensrud says.
Hensrud says coffee can ease migraines in some people. Coffee lovers who drink at work each day should keep up the habit on weekends, because skipping coffee can lead to withdrawal headaches, he says.
Too much coffee can increase anxiety, Zied says, especially in people who are prone to panic attacks. Lane has done studies showing that caffeine ups adrenaline and stress, especially if the body is already under stress.
The March of Dimes and the Food and Drug Administration recommend no more than 200 milligrams of caffeine a day for pregnant women and nursing mothers, says Montefiore obstetrician Rosser. More can affect babies in utero — increasing the heart rate and possibly slowing fetal growth. Trying to get pregnant? Same recommendation. But if infertility is a concern, avoid coffee.
The caffeine in coffee is a stimulant. It can make you jittery and contribute to insomnia, says sleep expert Craig Schwimmer, medical director of The Snoring Center in Dallas.
“It’s all in how you use it,” he says, explaining that caffeine has a half-life of about six hours. A couple of cups in the morning is fine, but for those with sleep troubles, cut coffee at least six hours before bedtime.
The amount of fish oil one has to take each day depends upon why one is taking it. Here are some diseases and the amount of the effective daily doses of total fish oil or EPA and DHA (the most active components of fish oil) needed for each disorder (according to the experts at the Natural Medicines Comprehensive Database): Continue reading
In my Amazon.com best-selling book, SuperSized Kids: How to protect your child from the obesity threat, I predicted that if we did not stem the epidemic of childhood obesity, that our children could become the first generation in American history to have a shorter life expectancy than their parents.
Now, the New York Times is reporting on a study published in the New England Journal of Medicine “that tracked thousands of children through adulthood found the heaviest youngsters were more than twice as likely as the thinnest to die prematurely, before age 55, of illness or a self-inflicted injury.”
While “youngsters with … pre-diabetes were at almost double the risk of dying before 55, and those with high blood pressure were at some increased risk,” it was obesity that was “most closely associated with an early death, researchers said.”
These “data come from a National Institutes of Health study that began in 1965,” USA Today reports.
After tracking “4,857 American Indian children in Arizona for an average of 24 years,” investigators found that “children who were the heaviest – the top fourth – were more than twice as likely to die early from natural causes, such as alcoholic liver disease, cardiovascular disease, infections, cancer, and diabetes, as children whose weight put them in the lowest quarter of the population.”
Bloomberg News reports, “The number of overweight and obese children has tripled since 1980, according to the US Centers for Disease Control and Prevention.”
Approximately “17 percent of US children ages two to 19 years old are considered obese and almost 12 percent are considered the heaviest kids, according to a CDC study released in January.”
The current study’s “findings detail the ‘serious health consequences’ that children might face as they get older, lead study author Paul Franks said.”
WebMD reported, “Death rates from natural causes among children in the highest group of glucose intolerance (a risk factor for developing diabetes) were 73% higher than among the children in the lowest group of glucose intolerance, the researchers found.”
While “no substantial links were found between cholesterol levels and premature deaths,” the study authors “did find that high blood pressure in childhood raised the risk of premature death from natural causes by about 1.5 times.”
HeartWire reported that an accompanying editorial “notes that the causes of obesity and diabetes appear to be rooted in culture – inactivity and large portion sizes of calorie-dense fast food – and that fighting these diseases with ‘clinical and adult-based approaches’ is akin to ‘pasting a small bandage on a gaping wound.'”
The new study is timely and important, says Marc Jacobson, MD, a Great Neck, N.Y., pediatrician who specializes in caring for children with obesity and cholesterol problems. “It gives us more hard data about the long-term effects of adolescent obesity,” he says.
Jacobson serves on the American Academy of Pediatrics’ Obesity Leadership Workgroup. The Academy recommends that BMI be measured in all children and that those with a BMI above the 85th percentile be helped to get it below the 85th percentile, which is considered a healthy weight, he says.
The American Academy of Pediatrics has a tool parents can use called 5210, Jacobson says. “It’s used to prevent childhood obesity.” It stands for:
- 5 servings of fruits and vegetables daily
- 2 hours or less of television viewing daily
- 1 hour of exercise daily
- 0 or nearly zero sugar-sweetened beverages daily
In the editorial accompanying the new study, Edward W. Gregg, PhD, of the DC, notes that the Pima Indians studied in the research are sometimes viewed as not representative of the U.S. population because their risk of diabetes is especially high.
But, he points out that 4% of the participants in the study had impaired glucose tolerance, a percentage similar to the 3% of U.S. teens overall who have the condition. And the condition affects 9.5% of obese teens, he says.
So, what’s a family to do? What if you are your children are overweight or obese? I have a number of resources to assist you:
- My Amazon.com best-selling book, SuperSized Kids: How to protect your child from the obesity threat. You can order the book here, read the Table of Contents here, or read the first chapter here.
- My SuperSized Kids Web site, that you can find here.
- My SuperSized Kids assessment tool that will help you evaluate the activity and nutrition habits of your family. That assessment tool is available for free here.
- My 8-Week Family Fitness Plan (SuperSized Kids 8-Week Plan), available for freehere.
MedScape reports that daily supplements of calcium plus vitamin D, but not of vitamin D alone, are associated with significantly reduced fracture risk, according to the results of a patient level-pooled analysis reported in the January 12 issue of the BMJ.
“A large randomised controlled trial in women in French nursing homes or apartments for older people showed that calcium and vitamin D supplementation increased serum 25-hydroxyvitamin D, decreased parathyroid hormone, improved bone density, and decreased hip fractures and other non-vertebral fractures,” write B. Abrahamsen, from Copenhagen University Hospital Gentofte, in Copenhagen, Denmark, and colleagues from the DIPART (vitamin D Individual Patient Analysis of Randomized Trials) Group.
“Subsequent randomised trials examining the effect of vitamin D supplementation — with or without calcium — on the incidence of fractures have produced conflicting results. … We used individual patient data methods to do a meta-analysis of randomised controlled trials of vitamin D — with or without calcium — in preventing fractures and investigated if treatment effects are influenced by patients’ characteristics.”
The goals of the study were to identify characteristics affecting the antifracture efficacy of vitamin D or vitamin D plus calcium regarding any fracture, hip fracture, and clinical vertebral fracture and to evaluate the effects of dosing regimens and coadministration of calcium.
Selection criteria were randomized trials with at least 1 intervention group in which vitamin D was given, in which there were at least 1000 participants, and in which fracture was an outcome. The investigators identified 7 major randomized trials of supplementation with vitamin D plus calcium or with vitamin D alone, enrolling a total of 68,517 participants.
Mean age was 69.9 years (range, 47 – 107 years), and 14.7% of participants were men. Significant interaction terms were identified with logistic regression analysis, followed by Cox’s proportional hazards models incorporating age, sex, fracture history, and use of hormone therapy and bisphosphonates.
Overall risk for fracture was decreased in trials using vitamin D with calcium (hazard ratio [HR], 0.92; 95% confidence interval [CI], 0.86 – 0.99; P = .025), and risk for hip fracture was also decreased (HR for all studies, 0.84; 95% CI, 0.70 – 1.01; P = .07; HR for studies using 10 μg of vitamin D given with calcium, 0.74; 95% CI, 0.60 – 0.91; P = .005).
There were no significant effects for vitamin D alone in daily doses of 10 μg or 20 μg, nor was there any apparent interaction between fracture history and treatment response. No interaction was noted for age, sex, or use of hormone replacement therapy.
“This individual patient data analysis indicates that vitamin D given alone in doses of 10-20 μg is not effective in preventing fractures,” the study authors write. “By contrast, calcium and vitamin D given together reduce hip fractures and total fractures, and probably vertebral fractures, irrespective of age, sex, or previous fractures.”
Limitations of this study include lack of data for 4 of the 11 identified studies meeting inclusion criteria, and insufficient information about compliance to do a per protocol analysis. In addition, only a single study provided data for vitamin D given alone at the lower dose.
“We must emphasise that this analysis does not allow for a direct comparison of vitamin D against vitamin D given with calcium, but only comparisons between each intervention and no treatment,” the study authors conclude.
“Whether intermittent doses of vitamin D given without calcium supplements can reduce the risk of fractures remains unresolved from the studies in this analysis. Additional studies of vitamin D are also needed, especially trials of vitamin D given daily at higher doses without calcium.”
In an accompanying editorial, Dr. Opinder Sahota, from Queen’s Medical Centre in Nottingham, United Kingdom, notes that these findings are important because they show that vitamin D alone, irrespective of dose, does not reduce the risk for fracture.
“Although the evidence is still confusing, there is growing consensus that combined calcium and vitamin D is more effective than vitamin D alone in reducing non-vertebral fractures,” Dr. Sahota writes.
“Higher doses are probably necessary in people who are more deficient in vitamin D, and treatment is probably more effective in those who maintain long term compliance. Further studies are needed to define the optimal dose, duration, route of administration, and dose of the calcium combination.”
Here are some of my other blogs on vitamin D:
- Heart patients lacking vitamin D more likely to be depressed
- Vitamin D deficiency in kids is getting more attention
- Study suggests 70 percent of children, young adults do not get enough vitamin D
- More reasons to consider having your vitamin D level checked – you may think better and have less arthritis
- Specific vitamins and a supplement (B vitamins, vitamin D, and calcium) may lower risk of stroke, blindness, and cancer
- Vitamin D tests soar as deficiency, diseases linked
- Lack of vitamin D raises death risk
- Vitamin D Recommendations for Teens May Be Too Low
- Vitamin D may protect against heart attack
- Low Vitamin D Levels Associated with Artery Disease
We all know that breastfeeding has myriad benefits for the baby. Breastfeeding reduces babies’ risk of these diseases by these percentages:
- Sudden Infant Death Syndrome (SIDS): 36%
- Type 1 Diabetes: 19-27%
- Type 2 Diabetes: 39%
- Leukemia (acute lymphocytic) : 19%
- Leukemia (acute myelogenous): 15%
- Asthma: 27%
- Gastrointestinal infections: 64%
- Lower respiratory tract diseases: 72%
- Atopic dermatitis: 42%
- Acute otitis media: 50%
We know that breastfeeding has psychological benefits for the mother — and that there are physical benefits for the mother including the fact that it is easier for a breastfeeding mother to loose weight after the birth and breast feeding helps reduce the risk of some types of cancer by these percentages:
- Ovarian cancer: 21%
- Breast cancer: 28%
Other health benefits to mothers who breastfeed include reduced risk of type 2 diabetes, reduced risk of osteoporosis, faster return of the uterus to its prepregnant state, steady weight loss based on use of fat deposits laid down during pregnancy for early milk production, and slower return of menses which can aid in natural child spacing.
Now, new reports indicate another breast feeding benefit for the mother.
USA Today reports that “breastfeeding may offer mothers long-term protection against a condition linked to diabetes and heart disease.”
Analyzing data on “704 women in an ongoing, government-funded study of heart-disease risk factors,” a team from Kaiser Permanente’s Division of Research found that “the longer women breast-fed, the lower their chance of developing metabolic syndrome.”
Even breastfeeding “for just a couple of months can significantly lower a woman’s risk of metabolic syndrome,” HealthDay reported.
“In women who didn’t have pregnancy-related (gestational) diabetes, breast-feeding between one and five months lowered a woman’s risk of developing metabolic syndrome by 39 percent, while breast-feeding for the same duration lowered the risk of the syndrome by 44 percent in women with gestational diabetes.”
WebMD reported, “In the population as a whole, breastfeeding for longer than nine months was associated with a 56% reduction in risk for developing metabolic syndrome during the follow-up period.”
In comparison, “in women who developed gestational diabetes during one or more pregnancies, the risk reduction was 86%.”
The study, which “was funded by the National Institutes of Health,” will appear “in … the journal Diabetes.”
USA Today reports that “seven out of 10 children and young adults don’t get enough vitamin D, which could increase their risk for bone and heart problems,” according to a study published online in the journal Pediatrics. Is your child at risk? And, what can you do?
More Information: Continue reading
One of the things people tell me is most difficult for them when it comes to starting to exercise regularly is just getting started. Now a study published in the journal BioMed Central Endocrine Disorders suggests that people unable to meet government guidelines calling for moderate to vigorous exercise 30 minutes a day, or several hours per week, can actually benefit from significantly less exercise.
More Information: Continue reading
Here are my takes on some of today’s health headlines:
A new systematic review reports to have “the strongest evidence to date” that supplemental vitamin D in babies and children may help reduce the risk of later development of type 1 diabetes by 29 percent.
Readers of this blog have read me frequently comment on the host of health problems prevented by vitamin D. Continue reading