Category Archives: Nutrition
Late last month, the Bipartisan Policy Center, a think tank based in Washington, D.C., released a new white paper, Teaching Nutrition and Physical Activity in Medical School: Training Doctors for Prevention-Oriented Care, that strongly recommends providing greater training in nutrition and physical activity for medical students and physicians in order to help reduce U.S. obesity rates. The report was jointly published with the American College of Sports Medicine and the Alliance for a Healthier Generation, a nonprofit founded by the American Heart Association and the Clinton Foundation as a response to the growing rate of childhood obesity. The report found that current training for medical professionals and students in nutrition and exercise is inadequate to cope with the nation’s obesity epidemic.
A survey conducted for the new report found that more than 75 percent of physicians felt they had received inadequate training to be able to counsel their patients on changing diet and increasing activity levels. It also found that while some schools have stepped up their performance, fewer than 30 percent of medical schools meet the minimum number of hours of education in nutrition and exercise science recommended by the National Academy of Sciences.
“The health care marketplace needs to place greater value on preventive care,” said Jim Whitehead, Chief Executive Officer and Executive Vice President of the American College of Sports Medicine. “Doing so will provide medical schools with the incentive to train their students accordingly. And it will give medical professionals the leverage they need to address healthy lifestyles with their patients.”
NewPublicHealth recently spoke with Lisel Loy, director of the Nutrition and Physical Activity Initiative at the Bipartisan Policy Center, about the report and about how to improve training for medical professionals on nutrition and exercise.
NPH: What was the idea that propelled you to look into making changing to medical school education?
Loy: Well, the technical launching pad was our June 2012 policy report called Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future. And in that, my four co-chairs recommended a suite of policy changes that would improve health outcomes and lower costs for families, communities, schools and work sites. Within that community context they called out the need to improve training for health professionals—not just physicians but health professionals much more broadly defined than that—in pursuit of the goal of reducing obesity and chronic disease and cutting costs.
So that’s sort of the technical answer to your question. The more philosophical answer is as we as a country shift toward more preventive care, they really saw a gap in the education and training of health professionals in terms of being able to best support improved health outcomes. So that’s how they determined that that belonged in our report as a policy recommendation, and since we put out that report we prioritized a handful of recommendations, one of which had to do with health professional training.
Proposed Tobacco Merger Could Boost Smoking Rates
The proposed merger of the Reynolds American and Lorillard tobacco companies announced earlier this week could result in increased smoking rates, according to the Campaign for Tobacco-Free Kids. “This proposed merger is clearly driven by steep smoking declines in the U.S.,” said Matthew L. Myers, president of Tobacco-Free Kids. Myers said cigarette sales fell by 37.1 percent from 2000 to 2013, with the largest decline in 2009, when a 62 cent per-pack increase in the federal cigarette tax was implemented. “Reynolds and Lorillard no doubt hope the economic and political power of a merged company will help them slow or reverse these trends. Elected officials and regulators must be equally aggressive in working to accelerate progress in reducing smoking and other tobacco use.” Read more on tobacco.
Health Education Program Also Reduces Youth Dating Violence
A health education program designed to delay sexual behavior and promote healthy data relationships also significantly reduces dating violence behaviors among minority youth, according to a new study in the American Journal of Public Health. Researchers at the University of Texas Health Science Center at Houston (UTHealth) analyzed 766 students in 10 middle schools in a large, urban school district in southeast Texas, where 44 percent were African American and 42 percent were Hispanic. They looked at four areas—physical victimization, emotional victimization, physical perpetration and emotional perpetration—finding that the It’s Your Game...Keep it Real program reduced all but physical dating violence, which comprised the smallest portion of the program; a revised program with a heavier emphasis on this area is currently being tested in schools. The U.S. Centers for Disease Control and Prevention estimates that 10 percent of high school youth are victims of physical dating violence (with ethnic-minority students at increased risk), with other studies indicating that as many as 20 percent are victims of emotional dating violence. Read more on violence.
CDC Report Finds High Rates of Youth Fruit, Vegetable Consumption
Approximately 77.1 percent of U.S. youth ages 2-19 years consume fruit on any given day and 92 percent consume vegetables, according to a recent NCHS Data Brief from the U.S. Centers for Disease Control and Prevention. However, the rate drops as youth age, while at the same time the amount of fruits and vegetables they eat should be increasing. The report used data from the National Health and Nutrition Examination Survey, 2009–2010. The focused report looked only at whether the foods were consumed, and now how much was consumed. Read more on nutrition.
CDC: 60 Percent of Diners Will Use Menu Calorie Counts When Available
Approximately 6 in 10 U.S. adults will choose their restaurant meals in part because of menu label information when it’s available, according to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Report. Researchers analyzed the self-reported usage of 118,013 adults in 17 states in 2012 to determine that about 57 percent will look to the provided calorie information. New York had the highest rate, with 61.3 percent, while Montana had the lowest, at 48.7 percent. Federal law requires calorie information be provided by any restaurant with 20 or more locations; while the regulations are not yet final, many establishments already voluntarily provide menu labeling, according to the CDC. Read more on nutrition.
Depression, Stress, Hostility Tied to Higher Stroke Risk
Depression, stress and hostility may be linked to a higher risk for stroke, according to a new study in the journal Stroke. Using information provided by approximately 7,000 adults who did not have heart disease or a history of stroke at the beginning of the study, researchers followed up nearly nine years later and determined that depression was associated with an 86 percent increased chance of a stroke or a transient ischemic attack, stress was associated with a 59 percent increase and hostility doubled the risk. “[C]hronic stress and negative emotions are important psychological factors that affect one's health, and findings from this study link these factors to brain health in particular," said the study's lead author, Susan Everson-Rose, an associate professor of medicine at the University of Minnesota, according to HealthDay. "Patients and their health care providers should be aware that experiences of chronic stress and negative emotional states can increase risk for stroke.” Read more on heart health.
Washington State Sees Most Measles Cases Since 1996
A slight decline in Washington State’s mumps and rubella vaccination rate has coincided with the state’s highest number of measles case in 18 years, according to officials. Washington has reported 27 cases so far this year and is currently in the midst of its third outbreak. While homegrown measles was declared officially eliminated from the United States in 2000, infections from people who have travelled overseas remain a threat. There were 554 total cases of measles and 17 outbreaks reported in the United States between Jan. 1 and July 3 of this year. Read more on infectious diseases.
Report: Food Sodium Levels at Many Top Chains Continue to Be Unhealthily High
From 2009 to 2013, the nation’s top restaurant chains reduced the sodium in their foods by an average of only 1.5 percent annually, according to a new report from the nonprofit Center for Science in the Public Interest (CSPI). In a review of 136 meals from 17 chains, researchers determined that approximately 79 percent of the 81 adult meals contained more than 1,500 milligrams (mg) of sodium—or one mg more than the U.S. Centers for Disease Control and Prevention recommends as a full day’s limit. The study also found efforts to reduce sodium to be inconsistent, with some chains actually increasing the amounts over the studied time period. CSPI Executive Director Michael F. Jacobson said the findings indicate that the U.S. Food and Drug Administration’s “wait-and-see” approach to sodium in packaged and restaurant food doesn’t work and that a new approach is needed. Read more on nutrition.
CDC: Antibiotic-resistant Foodborne Germs Remain a Serious Public Health Issue
New data from the U.S. Centers for Disease Control and Prevention (CDC) indicates both positive and negative trends in the ongoing public health fight against antibiotic-resistant foodborne germs, which contribute to an estimated 430,000 U.S. illnesses every year. According to the data, multi-drug resistant Salmonella—which causes approximately 100,000 U.S. illnesses annually—decreased over the past decade, but Salmonella typhi resistance to certain drugs increased by 68 percent in 2012, meaning one of the common treatments for typhoid fever may not be effective. “Our latest data show some progress in reducing resistance among some germs that make people sick but unfortunately we’re also seeing greater resistance in some pathogens, like certain types of Salmonella,” said Robert Tauxe, MD, MPH, deputy director of CDC’s Division of Foodborne, Waterborne, and Environmental Diseases. “Infections with antibiotic-resistant germs are often more severe. These data will help doctors prescribe treatments that work and to help CDC and our public health partners identify and stop outbreaks caused by resistant germs faster and protect people’s health.” Read more on food safety.
Four Communities to Share $120M in HUD Grants for Community Revitalization
Four U.S. communities will split nearly $120 million in U.S. Department of Housing and Urban Development (HUD) grants earmarked for the redevelopment of severely distressed public or HUD-assisted housing and their surrounding neighborhoods. "HUD's Choice Neighborhoods Initiative supports local visions for how to transform high-poverty, distressed communities into neighborhoods of opportunity," said HUD Secretary Shaun Donovan. "By working together, with local and state partners we will show why neighborhoods should always be defined by their potential—not their problems. Together, we will work to ensure that no child's future is determined by their zip code and expand opportunity for all."
The four communities are:
- Columbus (Ohio) Metropolitan Housing Authority — Columbus, Ohio
- Housing Authority of the City of Norwalk/Norwalk (Conn.) Redevelopment Agency
- City of Philadelphia, Office of Housing & Community Development/Philadelphia Housing Authority
- Housing Authority of the City of Pittsburgh/City of Pittsburgh
Read more on housing.
‘I Got Tested’ Campaign Promotes Importance of Knowing Your HIV Status
A new public information campaign from Greater Than AIDS is using real-life stories to advocate the importance of knowing your HIV/AIDS status. The “I Got Tested” campaign will place materials in clinics to support providers in HIV outreach; provide free HIV testing in select Walgreens pharmacies; and promote hotlines and online resources provided by departments of health and agencies, as well as the U.S. Centers for Disease Control and Prevention. “Despite overwhelming evidence that early diagnosis and treatment play an important role both in the health of those who are positive and in reducing the spread of HIV, many Americans at highest risk for infection still have not been tested,” said Tina Hoff, Senior Vice President and Director of Health Communication and Media Partnerships at the Kaiser Family Foundation, a co-founding partner of Greater Than AIDS, in a release. “This campaign is about helping to reduce the stigma surrounding HIV testing, to encourage patients to ask their providers to get tested, and to connect people with services in their communities.” Read more on HIV/AIDS.
Court: NYC’s ‘Soda Ban’ is Illegal
New York City’s ban on large sugary drinks—often referred to as former Mayor Michael Bloomberg’s “soda ban”—is illegal, according to a 4-2 ruling from the state Court of Appeals. The court found that the local health board that passed the regulation overstepped its authority. "By choosing among competing policy goals, without any legislative delegation or guidance, the Board engaged in law-making and thus infringed upon the legislative jurisdiction of the City Council of New York," wrote Judge Eugene Pigott for the majority. The soda ban was one of several public health initiatives pushed by Bloomberg, along with a ban on cigarettes in certain public spaces and a ban on trans fats from restaurants. Read more on nutrition.
Study: 3 Hours of Television Per Day Can Double Risk of Early Death
Watching more than three hours of television per day may double a person’s risk of an early death, compared to someone who watches less than one hour per day, according to a surprising new study in the Journal of the American Heart Association. Researchers tracked more than 13,000 seemingly healthy adults in Spain, finding that for every two additional hours a person spent watching television, their risk of death from heart disease climbed 44 percent, their cancer death risk climbed 21 percent and their risk of premature death climbed 55 percent for all other causes. The study found no such link for other sedentary causes, including working at a computer and driving. Read more on physical activity.
HHS’ Million Hearts Initiative Launches Health Eating Resource Center
The Million Hearts initiative from the U.S. Department of Health and Human Services has launched a new online resource center to promote healthier eating by individuals and families. The Healthy Eating and Lifestyle Resource Center features lower-sodium, heart-healthy recipes and family-friendly meal plans, and emphasizes managing sodium intake. The searchable recipes include nutritional facts and use everyday ingredients. “This resource helps people see that it’s not about giving up the food you love, but choosing lower sodium options that taste great," said Tom Frieden, MD, Director of the U.S. Centers for Disease Control and Prevention. “Small changes can make a big difference. We can prevent 11 million cases of high blood pressure each year if everyone reduced their daily sodium intake to 2,300 mg.” The Million Hearts initiative was launched with the goal of preventing 1 million heart attacks and strokes by 2017. Read more on nutrition.
3-D Mammograms Improve Breast Cancer Detection Rate, Reduce Recall Rate
Tomosynthesis—also known as 3-D mammography—can increase the detection rate of breast cancer while also decreasing false positives that can lead to multiple and unnecessary re-tests, according to a new study in the Journal of the American Medical Association. Researchers analyzed the results of 454,850 examinations, finding that when 3-D mammography was combined with traditional digital mammograms the detection rate for breast cancer climbed 40 percent while there was a 15 percent decrease in the recall rate, or the percentage of women who needed additional screening due to inconclusive results. The findings come as more and more hospitals and physicians are turning to 3-D mammography. The researchers cautioned that more study was needed into the relatively new technology. Read more on cancer.
AAP: Reading to Young Kids Starting in Infancy Improves Literacy Later in Life
Read to your kids—aloud and every day—starting as early as their infancy. That’s the latest recommendation from the American Academy of Pediatrics' (AAP) Council on Early Childhood. The policy statement is set to appear in the August print issue of the journal Pediatrics. "This is the first time the AAP has called out literacy promotion as being an essential component of primary care pediatric practice," said statement author Pamela High, MD, director of developmental and behavioral pediatrics at Hasbro Children's Hospital in Providence, R.I., and a professor at Brown University. "Fewer than half of children are being read to every day by their families, and that number hasn't really changed since 2003. It's a public health message to parents of all income groups, that this early shared reading is both fun and rewarding." According to the AAP, reading proficiency in the third grade is the most important predictor of eventual high school graduation, but approximately two-thirds of all U.S. children and 80 percent of kids living in poverty finish third grade lacking in reading proficiency. Reading aloud to a young child can promote literacy while also strengthening family ties. Read more on pediatrics.
Overly Clean Homes Can Increase Child’s Risk of Asthma, Allergies
Living in an overly clean home can actually increase an infant’s risk of developing allergies or asthma as they grow older, as their bodies are not given the chance to develop appropriate responses, according to a new study in the Journal of Allergy and Clinical Immunology. The researchers behind the study were surprised by the results, as they had been looking deeper into data that found that exposure to roach, mouse and pet droppings and other allergens increased asthma risk. "What we found was somewhat surprising and somewhat contradictory to our original predictions," said study co-author Robert Wood, MD, chief of the Division of Allergy and Immunology at the Johns Hopkins Children's Center in Baltimore, according to HealthDay. "It turned out to be completely opposite—the more of those three allergens you were exposed to, the less likely you were to go on to have wheezing or allergy." Approximately 40 percent of the allergy- and wheeze-free children in the study were raised in homes with high amounts of allergens and bacteria, while only 8 percent who suffered from both conditions had been exposed to allergens and bacteria while infants. Read more on pediatrics.
Study: Prenatal Medicaid Policy Reduces Smoking, But Doesn’t Improve Preterm Birthweights
While a Medicaid policy that fast-tracks applications of pregnant women helps reduce smoking during pregnancy, it has no significant effect on improving preterm birth rates or low birth weights, according to a new study in the journal Health Affairs. The study specifically looked at Medicaid’s presumptive eligibility and unborn-child option, which provides coverage for prenatal care. “Although the prevalence of prenatal smoking in the United States has declined in recent decades, it is nearly twice as high among low-income women enrolled in Medicaid than it is in the U.S. population as a whole,” said Marian Jarlenski, PhD, lead author of the paper. “Our research shows that Medicaid’s presumptive eligibility policy led to a nearly 8 percentage-point decrease in smoking during pregnancy, but neither policy significantly improved rates of preterm birth or babies born small for their gestational age.” Read more on maternal and infant health.
CDC: Watercress Tops ‘Powerhouse’ Fruits and Vegetables List
With a “nutrient density score” or 100.00, watercress tops the U.S. Centers for Disease Control and Prevention’s (CDC) new list of “powerhouse” fruits and vegetables. The list of 41 foods was created as a tool for nutrition education and dietary guidance. The study defined “powerhouse” as foods most strongly associated with reduced chronic disease risk, which are often green leafy, yellow/orange, citrus and cruciferous items. Chinese cabbage, chard, beet green and spinach rounded out the top five. The full list is available here. Read more on nutrition.
EPA Plans to Cut Carbon Emissions 30 Percent by 2030
The U.S. Environmental Protection Agency (EPA) announced plans today to reduce carbon emissions by 30 percent by 2030. The new Clean Power Plant proposal would be the first to cut emissions from existing power plants, which produce approximately one-third of the country’s domestic greenhouse gas emissions. The EPA estimates the proposed changes will help the United States avoid up to 6,600 premature deaths, up to 150,000 asthma attacks in children and up to 490,000 missed work or school days. "Climate change, fueled by carbon pollution, supercharges risks to our health, our economy, and our way of life,” said EPA Administrator Gina McCarthy, adding “By leveraging cleaner energy sources and cutting energy waste, this plan will clean the air we breathe while helping slow climate change so we can leave a safe and healthy future for our kids.” Read more on air and water quality.
Study: Tax on Total Calories in Sugary Drinks the Most Effective Way to Reduce Consumption
Tying a sugary drink tax to the amount of calories in a drink rather than its serving size would be more effective at reducing their consumption, according to a new study in the American Journal of Agricultural Economics. The study, which was financed by the Robert Wood Johnson Foundation, determined that such a tax of four-hundredths of a penny for every calorie would reduce calorie consumption by 9.3 percent; a tax of half a cent for each ounce in a can or bottle would reduce consumption by only 8.6 percent. “It provides a better incentive to the consumer to switch to lower-calorie drinks, which would be taxed at a lower rate than higher-calorie drinks,” said Chen Zhen, MD, a research economist at the food and nutrition policy research program at Research Triangle Institute and the lead author of the study, according to The New York Times. “One of the concerns about taxing ounces of sugar-sweetened beverages is that consumers are paying the same tax whether they buy 12 ounces of a drink with 150 calories or 12 ounces of a drink with 50 calories.” Read more on nutrition.
CDC: $19.5M for Innovative Public Health Prevention Research
Late last week the U.S. Centers for Disease Control and Prevention (CDC) awarded $19.5 million to 26 academic institutions for innovative public health prevention research to reduce health disparities. The grants will help the communities develop new methods to avoid or counter risks for chronic health care issues such as heart disease, obesity and cancer. “Prevention Research Centers have reached up to 31 million people in 103 partner communities, some of which are the most underserved in the country,” said Ursula E. Bauer, PhD, MPH., director of CDC’s National Center for Chronic Disease Prevention and Health Promotion, in a release. “By involving communities in conducting and disseminating research, this network of centers ensures that effective and innovative health strategies can be readily shared and applied where most needed.” Read more on prevention.
Mental Health Patients with Primary Care Physicians are Better at Managing their Health
Mental health patients who receive primary care from a physician’s office are generally more engaged in the active management of their mental health than are people who rely on outpatient clinics or emergency departments, according to a new study in the journal Health Education & Behavior. Using data from a large nationally representative survey, researchers assessed patient activation among patients diagnosed with depression in relation to variables such as the site of their usual source of care, community characteristics and other demographic characteristics. “Patients with mental disorders are less engaged in their health care than patients with other chronic diseases, so it is important to activate this group,” said Jie Chen, PhD, assistant professor in the department of health services administration at the University of Maryland School of Public Health. “In communities where patient activation is low, such as low-income communities with a large population of foreign-born individuals, there is an even greater need for interventions at mental health care institutions to engage residents in their health.” Read more on mental health.
Study: Low Cost of Food a Contributor to U.S. Obesity Epidemic
One of the driving factors in America’s growing obesity epidemic may very well be the increased access to cheap food, according to a new study. The average American spends only about one-tenth of their disposable income on food, compared to the 1930s, when the rate was about one-quarter. In addition, the average per capita consumption of calories has climbed approximately 20 percent since 1970. “Not only has food been getting cheaper, but it is easier to acquire and easier to prepare,” said Roland Sturm, lead author of the report and a senior economist at RAND, a nonprofit research organization. “It's not just that we may be eating more high-calorie food, but we are eating more of all types of food.” Possible public health solutions for this trend include imposing taxes on foods with low-nutritional value, as well as subsidies or discounts for healthier foods, according to the researchers. Read more on nutrition.
Expensive Co-pays a Barrier for Some Kids to Proper Asthma Treatments
Parents with higher health insurance co-pays report using less expensive asthma drugs, giving their children less medication than prescribed and even putting off doctor visits or trips to the emergency department for the respiratory disorder, according to a new study in the journal JAMA Pediatrics. Approximately 1 in 10 U.S. children suffer from asthma, and the prevalence of the illness is greater in low-income populations. "It is concerning that the children we deal with are sometimes more vulnerable in areas we didn't recognize," said Jefry Biehler, MD, chairman of pediatrics at Miami Children's Hospital in Florida. "We have to be careful that we don't create a void for those families that can't afford all the things they need for their child, but who are above the financial level that gives them government insurance that will provide everything at no or minimal cost.” Read more on pediatrics.
Study: Kids’ Cereals Average 40 Percent More Added Sugar than Adult Cereals
One bowl of kids’ cereal every morning would total as much as 10 pounds of sugar in a year, according to a new study from the Environmental Working Group (EWG). The organization assessed the sugar content of 1,500 cereals. While almost all had added sugar, the levels were higher in the 181 cereals specifically marketed to children—an average of 40 percent higher. “When you exclude obviously sugar-heavy foods like candy, cookies, ice cream, soft and fruit drinks, breakfast cereals are the single greatest source of added sugars in the diets of children under the age of eight,” said nutritionist and EWG consultant Dawn Undurraga, co-author of the organization’s new report, Children’s Cereals: Sugar by the Pound, in a release. “Cereals that pack in as much sugar as junk food should not be considered part of a healthy breakfast or diet. Kids already eat two to three times the amount of sugar experts recommend.” Read more on nutrition.
HHS, EU Making Progress in Fight Against Antimicrobial Resistance
This week the U.S. Department of Health and Human Services (HHS) and the European Commission released a progress report of the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR), a joint effort to combat antimicrobial resistance. In 2009, TATFAR identified and adopted 17 recommendations; the progress report includes one new recommendation to go along with 15 existing recommendations.
Notable TATFAR activities from 2011-2013 include:
- Adoption of procedures for timely international communication of critical events that might indicate new resistance trends with global public health implications
- Publication of a report on the 2011 workshop, “Challenges and solutions in the development of new diagnostic tests to combat antimicrobial resistance” to the TATFAR website
- Joint presentations to the scientific community to increase awareness about the available funding opportunities on both sides of the Atlantic
There are an estimated 25,000 deaths in Europe and 23,000 deaths in the United States linked to drug-resistant infections each year. Such infection also cost the United States and the European Union billions of dollars annually in avoidable health care costs and productivity losses. Read more on global health.
Women with Unintended Pregnancies Take the Shortest Maternity Leaves
Women with unintended pregnancies also take the shortest maternity leaves, according to a recent study from the University of Maryland School of Public Health published in the journal Women’s Health Issues. “We know that it’s better for women to take time off after childbirth to take care of their physical and mental health,” said Rada K. Dagher, MD, assistant professor of health services administration. “Returning to work soon after childbirth may not be good for these women or for their children.” Dagher’s previous research has indicated that six months of maternity leave is optimal for reducing a woman’s risk of postpartum depression. In addition to policies that enable women to take longer maternity leaves, she said there is also a need to counsel both women and men who are at risk for unintended pregnancies about effective contraceptive methods. Read more on maternal and infant health.