VitaminBlog.com

Healthnotes Newswire (July 31, 2008)—Women over 50 are usually reminded to have their bone density evaluated every couple of years, but many healthcare providers don’t know when to recommend this screening to men. To help pinpoint the right time for testing men’s bone density, a new review has identified the major factors that put men at risk for fracture from osteoporosis. The review, published in the Annals of Internal Medicine, analyzed the findings from 177 studies performed between 1990 and 2007 that assessed risk factors for osteoporosis-related fracture in men, and 20 studies that evaluated various screening tests for osteoporosis. The findings from a previous review were also included in the analysis.

What puts men at risk

It comes as little surprise that the two most important risk factors identified for men were the same as those for women: being over 70 years old and being thin (having a low body mass index). Other risk factors included sedentary lifestyle, having taken prolonged courses of steroid medications, weight loss, and having had a previous fracture due to osteoporosis. Androgen deprivation therapy, a prostate cancer therapy that reduces testosterone levels, was also found to significantly increase fracture risk.

Smoking was found to slightly increase fracture risk, while low dietary calcium from milk was not consistently associated with fracture risk. Drinking alcohol had no apparent effect on fracture risk or bone mineral density.

Although some studies identified rheumatoid arthritis, respiratory diseases such as asthma, and gastrointestinal disorders such as celiac disease as risk factors for low bone density and fracture, the evidence was not strong.

Are you a good candidate for screening?

Dual-energy x-ray absorptiometry (DEXA) is the current gold standard for diagnosing low bone density and osteoporosis in men and women. It is regularly recommended for women but less commonly for men, despite the fact that 25% of men over age 60 will have a fracture due to osteoporosis sometime in their lifetime.

A simple osteoporosis screening questionnaire involving age and weight as the only variables was found to be an accurate predictor of osteoporosis in men, and one study found that the strongest predictor for hip fracture risk was weight under about 150 pounds (70 kilograms).

“Osteoporosis in men is substantially underdiagnosed and undertreated in the United States and worldwide,” said lead study author Dr. Hau Liu of the Santa Clara Valley Medical Center in San Jose, California. “We determined that men of advanced age and low body weight are the best candidates for osteoporosis screening. Identifying other important risk factors, particularly weight loss, physical inactivity, corticosteroid use, previous osteoporotic fracture, and androgen deprivation therapy, can help healthcare providers select other men who are good candidates for screening.”

(Ann Intern Med 2008;148:685–701)

Healthnotes Newswire (July 17, 2008)—If you are chronically tired, getting moving might be just the thing to put some pep in your step. A new study has found that exercise can improve energy and lessen feelings of tiredness in people who suffer from persistent fatigue.

The effects of exercise on people with certain chronic medical conditions (heart disease and cancer, for example) are well documented, but less is known about its role in improving stamina in people suffering from fatigue without an underlying disease. The new study aimed to determine how exercise affects feelings of fatigue and energy in young people with fatigue unrelated to a medical condition.

In the study, published in Psychotherapy and Psychosomatics, 36 sedentary people with persistent fatigue ranging in age from 18 to 35 were assigned to a low- or moderate-intensity exercise group, or to a no-treatment control group. The low-intensity group worked out on a stationary bicycle at 40% of their peak oxygen consumption (roughly equivalent to walking at a leisurely pace) and the moderate intensity group at 75% of their peak oxygen consumption (about the same as walking at a fast pace), for 30 minutes three times per week for six weeks.

Slow and steady the best bet for persistent fatigue

People in the low- and moderate-intensity exercise groups had a 20% improvement in energy levels after six weeks compared with levels at the beginning of the study. Low-intensity exercise decreased feelings of fatigue by 65%, compared with 49% in the moderate-intensity group. The changes in fatigue and energy levels were unrelated to changes in aerobic fitness. The authors suggested that energy and fatigue improvements are due to the direct effects of exercise on the central nervous system.

Exercise professionals agree

“I have found that maintaining a consistent exercise routine keeps me feeling well balanced and energized,” says Rachel Weisz-Nesshoever, Aerobic and Fitness Association of America certified group exercise instructor in Narragansett, Rhode Island. “Exercise has a way of lifting the spirits and combating fatigue. Sometimes people who are chronically tired tend to avoid exercising. What they don’t realize is that—if it’s done right—exercise can actually give you more stamina and energy to do the things you want to do.”

(Psychother Psychosom 2008;77:167–74)

Healthnotes Newswire (June 26, 2008)—Yet more proof points to the importance of exercise and healthy eating to reduce the chance of developing diabetes in people at risk for the disease. With the onset of type 2 diabetes, the body’s ability to keep blood sugar (glucose) levels in check begins to diminish. Losing weight, exercising regularly, and eating well can help improve insulin sensitivity, protecting against diabetes or possibly halting its progression.

“In people with impaired glucose tolerance, group-based interventions targeting lifestyle changes such as diet and exercise produce a durable and long-lasting reduction in incidence of type 2 diabetes,” said the authors of a new study in the Lancet.

As part of the 20-year study, 577 people with impaired glucose tolerance (a prediabetic condition) were assigned to a control group (no intervention), or to one of three lifestyle intervention groups (diet, exercise, or diet plus exercise). The dietary intervention focused on eating more vegetables and consuming less sugar and alcohol. The exercise intervention concentrated on increasing leisure time physical activity.

The interventions lasted for 6 years; then the people were followed for 14 more to determine the long-term effects of the lifestyle changes on the risk of developing diabetes and related complications, including heart disease.

During the first 6 years, the people in the intervention groups had a 51% lower incidence of diabetes than did people in the control group. After 20 years, the intervention groups sustained a 43% lower diabetes incidence, and people in the intervention groups were diabetes-free for almost 4 years longer than people in the control group. The interventions did not seem to affect the risk of cardiovascular disease and other diabetic complications.

The World Health Organization estimates that at least 180 million people worldwide are living with diabetes. The risk of type 2 diabetes is higher in people with a family history of the disease; being overweight, having high triglycerides (a fat in the blood), and high blood pressure also raise risk.

Simple steps to protect your blood sugar

Dr. Leon Hecht, a New Hampshire naturopathic doctor specializing in diabetes, offers these tips for stabilizing blood sugar and avoiding diabetes and related problems.

• Focus your diet on whole foods, including vegetables, fruits, whole grains, lean animal proteins, legumes, nuts, and seeds.

• Eat a larger breakfast and a smaller dinner.

• Each day, make one meal a large salad with all the fixings.

• Decrease foods with flour in them—this means all cakes, cookies, and breads—as these foods will raise your need for insulin, causing you to store fat.

• Aim to lose abdominal fat, as weight in this area is a principal risk factor for type 2 diabetes.

(Lancet 2008;371:1783–9)

Healthnotes Newswire (June 19, 2008)—Childhood and teen obesity has leveled out, according to statistics from 2006. But it’s not time to celebrate yet—there is work to be done to reverse the trend and help kids become healthier. A new study reports that overweight and obesity rates in kids have not changed since 1999, giving us reason for both optimism and concern.

The study, published in the Journal of the American Medical Association, included data from the National Health and Nutrition Examination Survey, which has been conducted in multiple stages by the National Center for Health Statistics and the Centers for Disease Control and Prevention (CDC) since the 1960s. The researchers used health information collected from 2003 to 2006 for 8,165 children and adolescents ages 2 to 19. Body mass index (BMI) was calculated for each child and placed on the percentile graphs for boys and girls established in 2000 by the CDC.

What researchers found when the children weighed in

The surveys found:

• 11.3% of children and adolescents had an extremely high BMI, falling at or above the 97th percentile for their age

• 16.3% were obese, with BMI at or above the 95th percentile

• 31.9% were overweight, having BMI at or above the 85th percentile

• Children between 12 and 19 years old were more likely to have high BMI than younger children

• Mexican–American boys and girls and non-Hispanic black girls had higher BMI than non-Hispanic white boys and girls

When the researchers compared these percentages to those from previous surveys, no real change was seen since nearly a decade ago.

Based on data from older surveys, the trend in childhood overweight and obesity was clearly upward from 1980, when only 6.5% of children ages 6 to 11 were obese. By 1994 that number had risen to more than 11%, and by 2002, it had climbed to more than 16%, where it seems to have reached a plateau.

An opportunity to outpace obesity

Although the reasons for the change in trend is not yet known, we do know that some behaviors can help children avoid becoming overweight and obese. Taking steps when your children are young will help them develop positive habits that will keep them healthy into adulthood.

• Avoid fast foods, which are high in calories and fat. Home-cooked meals made with whole grains and lots of vegetables will help your family stay healthy.

• Watch the portions. Portion sizes of prepared foods are large and growing. Eat at home and try letting your children serve themselves. We tend to eat what’s put in front of us, but left to dish out their own food, children tend to take and eat smaller portions.

• Skip sugary soft drinks. These add empty calories in the form of high-fructose corn syrup, implicated in the rising trends in overweight, obesity, and type 2 diabetes.

• Keep kids active and limit screen time—including television, movies, and computers.

Healthcare professionals who work with children agree that these rates need to come down before we can breathe a sigh of relief. Said Cynthia Ogden, PhD, the study’s lead author and an epidemiologist at the National Center for Health Statistics, “It doesn’t mean we’ve solved it, but maybe there is some opportunity for some optimism here.”

(JAMA 2008;299:2401–5)

Healthnotes Newswire (June 12, 2008)—A study in the Journal of Clinical Oncology found that cancer survivors who practiced the positive lifestyle behaviors recommended by the American Cancer Society had a higher quality of life than those who made fewer changes.

Over ten million Americans have had some form of cancer; fortunately, certain lifestyle behaviors can help beat it and keep it from coming back. For example, physical activity helps prevent many types of cancer. The American Cancer Society recommends that cancer survivors get at least 150 minutes of moderate to strenuous or 60 minutes of strenuous exercise per week. They also recommend eating “5-A-Day”—five daily servings of fruits and vegetables—and not smoking.

The new study surveyed 9,105 survivors of six different kinds of cancer—breast, prostate, colorectal, uterine, skin melanoma, and bladder—to see the extent to which the survivors followed the American Cancer Society’s recommendations and how their habits affected their health-related quality of life.

A range of healthy habits is the key

Physical activity goals were met by 30 to 47% of the survivors, while only 15 to 19% met the 5-A-Day fruit and vegetable recommendation. Most survivors (up to 92%) did not smoke. “This suggests that it may be important to develop a multibehavioral lifestyle intervention rather than develop single behavior interventions,” the study’s authors commented.

Survivors of breast, prostate, and colorectal cancers who met the 5-A-Day or not smoking recommendations had a significantly higher quality of life than those who didn’t, and survivors of all types of cancer who were more physically active reported a higher quality of life. “Physical activity is a key lifestyle behavior that should be incorporated into all the interventions to improve health-related quality of life,” concluded the authors.

Dr. Lise Alschuler, author of Definitive Guide to Cancer: An Integrated Approach to Prevention, Treatment and Healing, said, “It seems to me that the main reason for the low rate of healthier lifestyle adoption is the difficulty of the changes themselves. It is hard for anyone to change their diet and equally as difficult to increase exercise. People who are successful in making positive changes to their dietary and exercise patterns feel better. As a result of eating differently and exercising regularly, people become more engaged in the process of living and as a result have more vitality and wellness.”

(J Clin Oncol 2008;26:2198–204)

Healthnotes Newswire (June 12, 2008)—As the summer solstice approaches, many of us notice how much long, sunny days can lift the mood. New research suggests there may be a physiological basis for this phenomenon. A recent study found that people with minor or major depression had lower vitamin D levels than people without depression.

The study, published in the Archives of General Psychiatry, was conducted in the high-latitude country of the Netherlands (where sun exposure is limited) and included people age 65 and older. Vitamin D levels in 169 people with minor depression and 26 people with major depression were compared with those from 1,087 people without depression.

Vitamin D levels were 14% lower in the people with major and minor depression compared with nondepressed people. Levels of parathyroid hormone, the hormone that helps regulate calcium levels in the body, was 5% higher in people with minor depression and 33% higher in people with major depression. When vitamin D levels are low, parathyroid hormone levels tend to rise, and high levels of this hormone have been linked to depression in the past.

D is for daylight

Vitamin D, produced through a chemical reaction that begins in sun-exposed skin cells, plays a critical role in calcium metabolism by increasing the absorption of dietary calcium and decreasing the amount of calcium lost through urine. Long known to be necessary for healthy teeth and bones, recent evidence has pointed toward its importance in preventing depression and some cancers.

Older people tend to spend less time outside than younger people, and many don’t get adequate sunshine, making them more susceptible to vitamin D insufficiency and deficiency. In the current study, almost 39% of men and 57% of women had levels of vitamin D that are considered insufficient, which means they were low but not low enough to be called deficient. The rate of depression in older people, estimated to be about 13%, is higher than in younger people.

Easy does it

“The dilemma is that sun exposure without sunscreen, which is necessary for vitamin D production, increases the risk of skin cancer,” commented Dr. Julianne Forbes, a naturopathic doctor who practices in Maine.((Same comment as on other.)) “Be sensible—cover up or use sunscreen if you plan to be in the sun for an extended period, but don’t be afraid to head out for a short walk or get short bursts of sun exposure over the course of an ordinary day.”

People can take several steps to prevent depression:

• Stay active—There is a wealth of research demonstrating a link between inactivity and depression.

• Avoid too much alcohol, which is a natural depressant.

• Eat foods rich in folic acid and vitamin B12, especially if you’re an older adult. Deficiencies in both of these vitamins are more common in seniors and are linked with depression.

• Get a little sunshine when possible, and consider supplementing with 1,000 IU of vitamin D per day, especially in the winter and if you live in a northern latitude.

(Arch Gen Psychiatry 2008;65:508–12)

Healthnotes Newswire (June 5, 2008)—Supplementing with Chinese club moss (Huperzia serrata) may improve brain and behavioral functioning in some people with Alzheimer’s disease, according to a new Cochrane Review.

The herbal Chinese club moss product, called Huperzine A, has been shown in to have positive effects on the central nervous system. This review, which included six Chinese trials and 454 patients, showed that compared with people who took placebo, certain symptoms were improved in people with Alzheimer’s disease who took Huperzine A.

“Huperzine A seems to have some beneficial effects on improvement of general cognitive function, global clinical status, behavioral disturbance, and functional performance, with no obvious serious adverse events for patients with Alzheimer’s disease,” said the study authors. They recommend further research to better understand the role of Huperzine A in the management of Alzheimer’s disease.

Alzheimer’s disease is a form of dementia that seriously impairs a person’s memory and ability to think. Eventually, the disease also affects the ability to carry out day-to-day activities and they experience behavioral changes such as wandering, agitation, and depression. Environmental and genetic factors play a role in disease development, which occurs more frequently in people over age 60. There is no cure for the disease but there are a number of drugs that have been shown to help delay brain deterioration and improve functioning.

Steps a caregiver can take to improve the life of a person with Alzheimer’s disease include the following:

• Music, art, or exercise classes that are designed specifically for people with Alzheimer’s can help stimulate their mind.

• Interaction with animals—known as pet therapy—may be helpful for people with Alzheimer’s disease. Petting animals can help relax the mind and body.

• Arranging and modifying the home environment to reduce accidents and falls is critical, as people with Alzheimer’s disease may not always have sound judgment or steady balance.

• Build a support network for both the patient and caregiver. It often takes many people to help care for a person with Alzheimer’s disease since the patient eventually becomes dependent on others for care. Support groups are available in senior centers and many local hospitals.

(Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD005592. DOI: 10.1002/14651858.CD005592.pub2)

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)