Category Archives: Obesity
Conflicts of Interest in Determination of Food Additive Safety
Who determines whether a food additive is safe? Often it’s people with ties to the food additive industry, according to a new conflict-of-interest study from The Pew Charitable Trusts in the journal JAMA Internal Medicine. From 1997 to 2012, about 20 percent of safety determinations submitted to the U.S. Food and Drug Administration were authored by employees of food additive manufacturers, and 13 percent were authored by someone working a consultant selected by the manufacturer. Researchers also found that the expert panels tasked with conducting most of the safety assessments rely on many of the same experts over and over again. "There's a cadre of 10 people that serve on almost all of these expert panels," said study author Thomas Neltner, director of Pew's food additives project. "Three-quarters of the panels contained at least one of these people. One person served on 44 percent of the panels, which tells us there's not only conflicts of interest, but there's a very small group of people making these decisions." Michael Jacobson, executive director of the Center for Science in the Public Interest, sees these results as a clear problem that needs to be addressed. "These committees give a very superficial, one-sided review," he said. "They want to please the sponsor, and then maybe they will get more business because they've proven themselves trustworthy, but it's no way to run a food safety review process." Read more on food safety.
CDC: 1 in 8 Preschoolers Obese, Raising their Risk for Adult Obesity
About one in eight—or 12 percent—of preschoolers are obese. However, after decades spent watching that number climb, nineteen states and territories are seeing drops in obesity among low-income preschoolers, according to the latest Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). Overweight and obese children are five times more likely to grow up to be obese adults, so early intervention by state and local health officials is critical. The report provides a number of ways they can help, including the creation of partnerships with community members to make community changes that promote healthy eating and active living, as well as making it easier for families with children to buy healthy, affordable foods and beverages in their neighborhoods. Read more on obesity.
Hospitals’ Exchange of Electronic Health Records Climbed 41 Percent from 2008 to 2012
Health information exchange (HIE) between hospitals and providers outside their organizations climbed 41 percent from 2008 to 2012, with six in 10 hospitals exchanging electronic health records (EHR) in 2012, according to a new study in the journal Health Affairs. The researchers say this illustrates how EHRs have become complementary tools that improve health care quality and safety. “We know that the exchange of health information is integral to the ongoing efforts to transform the nation’s health care system and we will continue to see that grow as more hospitals and other providers adopt and use health IT to improve patient health and care,” said Farzad Mostashari, MD, the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. “Our new research is crystal clear: health information exchange is happening and it is growing. But we still have a long road ahead toward universal interoperability.” Read more on technology.
Tackling the problem of obesity in the United States cannot be done with a single step solution. There are many factors that need to be addressed at the family, school and community levels in order for obesity rates to continue to decline across the country. Unfortunately, not everyone has equal access to the education and options that allow us to make healthier food choices. Higher prices and lack of accessibility to fresh produce serve as barriers for lower income communities in the battle against obesity and improving public health.
In urban areas across the country, groups focused on healthy living and eating are working to develop programs to create more healthy options for everyone. Programs in cities such as New York, Los Angeles and Philadelphia—to name just a few—have caught on with local food vendors, store owners, public health departments and the general public as we start to see rates of obesity drop in those targeted areas.
>>Read more about the fight against childhood obesity and the signs of progress in different areas across the country.
We have found some great examples of programs across the country that are proving successful in their attempts to increase the number of healthy options available to at-risk children and the greater community.
- In New York City, pediatricians at Lincoln Medical Center in the Bronx and Harlem Hospital have started prescribing fruits and vegetables for children. The prescriptions allow them to use coupons for produce at local farmers markets and city green carts. Medical professionals see this as a longer-term solution to the issues they are seeing children come in with, rather than simply prescribing them medicine.
- With Philadelphia weighing in as the most obese city in the nation, The Food Trust’s Brianna Almaguer Sandoval has enlisted the help of corner store owners to start providing healthier options on their shelves. The Healthy Corner Store Initiative provides store owners with free marketing materials such as labels and recipe cards; trainings on how to select, price and display the healthier offerings; and for some even funding for new shelves and refrigerator cases to help better stock fresh food.
- Groups in Athens, Ohio, are joining together to host an event called “Bounty on the Bricks,” to raise money to create a new grant program to enhance the capacity for local food pantries to provide more healthy options for their visitors in need. Those who bought tickets to the event will enjoy a meal celebrating local farmers and fresh produce along one of the main streets in Athens. The dinner will be held August 10 and organizers have already surpassed expected ticket sales.
Six States to Split $89.2M for Early Learning Programs
Six states will split approximately $89.2 million in federal funding as supplemental awards from the 2013 Race to the Top-Early Learning Challenge (RTT-ELC), which works to expand and improve early learning programs. The six states are California, Colorado, Illinois, New Mexico, Oregon and Wisconsin. Each must now submit detailed budgets, budget narratives, revised performance measures and signed assurances. The funds will go toward developing new programs and strengthening existing programs that help close the “opportunity gap,” according to U.S. Department of Education Secretary Arne Duncan. Added U.S. Department of Health and Human Services Secretary Kathleen Sebelius: “Kids who attend high-quality early learning and pre-school programs are more likely to do well in school. They're more likely to secure a good job down the road; and they're more likely to maintain successful careers long-term.” Read more on education.
A Single Fight-related Injury Can Reduce Adolescent IQ by Equivalent of One Lost School Year
A single fight-related injury can reduce an adolescent or teen girl’s IQ by about 3.02 points, according to a new study in the Journal of Adolescent Health. For a boy it can mean a loss of 1.62 points. Studies have measured the effect of missing a year of school as about a 2-4 point decrease in IQ. IQ loss is generally associated with poorer school and work performance; mental disorders; behavioral problems; and longevity, according to the researchers from the Florida State University researchers noted. About 4 percent of U.S. high school students suffer from fight-related injuries annually. "We tend to focus on factors that may result in increases in intelligence over time, but examining the factors that result in decreases may be just as important," said study co-author Joseph Schwartz, a doctoral student in the College of Criminology and Criminal Justice, in a release. "The first step in correcting a problem is understanding its underlying causes. By knowing that fighting-related injuries result in a significant decrease in intelligence, we can begin to develop programs and protocols aimed at effective intervention.” Read more on violence.
Study Links Sugary Drinks, Obesity in Preschoolers
Even though the percentage as a calorie source is relatively minor, preschoolers who drink sugar-sweetened soda, sports drinks or juices every day are at greater risk for obesity, according to a new study in the journal Pediatrics. The findings parallel studies on teens and adults, which show a link between sugary drinks and extra weight. Kids who consumed at least one of the drinks each day were 43 percent more likely to be obese than their counterparts. They were also more likely to have an overweight mother and to watch at least two hours of television daily from ages four to five; researchers adjusted for these factors, as well as socioeconomic status. Potential reasons include the possibility that the sugary drinks were not filling, so did not replace other calories in the children’s diets. The study did not account for other eating habits or physical activity. Read more on nutrition.
Tainted Salad Mix Linked to Parasite Outbreak in Two States; 13 Other States Still Looking for Answers
State and federal health officials have narrowed in on a prepackaged salad mix as the possible source of a cyclospora outbreak that has sickened 370 people in 15 states. Both Nebraska and Iowa officials have identified the salad as the source; a total of 221 people in those states have fallen ill so far from the stomach-sickening parasite. The U.S. Food and Drug Administration (FDA) is still working to identify the cause in the 13 other states. “FDA will continue to work with its federal, state and local partners in the investigation to determine whether this conclusion applies to the increased number of cases of cyclosporiasis in other states,” the FDA said in a statement. ”Should a specific food item be identified, the FDA, the U.S. Centers for Disease Control and Prevention, state and local partners will work to track it to its source, determine why the outbreak occurred, and if contamination is still a risk, implement preventive action, which will help to keep an outbreak like this from happening again.” Read more on food safety.
New Model Shows Kids Consuming Far More Calories than Previously Realized
It takes far more calories for kids to gain weight than was previously realized, according to a new study in The Lancet Diabetes & Endocrinology. And, given the high rate of childhood obesity, this means kids are consuming far more calories than either their parents or health care providers realize. The new caloric model takes into account the energy requirements for boys and girls; the fact that kids generally have higher metabolisms than adults; the average drop in physical activity as kids age; and the energy required to maintain a bigger body size as they age. Whereas the old model said a normal-weight girl at age 5 would need to consume about 40 extra calories a day to be 22 pounds overweight by age 10, the new model shows its actually 400 extra calories. "Importantly, given the rather large calorie excesses fueling childhood obesity, this model is a rebuttal to the food industry arguments that exercise alone can be the answer," said David Katz, MD, director of the Yale Prevention Research Center and editor of the journal Childhood Obesity, who was not involved in the study. "For our kids to achieve healthy weight, control of calories in, not just calories out, will have to be part of the formula." Read more on obesity.
Sequester to Close all HUD Offices on Friday, August 2
Every office of the U.S. Department of Housing and Urban Development (HUD) will be closed on Friday, August 2 as part of the sequester which is being felt across all of government. The automatic spending cuts took effect March 1. HUD’s plan is to pair its seven required furlough days with holidays and weekends. HUD is encouraging people and businesses that work with the agency to plan around the schedule day of shutdown. Read more on budgets.
Smoking During Pregnancy, Kids Behavioral Problems Linked
Women who smoked during pregnancy are more likely to have children with behavioral disorders, according to a new study in the journal JAMA Psychiatry. Researchers analyzed data from three separate studies, findings that the kids of smokers exhibited a noticeable increase in negative behaviors such as getting in fights or having difficulty paying attention. Possible explanations include being born smaller or experiencing impaired brain development. "It's illuminating the prenatal period as having an ongoing influence on outcomes," said Gordon Harold, the study's senior author from the University of Leicester in the U.K. "We're not saying life after birth is no longer relevant… Rather, both influences are clearly important." Read more on tobacco.
Study: Family History of One Cancer Type Can Also Raise the Risk of Other Tumor Types
Health care professionals already knew that people are at increased risk for developing the same type of cancer as a close relative. A new study in the journal Annals of Oncology shows that they are also at increased risk for developing cancer in general, including types of tumors dramatically different than those developed by relatives, which could provide physicians with new ways to identify cancers earlier. Previous genetic studies have shown that certain gene mutations can increase the risk of multiple types of cancer. The new findings include:
- A 1.5-fold increased risk of breast cancer in women with a history of colorectal cancer in the family.
- A 3.3-fold increased risk of oral and pharyngeal cancer among people who had a first-degree relative with cancer of the larynx.
- A four-fold increased risk of cancer of the esophagus among people with a first-degree relative who had oral or pharyngeal cancer.
- A 2.3-fold increased risk of ovarian cancer among those with a first-degree relative who had breast cancer.
- A 3.4-fold increased risk of prostate cancer if a first-degree relative had bladder cancer.
"These findings may help researchers and clinicians to focus on the identification of additional genetic causes of selected cancers and on optimizing screening and diagnosis, particularly in people with a family history of cancer at a young age," said study co-author Eva Negri, MD, head of the laboratory of epidemiologic methods at the Mario Negri Institute for Pharmacological Research in Milan, Italy. Read more on cancer.
Weight Discrimination Increases the Likelihood of Obesity
People who face discrimination for being overweight may be as much as two and a half times more likely to become or stay obese, according to a new study in the journal PLoS One. "Discrimination is hurtful and demeaning, and has real implications for physical health," said lead researcher Angelina Sutin, an assistant professor of psychology at Florida State University. "In the case of weight discrimination, people often rationalize that it is OK to do because it will motivate the victim to lose weight. Our findings suggest the opposite." The experience of “weightism” damages self-esteem and undermines efforts to maintain a healthy weight. Researchers said the observed increase in the likelihood of obesity was independent of factors such as age, sex, ethnicity and education. Experts say that approaches to improving the treatment of obesity could include working with patients to develop adaptive ways to cope with discrimination, public messaging campaigns to raise awareness of the negative effects of “weightism” and even working with health care professionals to ensure they are not exhibiting discriminatory behaviors which could actually damage their patients’ health. Read more on obesity.
Study: Pertussis Booster Only ‘Moderately’ Effective
The “booster” vaccine for pertussis—or whooping cough—is only “moderately” effective in preventing the disease in adolescents and adults, according to a new study in the journal BMJ. The Kaiser Permanente-backed study, which is the first to look at the effectiveness of the Tdap booster shot in the new generation that has only received acellular vaccines, found the effectiveness to be between 53 and 64 percent. This indicates that additional vaccinations may be required to adequately prevent outbreaks according to lead author Roger Baxter, MD, co-director of the Kaiser Permanente Vaccine Study Center. The state of California saw its highest number of cases of pertussis in more than 60 years in 2010, when it had more than 9,000 cases that led to 809 hospitalizations and 10 deaths, according to the National Center for Biotechnology Information. Read more on vaccines.
NYC Hospitals Prescribing Fruits, Vegetables to At-risk Youth
An apple a day to keep the doctor away? At two New York City hospitals, you can get a prescription for just that. Under a four-month pilot program, doctors at Lincoln Medical Center in the Bronx and Harlem Hospital are giving prescriptions for fruits and vegetables to at-risk youths. The kids and their families receive coupons which can be redeemed for product at local farmers markets and city green carts. “This is probably going to prevent an awful lot more disease over the long-term than a lot of the medicines we tend to write for,” said New York City Health Commissioner Thomas Farley, MD, said Tuesday in the green market outside Lincoln Medical Center. Read more on nutrition.
Breast Cancer Survival Times Shorter for Black Women
The fact that black women receive less health care overall than their white counterparts, combined with the lack of early screening and detection programs in many black communities, means they live an average of three fewer years with a breast cancer diagnosis, according to a new study in The Journal of the American Medical Association. Researchers at the University of Pennsylvania found that black women were less likely to receive an early diagnosis when the cancer was more treatable; they also found that quality of care was in general lower, though not enough to explain the survival gap. Data showed that 70 percent of white women lived at least five years after a breast cancer diagnosis, compared to 56 percent of black women. “Something is going wrong,” said Jeffrey H. Silber, MD, a professor at the University of Pennsylvania and the director of the Center for Outcomes Research at the Children’s Hospital of Philadelphia, which studies disparities in health care. “These are huge differences. We are getting there too late. That’s why we are seeing these differences in survival.” Read more on cancer.
Much Like Television, Excessive Cell Phone Use Lowers Fitness Levels
Are you reading this on your smartphone? If so, it’s probably not doing your weight any good. A new study in the International Journal of Behavioral Nutrition and Physical Activity has linked cell phone use by college students to decreased physical activity and fitness levels. Much like watching television, cell phone use is a largely sedentary activity that is easy to get lost in. It can also lead to casual overeating. Researchers found the average student spent about five hours on the phone each day and sent hundreds of text messages. "We have to look at this similar to what happened in the industrial revolution and how it changed us," said Nancy Copperman, director of public health initiatives at North Shore-LIJ Health System, in Great Neck, N.Y. "A study like this raises the importance of how this technology affects how we move, eat and sleep. We have to look at the impact of technology on our health." Read more on technology.
Study Links Bipolar Disorder, Early Death
A new study showing that people with bipolar disorder are more likely to die early and from a variety of causes also illustrates the difficulty of treating the physical effects of the illness. "Whatever we're doing, these people are not dying (just) because of suicide. That's not the reason for increased mortality. That's a hard thing to get across," said David Kupfer, PhD, a professor of psychiatry at the University of Pittsburgh School of Medicine, who was not a part of the study. The study found that people with bipolar disorder—an estimated 1 to 5 percent of the global population—die about nine years earlier and are at higher risk for heart disease, diabetes, chronic obstructive pulmonary disorder, the flu and pneumonia. However, people who knew they were bipolar had the same death rates as those who were not, which suggests "that timely medical diagnosis and treatment may effectively reduce mortality among bipolar disorder patients to approach that of the general population," according to the study. Read more on mental health.
One Dose of ADHD Medication Improves Balance in Older Adults
A single dose of an attention deficit/hyperactivity disorder (ADHD) medication can improve the balance of older adults who have difficulty walking, according to a new study in The Journals of Gerontology. Methylphenidate (MPH) is also used to treat narcolepsy. Researchers at Ben-Gurion University of the Negev found that it can reduce the number and rate of step errors in both single and dual tasks. "Our results add to a growing body of evidence showing that MPH may have a role as a therapeutic option for improving gait and reducing fall risk in older adults," said Itshak Melzer of BGU's Schwartz Movement Analysis and Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences. "This is especially true in real-life situations, where the requirement to walk commonly occurs under more complicated, 'dual task' circumstances with cognitive attention focused elsewhere (e.g., watching traffic, talking) and not on performing a specific motor task." Read more on aging.
Study: The Longer People Are Obese, the Greater Their Risk for Heart Disease
At a time when obesity rates for both U.S. adults and children are rising, new research indicates that the longer someone is obese, the greater their risk for heart disease. The study appeared in the Journal of the American Medical Association. "Each year of obesity was associated with about a 2 to 4 percent higher risk of subclinical coronary heart disease," said study lead author Jared Reis, an epidemiologist with the U.S. National Heart, Lung, and Blood Institute. "Those with longest duration of both overall obesity and abdominal obesity tended to have the highest risk [for subclinical disease].” Subclinical heart disease includes arterial damage indicated by markers such as calcium buildup on arterial walls, but which “has not yet developed into symptomatic illness,” according to HealthDay. The study is yet more evidence of the need to focus on the prevention and treatment of childhood obesity, according to the researchers. Read more on heart health.
EHRs Would Help Doctors’ Offices Cut Costs Slightly
Doctors’ offices that utilize electronic health records (EHRs) will spend less per patient than offices that use traditional paper records, according to a new study in the journal Annals of Internal Medicine. While the savings is expected to be small—about $5 per patient per month—they will add up over time. With a government commitment of about $30 billion for the widespread adoption of EHRs, the hope is the decrease in inefficiencies, incorrect care and errors will lead to better, cheaper health care. Previous studies have shown conflicting results. Rainu Kaushal, MD, who wrote an editorial that accompanied the study, said that while she does not expected the EHRs to contribute significantly to cost savings, their adoption is still vital. "EHRs may or may not directly contribute to those savings… but without investing in them you cannot achieve new models of healthcare delivery," said Kaushal, director of the Center for Healthcare Informatics and Policy at Weill Cornell Medical College in New York. Read more on technology.
No Evidence of Benefits of Community-wide Dementia Screening
New research has found no proof that there are any clinical, economic or emotional benefits to programs that use community-wide screening to identify people with dementia. "We found no evidence that population screening would lead to better clinical or psychosocial outcomes, no evidence furthering our understanding of the risks it entails and no indication of its added value compared to current practice," said author Carol Brayne, a professor of public health medicine from Cambridge Institute of Public Health, in the United Kingdom. The debate over the strategy’s efficacy has been going on for quite some time, with one side noting that there isn’t even a cure for Alzheimer’s disease, and the other noting that as many as half of the people with dementia remain undiagnosed. The researchers, however, did emphasize that family and friends should be aware of the warning signs of dementia so they can help loved ones get treatment. Read more on community health.
The final plenary session at this year’s NACCHO Annual included a talk by Christopher Murray, MD, DPhil, director of the Institute for Health Metrics and Evaluation at the University of Washington on how data is used to measure health, evaluate interventions and find ways to maximize health system impact. Dr. Murray was a lead author on three pivotal studies published last week that used data to assess the state of health in the United States compared with 34 other countries and county level data on diet and exercise. One of the key findings is that Americans are living longer, but not necessarily better—half of healthy life years are now lost to disability instead of mortality; and dietary risks are the leading cause of U.S. disease burden.
NewPublicHealth spoke with Dr. Murray about the study findings, their impact and upcoming research that can add to the data public health needs to improve the health of all Americans.
NewPublicHealth: Tell us about the three studies that were published this week using the Institute’s research.
Dr. Murray: The study in JAMA [Journal of the American Medical Association] is an analysis of a comprehensive look at the health of the United States in comparison to the 34 OECD [Organisation for Economic Co-operation and Development] countries. The study looks at both causes of death and premature mortality through over 290 different diseases and puts them all together in a comprehensive analysis of what the contributors are to lost healthy life. That study also looks at the contribution to patterns of health in the U.S., from major environmental, behavioral, and metabolic risk factors. In each of those categories, there are important findings:
- The U.S. spends the most on healthcare but has pretty mediocre outcomes and ranks about 27th for life expectancy among its peer countries.
- For many large, important causes of premature death, the U.S. does pretty poorly. And we also see a big shift towards more and more individuals having major disability—from mental disorders, substance abuse, and bone and joint disease.
- On the risk factor front, the big surprise is that diet is the leading risk factor in the U.S. It is bigger than tobacco, which is second and then followed by obesity, high blood pressure, high blood sugar, and physical inactivity. Diet in this study is made up of 14 subcomponents, each analyzed separately and then put together.