While laws to help make it easier for everyone to get their veggies are cropping up all over, some would-be planters get stopped in their carrot tracks by regulations that prohibit use of public spaces for planting, or even limit what can be grown on private property, according to a recent article in the Wall Street Journal [note: subscription required]. In some jurisdictions, according to the article, sidewalk gardeners have been fined and may lack the clout to advocate for changing the laws.

>>Bonus Link: Read about Urban Farming, a nonprofit group with high-profile corporate sponsors that supports gardens on unused land.

Doctors’ Knowledge of Lab Test Costs Reduces Unnecessary Testing
Knowing the cost of a laboratory tests makes doctors less inclined to order them for hospitalized patients, according to a new study in JAMA Internal Medicine. About $226 billion was wasted on unnecessary tests in 2011, according to the study from researchers at The Johns Hopkins University School of Medicine in Baltimore. Unnecessary tests also increase the risk of patient harm and false positives. "The rational approach to ordering tests is something we should all be interested in, and something—if we did better—that would save the system money and save the patients the horror of causing harm," said Leonard Feldman, MD, of Johns Hopkins. Read more on access to health care.

Mass. Study Shows Importance of Simplifying Health Insurance Benefits Options
Just six months before open enrollment for the Affordable Care Act’s health insurance marketplaces begins, a new study in the journal Health Affairs shows that some Massachusetts families who enrolled in unsubsidized Commonwealth Health Insurance Connector Authority plans experienced higher financial burdens due to health care costs. The study found that 38 percent saw financial burdens and 45 percent saw higher-than-expected out-of-pocket costs—indicating that lower-income families with increased health care needs and multiple children are at particular risk for higher costs. “Given the complexity of health insurance choices and consumers’ limited understanding of health insurance benefits, policy makers need to reach out and simplify information to promote optimal plan choices for the people,” wrote the study’s authors. Read more on community health.

CSPI Classifies Ginkgo Biloba as ‘Avoid’
The Center for Science in the Public Interest (CSPI) is now recommending people avoid Ginkgo biloba after a National Toxicology Program study linked it to liver cancer in mice and thyroid cancer in rats. The substance can be found in many dietary supplements, herbal teas and energy drinks. "Ginkgo has been used in recent years to let companies pretend that supplements or energy drinks with it confer some sort of benefit for memory or concentration," said CSPI executive director Michael F. Jacobson. "The evidence for those claims has been dubious, at best. The pretend benefits are now outweighed by the real risk of harm." The U.S. Food and Drug Administration has previously sent warning to drink manufacturers stating that the ingredient is not generally considered safe for food. Read more on nutrition.

Small Amounts of Daily Exercise Can Help Teens Quit Smoking
As little as 30 minutes of daily exercise can help kids quit smoking, according to a new study in the Journal of Adolescent Health. It can also help to reduce tobacco use. Researchers found that daily smokers were more likely to reduce or quit smoking if they combined a fitness program with a smoking cessation program, rather than just a cessation program alone. Every teen in the study smoked an average of half a pack of cigarettes each weekday and a full pack a day on weekends. And that was just one of the poor health habits of many of the participants. "It is not unusual for teenage smokers to engage in other unhealthy habits,” said author Kimberly Horn, associate dean for research at the George Washington University School of Public Health and Health Services. “Smoking and physical inactivity, for instance, often go hand in hand.” According to the U.S. Centers for Disease Control and Prevention, about 13 percent of Americans age 18 and under smoke tobacco. Read more on tobacco.

Study: Low Food Security, Exposure to Violence Closely Linked
There is a close correlation between low food security and exposure to violence, according to a new study in Public Health Nutrition. Researchers spoke with forty-four mothers of children age 3 and under who participated in public assistance programs, finding increased exposure to violence, which in turn increased the chance of negative mental health, an inability to continue school and an inability to make a living wage.  The violence included child abuse, neglect and rape. The study clearly demonstrates the need to consider and include violence prevention efforts when establishing policies to deal with hunger. Read more on violence.

Size of Parents’ Social Groups Can Affect Whether Kids are Vaccinated
What they hear from friends and the people in their social group may affect whether parents have their children vaccinated, according to a new study in the journal Pediatrics. Parents who were less likely to vaccinate were also more likely to have large social groups and rely on books, pamphlets and the Internet for information on vaccines. "I think that what needs to be done is that everybody needs to understand the importance of vaccines,” said Joseph Anthony Bocchini, Jr., MD, chairman of Pediatrics Medicine at Louisiana State University Health Sciences Center in Shreveport. “And they're not only important for the people who receive them but they're also important for the community." About 95 percent of kindergarten-aged children are appropriately vaccinated, according to the U.S. Centers for Disease Control and Prevention. Read more on vaccines.

Smaller, Frequent Meals Help Kids Keep Weight Off
Smaller, more frequent meals can help kids ward of overeating and obesity, according to several new studies in the journal Pediatrics. One study found that simply using smaller dishware—thus forcing smaller portions—meant kids ate less; they found that adult-sized dishware led first-graders to take 90 calories more of food. Researchers also found kids who ate more often were 22 less likely to be overweight. "The results are very interesting and confirm our expectations that the impact of plate size on adults in the laboratory also apply to children," said Thomas Robinson, MD, a childhood obesity researcher at Stanford University, according to Reuters. "This study provides very important preliminary evidence that using smaller dishware may help reduce children's energy intakes." Read more on obesity.

Low-calorie Drinks Increasingly Popular for Kids
While sugary drinks remain popular, low-calories drinks are also gaining more and more consumers, according to a new study in the journal Pediatric Obesity. Researchers at the University of North Caroline (UNC) found both that consumption of calories from sweetened drinks was down and consumer of low-calorie drinks was up over a 10-year period. The findings were especially significant for kids. "The food industry is trying many ways to reduce the caloric content of foods and beverages," said Barry M. Popkin, PhD, W.R. Kenan Jr. Distinguished Professor of Nutrition at UNC's Gillings School of Global Public Health. "We are increasingly seeing them replace caloric sweeteners with low-calorie sweeteners. This trend has particularly emerged in the last three to four years as U.S. concern about obesity, diabetes and other complications of consuming excessive sugary high-calorie beverages has increased." Read more on nutrition.

Missed, Delayed Mammograms Increase Death Risk for Older Women
Older women with misses or delayed mammograms are significantly more likely to die from breast cancer, according to new research to be presented at the annual meeting of the American Association for Cancer Research. Researchers found “that 23 percent of women who had their last mammogram five or more years before being diagnosed with breast cancer had advanced cancer, compared with 20 percent of those who had a mammogram six months to a year before their diagnosis,” according to HealthDay. Increased time between mammograms also significantly increased the risk of death from cancer for women age 75 and older. Researchers said more study is needed to examine the connection. "It is possible that the differences in the relationship between screening interval and [death] in older versus younger women may be related to the more aggressive nature of the tumors in younger women, which might obliterate the effects of more screening,” said Michael Simon, MD, leader of the breast multidisciplinary team at the Barbara Ann Karmanos Cancer Institute in Detroit. “Other reasons may include differences in cancer treatment, information that was not available for this [group] of women.” Read more on cancer.

Study: Most Intend to Comply With Mandatory Hurricane Evacuation
Most residents of areas most likely to be hit by hurricanes—no matter their income level—intend to comply with mandatory evacuation orders, according to a new study in the journal Disaster Medicine and Public Health Preparedness. Researchers at The University of Texas School of Public Health did find variations with other demographic differences, such as age, ethnicity and education level. The findings indicate that disaster preparedness should focus more on how to best evacuate the most vulnerable residents, which could include targeted messaging and education. Read more on preparedness.

Breath Test May Identify People Prone to Obesity
A breath test that measures bacterial overgrowth in the stomach could be used to determine whether a person will become overweight, according to a new study in the Journal of Clinical Endocrinology & Metabolism. Researchers found that higher levels of methane and hydrogen from the bacteria Methanobrevibacter smithii were associated with higher BMIs and more body fat. Overgrowth of “bad” bacteria can also lead to bloating, constipation and diarrhea. While noting that obesity is “not a one-size-fits-all disease," study author Ruchi Mathur, MD, director of the outpatient diabetes treatment center at Cedars-Sinai Medical Center in Los Angeles, said this could help identify people who would respond best to particular weight loss methods. Read more on obesity.

Study Finds Most Major Restaurants Post Accurate Nutrition Info
A new study from Consumer Reports found that most major chain restaurants post accurate nutritional information about their food. Shoppers purchased and tested 17 menu items from restaurants and fast-food chains, comparing the results for each item to the same items purchased at other restaurants in the chain. They determined that only two items had higher fat or calorie content than advertised: Olive Garden’s Lasagna Primavera with Grilled Chicken and Outback Steakhouse’s Chicken on the Barbie. “We found that you can usually trust the figures you see,” said editor Leslie Ware. “On average, most of them were telling the truth.” The U.S. Food and Drug Administration is slated to release new regulations regarding nutrition labeling later this year. Read more on nutrition.

CDC: U.S. Kids Consume Nearly as Much Salt as U.S. Adults
The average U.S. kid consumes about as much salt in a day as the average U.S. adult—which is to say far too much, according to a new study in the journal Pediatrics. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found the average youth age 8 to 18 has a daily sodium intake of approximately 3,387 mg; the recommended daily limit is 2,300 mg. Processed foods are one of the biggest culprits. Excessive sodium is linked to a myriad of health issues. "We found that higher sodium intake was associated with higher blood pressure," said Janelle Gunn, a public health analyst with the CDC. "We found among overweight and obese participants (in the study), that for every 1,000 mg of sodium they consumed, their blood pressure response was seven times greater (compared to healthy-weight children)." Read more on nutrition.

Norovirus Top Cause of Pediatric Medical Care for Acute Gastroenteritis
Norovirus will cause about 1 in every 14 children to seek emergency care treatment and 1 in 6 to need outpatient care before the age of 5, according to a new study in the New England Journal of Medicine. Researchers determined the highly infectious norovirus is now the number one cause of the need for medical care for acute gastroenteritis in that age group. From 2009 to 2010 there were about 1 million pediatric medical care visits linked to norovirus. “Infants and young children are very susceptible to norovirus infections, which often result in a high risk of getting dehydrated from the sudden onset of intense vomiting and severe diarrhea,” said Daniel Payne, MD, an epidemiologist in the Division of Viral Diseases at the U.S. Centers for Disease Control and Prevention. Read more on infectious disease.

Study: Online Venting Will Probably Just Make You Angrier
That little bit of relaxation you feel right after responding to an infuriating comment on the internet may just be a brief respite on the path to long-term frustration, according to a new study in the journal Cyberpsychology, Behavior, and Social Networking. Lead author Ryan Martin, an associate professor of human development and psychology at the University of Wisconsin-Green Bay, said the anonymity and social distance of many online sites makes responding quickly and in anger too easy. While there are many good reasons to be angry, he said the healthier approach is to get involved with an issue that frustrates you and try to change things, rather than railing at a stranger on Facebook, Twitter or a blog site. "Most of these sites encourage venting as a way of dealing with anger," Martin said. "They think of venting as a healthy adaptive approach, and it's not." Read more on mental health.

U.S. Cesarean Delivery Rates Vary Widely
A new study in the journal Health Affairs finds that the rates of cesarean deliveries, the most common surgery in the United States, vary widely across the country, ranging from 7.1 percent to 69.9 percent of deliveries at close to 600 hospitals studied since 2009. About four million babies are born in the country each year. The study authors also looked at cesarean rates among low risk mothers and found that the variation rate for this group was higher—from 2.4 percent to 36.5 percent. "The variations we uncovered were striking in their magnitude, and were not explained by hospital size, geographic location, or teaching status," said Katy Kozhimannil, an assistant professor at the University of Minnesota’s School of Public Health and the lead researcher of the study. Cesarean rates have increased in the United States from 20.7 percent in 1996 to 32.8 percent in 2011, according to the study. There has been an increased focus on some cesarean deliveries performed before the baby is full term because of the many risks a baby faces when it is born prematurely. Another critical reason to address the issue, say the study authors, is that half of all U.S. births are paid for by the Medicaid program and cesarean births are much more costly than vaginal deliveries. Read more on maternal and infant health.

Chronic Disease Management for Medicaid Beneficiaries Could Lower Health Costs
A recent study of 75,000 women on Medicaid by researchers at the East Tennessee State University found that women with low incomes have a high prevalence of physically disabling conditions and chronic disease. Common chronic diseases included high blood pressure, depression, multiple sclerosis, arthritis, injury, back disorder and Parkinson’s disease. The researchers also found that women who used a mobility device—such as a walker, crutches, or wheelchair—were more likely to suffer from chronic diseases such as diabetes, pulmonary disease, and depression. “These are not women of retirement age. These are rates of chronic disease and disability in a working-age population, so the economic loss to society and the impact on health care costs is substantial," said Amal Khoury, MD, a professor and chair in the department of health services management and policy and the lead author of the study.  "Strategies to improve chronic disease management in the younger adult population may curtail higher disability rates in working-age adults and lower Medicaid and Medicare costs in the long run." Read more on prevention.

Fundraisers at U.S. Schools Too Often Sell Unhealthy Foods
Many public U.S. elementary schools ignore state and district policies banning unhealthy fundraisers, according to a study by researchers at the University of Illinois at Chicago. In the study, principals of 1,215 schools across the United States completed surveys on school food policies for the 2009-11 school years. Overall, only 39 percent of schools had nutritional restrictions on fundraisers, but schools within districts and states with strong policies were more than twice as likely to limit the sale of high-calorie and high-fat foods to raise money. Lindsay Turner, a researcher at the Institute for Health Research and Policy at the university and the lead author of the study, said “[i]t’s hard for schools to give up those financial resources, so that’s why it is essential to have alternative fundraising activities that don’t involve high-calorie products.” Turner ticked off alternatives suggested by the Center for Science in the Public Interest, including walk-a-thons and selling books, greeting cards, fruit, holiday decorations or wrapping paper. “This study puts fundraising on the radar as an issue that needs to be attended to in policy making,” said Turner. “There has been a lot of attention paid to competitive foods and beverages, and this is a really important piece of the entire picture of what’s going on in schools.” Read more on obesity.

AAP: Out-of-school Suspensions, Expulsions Harmful to Kids
Out-of-school suspensions and expulsions are generally counterproductive and can have profound long-term negative effects, according to the American Academy of Pediatrics (AAP). Data shows the youth are more likely to drop out of school, more likely to be involved in the juvenile justice system and will earn $400,000 less over a lifetime than a high school graduate. Such discipline also does not address potential underlying issues, such as drug abuse, racial tension, violence and bullying, according to AAP. AAP recommends early intervention programs to recognize and address behavioral and other problems. Recommendations also include a Positive Behavior Intervention and Support program to teach proper behavior at both the individual and school-wide levels. Read more on violence.

Study: 1 in 4 Admit to Bizarre Late-night Snacking
Approximately one in four students admit to creating and eating late-night crazy food concoctions, according to a new report in the International Journal of Eating Disorders. Researchers defined the relevant snacks as “strange food mixtures that you would be too embarrassed or ashamed to share with others” (e.g. sugar-covered scrambled eggs or mayo-smothered vegetables). While there is no inherent health danger in such mixing, health professionals recommend that people try to make healthy choices when selecting late-night snacks. About one-third of U.S. adults and nearly one in five youth ages 2-19 are obese, according to the U.S. Centers for Disease Control and Prevention. Read more on nutrition.

Study: Mediterranean Diet Good for Heart Health
A Mediterranean diet—rich in olive oil, nuts, fresh fruits, fresh vegetables and even red wine—is more effective than a low-fat diet at helping at helping people at high risk for cardiovascular disease to ward off health problems, according to a new report in the New England Journal of Medicine. Researchers found a 30 percent greater reduction in relative risk of a heart attack, stroke or death, according to lead author Miguel Angel Martinez-Gonzalez, MD, MPH, PhD, chairman of preventive medicine and public health at the Universidad de Navarra in Spain. He said the findings are likely to due to the good-quality fats and wide array of nutrients. The findings give further support to the effectiveness of a Mediterranean diet at preventing heart disease. Read more on heart health.

IOM Report Finds U.S. Global AIDS Efforts Successful, Stresses the Need to Help Countries Manage their Own Programs
A new report from the Institute of Medicine finds that the President's Emergency Plan for AIDS Relief (PEPFAR) has saved and improved millions of lives around the world. The report says the program also shows that HIV/AIDS services can be effectively delivered on a large scale even in countries with high rates of disease and resource challenges. The report also stresses the need for the program to increase its efforts to help partner countries develop the capacity to manage their own programs, sustain the gains that have been made in controlling the HIV epidemic and improve their citizens' access to services. PEPFAR was established in 2003 through legislation that authorized $15 billion for HIV/AIDS and other related global health issues over five years. In 2008, the legislation was reauthorized, providing up to $39 billion through 2013 for PEPFAR bilateral HIV/AIDS programs as well as U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. PEPFAR has supported HIV/AIDS programs in over 100 countries. As part of the reauthorization, Congress requested that IOM evaluate the program. That evaluation included visits to thirteen countries by the IOM's international committee of experts. Read more on HIV/AIDS.

Flu Vaccine 56 Percent Effective Overall, 27 Percent for Seniors
This season’s flu vaccine has been only 56 percent effective as of February and largely ineffective at protecting the elderly, according to the U.S. Centers for Disease Control and Prevention. It was only 27 percent effective for people ages 65 and older; 71 percent of Americans in that age group have been vaccinated. “The older you get, the less potent is your immune response,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Reuters. “This is just a fact of physiological life in the immune system.” He said better data on seniors is needed and there are ways to improve the vaccine going forward. Read more on influenza.

‘Smarter Lunchroom’ Setups Increase Kids’ Consumption of Fruits, Vegetables
Improving the location and attractiveness of fruits and vegetables in school cafeterias can help kids make healthier food choices, according to a new report in the Journal of Pediatrics. Researchers at the Cornell Center for Behavioral Economics in Child Nutrition Programs, in Ithaca, N.Y. also found that simply asking kids if they want to try one of the healthier choices can increase the odds. The inexpensive “smarter lunchroom” setup "not only preserves choice, but has the potential to lead children to develop lifelong habits of selecting and consuming healthier foods even when confronted with less healthy options," said study author Andrew Hanks. They found that post-makeover kids were 13 percent more likely to choose fruits and 23 percent more likely to choose vegetables. Read more on nutrition.

Expansion of Health Insurance Coverage Could Lead to Physician Shortage
A new study in Health Affairs finds that expansion of insurance coverage under the Affordable Care Act could increase demand, on average, for primary care physicians more than 5 percent above the current number of available doctors. It also found that seven million people live in areas where the demand will exceed the supply of primary care providers by more than 10 percent. The researchers say the study emphasizes the need to promote policies that encourage more primary care providers to practice in areas where shortages will be very high. Read more on health disparities.

Institute of Medicine Launches ‘Roundtable on Population Health Improvement
The Institute of Medicine has launched a Roundtable on Population Health Improvement to provide opportunities for experts on education, urban planning, medicine, public health, social sciences and other fields to make recommendations on improving the nation’s health. "The evidence is now clear that broader social and environmental factors play major roles in a person's likelihood to have a low birth weight baby—a risk for many serious health problems— or die of a heart attack or complications from diabetes," said roundtable co-chair David Kindig, Emeritus Professor of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison. "That's why it's essential to engage all these sectors—education, housing, transportation, community organizations, and business among others— in efforts to improve health outcomes." The issues the roundtable will address include expanding reimbursement to include more nonclinical, population-based interventions; reorienting the relationship between clinical medicine and public health in ways that will benefit population health outcomes; and engaging professionals from nonhealth fields in health improvement efforts. Read more on community health.

CDC: 11% of Daily Calories for Adults Comes from Fast Food
From 2007 to 2010 approximately 11 percent of the calories in American adults' daily diets came from fast food, according to a report from the U.S. Centers for Disease Control and Prevention. While high, the rate was down from 2003 to 2006, when about 13 percent of daily calories came from restaurants such as McDonald's, Burger King, Wendy's and Pizza Hut. "The good news from this study is that as we get older, perhaps we do get wiser and eat less fast food," said Samantha Heller, a clinical nutritionist at the NYU Center for Musculoskeletal Care in New York City. "However, a take-home message is that the study suggests that the more fast food you eat, the fatter you get." Read more on nutrition.