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Healthnotes Newswire (May 29, 2008)—The President’s Council on Physical Fitness and Sport recently released a fitness test for people over age 18. The test helps estimate aerobic fitness level, muscle strength and endurance, flexibility, and body composition.

Better overall physical fitness helps lower the risk of cardiovascular disease, diabetes, high blood pressure, stroke, and certain cancers. It can also improve mood and help avoid accidents and muscle strain due to underused and inflexible muscle groups.

The new President’s Challenge and Adult Fitness Test was created to help people understand their own fitness level and make positive gains in physical fitness. The test is available as a downloadable booklet at www.adultfitnesstest.org/resources/testbooklet.pdf; individual results can be entered and evaluated online.

Each test section is followed by a “FITT” box which stands for Frequency—how often the exercise is performed; I—the intensity at which the exercise is carried out; T—time, or how long the session lasts; and T—type of exercise being performed. These boxes help users customize their fitness goals.

Aerobic Fitness

To test aerobic, or cardiovascular, fitness, choose a 1-mile walk or a 1.5-mile run. For the walk, after a brief warm up, have a partner time you walking at a brisk pace for one mile, and take your pulse immediately after finishing. For the running option, warm up with a light jog. Then, having a partner time you, run as fast as possible for 1.5 miles. Only attempt the run if you currently run for at least 20 minutes three or more times per week.

FITT tips

Frequency: Depending on the level of intensity, exercise three to five days per week.

Intensity: Moderate-intensity exercise is a brisk walk; vigorous activity is running.

Time: For moderate activity, do at least 30 minutes per session; vigorous activity should last for 20 to 30 minutes.

Type: Examples are walking, running, dancing, cycling, and swimming.

Muscular Strength and Endurance

These tests assess basic muscle strength required to carry out household or work-related tasks. Do half sit-ups by lying face-up on a rug or mat with knees bent at a right angle and feet flat on the floor. With palms flat on the floor, sit up and slide hands forward 3.5 inches (mark distance with masking tape on the working surface before starting). Having a partner time you, do as many sit-ups as you can in one minute. Then do push-ups with legs extended (men) or with knees touching the floor (women). Do as many push-ups as you can and record the number.

FITT tips

Frequency: Do muscular strength and endurance exercises on at least three days per week.

Intensity: Vary the intensity during the workout.

Time: Gradually increase the number of half sit-ups and push-ups until you can do three sets of 25 half sit-ups and three sets of 10 to20 push-ups.

Type: Master the test movements and then add other equipment (balance balls, weights, or elastic tubing).

Flexibility

These tests assess the range of motion of muscles needed to walk, lift, and step normally. Sitting on the floor, place a yardstick between the legs with feet about a foot apart. Place a piece of tape across the yardstick at the 15-inch mark. With fingers on the yardstick, slowly reach forward as far as possible. Record to the nearest inch that your fingertips can reach.

FITT tips

Frequency: Do flexibility exercises at least three days per week.

Intensity: Stretch to the point of tension, never to pain.

Time: Hold each stretch for 20 to 30 seconds, repeating three times.

Type: Begin with static stretches, gradually adding dynamic (moving) stretches. Try learning a practice that includes flexibility exercises, such as yoga and Pilates.

Body Composition

Body mass index (BMI) and waist circumference can be measured to estimate disease risk. To calculate BMI, weigh yourself and have a partner measure your height with shoes off. Wrap a flexible tape measure around your abdomen just above the hip bones; measure and record. Determine your BMI using the booklet’s chart.

A normal BMI is between 18.5 and 24.9; overweight is between 25 and 29.9; obese is greater than 30.

If you are overweight or obese, you can improve your BMI and waist circumference by making sure that you burn more calories than you eat. In order to lose weight, emphasize whole grains, fiber, fruits and vegetables; limit processed and high-carb, high-fat foods, and work in 60 to 90 minutes of daily moderate intensity exercise.

(www.adultfitnesstest.org/adultFitnesstestLanding.aspx; accessed 26 May 2008.)

Healthnotes Newswire (May 29, 2008)—If you want to help your kids do better in school, you can start by providing them with healthy food. A new study has found that a high-quality diet is linked to a higher level of academic performance in schoolchildren.

The researchers surveyed 5,200 fifth-graders and their parents for the study, published in the Journal of School Health, and used the information to calculate a score for each child’s diet that represented nutrient content; food variety; balance of protein, fat, and carbohydrate; and the amount of saturated fat, salt, and junk food eaten. Academic performance was measured using a standardized reading and writing test.

Children who had the highest diet quality scores—and therefore the healthy diets—were 41% less likely to fail the literacy test than children with the lowest diet quality scores, which indicated poor diets. Variety and adequate nutrition were linked with academic performance, and children who ate more fruits and vegetables and fewer calories from fat did better on the test.

“Dietary adequacy and variety were the specific factors found to positively influence academic performance, highlighting the value of eating a diverse array of foods in order to reach recommended levels of intake for nutrients and foods,” said study coauthor, Dr. Paul Veugelers, at the School of Public Health, University of Alberta, Canada.

Previous research showing that eating a healthy breakfast can help children do better in school influenced the widespread implementation of school breakfast programs. Other studies have found that being overweight or obese has a negative influence on academic performance, suggesting that school programs emphasizing both healthy eating and physical exercise might have the best effect on raising achievement in school.

Tips to build your kids’ brainpower

Parents can take the following steps to improve their children’s likelihood of doing well in school:

• Make sure your children get to bed on time and get plenty of sleep.

• Start them out with a healthy breakfast, including whole grains and fruits.

• Pack healthy foods to take to school, including whole grain bread for sandwiches, vegetables, fruits, and nuts and seeds.

• Make dinner a family affair and keep it wholesome and varied, introducing new foods to kids on a regular basis.

• Turn off the television, computer, and video games and encourage your kids to be active.

Establishing good habits early in life will help your children to be successful now and in the future.

(J Sch Health 2008;78:209–15)

Healthnotes Newswire (May 1, 2008)—Weight-loss diets can lead to a modest decrease in blood pressure among people with hypertension, confirms a recent review published in the Archives of Internal Medicine.

Modern weight-loss programs range from dietary changes, weight-loss pills, and surgical procedures. A recent review looked at seven studies that compared a weight-loss diet with usual care among 1,632 people who had high blood pressure. After 12 months, the people on the weight-loss diet saw a decrease in their systolic blood pressure (the top number of the blood pressure reading). A weight loss of 4 kg (about 9 pounds) was necessary to achieve a reduction of 6 mm Hg in systolic blood pressure.

High blood pressure and being overweight are both major risk factors for developing cardiovascular problems such as heart disease and stroke. Maintaining a healthy weight and lowering blood pressure can decrease cardiovascular disease risk.

“High blood pressure is estimated to lead to more than 7 million deaths each year, approximately 13% of the total deaths worldwide,” said lead author of the review, Karl Horvath, MD, and his colleagues from the Department of Internal Medicine, Medical University of Graz, in Austria. “Lowering blood pressure levels in hypertensive patients has been shown to be a very effective means of reducing patients’ cardiovascular risk, with a significant reduction in cardiovascular morbidity and mortality.”

How to lower your risk

Being overweight and having high blood pressure are two independent risk factors for cardiovascular disease. But when you have both conditions, the risk is even greater. The following lifestyle tips may help you lower your risk of cardiovascular disease by maintaining a healthy weight and keeping blood pressure down:

• If you’re overweight, lose weight to maintain your optimal weight, which can be determined based on your height, body composition, and level of physical activity.

• Regular exercise is important for keeping weight down and for lowering blood pressure. Adults should engage in moderate physical activity for one hour each day.

• Follow a healthy diet that is low in cholesterol, added salt, and total fat, and emphasizes fruits, vegetables, and whole grains.

• Don’t smoke. Smoking is a risk factor for cardiovascular disease and other serious diseases.

If you are overweight or have high blood pressure, see a doctor to determine your optimal weight and to discuss other lifestyle changes that can help lower your risk for cardiovascular disease.

(Arch Intern Med 2008;168:571–80)

Healthnotes Newswire (May 1, 2008)—Concerns over body image and fitting in might lead some teens to skip meals in an attempt to lose weight. A new study in Pediatrics suggests that this approach could backfire, though; teens who miss out on breakfast are actually more likely to be overweight.

The new study, as part of Project EAT (Eating Among Teens), gathered information from 2,216 adolescents about their eating and exercise habits, as well as dieting and weight-control behaviors to see what effect eating breakfast had on weight changes over a five-year period.

Although teens who ate breakfast regularly took in more calories in a day than their breakfast-skipping counterparts, they were less likely to be overweight. Eating breakfast more frequently was associated with lower body mass index (a measure related to body weight) in a dose-response fashion—meaning that the more often teens ate breakfast, the lower their body mass index. Breakfast-eating teens were also more likely to be physically active. “Breakfast habits may be important markers of an overall healthful lifestyle pattern in youth and … frequent breakfast consumption may impart important weight gain prevention effects,” the authors concluded.

It may seem counterintuitive that eating more can lead to weight loss. A possible explanation could lie in the body’s fat receptors. With extreme caloric restriction, the body makes more receptors on fat cells, causing them to gobble up any available fat when it’s eaten. People who eat more regularly and include healthy amounts of fat in the diet have less fat receptors on their cells; these people are likely to be thinner than “fad dieters.” Eating breakfast regularly can help keep fat receptors in check, leading to healthier weight. Breakfast eaters might also be thinner than teens who skip meals because the quality of their diet and their attitudes toward food might be better.

Results from the 2003-2004 National Health and Nutrition Examination Survey (NHANES) showed that about 17% of children and adolescents ages 2 to 19 are overweight. Being overweight can lead to health problems including heart disease, diabetes, and the development of certain cancers. As more people are becoming overweight earlier in life, the incidence of these diseases is rising in the younger population.

According to the authors, “More emphasis should be placed on breakfast habits, especially among adolescents and young adults, when behavioral patterns are developing and stabilizing.”

(Pediatrics 2008;121:e638–45)

Healthnotes Newswire (January 31, 2008)—For pregnant women, energy boosters such as nutritious beverages, protein snacks, and exercise may be a safer option than caffeine. A study in the American Journal of Obstetrics and Gynecology reports that drinking caffeinated beverages might increase miscarriage risk. “The main message for pregnant women is that they probably should consider stopping caffeine consumption during pregnancy,” says De-Kun Li, MD, the study’s lead investigator. “This research provides clearer and stronger evidence that high doses of caffeine intake during pregnancy can increase the risk of miscarriage.”The new study included 1,063 pregnant women who were members of the Kaiser Permanente Medical Care Program. The women were interviewed early in their pregnancies regarding their intake of caffeine-containing beverages (including coffee, tea, soft drinks, and hot chocolate) and about pregnancy-related symptoms like nausea and vomiting.

Women who drank 200 mg of caffeine per day—the amount found in 10 ounces of coffee or 25 ounces of tea—or more were over two times as likely to have a miscarriage than were those women who didn’t drink any caffeinated beverages. Drinking less than 200 mg per day also raised the risk, but to a lesser extent.

Caffeine crosses the placenta and may interfere with normal growth of the unborn baby. Most healthcare practitioners advise pregnant women to limit their caffeine intake, but until now specific recommendations about caffeine consumption during pregnancy couldn’t be made.

Women with morning sickness are known to be less likely to miscarry, and many of these women might also avoid caffeine because of their nausea. This has led to confusion about whether women with morning sickness are less likely to miscarry because they avoid caffeine or because they have healthier pregnancies overall. The new study helped to sort this out, finding that caffeine increased miscarriage risk—regardless of the presence of morning sickness.

Many pregnant women struggle with decreased energy during their pregnancies, especially during the first trimester. Thankfully, there are safer options than using caffeine that can help boost energy during these months.

Energy lifters for the mother-to-be

• “Perk up with natural energy boosts like a brisk walk, yoga stretches, and snacking on dried fruits and nuts,” suggests Tracy Flanagan, MD, director of Women’s Health, Kaiser Permanente Northern California.

• Keep blood sugar levels up with small, frequent meals and snacks that include a protein source like a hard boiled egg, slices of lean deli meats, a protein bar, or a fruit and yogurt smoothie.

• Make sure to get plenty of rest—this is key to avoiding the need for an artificial energy spike.

• “Stay hydrated by replacing caffeinated drinks with more nutritious fluids,” offers Michelle Palmer, certified nurse-midwife. “Lemon water is a refreshing pick-me-up.”

(Am J Obstet Gynecol doi 10.1016/j.ajog.2007.10.803)