Pedal Your Way to Heart Health

MONDAY, Oct. 31, 2016 (HealthDay News) -- Regular bicycling may lower your risk of heart disease and heart attack, two new studies find.

One study looked at thousands of Danes, aged 50 to 65. Those who started cycling and kept with it had a 25 percent lower risk of developing heart disease over 15 years than those who did not cycle, researchers found.

Also, Danes who regularly used their bikes for recreation or commuting had 11 to 18 percent fewer heart attacks during a 20-year follow-up, according to the study. The results were published Oct. 31 in the journal Circulation.

"Finding time for exercise can be challenging for many people, so clinicians working in the field of cardiovascular risk prevention should consider promoting cycling as a mode of transportation," senior study author Anders Grontved said in a news release from the American Heart Association. He's an associate professor of physical activity epidemiology at the University of Southern Denmark.

Grontved's team cautioned that the study can't prove that cycling is a coronary cure-all. Still, the researchers believe that the benefits shown for regular bikers are a strong indicator that cycling can boost heart health.

Recreational and commuter biking is an easy way to make physical activity part of your routine in an informal fashion, said study author Kim Blond, a research assistant at the university.

"Based on the results, public health authorities, governments and employers ought to consider initiatives that promote bicycle riding as a way to support large-scale cardiovascular disease prevention efforts," Blond said.

The other study followed more than 20,000 Swedes in their 40s, 50s and 60s for a decade. Compared to those who did not cycle, those who regularly biked to work were significantly less likely to be obese, have high blood pressure, high cholesterol and diabetes. These are all major risk factors for heart disease.

"We found active commuting, which has the additional advantages of being time-efficient, cheaper and environmentally friendly, is also great for your health," said senior study author Paul Franks, a professor in the department of clinical sciences at Lund University in Sweden.

This is a message that "many patients will embrace more readily than being told to join a gym, go for a jog or join a sports team," Franks said.

The researchers estimated that maintaining or switching to bike commuting may have prevented 24 percent of obesity cases, 6 percent of high blood pressure diagnoses, 13 percent of high cholesterol diagnoses, and 11 percent of diabetes cases.

It's never too late to benefit from an active lifestyle, Franks added. "People who switched from passive to active commuting saw considerable gains in their cardiovascular health," he said.

The study was published Oct. 31 in the Journal of the American Heart Association.

More information

The U.S. National Heart, Lung, and Blood Institute has more about physical activity and your heart.

SOURCE: American Heart Association, news release, Oct. 31, 2016

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When Soda Makers Fund Studies, Links to Obesity Weaken

MONDAY, Oct. 31, 2016 (HealthDay News) -- If you come across a study claiming that sugary drinks don't cause obesity or diabetes, check to see who's paid for the research.

Most likely the study has financial ties to the beverage industry, according to a new review of the scientific evidence.

Every experimental study that found no link between sugary drinks and obesity or diabetes has received financial support from the beverage industry, said lead researcher Dr. Dean Schillinger. He's a professor of medicine and founding director of the University of California, San Francisco's Center for Vulnerable Populations.

On the other hand, nearly all experimental studies that establish a direct link between consuming sugary drinks and developing obesity and diabetes have not received funding from beverage makers, Schillinger and his colleagues reported.

"The industry seems to be using the scientific method to sow doubt about the truth related to their products," Schillinger said.

The American Beverage Association (ABA) countered that Schillinger has a conflict of interest himself, calling him a "paid expert" in a lawsuit over San Francisco's attempt to require health warning labels on billboards promoting soft drinks.

"It's ironic that he would write about bias in research when he himself is clearly not an impartial researcher," the ABA said in a written statement.

Schillinger and his colleagues reviewed all available literature for scientific head-to-head experiments examining the health effects of sugary beverages.

These are all "actual head-to-head comparison studies where you take people and you make them drink soda and you take other people and you make them drink water -- actual experiments in humans over the last 15 years," Schillinger said.

Out of 60 studies uncovered by the review, 26 received financial support from the beverage industry, the researchers found. Either the studies had been paid for by the beverage industry, or researchers participating in the study had financial ties to the industry.

None of the 26 industry-funded studies found a link between sugary drinks and obesity or diabetes, Schillinger said.

On the other hand, 33 out of 34 studies that reported a direct link between sugary drinks and obesity or diabetes had received no money from the beverage industry, the researchers said.

According to Dr. Michael Siegel, a professor of community health sciences with the Boston University School of Public Health, "It clearly reveals the bias that's present in these studies. This is not a subtle finding."

Siegel said his own research has found a pattern of financial ties between beverage makers and American medical groups.

Coca-Cola Co. and PepsiCo provided sponsorships to 96 health and medical groups in the United States between 2011 and 2015, according to study results released recently by Siegel.

Those organizations included the American Heart Association, the American Diabetes Association and the U.S. Centers for Disease Control and Prevention.

"We have a right -- and a responsibility -- to engage in scientific research," the American Beverage Association statement reads.

"The research we fund adheres to the highest standards of integrity for scientific inquiry based on recognized standards by prominent research institutions . . . and enables consumers to make informed decisions," according to the ABA statement.

However, Schillinger said, the new research shows that industry-funded studies appear aimed mainly at raising doubt among consumers about the health hazards of excess sugar.

"If you were to poll the average American, you would find tremendous variation in the degree to which they understand and/or believe drinking five Mountain Dews a day can cause diabetes," Schillinger said. That's the average amount consumed by teenagers in West Virginia, he added.

"We're talking about a public that has not been made aware of these relationships because of the muddying of the water and the overwhelming amount of positive marketing to which they are exposed," he concluded.

Siegel added that industry-funded studies also may have an impact on elected officials and policy makers who might favor more restrictions or higher taxes on sugary beverages.

"I think it makes it more difficult for them to stand up against the industry and take controversial stands, when they're being fed 26 different studies all purporting to show there's no tie between soda and obesity," Siegel said.

The ABA contends that "beverage companies are engaged in public health issues because we too want a strong, healthy America. We recognize that we have a role to play in reducing obesity, and we are taking voluntary actions to reduce calories and sugar from beverage consumption -- working together as competitors and engaging with prominent public health groups."

The new review was published Oct. 31 in the Annals of Internal Medicine.

More information

For more on sugary drinks and obesity, visit the Harvard T.H. Chan School of Public Health.

SOURCES: Dean Schillinger, M.D., professor of medicine and founding director, University of California, San Francisco's Center for Vulnerable Populations; Michael Siegel, M.D., professor, community health sciences, Boston University School of Public Health; American Beverage Association, statement, Oct. 31, 2016; Annals of Internal Medicine, Oct. 31, 2016

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Weight-Loss Surgery May Lower Risk of Pregnancy Complications

FRIDAY, Oct. 28, 2016 (HealthDay News) -- Women who undergo weight-loss surgery gain major benefits when it comes to pregnancy, a new study suggests.

Researchers found these women appear to be less likely to need a cesarean-section delivery and more likely to have a normal-sized baby.

"These findings are important because we were able to confirm that obese women who undergo bariatric [weight-loss] operations prior to conceiving do not have worse outcomes, compared with obese women who don't have these procedures," said senior study author Dr. Aliu Sanni. He is medical director of the department of metabolic and bariatric surgery at Eastside Medical Center in Snellville, Ga.

"We want to make sure that bariatric surgery performed before pregnancy will have benefits for these women, and that having a procedure won't harm the baby," he said in a news release from the American College of Surgeons.

It's well documented that obese women face more medical complications during pregnancy. But, the effects of weight-loss procedures on pregnancies haven't been clear, the study authors said.

"We know that the prevalence of obesity in women is increasing, so we wanted to know more about the impact of bariatric surgery on pregnancy, the mother and the baby," said study co-author Samantha Drew. She is a medical student at the Philadelphia School of Osteopathic Medicine in Suwanee, Ga.

For the study, the investigators combined statistics from five studies that examined pregnancy and delivery after weight-loss operations and compared the outcomes to those for obese women who did not get the surgery.

In total, the studies tracked more than 4,300 cesarean sections in almost 11,000 women after weight-loss procedures, and more than 133,500 C-sections in nearly 224,000 obese women.

The findings showed that 1 percent of those who had a weight-loss procedure before pregnancy underwent a C-section, compared to 38 percent of obese women who did not have the procedure.

The researchers also found that women who had weight-loss procedures were less likely to have abnormally large babies.

According to study co-author Brittanie Young, a medical student at the Philadelphia School of Osteopathic Medicine, "If the child is less at risk of being very large for its gestational age, the woman is less likely to have a C-section."

The findings were presented recently at the Clinical Congress of the American College of Surgeons, in Washington D.C. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more about weight-loss procedures and pregnancy, visit the American College of Obstetricians and Gynecologists.

SOURCE: American College of Surgeons, news release, Oct. 17, 2016

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Weight-Loss Surgery Pays Off for Severely Obese Teens

WEDNESDAY, Oct. 26, 2016 (HealthDay News) -- Weight-loss surgeries can help severely obese teens shed pounds. And now a study finds these procedures can also pay for themselves in health care savings over time.

"Our analysis indicates that it can also be cost-effective when assessed over a relatively short time horizon," wrote a team led by Dr. Chin Hur of Massachusetts General Hospital in Boston.

According to background information in the study, up to 6 percent of American youths are severely obese, and that rate is expected to rise.

Lifestyle changes -- diet and exercise -- are the first-line treatment for these teens, but this approach rarely leads to significant lasting weight loss, the researchers said. So, weight-loss (bariatric) surgery is increasingly being viewed as an option for these teens.

But the surgeries can be expensive, and there's little data on whether those expenses outpace cost savings down the line.

That led the authors of this study to compare health care costs for 228 severely obese teens, average age 17, who did or did not have weight-loss surgery.

The researchers calculated that while weight-loss surgery was not cost-effective over three years following the procedure, it could become cost-effective over five years.

"Longer-term studies that track quality of life, weight loss, comorbidity [illness] resolution, and health care costs are needed to confirm our findings," the researchers added.

Of course, there are other benefits to young people as well, the researchers said.

"At present, bariatric surgery is performed in approximately 1,000 adolescents per year," Hur's team said. "Bariatric surgery can result in life-altering weight loss, which not only leads to the resolution and prevention of disease but also allows patients to avoid the stigma, bullying and isolation that often accompany severe obesity."

Two weight-loss surgeons agreed.

"With an active teenage program, I not only agree with these findings but go further," said Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City. "Bariatric surgery, done in properly selected teenagers with functioning homes, can change their entire life. We have had kids ostracized from school become varsity athletes."

He added that "in our program we prefer to treat earlier, around 15 or 16, so an adjustment can be made before going to college and living independently."

Dr. Alexander Barkan is a bariatric surgeon at Winthrop-University Hospital in Mineola, N.Y. He agreed with the study authors that lifestyle change, typically, isn't enough to help very obese teenagers lose weight on a sustained basis.

"Teenagers who are suffering with weight can be forever damaged in social settings and psychologically," Barkan said. "Weight loss provides them with confidence and a healthier sense of self."

The study was published online Oct. 26 in the journal JAMA Surgery.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on weight-loss surgery.

SOURCES: Mitchell Roslin, M.D., chief, obesity surgery, Lenox Hill Hospital, New York City; Alexander Barkan, M.D., bariatric surgeon, Winthrop-University Hospital, Mineola, N.Y.; JAMA Surgery, news release, Oct. 26, 2016

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Many Teens Light Up to Lose Weight, Study Suggests

MONDAY, Oct. 24, 2016 (HealthDay News) -- Many American teens may smoke to control or lose weight, a new study suggests.

Researchers analyzed data from nearly 10,500 youngsters between the ages of 11 and 15. Among frequent smokers, 46 percent of girls and 30 percent of boys said weight control was one of the reasons they smoked.

The study also revealed that smoking to lose weight was much more common among teens who felt they needed to drop weight. Girls who believed they were "much too fat" were nearly 225 percent more likely to smoke to lose weight than girls who felt their weight was about right.

Boys who thought they were "much too fat" were nearly 145 percent more likely to smoke for weight loss than boys who were happy with their weight, the study found.

The researchers also found that white teens were more than twice as likely as black teens to smoke for weight loss.

The findings help "us better understand why people choose to engage in risky health behaviors. It's not always just about the immediate pleasure or enjoyment; sometimes it's a means to another end," study author John Cawley, a professor of policy analysis and management at Cornell University in Ithaca, N.Y., said in a university news release.

Anti-smoking policies could also be altered to be more effective, the researchers added.

For example, Cawley suggested, the U.S. Food and Drug Administration could prohibit cigarette makers from promoting the idea that smoking can help people control or lose weight. Doing so might make teens less likely to buy cigarettes if taxes were increased, he said.

"There's a strong economic case for taxing cigarettes. It's just that the taxes may not decrease consumption among girls as much as you might hope or think," he said. "But if you can break the perceived connection between smoking and weight loss, you may increase their responsiveness to taxes."

The study was published recently in the journal Health Economics.

More information

The U.S. Centers for Disease Control and Prevention has more on youth and smoking.

SOURCE: Cornell University, news release, Oct. 13, 2016

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Having Baby Too Soon After Weight-Loss Surgery May Raise Risks

WEDNESDAY, Oct. 20, 2016 (HealthDay News) -- Infants born to mothers who've had weight-loss surgery have a higher risk for complications, and the risks are greatest for those born within two years of the surgery, a new study finds.

"A recently postoperative mother with underlying nutritional, metabolic, and physiological changes is at an elevated risk for perinatal complications," concluded a team led by Dr. Brodie Parent, of the University of Washington Medical Center in Seattle.

One obstetrician who reviewed the findings said the issue is arising more frequently as bariatric (weight-loss) surgeries surge in popularity.

"I have been acutely aware of the recent increase in patients who have had bariatric procedures," said Dr. Brian McKennna, who directs gynecology at Northwell Health's Southside Hospital in Bay Shore, N.Y.

"Many of these patients have had serious nutritional deficits even before their surgery," he added, and following the surgery, "balancing the nutritional needs of pregnancy presents unique challenges."

In the new study, Parent's team tracked outcomes for infants born to more than 1,800 mothers who were, on average, 29 years old. The women had all undergone weight-loss surgery less than two years or more than four years before they gave birth.

That data was compared to outcomes for infants born to more than 8,400 mothers who did not have weight-loss surgery.

Compared to infants of mothers who didn't have weight-loss surgery, infants born to mothers who did were at higher risk for prematurity (8.6 percent vs. 14 percent), neonatal ICU admission (11 percent vs. 15 percent), and being underweight (8.9 percent vs. 13 percent).

The amount of time elapsed between the surgery and the birth seemed to matter, the Seattle researchers noted.

For example, compared to infants of mothers who had weight-loss surgery more than four years before giving birth, infants of mothers who had the surgery less than two years before giving birth were at higher risks for:

• prematurity (12 percent vs. 17 percent),

• neonatal ICU admission (12 percent vs. 18 percent),

• and being underweight (9 percent vs. 13 percent).

Parent's group stressed that the study does not conclude that obese women who'd like to have children should reject weight-loss surgery.

"Undoubtedly, bariatric operations result in many health benefits for morbidly obese women of childbearing age and reduce obesity-related obstetrical complications," the researchers wrote in the study. "Findings from this study should not deter bariatric surgeons from offering such therapy to this population."

McKenna agreed, saying that women and their physicians should work together to ensure that moms-to-be's nutritional needs, and their baby's, are being met during pregnancy. That's especially true for women who've undergone bariatric surgery, he said.

"We need to maximize a safe and nurturing environment for babies, and the first step is to help expectant mothers to achieve nutritional support and balance early on," McKenna said. "Bariatric surgery is the beginning of a long process of healing and restoration toward normal physiology. It would be wise to counsel our patients to allow adequate time for their bodies to re-balance after these procedures."

Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City, agreed that timing is key to minimizing any risks to pregnancy following weight loss surgery.

"We usually suggest that patients are weight-stable and nutritionally replete before attempting pregnancy -- in our practice, 18 months," Roslin said.

"With proper education, patients can remain nutritionally replete even after aggressive bariatric procedures," he added. "Healthy women make healthy mothers."

The study was published online Oct. 19 in the journal JAMA Surgery.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on weight loss surgery.

SOURCES: Brian P. McKenna, M.D., director of gynecology and VP, Women's Strategic Initiatives, Northwell Health's Southside Hospital, Bay Shore, N.Y.; Mitchell Roslin, M.D., chief, obesity surgery, Lenox Hill Hospital, New York City; JAMA Surgery, news release, Oct. 19, 2016

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Are Vegetarian Diets Heart-Healthier?

TUESDAY, Oct. 18, 2016 (HealthDay News) -- Vegetarians are assumed to be healthier than carnivores, but a new study questions that assumption. It found meat eaters had no significantly greater risk of heart disease over 10 years compared to those who favored no-meat diets.

"I wouldn't say a vegetarian diet is useless for preventing cardiovascular risk," said study leader Dr. Hyunseok Kim.

However, the heart benefits on a population level may be less than some believe, said Kim, an internal medicine resident at Rutgers New Jersey School of Medicine in Newark.

The study findings puzzleded one nutritionist who said previous research has indicated that a vegetarian diet is good for the heart.

The study used U.S. national survey data to compare adult vegetarians to thousands of meat eaters. While vegetarians were thinner, their overall heart risk wasn't actually different, according to the study.

"Followers of the vegetarian diet do have lower risks of obesity, high blood pressure and metabolic syndrome," all risk factors for heart disease, Kim said. But that may be partly because vegetarians are often younger and female, so they're already at lower risk for heart disease, the study said.

Kim and his Rutgers colleagues used the U.S. National Health and Nutrition Examination Survey from 2007 to 2010. It included nearly 12,000 adults age 20 or older. Of those, 263 -- 2.3 percent -- followed a vegetarian diet.

The researchers examined rates of obesity, average waist circumference, high blood pressure and metabolic syndrome -- a cluster of conditions, including high cholesterol and glucose levels -- that raise the risk for heart disease.

They also assessed the Framingham cardiovascular-disease risk estimate, which factors in age, gender, cholesterol levels, blood pressure and smoking status to predict the chances of developing cardiovascular disease in the next decade.

When the researchers calculated the participants' Framingham risk, the vegetarians had a risk of 2.7 percent, while the non-vegetarians had a 4.5 percent risk. The difference between the groups was not statistically significant, Kim said.

The findings surprised one nutrition expert.

"We would certainly consider this study as we look for more data on the health benefits of vegetarian diets, but this study is contrary to evidence provided in the 2015 Dietary Guidelines for Americans and in a position paper of the Academy of Nutrition and Dietetics," said Connie Diekman. She's the director of university nutrition at Washington University in St. Louis.

Under those guidelines, "consuming more fruits and vegetables is connected with a lower risk of cardiovascular disease," Diekman said. Eating more whole grains is also thought to lower the risk, she noted.

"The Academy position states that a vegetarian diet is associated with a lower risk of death from ischemic heart disease," added Diekman, who wasn't involved in the study.

She said she encourages people to adopt a diet "that more closely resembles a vegetarian eating plan."

The study is cross-sectional, sort of a snapshot in time, Kim said, so that is one inherent limitation. Another is that people self-reported their diet.

Studies that follow people over time are needed to better assess the benefits of vegetarian diets, Kim added.

Kim presented the findings Monday at the American College of Gastroenterology meeting in Las Vegas. Research presented at medical meetings is viewed as preliminary until published in a peer-reviewed journal. The study had no outside funding and no industry funding.

More information

For more on a vegetarian diet, visit Harvard Health Publications.

SOURCES: Hyunseok (Brandon) Kim, M.D., M.P.H., internal medicine resident, Rutgers New Jersey Medical School, Newark; Connie Diekman, R.D., director, university nutrition, Washington University in St. Louis; American College of Gastroenterology, annual meeting, Oct. 17, 2016, Las Vegas

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Obesity More Common Among Teens With Autism: Study

MONDAY, Oct. 17, 2016 (HealthDay News) -- Teens with an autism spectrum disorder (ASD) may be more likely to be obese and stay obese throughout their teen years compared to other teenagers, a new study suggests.

The researchers noted that childhood obesity could have long-term health consequences for those with ASDs. They said more study is needed to understand age-related changes that could help prevent and treat obesity among teens with the disorder.

"Children with developmental disabilities face unique challenges and are not always served by health interventions aimed at those without disorders such as ASD," said study author Aviva Must. Must is chair of public health and community medicine at Tufts University School of Medicine in Boston.

"The complexity of their medical needs is both why particular attention should be paid to their circumstances and why it is difficult to do so," Must said in a university news release.

The study included almost 44,000 people between the ages of 10 and 17. The children and teens had participated in the 2011-2012 National Survey of Children's Health. That survey included information about weight, height, gender, race, socioeconomic status and whether or not someone had an ASD.

Obesity was more common among the children and teens with an autism spectrum disorder. The researchers found 23 percent of those with the disorder were obese, compared to 14 percent of those who didn't have ASD.

The rate of obesity among young people who didn't have autism spectrum disorder fell by 50 percent between the ages of 10 and 17. But, obesity rates among those with an ASD didn't change during these years, the study showed. Obesity was also more common among boys with ASD than girls, the researchers noted.

"We expected to see an increased prevalence of obesity with age in children with ASD compared to those without ASD, which would increase the obesity disparity," said Must.

"What we found was that the disparity did increase with age over adolescence, but the underlying patterns were not as expected. The prevalence of obesity in the ASD group was high and remained so, while the prevalence in children without ASD declined over adolescence," Must said.

Young people with autism spectrum disorder tend to have rigid behaviors, relying on routine and lack of change. They may also have sensory sensitivity. Use of food to ease these behaviors or reduce stress during certain situations could play a role in high rates of obesity among these children, the study's authors explained.

Young people with ASD may also be less active, increasing their risk for weight gain, the researchers pointed out.

"When it comes to energy expenditure, exercise for many teens comes in the form of competitive sports, in which children with developmental disabilities are less likely to take part," said study senior author Linda Bandini. She's an associate professor at UMass Medical School Shriver Center and the department of health sciences at Boston University.

"And another reward and calming technique parents of children with ASD have reported using is television, which may contribute to higher levels of sedentary behavior," she added.

More information

The U.S. National Institute of Neurological Disorders and Stroke provides more information on autism spectrum disorder.

SOURCE: Tufts University School of Medicine, news release, Oct. 11, 2016

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Foster Kids Face Higher Risk of Health Problems: Study

MONDAY, Oct. 17, 2016 (HealthDay News) -- Children in foster care face increased risks of physical and mental health issues, from asthma to ADHD to depression, a new study finds.

Considering the adversity foster children face, the study results aren't surprising, the researchers added.

But this is the first study to compare their rates of health issues to those of U.S. children as a whole, including kids from low-income or single-parent families.

The study confirms that children in foster care are particularly vulnerable, said lead researcher Kristin Turney, an associate professor of sociology at the University of California, Irvine.

Overall, her team found, foster kids faced two to three times higher risks of physical health issues such as asthma, obesity and hearing and vision problems.

And they were five to seven times more likely to have behavioral issues or symptoms of depression or anxiety.

No one is saying that foster care caused those problems, Turney stressed. "We can't conclude that foster care created them, or made them worse," she said.

The point, according to Turney, was to paint a clearer picture of how U.S. foster children are faring.

Under the foster care system, a designated adult temporarily cares for a child or children whose birth parent is unable to care for them.

To Julie Steele, the results of the new study ring true to what she sees in her own practice.

Steele is an assistant professor of nursing at the University of Utah, where she also manages the South Main Foster Care Clinic.

She said that while the study findings aren't surprising, they're important. "They expand our understanding, by really quantifying the risks these children face," said Steele, who was not involved in the research.

Beyond that, she said, the study shines a light on a group of children who often "fall below the radar."

In general, Steele said, children should get physical and mental health evaluations when they enter the foster system. And ideally, she added, kids who need help with problems like depression and anxiety should get specialized "trauma-informed" therapy.

But the reality does not always match the ideal.

First, Steele explained, foster care systems and the laws governing them vary by state. Local resources also vary: In rural areas, for example, there may be no providers with expertise in trauma-informed therapy, she pointed out.

What's needed, Steele said, is better funding and more resources. "As a society, we need to support these vulnerable children," she said.

The findings come from a nationally representative government health survey done between 2011 and 2012. It covered nearly 96,000 children and teenagers, 0.5 percent of whom were in foster care.

Overall, foster care kids had higher rates of certain physical health issues: 18 percent had asthma, for example, versus 9 percent of other U.S. kids. Almost one-quarter were obese, versus 16 percent of other children.

Often, the study found, there were more stark differences when it came to mental health and behavior.

Between 14 percent and 17 percent of foster children had been diagnosed with anxiety, depression or behavior problems, based on foster parents' reports. That compared with 2 percent to 3 percent of other U.S. kids. Another 22 percent had been diagnosed with ADHD, versus about 7 percent of other kids.

The findings were published online Oct. 17 in the journal Pediatrics.

Turney pointed to another important finding. Foster children had higher risks of mental and behavioral issues -- even when compared with other kids who often face challenges, like those from low-income or single-parent families.

For foster parents, Steele said, the message is to ask for help when they need it.

"They can reach out to health care providers," she said. "They should not feel like they have to do it all themselves."

More information

The American Academy of Pediatrics has more on foster care.

SOURCES: Kristin Turney, Ph.D., associate professor, sociology, University of California, Irvine; Julie Steele, D.N.P., M.N., assistant professor, College of Nursing, and adjunct assistant professor, pediatrics, University of Utah, Salt Lake City; Oct. 17, 2016, Pediatrics, online

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More Evidence Linking Obesity to Liver Cancer

FRIDAY, Oct. 14, 2016 (HealthDay News) -- Having a large waistline, a high body mass index (BMI) and type 2 diabetes, may raise your risk for liver cancer, a new study suggests.

"We found that each of these three factors was associated, robustly, with liver cancer risk," said study co-author Peter Campbell. He's strategic director of digestive system cancer research at the American Cancer Society.

Liver cancer rates have roughly tripled in the United States since the mid-1970s, "and the prognosis for patients diagnosed with this type of cancer is especially grim," Campbell said.

He and his colleagues examined data on 1.57 million adults from 14 U.S. studies to look for an association between obesity and type 2 diabetes and liver cancer. None of the participants had cancer when the study began.

Over time, 6.5 percent of the participants were diagnosed with type 2 diabetes, which is an obesity-related disease. More than 2,100 developed liver cancer, the study found.

After comparing rates of liver cancer among those who were obese and had diabetes and those who were obese but didn't have diabetes, the researchers found that people with type 2 diabetes were 2.6 times more likely to be diagnosed with liver cancer. The findings held even after accounting for other risk factors, such as drinking, smoking and race.

As the participants' BMI -- a calculation based on height and weight -- increased, so did their risk for the cancer. The researchers found an 8 percent increase in risk for liver cancer for every extra 2 inches added to the waistline.

The results were published Oct. 14 in the journal Cancer Research.

"This adds substantial support to liver cancer being on the list of obesity-associated cancers," Campbell said in a journal news release. "This is yet another reason to maintain a body weight in the 'normal' range for your height."

In the United States, approximately eight adults out of 100,000 will develop liver cancer in a given year, the researchers said.

While the study found an association between obesity and liver cancer, it doesn't prove a direct cause-and-effect relationship. Still, the findings support previous studies suggesting that obesity and diabetes may be contributing to the sharp increase in liver cancer in recent years, the researchers said.

"Liver cancer isn't simply related to excess alcohol intake and viral hepatitis infection," Campbell said.

"For adults with type 2 diabetes mellitus, their risk of developing liver cancer is more than doubled relative to those who do not have type 2 diabetes mellitus, according to this study," he added.

From a public health perspective, these study results are important because obesity and diabetes are so common, said study co-author Katherine McGlynn, a senior investigator at the U.S. National Cancer Institute.

"While some other well-described risk factors, such as hepatitis B virus or hepatitis C virus, are associated with increased risks of liver cancer, these factors are much less common than are obesity and diabetes," McGlynn said.

More information

The U.S. National Cancer Institute has more about liver cancer.

SOURCE: American Association for Cancer Research, news release, Oct. 14, 2016

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High-Protein Diets May Not Help Fend Off Diabetes: Study

TUESDAY, Oct. 11, 2016 (HealthDay News) -- While many believe that a high-protein diet can help with weight loss, a new study finds it might actually prevent an important health benefit that comes with slimming down.

The research found that when you lose weight on a high-protein diet, there's no improvement in what doctors call "insulin sensitivity" -- a factor that could lower your risk for diabetes and heart disease.

In type 2 diabetes, cells gradually lose insulin sensitivity -- their ability to respond to the metabolic hormone.

This often occurs with rising obesity, so improved insulin sensitivity can be one of the byproducts of weight loss.

However, "we found that women who lost weight eating a high-protein diet didn't experience any improvements in insulin sensitivity," said study principal investigator Bettina Mittendorfer. She's a professor of medicine at Washington University School of Medicine in St. Louis.

Mittendorfer's team tracked outcomes over seven months for 34 obese women aged 50 to 65, none of whom had diabetes at the study's outset. The women were divided into three groups: a no-dieting group where women simply maintained their weight; a dieting group that ate the recommended daily level of protein; and a dieting group that stuck to a high-protein regimen.

At the end of the study period, women who ate a high-protein diet did not show improvement in insulin sensitivity, an important factor in reducing diabetes and heart disease risk.

The women who dieted but ate the standard amount of protein had a 25 to 30 percent improvement in their insulin sensitivity, the researchers reported.

"Women who lost weight while eating less protein were significantly more sensitive to insulin at the conclusion of the study," Mittendorfer said in a university news release. "That's important because in many overweight and obese people, insulin does not effectively control blood-sugar levels, and eventually the result is type 2 diabetes," she explained.

The researchers also found that consuming high levels of protein offered little benefit in terms of preserving muscle while dieting.

"When you lose weight, about two-thirds of it tends to be fat tissue, and the other third is lean tissue," Mittendorfer noted. "The women who ate more protein did tend to lose a little bit less lean tissue, but the total difference was only about a pound. We question whether there's a significant clinical benefit to such a small difference."

It's not known why insulin sensitivity didn't improve among women who ate high-protein diets, or if the same results would occur in men or in women already diagnosed with type 2 diabetes, the study authors said.

One expert nutritionist said the findings make sense, metabolically speaking.

"Your body needs protein. But consuming an amount of protein beyond your needs is unnecessary, may be harmful if you have kidney issues, and can lead to weight gain since excess calories from protein are stored as fat," explained Stephanie Schiff. She's a registered dietitian at Huntington Hospital in Huntington, N.Y.

"For obese, postmenopausal women, add in the factor of decreased insulin sensitivity and the perceived benefits from high-protein diets are lost," she said.

Schiff believes the healthiest diet is a "balanced" one that includes complex carbohydrates as well as a recommended level of daily protein.

However, one diabetes expert believes healthy weight loss is typically beneficial in terms of preventing diabetes -- even if it involves high-protein regimens.

"Most of the time people who lose weight become more insulin sensitive," said Dr. Gerald Bernstein, who coordinates the Friedman Diabetes Program at Lenox Hill Hospital in New York City.

He believes exercise is key, too.

"A reasonable amount of physical activity can increase insulin sensitivity in muscles," Bernstein said, "and we generally work on caloric restriction and physical activity together."

The findings were published Oct. 11 in the journal Cell Reports.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases explains how to choose a safe and successful weight-loss program.

SOURCES: Stephanie Schiff, RDN, registered dietitian, Huntington Hospital, Huntington, N.Y.; Gerald Bernstein, M.D., endocrinologist and coordinator, Friedman Diabetes Program, Lenox Hill Hospital, New York City; Washington University, news release, Oct. 11, 2016

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Day Care Doesn't Encourage Weight Gain in Kids

MONDAY, Oct. 10, 2016 (HealthDay News) -- A child placed in day care is no more likely to gain too much weight than a child who stays home with a parent, a new study indicates.

Earlier research had suggested there may be an increased risk of obesity for children in day care.

But a new analysis reveals that the potential association between excess weight and non-parental child care faded away after researchers took into account other factors that also influence childhood obesity.

"When we implemented these more sophisticated analytical approaches, we found that association really went away," said study author Dr. Inyang Isong, an instructor at Harvard Medical School and a pediatrician with Boston Children's Hospital.

"We cannot say that sending a child to day care makes your child overweight," Isong continued. "We just don't have enough evidence to say that."

Three out of five children in the United States are in some kind of regular child care, the study authors said in background notes.

"Given that 60 percent of children are in some kind of day care arrangement, these results should be good news for many, many parents," said Dr. Michael Grosso, medical director of pediatrics at Northwell Health's Huntington Hospital in Huntington, N.Y.

Pediatricians and parents have had longstanding concerns that child care might increase a child's risk of gaining weight, said Dr. Allison Driansky, an attending pediatrician at Cohen Children's Medical Center in New Hyde Park, N.Y.

Most states do not have strict regulations regarding diet and exercise provided at day care, Isong and Driansky said.

"The concern was anytime you take control out of a parent's hands about what a child is eating or what a child is doing during a day, that could lead to obesity," Driansky said. "Not every parent is lucky enough to have a top-of-the-line day care. I think there was some concern that the day care wouldn't cooperate with what a parent wants for their child."

The new analysis included data from about 10,700 U.S. children from diverse social, economic and ethnic backgrounds.

In the study, Isong and her colleagues assessed the potential influence on weight gain from a number of factors in children's lives. These included a child's gender and race, the age and weight of the mother, the family's financial and social status, the number of parents in the home, and the quality of the neighborhood in which the family lived.

"We tried to control for a vast array of factors that could influence decisions to place children in child care," Isong said. "When we controlled for all those factors, the association went away."

However, Isong added that this study "is not in any way full proof." Such proof would involve a clinical trial in which children would be randomly assigned to either child care or home care.

The findings were published online Oct. 10 in the journal Pediatrics.

"This study did a really beautiful job attempting to understand this very complicated problem," Driansky said. "I'm not sure [the study authors] completely put it to rest, but I think they certainly helped alleviate this worry and highlighted future areas of research for this question."

Regardless, parents still should make sure that their day care is providing nutritious food and encouraging physical activity, Grosso said.

"Undoubtedly, individual child care settings will produce different outcomes," Grosso said. "Children encouraged to spend active time outdoors will do better than those stuck to a screen. Those who are offered calorie-dense foods as entertainment will be at risk, while those receiving healthful portions of whole grains, fruits and vegetables will do better."

Driansky offered some tips for parents worried about their kids' weight:

• Encourage activity and outdoor play, and get them involved in sports.

• Provide at least five servings of fruits or vegetables a day.

• Limit sugary beverages, including fruit juice.

• Limit TV time, including no TV before the age of 2 and no more than an hour a day after that.

More information

For more on childhood obesity, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Inyang Isong, M.D., M.P.H., instructor, Harvard Medical School, and pediatrician, Boston Children's Hospital; Michael Grosso, M.D., medical director, pediatrics, Northwell Health's Huntington Hospital, Huntington, N.Y.; Allison Driansky, M.D., attending pediatrician, Cohen Children's Medical Center, New Hyde Park, N.Y.; Oct. 10, 2016, Pediatrics, online

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Healthy Living May Mean More Healthy Years for Seniors

FRIDAY, Oct. 7, 2016 (HealthDay News) -- Seniors who __eat healthy, exercise regularly, keep a trim waistline and stay away from smoking can look forward to more disability-free years, a new study finds.

"There is great concern in society that a longer life will be a great burden to society," said study co-author Dr. Anne Newman, director of the University of Pittsburgh's Center for Aging and Population Health.

"This study shows that a longer life was also a better life in those with healthy lifestyles," she said.

The bottom line, said Newman, is that those with the healthiest habits could expect to live out roughly 80 percent of their remaining years disability-free. In contrast, among those with "the lowest level of health habits, only 55 to 60 percent of [their] remaining years were disability-free," she added.

"So, we can say that having a healthy lifestyle later in life was important for staying healthy and disability-free," Newman said.

For the study, Newman's team sifted through data on almost 5,900 men and women aged 65 and older. At the start of the study, all the seniors were fully mobile and lived independently in Sacramento County, Calif.; Forsyth County, N.C.; Washington County, Md.; and Allegheny County, Pa.

Starting in 1990, and continuing for another 25 years, the researchers tracked the study participants' lifestyle habits twice yearly. Those habits included smoking, drinking and physical activity, as well as diet, weight status and socializing routines.

By the end of the study period, roughly nine in 10 participants had died. On average, women tended to live 15 years after the launch of the study, and almost 11 of those years were characterized as disability-free. That meant they had no difficulty performing routine daily activities, such as eating, using the bathroom, getting dressed, getting in and out of bed or a chair, and walking throughout the home.

Men in the study lived an average of 12 years, and were considered disability-free for about 10 of those years.

But lifestyle was found to have an effect on disability risk.

After adjusting for factors such as age, race, income level, educational background, marital status and ongoing long-term health issues, the study authors found those who led the healthiest lifestyles lived longer and with fewer years of disability than those who led the least healthy lifestyles.

Specifically, obese men and women saw both their longevity and their overall years of able living cut by more than 7 percent, compared with those of normal weight.

Similarly, the least healthy eaters saw both their longevity and years of able living drop by nearly 4 percent.

And for every additional 25 blocks a man or a woman walked per week, their longevity and years of able living rose half a percentage point.

The findings were published in the October issue of the Journal of the American Geriatrics Society.

Dr. Gregg Fonarow, co-director of the preventative cardiology program at the University of California, Los Angeles, said the study suggests that "it is never too late to adopt a heart-healthy lifestyle and derive health benefits.

"The magnitude of benefit in terms of extra years of disability-free life associated with these factors may be surprising to many," he said.

"[But] these findings suggest that, even later in life, having or adopting healthy lifestyle factors can potentially extend the period of future life lived with good health, free of disability," Fonarow said.

More information

There's more on healthy living for seniors at the U.S. National Institutes of Health.

SOURCES: Anne Newman, M.D., M.P.H., chair, department of epidemiology, Graduate School of Public Health, and director, Center for Aging and Population Health, University of Pittsburgh; Gregg Fonarow, M.D., professor, cardiology, and co-director, Preventative Cardiology Program, University of California, Los Angeles; October 2016, Journal of the American Geriatrics Society

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Target Fast-Food Combo Meals to Cut Sugary Drinks for Kids: Study

FRIDAY, Oct. 7, 2016 (HealthDay News) -- Children and teens are more likely to have sugary drinks if they get fast-food combo meals that come with a beverage, a new study suggests.

The findings suggest that uncoupling sugary drinks from combo meals may help reduce kids' calorie intake, the researchers said.

The researchers reviewed the meal choices of 483 boys and girls at McDonald's, Burger King, KFC, Wendy's or Subway locations in New York City and Newark and Jersey City, N.J.

On average, kids consumed 179 more calories overall if their combo meal came with a soda, sweetened tea or juice, or flavored milks. They drank 82 more calories than when beverages were bought separately.

Parents who picked combo meals were 24 percent more likely than those who ordered item by item to get a sugar-sweetened drink instead of a non-sweetened one or no beverage.

The findings were published online Oct. 7 in the American Journal of Public Health.

"Our study strongly suggests that uncoupling sugary drinks from combo meal deals might reduce high-calorie beverage consumption and help to curb childhood obesity rates fueled by these kinds of liquid calories," senior investigator Brian Elbel said. Elbel is an associate professor of population health and health policy at NYU Langone Medical Center in New York City.

"Although our study does not prove cause and effect with respect to obesity and bundled fast-food meals, policy-makers will ideally be able to use research like ours to guide them in formulating public health policies that may effectively decrease consumption of unhealthy sugar-sweetened beverages," Elbel said in a medical center news release.

Some cities have attempted to reduce consumption of supersized soft drinks by boosting sales taxes on them.

More information

The American Academy of Pediatrics has more on nutrition.

SOURCE: NYU Langone Medical Center, news release, Oct. 7, 2016

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How 'Mindful Eating' Can Keep Kids Slim

FRIDAY, Oct. 7, 2016 (HealthDay News) -- Most childhood obesity-prevention programs stress calorie counting and exercise. But one pediatrician likes to emphasize an approach called "mindful eating" instead.

"Mindful eating is a more compassionate and holistic way to approach healthy eating. It not only focuses on what foods we eat, but on how our bodies feel," said Dr. Lenna Liu, a pediatrician at Seattle Children's Hospital. "It allows us to pay attention to hunger and fullness, emotional connections to food and the relationships involved in eating."

Mindful eating focuses on positives, not negatives, Liu explained. And it requires thinking about why you __eat and when.

Reflect on your emotional connections to food, she said. Do you turn to food for comfort or when you're stressed? Does your child swing by the kitchen for a snack during a commercial every time they're watching TV?

Better awareness of your family's eating habits allows you to think of alternatives to reaching for food when you're feeling an emotion or you're trying to unwind, but aren't truly hungry, she added.

Liu noted that hunger develops slowly, but the urge to __eat due to emotions can occur suddenly and urgently. Learn to recognize the difference and to help your children to do the same, she suggested.

Liu, who also leads the hospital's Obesity Program, offers additional tips.

Train yourself to think of food as necessary for physical and mental health, she said, and teach your children that food gives them the energy to learn, think, play and grow.

"When thinking of food in this way, it's easier to understand that what you choose to eat impacts your health," Liu explained in a hospital news release. "It's reinforcement for following the traditional advice of shopping the outer aisles of the grocery store, filling at least half of the plate with fruits and vegetables and choosing water over sugary drinks."

Eating together as a family and discussing the day helps everyone to slow down and pay attention to what they're eating, she added.

Sharing responsibility also helps children build a healthy relationship with food, Liu said. The parent provides healthy food and drinks on a regular schedule, and the child decides whether to eat and how much. Eating patterns change as children grow, she pointed out.

Mindful eating is part of a healthy lifestyle that helps prevent obesity and its harmful health effects, she added.

"There is so much stigma around weight, and judgment around right and wrong eating behavior, and good and bad food in our culture," Liu said. "Mindful eating fills in gaps in the traditional approach of discussing weight management."

More information

The U.S. National Heart, Lung, and Blood Institute has more on obesity prevention.

SOURCE: Seattle Children's Hospital, news release, Sept. 28, 2016

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Older Surgery Patients Should Be Screened for Frailty: Study

THURSDAY, Oct. 6, 2016 (HealthDay News) -- Screening older surgery patients for frailty could improve their outcomes and chances for survival, researchers say.

But frailty often goes unrecognized in these patients, according to a study published online Oct. 6 in The Annals of Thoracic Surgery.

"Patients with frail health have less ability to overcome stressors such as illness, falls and injury, and have a higher risk of adverse effects from medications, procedures and surgery," study co-author Dr. Angela Beckert said in a journal news release. Beckert is an assistant professor in the division of geriatrics and gerontology at the Medical College of Wisconsin, in Milwaukee.

"If a patient is more robust, with better physical performance and vigor -- in other words, less frail -- then I believe surgical outcomes would be better," she added.

Beckert's team screened 125 patients for signs of frailty; their average age was 70. The patients were being assessed for major thoracic surgery such as full or partial removal of the esophagus, lung or chest resection.

The frailty screening checked for five traits: unintentional weight loss, weakness (grip strength), exhaustion, low activity level and slow gait. Exhaustion was most often found; slow gait, the least often, according to the study authors.

Nearly 69 percent of the patients in the study were found to be frail or "pre-frail" -- suggesting the problem may be seriously under-recognized.

"This study indicated that a large number of patients who are candidates for major surgery have important risk factors related to frailty," study co-author Dr. Mark Ferguson, a thoracic surgeon, said in the news release.

"Knowing what these factors are can help physicians, patients and the patients' families better understand the risks and may motivate them to participate in activities that reduce their risks," he said. Ferguson is a professor of surgery at University of Chicago School of Medicine.

Frailty increases the odds for surgical complications and higher health costs. Frail patients are likely to spend more time in the hospital and to be discharged to a rehabilitation facility instead of home. They also are more likely to be readmitted to the hospital and to have a poorer quality of life, according to the study.

More information

The U.S. National Institute on Aging has more about surgery.

SOURCE: The Annals of Thoracic Surgery, news release, Oct. 6, 2016

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3 Lifestyle Changes To Help Prevent Breast Cancer

TUESDAY, Oct. 4, 2016 (HealthDay News) -- Although breast cancer is the second most common type of cancer among American women, there are three steps women can take to reduce their risk, a nutritionist says.

The American Institute for Cancer Research (AICR) estimates that about one-third of breast cancer cases could be prevented with weight control, exercise and cutting back on alcohol.

"While there are no guarantees when it comes to developing cancer, what we do know is that women can take steps every day to reduce the odds of developing breast cancer, along with many other cancers and chronic disease," said Alice Bender, head of nutrition programs at AICR.

The first is to achieve and maintain a healthy weight. About 20 percent of breast cancer cases are due to excess body fat. And along with breast cancer, overweight and obesity increases the risk of 10 other cancers, Bender said in an institute news release.

The second step is to get at least 30 minutes of moderate physical activity each day. Doing so helps manage weight and boost the immune system.

And the third step is either avoid alcohol or drink in moderation. Even small amounts of alcohol on a regular basis increase the risk of breast cancer, according to Bender. Women who drink should limit their alcohol consumption to one glass a day.

Researchers also have found that breast-feeding reduces the risk of breast cancer, she said.

"When it comes to breast cancer, you can take control to lower risk through lifestyle changes that offer powerful protection," Bender said.

October is National Breast Cancer Awareness Month.

More information

The U.S. National Cancer Institute has more on breast cancer prevention.

SOURCE: American Institute for Cancer Research, news release, Sept. 30, 2016

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