Category Archives: Nutrition
Study: Newly Insured Visit Emergency Departments More Often
While some experts have speculated that expanded insurance under the Affordable Care Act would decrease the rate of emergency department visits, a new study in the journal Science indicates that newly insured people actually visit the departments significantly more than people who were uninsured. The study of 25,000 Medicaid lottery participants in Oregon in 2008 found that people who received expanded coverage increased their visits by 40 percent—or 0.41 visits—over a period of 18 months. The visits encompassed all manner of health issues, included issues that could have been treated by a primary care physician and would have been covered by the insurance. Read more on access to health care.
Electronic Media Use During Family Meals Tied to Poorer Nutrition and Communication
The use of electronic devices—including television, music with headphones and texting—by teens during meals is linked to less nutritious food and poorer family communication, according to a new study in the Journal of the Academy of Nutrition and Dietetics. In a survey of more than 1,800 parents, researchers asked how often adolescent children used a variety of electronics during family meals, whether they had any rules regarding their use and whether they felt family meals were important; the children were asked questions about family communication, such as how often they discussed their problems with their parents. The study found that two thirds of the teens watched television or movies some of the time, with one quarter watching frequently. Other electronic activities were less common, occurring 18 to 28 percent of the time. About 75 percent of the families had limits on mealtime media. "There is no magic number of how many (family meals) to have, not all food at meals has to be 100% healthy and having electronic media at meals is not all bad (e.g., an occasional movie night with dinner) if it facilitates family time," said lead author Jayne A. Fulkerson. "But, parents can take small steps to have quality time with their children by reducing media use at mealtimes." Read more on nutrition.
Smoking Adds $17 Billion to Post-Surgery Costs Each Year
Smoking-related complications following surgery—for both current and former smokers—add an estimated $17 billion in direct U.S. medical costs each year, according to a new study in JAMA Surgery. The study, led by David Warner, MD, of the Mayo Clinic, looked at surgical patients between April 2008 and December 2009. While the costs for initial hospitalizations was relatively consistent for current smokers, former smokers and people who never smoked, post-surgery costs were an estimated $400 higher for current smokers and $273 higher for former smokers. Read more on tobacco.
FDA Proposes New Rules for Proving Effectiveness, Safety of Antibacterial Soaps
A new proposed rule from the U.S. Food and Drug Administration (FDA) would require manufacturers of antibacterial hand soaps and body washes to prove not only that their products are more effective than normal soap when it comes to preventing illness and infections, but that they are also safe for daily long-term use. Products that can’t meet these standards would need to be reworked before coming to market. The regulatory move comes as research suggests that not only are antibacterial products not helpful, but they could also be harmful in the long term, leading to bacterial resistance and hormonal problems. Hand sanitizers, wipes and other antibacterial products used in health care settings would not fall under the new regulations. “Antibacterial soaps and body washes are used widely and frequently by consumers in everyday home, work, school, and public settings, where the risk of infection is relatively low,” said Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research (CDER). “Due to consumers’ extensive exposure to the ingredients in antibacterial soaps, we believe there should be a clearly demonstrated benefit from using antibacterial soap to balance any potential risk.” Read more on infectious disease.
NIH, NFL to Research Ways to Diagnose, Treat Traumatic Brain Injuries
New research projects from the U.S. National Institutes of Health (NIH) will explore methods to diagnose and treat chronic traumatic encephalopathy, or CTE, in football players and others who experience head injuries and concussions. Current science only allows health care professionals to diagnose the traumatic brain injuries after death. "This is a public health problem," said Walter Koroshetz, deputy director of the NIH's National Institute of Neurological Disorders and Stroke. "We don't know the mechanics of the head injuries that lead to this, the number and severity that is required to get this. We don't know whether certain people based on their genes are more susceptible or not. There are a lot of questions to be answered." The National Football League will cover $12 million of the $14 million in research costs. Earlier this year the league agreed to pay as much as $765 million to former players who accused the league of covering up and downplaying the risks of brain injury. Read more on mental health.
Studies: Multivitamins, Supplements Don’t Improve Overall Wellness
Daily multivitamins and mineral supplements don’t prevent heart problems or memory loss, and are also not linked to longer lives, according to three new studies in the journal Annals of Internal Medicine. The researchers said the findings indicate that U.S. consumers should stop taking the dietary supplements, which are part of a multibillion-dollar U.S. industry. "We believe that it's clear that vitamins are not working," said Eliseo Guallar, MD, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, adding “"The probability of a meaningful effect is so small that it's not worth doing study after study and spending research dollars on these questions." Read more on nutrition.
CDC: Measles Remains a Threat to U.S. Health Security
Fifty years after the creation of the measles vaccine, the disease continues to be a very real public health threat both in the United States and globally, according to the U.S. Centers for Disease Control and Prevention (CDC). While a recent study in JAMA Pediatrics confirmed U.S. measles elimination starting in 2000 and sustained through 2011, international travel means people from countries where the disease persists could still bring it to the United States. Approximately 158,000 globally died from measles in 2011, with an average of 430 children dying each day. These facts illustrate the need to be vigilant in reporting suspected cases to public health departments. “The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day,” said CDC Director Tom Frieden, MD, MPH. “Someday, it won’t be only measles at the international arrival gate; so, detecting diseases before they arrive is a wise investment in U.S. health security.” Read more on infectious disease.
HHS: $55.5M to Strengthen Training of U.S. Health Professionals, Especially in Nursing
The U.S. Department of Health and Human Services has announced the planned investment of millions to strengthen training for health professionals and add more professionals to the U.S. health care workforce, with a clear emphasis on nursing workforce development. About $45.4 million of the $55.5 million in FY 2013 will go toward nursing, including adding to the number of nurse faculty ($22.1 million), improving nurse diversity ($5.2 million), promoting interprofessional collaborative practice ($6.7 million) and supporting nursing education ($9.2 million). The more than 270 grants will also deal with overall public health, behavioral health and dentistry. Read more on nursing.
Switching to a Healthy Diet Adds About $1.50 Daily to Food Costs
Switching to a healthier may lighten your wallet a bit, but not so much that it isn’t worth it, according to a new study in the journal BMJ Open. Looking at 27 studies in 10 countries, researchers found that a diet that emphasizes fruits, vegetables, nuts and fish will add about $1.50 per day, or $550 per year, to an individual’s food budget. Healthy proteins such as boneless, skinless chicken breast were behind most of the additional costs. While this difference could be an issue for low-income families, middle-class families shouldn’t see much of a problem in making the healthy switch, according to study author Mayuree Rao, a junior research fellow in the department of epidemiology at the Harvard School of Public Health. "$1.50 is about the price of a cup of coffee and really just a drop in the bucket when you consider the billions of dollars spent every year on diet-related chronic diseases." Read more on nutrition.
CDC Releases ‘Winnable Battles Progress Report 2010-2015’
The U.S. Centers for Disease Control and Prevention (CDC) has released its Winnable Battles Progress Report 2010-2015, which details the progress made in key areas where CDC has determined that progress is possible. The individual reports detail what’s been accomplished, and what still needs to be accomplished, to reach these goals by 2015. They include healthcare-associated infections; tobacco; nutrition, physical activity and obesity; food safety; motor vehicle safety; teen pregnancy; and HIV prevention. “By implementing the programs with the greatest potential impact, we are addressing Americans’ biggest health challenges while we try to get the most health bang for precious resources,” said CDC Director Tom Frieden, MD, MPH. Read more on the CDC.
Study: One-third of Kids’ Calories from Schools, Stores, Fast Food Restaurants are ‘Empty Calories’
In the battle to improve nutrition for kids, parents need to look beyond just fast food restaurants and take a closer look at food from grocery stores and at schools. A new study in the Journal of the Academy of Nutrition and Dietetics found that roughly a third of the calories consumed from each of these three sources constituted “empty calories” coming from added sugar or solid fat. The 2010 Dietary Guidelines for Americans recommends between 8 and 19 percent of calories should be “empty” for both kids and adults; excessive empty calories can lead to weight gain and obesity. While all three sources offered high counts of empty calories, they did so for different reasons, demonstrating the need to tailor health efforts to meet their particular obstacles. "Our study found that 20 percent of pizza and 22 percent of high-fat milk consumed by kids are provided by schools, and 72 percent of sugar-sweetened beverages like sodas, fruit drinks, sports drinks and energy drinks consumed by kids are obtained from grocery stores," said study author Jennifer M. Poti, a doctoral candidate in nutritional epidemiology at the University of North Carolina at Chapel Hill. Read more on nutrition.
American Headache Society: New Guidelines on Treating Migraines, Limiting Unnecessary Treatments
The American Headache Society has issued new guidelines on how physicians can better treat patients with migraines while limiting unnecessary or even risky treatments. For example, because of their serious long-term risks, opiod painkillers such as OxyContin and Vicodin, as well as the barbiturate butalbital, should not be the first treatments prescribed. Also, CT scans should only be limited to non-emergency situations when possible, as MRIs are both able to diagnose more conditions and do not expose patients to radiation. "Our aim is to encourage doctors and patients to think carefully about medical care that can be harmful or unnecessary," said Elizabeth Loder, MD, president of the American Headache Society. "We didn't approach this with cost uppermost in mind. The goal is to help address the problems of low-value care." Approximately 12 percent of Americans are estimated to suffer from migraines. Read more on migraines.
FDA Takes Another Step to Reduce Consumption of Trans Fats
The U.S. Food and Drug Administration has taken another step to reduce American’s consumption of trans fats with a preliminary determination that partially hydrogenated oils (PHOs) are not “generally recognized as safe” for use in food. PHOs are the primary dietary source of artificial trans fat in processed foods. Up next is a 60-day comment period to collect more information and input on exactly what it would take for food manufacturers to reformulate products so that they do not include PHOs. “While consumption of potentially harmful artificial trans fat has declined over the last two decades in the United States, current intake remains a significant public health concern,” said FDA Commissioner Margaret A. Hamburg, M.D. “The FDA’s action today is an important step toward protecting more Americans from the potential dangers of trans fat. Further reduction in the amount of trans fat in the American diet could prevent an additional 20,000 heart attacks and 7,000 deaths from heart disease each year—a critical step in the protection of Americans’ health.” Read more on food safety.
Lack of Light Disrupts Sleep Cycles During Hospital Stays, Increases Patient Discomfort
Hospital stays may be even more uncomfortable for most patients than necessary because of an overall lack of adequate light, according to a new study in the Journal of Advanced Nursing. The small study found that lower levels of daytime light exposure were connected to worse mood, as well as more fatigue and pain, in patients. The poor light interfered with their bodies’ ability to adopt a normal sleep-wake cycle. Researchers found the lowest levels of daytime light exposure were tied to worse mood and more fatigue and pain among patients, compared to those whose rooms were better-lit during the day. "Until now, no one has looked at the associations among light and outcomes such as sleep, mood and pain experienced in the hospital," said Esther Bernhofer, lead author of the study and a nurse researcher at the Cleveland Clinic's Nursing Institute. "This study forms a basis for testing future lighting interventions to improve sleep-wake patterns, mood and pain in hospitalized adults.” Read more on mental health.
Study: No Link Between IVF, Increased Risk of Cancer in Kids
Despite years of concerns, a new study on in vitro fertilization (IVF) found no link between the conception technique and an increased risk of cancer in children. The findings were published in the New England Journal of Medicine. Researchers analyzed data on more than 106,000 children born through assisted reproduction between 1992 and 2008, finding the risk of them developing cancer was "the same as naturally conceived children," according to lead researcher Alastair Sutcliffe, MD, a specialist in general pediatrics at the University College London. More than 5 million children have been born through IVF since the first successful birth in 1978. "This study is extremely reassuring and should relieve anybody's anxiety about IVF," concluded Lawrence Grunfeld, MD, an associate clinical professor of obstetrics, gynecology and reproductive science at the Mount Sinai Icahn School of Medicine, in New York City. Read more on cancer.
Harvard Pilgrim Health Care Foundation’s work on childhood obesity is driven by one startling fact: one in three Massachusetts children are overweight or obese. To find out why, Executive Director Karen Voci and her colleagues went to the places where children learn and play—schools, after school programs and child care centers— and found that children were sitting for most of the day and foods were heavy on starch and sugar. With a limited budget, Voci and her team found opportunities and partners in Massachusetts, New Hampshire and Maine to improve childhood obesity rates.
“It’s hard to measure what you’re accomplishing,” said Voci at one session during the American Public Health Association (APHA) 2013 meeting. “These environments look and feel different, but it’s hard to capture this feeling in a meaningful statistic that can be used further down the road.”
As a result, most of the results shared focused on process and intermediate outcomes rather than actual health outcomes—for now—but the communities are optimistic that they’re moving in the right direction.
Voci underscored the importance of staying committed, noting that Harvard Pilgrim and its partners had been at this for years and they were in fact moving the needle. Session presenters shared successes from Massachusetts, New Hampshire and Maine.
Harvard Pilgrim partnered with the Massachusetts Department of Public Health and other foundations and businesses on the Mass in Motion initiative to combat childhood obesity in its home state. Led by their elected officials, 14 communities developed health improvement plans and received technical assistance to improve local food sources and increase physical activity. The multifaceted initiative included a “call to action” report, as well as a Governor’s Executive order establishing a nutrition standard for the food procured for the state of Massachusetts. In addition, the program implemented a body mass index (BMI) regulation that required schools to screen children’s BMI in order to identify potential issues early. The Department of Public Health worked within these communities to share information on physical activity and nutrition, all culminating in growth of the program to 52 communities in the state.
Communities in Eastern Massachusetts are showing concrete signs of progress on the childhood obesity front. Reports from this summer have shown that the obesity rate for the region’s children under six years of age has decreased by 21.4 percent—likely due in part to initiatives such as Mass in Motion, the Cambridge Healthy Children Task force and Shape Up Somerville.
CATCH Kids Club is an evidence-based, after-school environment that has been adopted by 117 sites in nine of New Hampshire’s ten counties. The CATCH program promotes exercise and healthy eating in elementary school children with a four-phased approach:
- Curriculum development
- Staff and booster training
- Staff support
- Environment and policy assessment
In the environment and policy assessment phase, CATCH found that 93 percent of participating after-school programs made four or more changes to improve children’s physical activity and healthy eating. In addition, most sites now offer programs that promote these goals between three and five times a week.
In Maine, the Let’s Go! 5210 Goes to School program offers resources to help schools create a culture of health. It aims to take the focus off of the highly charged weight management issue and shift it toward four simple and embraceable goals for each day:
- Eat 5 fruits and vegetables
- Limit screen time to 2 hours or less
- Get at least 1 hour of exercise
- Drink 0 sugary drinks
While each school decides which of these four goals it would like to adopt, they often end up promoting all four points of the program as time goes on. In fact, the 5210 initiative reaches children in all 16 Maine counties in schools, after school programs, early childhood education, doctors’ offices and more locations.
One of the key lessons learned was to engage busy school representatives at a level that made sense for them. “Don’t ask them to do something unrealistic,” said Torey Rogers of the Let’s Go! 5210 Goes to School Program and The Barbara Bush Children’s Hospital at Maine Medical Center.
Representatives from each of these programs offered insights and lessons learned when it comes to working with schools. When speaking with school representatives, organizations are often successful when they relate the goal back to the mission of schools: education. By highlighting the secondary benefits to attendance and active participation of students, organizations can engage teachers as partners in public health initiatives.
>>For more information on the successes of state and community efforts to reduce childhood obesity, view an interactive map on the signs of progress on childhood obesity.
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Follow the coverage here.
In 2012 alone, the fast food industry spent $4.6 billion to advertise mostly unhealthy products, with many of those ads specifically targeting children and teens. A new report, Fast Food FACTS 2013, examined 18 of the nation’s top fast-food restaurants, following up on a 2010 report to see how the food selection and advertising landscapes have changed. And while there have been some positive developments—healthier sides and beverages are available in most kids’ meals—the findings indicate there is still a very long way to go.
Detailed findings from the report, which was supported by a grant from the Robert Wood Johnson Foundation, will be presented today at the American Public Health Association’s (APHA) annual meeting in Boston.
>>Read more on the Fast Food FACTS 2013 report.
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders, hearing from attendees on the ground and providing updates from sessions, with a focus on building a culture of health. Follow the coverage here.
NewPublicHealth spoke with Jennifer Harris, the Yale Rudd Center for Food Policy & Obesity’s director of marketing initiatives and lead author of the report, and Marlene Schwartz, the Center’s director, about their findings and how fast food advertising continues to impact our nation’s youth.
NewPublicHealth: Has any progress been made in the nutritional quality of fast food kids' meals?
Jennifer Harris: There have been a lot of changes in kids’ meals over the past three years and a lot of it has been good. Most of the restaurants have added healthy sides and healthy beverages to their kids’ meals. Now it’s possible to get a fairly healthy kids’ meal at most of the restaurants we looked at. But the problem is it’s kind of like finding a needle in a haystack. Almost all of the meals they offer are high in fat, sugar or sodium.
Marlene Schwartz: The odds of you getting the healthy combination when you go are extraordinarily low. For every healthy combination, there are roughly 250 unhealthy combinations.
Research shows that people invariably look at Mondays as a time to reconsider their habits and even perhaps to make changes in their lives. The Monday Campaigns movement is a non-profit initiative that works to make healthy behaviors a focus at the beginning of every week.
NewPublicHealth spoke with Rachelle Reeder, Program & Research Associate at The Monday Campaigns, about how their efforts are helping to improve public health.
NewPublicHealth: We’re very interested about the Monday conferences and college students. Are they a specific demographic that you’re targeting now?
Rachelle Reeder: Yes. We’ve been targeting many different groups, whether it’s hospitals, college students, K-12. We target a lot of different groups depending on the campaigns. We provide universities—or any of our partners, but universities particularly—with catchy social marketing campaigns to kind of help and encourage the students to adopt and sustain healthy behaviors, and we do everything for free. So we might be working with student health centers, with food service providers, wellness teams or student groups themselves. But our organization is this blend of marketers and public health professionals, so usually what we’re able to offer universities are these compelling, creative campaigns that are also backed by research and a theory.
So that’s one of the great things about the Monday campaigns. And actually, I’m a public health professional myself and I’ve seen a lot of universities or public health services out there and they’re doing great things, but they don’t always have the skills or the capacity to market themselves, so that’s kind of where we step in and provide them with that marketing and creative expertise.
NPH: How would the efforts toward college students be different than they would be toward an older or even a younger demographic?
Reeder: It just kind of depends on the tone of the different campaigns that we take. For instance, we have Man Up Monday, which was really successful over at Murray State University. That campaign has kind of a cheeky sort of fun vibe that’s supposed to be a little bit funny, but what it is it’s reaching out to young men and it’s all about sexual health. Basically they encourage young men to engage in healthy sexual behavior on Mondays, to use Monday as the day to restock condoms, to make an appointment to get tested or to just reflect on decisions over the weekend. So that’s just an example of one of our university partners and that campaign wouldn’t necessarily be something we’d target for younger audiences or something like that.
HPV Vaccines Less Effective in African-American Women than in White Women
Perhaps because of their lower participation rates in clinical trials, African-American women are less likely to benefit from available human papillomavirus (HPV) vaccines that guard against cervical cancer, according to new findings presented at the 12th annual International Conference on Frontiers in Cancer Prevention Research. The two most popular vaccines in use protect against infection by HPV 16 and HPV 18, which are responsible for about 70 percent of cervical cancers. However, these two subtypes are half as likely to be found in black women as they are in white women. Researchers found that the most common infections for white women are from subtypes 16, 18, 56, 39 and 66; the most common for black women are 33, 35, 58 and 68. "Since African-American women don't seem to be getting the same subtypes of HPV with the same frequency, the vaccines aren't helping all women equally," said study author Adriana Vidal, Ph.D., assistant professor of obstetrics and gynecology at Duke University School of Medicine. Read more on health disparities.
San Francisco Proposes Tax on Soda, Other Sugary Beverages
In an effort to curb the growing rate of obesity and obesity-related health issues, a San Francisco, California city supervisor has proposed a ballot measure that would impose a 2-cents-per-ounce tax on soda and other sugary beverages with at least 25 calories per ounce. This would be the first and strongest such city measure in the country, amounting to an additional 24 cents for a normal 12-ounce can of soda. Supervisor Scott Wiener said the tax proceeds, which he estimates would be $30 million annually, would go toward physical education and healthy lunch programs in city schools, as well as city parks, recreation programs and community health organizations. The California cities of Richmond and El Monte last year failed to enact similar taxes. A ballot measure requires a two-thirds majority to pass. "We know that this will be a long road," said Wiener. "This type of proposal has occurred in other cities and the beverage industry always comes out full guns blaring, so we're going to need to pull together to make sure that this wins." Read more on obesity.
Study: Young Cancer Patients at Increased Risk for Suicide
The stress of a cancer diagnosis means that teens and young adults who are diagnosed should be carefully monitored for behavior changes and other issues that could be a sign of suicidal thoughts, according to a new study in the Annals of Oncology. While there is an elevated risk of suicide for cancer patients of all ages, “because adolescents and young adults are still developing their coping strategies for stress, they may be more affected than adults when facing major adversity such as a cancer diagnosis," said lead researcher Donghao Lu, from the department of medical epidemiology and biostatistics at the Karolinska Institute in Stockholm, Sweden. Lu and his team found that Swedes ages 15-30 with a cancer diagnosis were at a 60 percent greater risk of suicide or attempted suicide, compared to people in the same age group but without cancer; in the first year after the diagnosis the risk was 150 percent higher. Lu said the findings indicate the need for greater communication and cooperation among medical professionals, psychological professionals, family members and social workers. Read more on cancer.
Electronic Laboratory Reporting Increasing
Federal agencies are reopening today after a 16 day shutdown and public health updates such as FluView from the Centers for Disease Control and Prevention are expected to come back online within the new few days. CDC’s last news release before the shutdown was on the increasing capability of laboratories to report findings to local and state health agencies electronically. The report was published in the most recent issue of Morbidity and Mortality Weekly Report (MMWR).
According to CDC, the number of state and local health departments receiving electronic reports from laboratories has more than doubled since 2005, however, progress is still needed. The MMWR report shows that only about a quarter of the nation’s labs are reporting electronically and that electronic reporting lags for some diseases behind others. For example, 76 percent of reportable lab results for general communicable diseases were sent electronically, compared to 53 percent of HIV results and 63 percent of results for sexually transmitted diseases. Read more on infectious disease.
District Laws and Policies Reduce Sugary Foods and Drinks at School Parties
Schools with a district policy or state law discouraging sugary foods and beverages were 2.5 times more likely to restrict those foods at school parties than were schools with no such policy or law, according to a new study published online in the Journal of Nutrition Education and Behavior.
Researchers at the University of Illinois at Chicago School of Public Health examined the linkages between state laws, district, and school-level policies for classroom birthday and holiday parties through surveys of more than 1,999 schools in 47 states.
About half the schools had either no restrictions or left the decision to teachers; one-third had school-wide policies discouraging sugary items; and fewer than 10 percent actually banned sweets during holiday parties or did not allow parties.
The study was supported by the Robert Wood Johnson Foundation. Read more on nutrition.
Children of Same Sex Marriages Less Likely to be Covered by Health Insurance
Children with same sex parents are less likely to have private health insurance than children with married opposite-sex parents, according to a recent study in Pediatrics. Using data from the 2008-2010 American Community Survey on children aged 0-17 years, the researchers found that 78 percent of children with married opposite-sex parents had private health insurance coverage, compared to 63 percent of children with same-sex fathers and 68 percent of those with same-sex mothers.
However, in states with legal same-sex marriage or civil unions, or in states that allowed second-parent adoptions, the disparities in private health insurance was lower for children of same-sex parents, suggesting that children of gay and lesbian households benefited from these policies. The American Academy of Pediatrics endorsed same-sex marriage in March. Read more on access to health care.