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Healthnotes Newswire (July 24, 2008)—People with type 2 diabetes are more likely to suffer from memory problems, especially right after eating. A new study in Nutrition Research found that taking antioxidant vitamins with food can help people with diabetes offset the memory-robbing effects of a heavy meal.

Putting antioxidants to the test

Diabetes is characterized by higher than normal blood sugar (glucose) levels. Long-term elevations in blood sugar increase the body’s production of free radicals—tissue-damaging compounds that cause many of the complications of diabetes including eye and kidney damage, heart disease, and memory impairment. Eating a meal increases free radical production in the body, and people with diabetes are particularly prone to the negative effects of this sudden rise.

In the new study, 16 adults with diabetes, on separate occasions, were given a high-fat high-carbohydrate meal or the same meal plus 1,000 mg of vitamin C and 800 IU of vitamin E. After eating, they took a series of tests to measure memory capacity.

After eating the test meal alone, the people had a harder time remembering words and information presented to them. Taking antioxidant vitamins with the meal prevented this from happening. “In adults with type 2 diabetes, co-consumption of antioxidant vitamins minimizes meal-induced memory impairment, implicating oxidative stress as a potential contributor to these decrements,” said the study’s authors.

Upgrade your diet for better health and sharper memory

While taking supplements can be useful in the short term, it’s a good idea to eat healthful foods that are naturally rich in antioxidants and other substances known to combat diabetes like fiber, magnesium, and chromium.

• Eat lower-fat meals. Limit packaged and snack foods, and cook foods at home to control the amount of fat, sugar, and other processed ingredients that go into a meal.

• Use unprocessed foods in meal preparation. Skip “white foods” like flour, rice, bread, potatoes, and sugar. Whole grains may be substituted for processed ones; these will not have the same detrimental effects on blood sugar and memory function.

• Focus on antioxidant-rich foods. Great choices include berries, winter squash, cantaloupe, sweet potato, broccoli, tomatoes, oranges, pomegranate, artichoke, red grapes, nuts and seeds, sweet peppers, mango, legumes, whole grains, and dark green leafy veggies (kale, collards, chard).

(Nutr Res 2008;28:423–9)

Healthnotes Newswire (July 10, 2008)—Good news for your little juice lovers: Although several studies have suggested that drinking fruit juice might contribute to overweight in children, a review of 21 studies found that the link was not strong. “There is no systematic association between consumption of 100% fruit juice and overweight in children and adolescents,” said the study’s authors in the American Journal of Lifestyle Medicine.

The origins of overweight

While genetics play a role, diet and exercise patterns are also intimately involved in maintaining healthy weight. In a previous study, one researcher found that children who drank more than 12 ounces of fruit juice per day were more likely to be overweight than children who drank less juice. Since juice is the drink of choice for many youngsters, the new study compiled evidence from studies concerning juice consumption and overweight in children to try to answer the question: Does drinking juice make kids fatter?

Only 6 of the 21 studies reviewed found a relationship between drinking 100% fruit juice and overweight in children, none of which were based on a nationally representative sample. Those that found a relationship did so only in adolescent girls and children who were overweight to begin with. The other 15 studies—5 of which were based on nationally representative samples—found no relationship between drinking juice and becoming overweight.

The authors concluded, “The data do support consumption of 100% fruit juice in moderate amounts and suggest that consumption of fruit juice may be an important strategy to help children meet the current recommendations for fruit.”

“As the mother of one child who wants nothing to do with juice, and another who would drink it all day long, it is a relief to read this new study. I feel like it’s one less thing for me to stress about as a mom,” said Erin Goodman, founder of the Rhode Island Birth Network.

The importance of addressing obesity

According to the 2003-2004 National Health and Nutrition Examination Survey (NHANES), 17% of all children and adolescents are overweight. Among 2 to 5 year olds, the prevalence increased from 7 to 14% between 1988 and 2004; similar increases were seen among 6- to 19-year-olds in this time span, with an increase in the percentage of overweight children from 11 to 19%.

Says Dr. Matthew Baral, medical director of Hamilton Elementary School Clinic in Phoenix, “Eating the whole fruit is preferable to the juice, since the release of sugar in the bloodstream is somewhat blunted by the fiber in whole fruit. When consuming juice, dilute it with water to lessen the amount of sugar the child is getting.”

Help your child maintain a healthy weight

Here are some simple things that parents can do to help keep kids’ weight in a healthy range:

• Snack on fruits and veggies—Make a big fruit salad on the weekend; store in the fridge and eat all week. Keep ready-to-eat cut-up vegetables on hand for quick snacks. Baby carrots, snap peas, broccoli, and cauliflower are easy to eat on the go.

• Get moving in your free time—Set a positive example by making exercise a priority for the whole family.

• Limit TV time—Kids who watch more TV or eat while watching TV are more likely to become overweight.

• Avoid processed foods—Packaged snacks can contain hidden fats and sugar. Opt for home-baked goods to satisfy the urge to snack.

(AJLM 2008;doi:10.1177/1559827608317277)

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 (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)—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 (May 1, 2008)—What do men in their 90s have in common? They exercise regularly, don’t smoke, have normal blood pressure, and keep their figures, says a new study.

The study, published in the Archives of Internal Medicine, examined the health and lifestyles of 2,372 senior men and followed them for 25 years. The men were age 65 or older and generally healthy at the beginning of the study, giving them all the possibility of reaching 90 by the end of the study, which 41% of them did.

• Smoking was the strongest predictor of dying before 90—nonsmokers were twice as likely to live past their 90th birthday.

• Diabetes was the second strongest risk factor for not seeing 90, followed by obesity and high blood pressure.

• Vigorous exercisers were 20 to 30% more likely to reach their 90s. Nonsmoking men who exercised and did not have diabetes, obesity, or high blood pressure in their 70s were nearly 14 times more likely to live into their 90s than those who had none of these factors in their favor.

The men who lived to 90 or older reported better physical functioning, mental well-being, and self-perceived health on a survey they completed 16 years into the study. Smoking, obesity, and inactivity were also associated with poorer functioning in these elderly men.

While a number of studies have similarly and consistently demonstrated the benefits of good lifestyle habits on health and longevity, none have looked at men who reach this exceptional age. These findings suggest that maintaining good habits even in old age can have an important effect on how long men live and how well they feel and function.

“Our study provides evidence that certain negative health behaviors continue to pose a risk very late in life, and shows the detrimental and long-term effects of smoking, obesity, and inactivity on late-life functioning and well-being,” commented Dr. Laurel Yates of Brigham and Women’s Hospital in Boston, lead author of the study. “Based on our findings, the factors closely associated with exceptional life span, good health, and good functional status are strongly related to lifestyle choices.”

(Arch Intern Med 2008;168:284–90)

Healthnotes Newswire (March 6, 2008)—Every bartender knows that the way to sell more beer is to keep the salted snack bowl full, but it may not be common wisdom that the amount of fluid we drink is directly related to the amount of salt in our food.

Children, like adults, are eating more and more highly processed high-salt foods, and because their drinks are often sugary sodas, the consequences could be compounded. A new study has found a direct link between the amount of salt kids eat and the amount of sugary beverages (including soda and sports drinks) they drink, suggesting that eating less salt might be one way to counter the rising rate of childhood obesity.

The study, published in Hypertension, used data from 1,688 children and adolescents between 4 and 18 years old who completed the National Diet and Nutrition Survey for young people in Great Britain. The children kept a seven-day record of their food and drink intake, with those seven and older also recording their activity level.

Only 9% of the fluid consumed by the kids was water. Soft drinks represented 56% of total fluid intake, and more than half of the soft drinks were sugar-sweetened. Salt intake was closely linked to total fluid and sugary soft drink intake in all age groups and at all levels of physical activity. The researchers calculated that for every gram of salt in the diet, children would drink 27 grams (about one ounce) of sugary soft drink.

“Children aged 4 to 18 years in the United Kingdom consumed on average about 6 grams [1 tsp] of salt per day at the time of the survey [1997],” commented study author Dr. Feng J. He at the Blood Pressure Unit, St George’s University of London. “That is a lot of salt. We estimate that reducing this by half could reduce sugar-sweetened soft drink consumption by an average of more than two soft drinks per week per child. This would be equivalent to taking 244 calories out of each child’s diet every week. Over time, this could have a significant impact on reducing overweight and obesity in childhood.”

Concerned by the rapidly rising rates of childhood overweight, obesity, and diabetes, many parents are searching for ways to help their kids develop healthy eating habits. Cutting down on sugary foods is one important way, but the sugar in soft drinks—which in the average kid represents a significant portion of their calorie intake—is often overlooked. The evidence from this study suggests that cutting down on salt is another way to reduce kids’ sugar intake and contribute to lifelong healthy eating habits.

Help your kids sidestep salt & sugar

In addition to obesity, too much sugar has been associated with diabetes, hyperactivity, and other problems in children, and salt may contribute to kids developing high blood pressure. To offset unhealthful snacking, parents may experiment with other choices:

• Savory snacks: Baby carrots (or any other finger-sized veggies), popcorn (lightly salted or with brewer’s yeast), bite-sized hunks of cheese, hard-boiled eggs, and edamame (cooked soybeans).

• Sweet snacks: Dried fruits or fresh are both good choices: try grapes and harder varieties, such as pears, apples, and mangos cut up into fun sizes and shapes. Homemade juice popsicles are also a fun (and easy) treat.

• Thirst quenchers: Spritzers (bubbly water mixed with unsweetened juice), warm or cold herbal teas—or even water! Try to limit diet drinks, as the safety of artificial sweeteners has not been evaluated in long-term studies.

Whenever possible, look for low-salt, low-sugar, less-refined versions of the snacks your kids love.

(Hypertension 2008;51:629–34)

Healthnotes Newswire (February 7, 2008)—People with diabetes may be able to reduce the risk of a common and uncomfortable complication of the disease: they may avoid painful foot ulcers by monitoring the temperature of their feet. According to a new study published in the American Journal of Medicine, this kind of care may reduce the risk of foot ulcers by more than 30%.Constant blood sugar elevation causes the nerve damage (neuropathy) responsible for diabetic foot ulcers. Neuropathy reduces the feelings of pain or inflammation, making it difficult for people with diabetes to notice inflammation or skin injuries. Unfortunately, if even a minor skin tear is left untreated, it can develop into a serious ulcer.

In this 18-month study, 225 military veterans with diabetes who were at risk for foot ulcers due to nerve damage, foot deformities, or prior foot ulceration were randomly assigned to receive either standard therapy—which consisted of therapeutic footwear, education, regular foot care, and a daily structured foot self-inspection—or standard therapy plus the use of an in-home infrared skin thermometer to measure the temperature of several spots on their feet twice a day.

During the study, 8.4% of the people developed foot ulcers—14 from the standard therapy group and 5 from the skin thermometer group. People in the skin thermometer group had a temperature difference of 4.8 times greater in the region of ulceration during the week before the ulcer appeared than did a random sample of 50 people who did not develop ulcers. People in the skin thermometer group were one-third as likely to develop ulcers as people in the standard therapy group.

“Self-monitoring is necessary to identify early warning signs to reduce the incidence of diabetic foot complications and the associated decrements in quality of life and high resource costs,” said David Armstrong, DPM, PhD, and colleagues from the Rosalind Franklin University of Medicine and Science in Chicago, Illinois. “Sadly, the ability of the most motivated patients with diabetes, their family members, and even health care professionals to identify ‘early warning signs’ is limited. Self-evaluation of temperature seems to offer a mechanism to identify an early sign of injury, when there is still time to avert a wound.”

Foot ulcers can be painful and costly but the incidence can be reduced with disciplined foot care and attention to early warning signs such as inflammation or injury. Additionally, Armstrong and his colleagues recommend using the simple and inexpensive skin thermometer to reduce foot ulcers in high-risk patients. People with diabetes should speak with their physician or a diabetic educator about measures they can take to reduce their risk.

(Am Med J 2007;120:1042–6)