Smartphones, Tablets and Weight Gain in Teens

WEDNESDAY, Dec. 14, 2016 (HealthDay News) -- Teens glued to their tablet, smartphone or computer for hours on end may be more likely to become obese, a new study suggests.

Those who used screen devices for five or more hours daily were twice as likely to drink more sugary beverages and engage in too little physical activity, the researchers found.

As a result, these teens showed a 43 percent increased risk of obesity compared with kids who don't use smartphones or tablets at all. But the study did not prove that high use of these technologies caused obesity risk to rise.

"Parents should be cautious with their kids in terms of how much they're using these devices, especially if you see your child on them several hours a day," said study lead author Erica Kenney. "It is something to keep an eye on and be concerned about, because it could be having an effect on their health."

Kids using a screen device for that amount of time is not that uncommon, Kenney, a research fellow with the Harvard T.H. Chan School of Public Health in Boston, and her co-author found.

One of every five U.S. teenagers spends more than five hours a day on smartphones, tablets, computers and video games, the researchers discovered. By comparison, only 8 percent of kids watch more than five hours a day of TV.

"We know kids are shifting their time away from TV and onto these other devices," Kenney said.

Previous studies have linked excessive TV viewing with increased consumption of sugary drinks, fast foods, sweets and salty snacks -- all leading to a higher risk of obesity, the study authors said.

Kenney decided to see whether this risk also applied to kids who've ditched TV for screen devices.

The study relied on data drawn from the 2013 and 2015 waves of the Youth Risk Behavior Surveillance System, a regular youth survey conducted by the U.S. Centers for Disease Control and Prevention. Researchers reviewed responses from almost 25,000 teens in grades 9 through 12.

The results regarding excess TV viewing agreed with earlier findings, the researchers said. Teens who watched five or more hours of TV daily were nearly three times as likely to drink sugary beverages daily and 78 percent more likely to become obese, compared with kids who didn't watch TV.

But those bad habits also appeared to transfer over when kids used smartphones, tablets or computers. Five or more hours of screen device time every day was linked to a doubled risk of drinking sugary beverages and getting too little exercise every day, and a 74 percent increased risk of poor sleep.

Kids tend to snack too much while using electronic devices, explained Stephanie Schiff, a registered dietitian with Northwell Health's Huntington Hospital in Huntington, N.Y.

"If kids are playing video games on the computer while they're eating, they sometimes don't register an end to their hunger," Schiff said. "Eating can become mindless rather than mindful, and they may not realize they are actually full."

In addition, a more insidious process tied to screen use could be influencing their food choices, Kenney said.

"A lot of the literature on TV and diet and TV and obesity risk really suggests the key factor driving these associations is exposure to advertising for unhealthy things that kids nag their parents to get in the supermarket," she said. "We do know in recent years a lot of the money towards marketing foods and beverages has shifted more towards marketing on social media and video games and things like that."

These electronic devices also share TV's ability to glue kids to a couch, Schiff said.

"Years ago, kids would play in the playground at recess or come home after school and play in their yards or on the sidewalk," Schiff said. "That play has been replaced to an extent by video games, Facebook, YouTube and texting.

"It's not a surprise that childhood obesity is on the rise, since to some extent virtual games have replaced real-time play and interaction, and physical activity has been relegated to fingers and thumbs," she continued.

Kenney recommends getting advice on ways to limit screen time if your child is using smartphones or tablets more than a couple hours a day.

"If they're regularly on these devices for long periods of time, you maybe want to talk with your pediatrician about strategies for how to cut back a little bit," she said.

The new study was published online Dec. 14 in The Journal of Pediatrics.

More information

For more on childhood obesity, visit the Obesity Society.

SOURCES: Erica Kenney, Sc.D., M.P.H., research fellow, Harvard T.H. Chan School of Public Health, Boston; Stephanie Schiff, R.D.N., registered dietitian, Northwell Health's Huntington Hospital, Huntington, N.Y.; Dec. 14, 2016, Journal of Pediatrics

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Fewer Babies in Poor Families Are Overweight: CDC

TUESDAY, Dec. 13, 2016 (HealthDay News) -- The percentage of overweight babies in poor families in the United States may be on the decline, a new study suggests.

Researchers found that fewer babies enrolled in the federal Women, Infants and Children (WIC) nutritional assistance program had a high "weight-for-length" in 2014, when compared with 2010. The percentage went from 14.5 percent to just over 12 percent in that period.

The WIC program helps low-income pregnant women, new mothers and children up to age 5. With federal funding, states provide those families with supplemental foods, nutrition education and health care referrals.

Researchers said the new findings are "encouraging."

High weight, even in infancy, has been linked to an increased risk of obesity later on, said study author David Freedman. He is a researcher with the U.S. Centers for Disease Control and Prevention.

And children in low-income families are at particular risk of both a high weight in infancy and childhood obesity, Freedman pointed out.

Dr. William Dietz, director of the Global Center for Prevention and Wellness at George Washington University, in Washington, D.C., agreed that "high weight-for-length is beyond 'chubbiness.' "

Dietz, who was not involved in the study, pointed to a finding he thought was particularly encouraging: Weight improvements were greatest among babies in certain minority groups. Hispanic and Native American babies showed the biggest changes.

The prevalence of high weight among Hispanic babies dropped from 17 percent in 2010 to just under 14 percent in 2014; among Native Americans, the prevalence fell below 16 percent -- down from almost 19 percent, the findings showed.

Meanwhile, just under 12 percent of black babies had a high weight in 2014, compared with 11 percent of white babies.

"The declines were greatest in groups disproportionately affected by obesity," Dietz said. "So those disparities, at least in this youngest age group, may be narrowing. That's an important finding."

The results were based on nearly 17 million U.S. babies younger than 2 whose families took part in WIC between 2000 and 2014.

Between 2000 and 2004, the proportion of babies with a high weight-for-length rose from roughly 13 percent to 14.5 percent. That figure held steady through 2010, then dropped to just above 12 percent by 2014.

Why did the picture improve? Changes to the WIC program are one likely reason, Freedman said.

During the study period, the program's food allocation package was revamped to fall in line with federal dietary guidelines, as well as infant feeding recommendations from the American Academy of Pediatrics.

"There were changes that resulted in increased consumption of whole grains, fruits and vegetables," Freedman said.

Plus, he added, those years saw a growing awareness -- among health professionals and parents -- of the childhood obesity problem.

Freedman did underscore a limitation of the study: Since the findings come from the WIC program, they do not reflect U.S. families as a whole.

However, recent studies have found that early childhood obesity seems to be on the decline nationwide. According to the CDC, just over 9 percent of 2- to 5-year-olds were obese in 2014 -- down from 14 percent a decade earlier.

That's in contrast to what's going on with older kids and adults, Freedman pointed out.

Among 2- to 19-year-olds, the CDC says, the prevalence of obesity has remained stubbornly stable -- at around 17 percent. And roughly one-fifth of U.S. teenagers are obese.

Still, the fact that the youngest kids are showing a different pattern is a positive sign, according to Dietz.

"This shows that we are making some progress," he said.

Freedman agreed. "We are seeing some positive results," he said. Now, the question is whether the encouraging trends will continue, he added.

More information

The CDC has more on childhood obesity.

SOURCES: David Freedman, Ph.D., distinguished consultant, division of nutrition, physical activity and obesity, U.S. Centers for Disease Control and Prevention, Atlanta; William Dietz, M.D., Ph.D., director, Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, D.C.; Dec. 13, 2016, Pediatrics, online

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7 Black Workout Leggings Health Editors Swear By

There’s no shortage of bold and bright workout leggings out there—but sometimes, all you really want is a basic black pair. Black tights slim the legs and hips, match all your other workout apparel, and can easily go from your sweat session to running errands. We asked our editors what their go-to pair of black leggings were for all of their workout needs and here are their favorites.

Onzie Track Leggings ($69; zappos.com)

“I have a relatively slim waist compared to my hips, and despite all those squats I’ve been doing at the gym, my butt’s still kind of flat. My shape makes it hard for me to find leggings that don’t slide down during my workouts. So I was thrilled with I tried Onzie leggings and realized that not only do I look and feel amazing in them, they stay put! This pair has mesh cutouts around the knees that add a fun little extra to basic black.” —Christine Mattheis, deputy editor

Photo: Zappos.com

Champion Shape Women’s Tights ($50; hanes.com)

“I LOVE the Champion Shape tights. They used to only make them in a crop style, but they have full-length leggings now. Woo! The name says it all: The seams are in places that almost help contour your hips, thighs and butt, so they look super-flattering on any __body type. They are also affordable, yet don’t get destroyed in the wash.” —Jacqueline Andriakos, associate editor

Photo: Hanes.com

Old Navy Go-Dry High-Rise Compression Leggings ($30; oldnavy.com)

“I’m addicted to Old Navy activewear. The price is always agreeable (there’s always a sale!) and they always have a wide selection of black leggings that can range from plain to something with more flair like cutouts or a subtle pattern. I’m loving the high waist on this pair because it keeps me tucked in and I don’t have to worry about exposing my belly when I’m moving about.” —Dwyer Frame, contributing editor

Photo: Oldnavy.com

Lululemon Pace Rival Crop ($88, lululemon.com)

“I can’t live without my Lululemon Pace Rival crops. I have numerous pairs, and they have never failed me (even if they rip, Lululemon will replace them). I wear them on my runs and when I go to the gym. There is mesh behind the knee that gives you extra mobility and keeps you cool, and big pockets on the sides for gels, keys, or a phone. They fit perfectly—not too low or high—and the fabric is moisture-wicking and quick-drying, and they have plenty of stretch while hugging you in at the same time.” —Alison Mango, editorial assistant

Photo: lululemon.com

 

Fabletics Winn Mid Rise Capri ($50; fabletics.com)

“I tried the Kate Hudson/Fabletics intro offer for a full workout outfit for $25 a few months back. After it arrived, I decided that the concept of subscribing to monthly fitness outfits wasn’t really for me, BUT I did end up loving the pair of black capri leggings that came with the outfit. They’re also sold on the regular Fabletics site (so you don’t need to sign up for a monthly membership to buy them).” —Kathleen Mulpeter, senior editor

Photo: fabletics.com

Brooks Running Women’s Streaker Tight ($105; brooksrunning.com)

“They’re seamless and feel amazing!” —MaryAnn Barone, social media editor

Photo: Brooksrunning.com

REI Lucy Hatha Leggings ($89; rei.com)

“I love the Lucy Hatha Leggings at REI because they make my legs look tight. They’re comfortable and they are moisture-wicking—I’ve worn them to yoga, on hikes, and as thermals under my clothes in the winter.” —Janet Lawrence, senior video editor

Photo: REI.com

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Vegetarian Diets Called Good for People and the Planet

THURSDAY, Dec. 1, 2016 (HealthDay News) -- Vegetarian diets are healthy for people of all ages, as well as the environment, according to a new update of the Academy of Nutrition and Dietetics' (AND) position on vegetarian diets.

Studies show that vegetarians generally have lower risks of obesity and chronic diseases such as type 2 diabetes, heart disease and certain cancers, according to the AND. That includes vegans -- who eschew not only meat and fish, but all animal products, including dairy.

On top of that, the new report said the diets are kinder to the environment.

It takes far fewer resources -- land, water, fuel and fertilizer -- to produce a pound of kidney beans than a pound of beef, for example.

"Vegetarian diets leave a lighter carbon footprint," said Susan Levin, one of the report authors and director of nutrition education at the nonprofit Physicians Committee for Responsible Medicine in Washington, D.C.

The AND's expertise is nutrition, but it chose to include the environmental aspect in the report because of growing evidence that vegetarian diets do less harm to the planet, according to Levin.

"The evidence has become really hard to ignore," she said.

The report, in the December issue of the Journal of the Academy of Nutrition and Dietetics, also stressed another point: Vegetarian diets can be safe and healthy for people of any age.

According to Levin, the science has long shown that. But there are still lingering misconceptions that plant-based eating is unsound for children.

"No one should doubt that vegetarian diets are safe at all life stages, including infancy, childhood and adolescence," Levin said.

In fact, she added, studies show that children on vegetarian diets __eat more fruits and vegetables, and fewer sweets and salty snack foods. They're also less likely to be overweight or obese.

The academy also noted that vegetarian and vegan diets can be safe during pregnancy and lactation. These diets can also be fine for athletes and the elderly, the report said.

A registered dietitian who reviewed the report agreed that plant-based diets can be nutritionally sound. And they've moved into the mainstream.

The latest U.S. government dietary guidelines include a vegetarian diet as one of three examples of a healthful eating plan, said Connie Diekman, director of university nutrition at Washington University in St. Louis.

Still, any diet is only as good as a person's food choices. If you subsist on white rice, Levin pointed out, that might be technically vegetarian, but not nutritious.

So it's important to __eat a variety of foods, she said -- including a range of whole grains, beans, fruits and vegetables, and nuts and seeds.

Vegetarians and vegans do need to be mindful to get enough of certain nutrients such as vitamin B12, which is present only in animal products, Diekman said.

According to the AND report, vegans should take supplemental vitamin B12. Vegetarians usually need supplements or B12-fortified foods, too, the group said -- since their dairy intake may not supply enough of the nutrient.

But, Levin said, B12 is the only supplement vegans need. They can get all of their other nutrient needs from food.

That's counter to the common myth that vegetarians have a tough time getting enough nutrients such as protein, calcium and iron, Levin said.

"If you're consuming enough calories, you will get enough protein," she said.

But, the report noted, it's important to make wise food choices: Calcium from vegetables like kale, turnip greens and bok choy is much better absorbed than calcium from high-oxalate vegetables such as spinach and Swiss chard, for example.

According to Diekman, people who want to go vegetarian can get help from a registered dietitian in crafting a new way of eating.

And for those unwilling to give up meat, she said, simply getting more plant-based foods onto their plates is a healthy step.

Levin made another point: Vegetarian diets have gotten a reputation as being ones of "privilege." But they can be affordable, and based on products readily available at the local grocery store, she said.

"The food does not have to be organic, or fresh," Levin said. "You can use canned beans and frozen vegetables."

As for the potential health benefits, studies have found that vegetarians and vegans tend to weigh less and have lower cholesterol levels than omnivores do. They also tend to have lower risks of high blood pressure, heart disease, type 2 diabetes and certain cancers, such as cancers of the prostate and gastrointestinal tract.

"If there were a pill that did all of that," Levin said, "everyone would be taking it."

More information

The academy has advice on building a vegetarian diet.

SOURCES: Susan Levin, M.S., R.D., director, nutrition education, Physicians Committee for Responsible Medicine, Washington, D.C.; Connie Diekman, M.Ed., R.D., director, university nutrition, Washington University, St. Louis; Dec. 2016, Journal of the Academy of Nutrition and Dietetics

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Standing or 'Easy' Walks May Help Type 2 Diabetics Control Blood Sugar

WEDNESDAY, Nov. 30, 2016 (HealthDay News) -- For people with type 2 diabetes, better blood sugar control may be as easy as getting up off the couch and standing every so often, or taking a leisurely walk, a new study shows.

Dutch researchers noted that "moderate to vigorous" exercise is often recommended for people with diabetes -- but most patients don't comply with that advice.

This small new study suggests that even sitting a bit less might be of real benefit.

One diabetes expert in the United States agreed with that advice.

"For years, I would suggest an exercise regimen to my patients that I knew was doomed to failure," said Dr. Robert Courgi, an endocrinologist at Northwell Health's Southside Hospital in Bay Shore, N.Y.

However, "by tweaking the message a bit, the odds of success increase significantly," he said. "Ultimately, any activity helps lower glucose [blood sugar]. The message of 'sitting less' will have a higher success rate than exercise regimens of the past."

Current physical activity guidelines call for a minimum of 150 minutes of moderate to vigorous exercise a week to help prevent type 2 diabetes. But the study authors pointed out that nine out of 10 people fail to meet this guideline.

The new study was led by Bernard Duvivier of the department of human biology and movement science at Maastricht University Medical Center in the Netherlands. His team wanted to see if a program to reduce sitting time -- by encouraging patients to simply stand and do light-intensity walking -- could offer an alternative to a standard exercise regimen.

The study included 19 adults, average age 63, with type 2 diabetes who did three programs, each lasting four days. In the first program, the participants sat for 14 hours a day and did only one hour a day of walking and one hour a day of standing.

In the second program (the "sit less" program), the participants did a total of two hours a day of walking and three hours a day of standing by breaking up their sitting time every 30 minutes.

In the third program (exercise), the participants replaced an hour a day of sitting time with indoor cycling.

The sit less and exercise programs were designed to burn similar amounts of energy, the researchers said.

Significant improvements in blood sugar control occurred when the patients did the sit less program or the exercise program, but the improvements were generally stronger during the sit less phase, according to the study.

Courgi said the new trial has helped him "rethink the way I treat diabetes with exercise."

He said that, although it would be nice to see the results replicated in a larger trial, the study findings remain "very interesting."

The study was published Nov. 30 in the journal Diabetologia.

More information

The American Academy of Family Physicians has more on diabetes and blood sugar levels.

SOURCES: Robert Courgi, M.D., endocrinologist, Northwell Health's Southside Hospital, Bay Shore, N.Y.; Diabetologia, news release, Nov. 30, 2016

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3 Keys to Cutting Your Risk of Heart Failure

MONDAY, Nov. 28, 2016 (HealthDay News) -- Middle-aged adults who've avoided obesity, high blood pressure and diabetes are far less likely than others to experience heart failure in their later years, new research reports.

Investigators found that a 45-year-old without those three key risk factors has as much as an 86 percent lower risk for heart failure compared with someone with poor control of weight, blood pressure and blood sugar.

"This paper provides more evidence to demonstrate the importance of a heart-healthy lifestyle," said study co-author Dr. John Wilkins. He's a cardiologist and assistant professor of medicine and preventive medicine at the Northwestern University Feinberg School of Medicine in Chicago.

Good lifestyle habits can help prevent obesity, high blood pressure and diabetes in many people, "which will substantially reduce their chances of developing cardiovascular disease later in life," Wilkins said.

According to another heart specialist, Dr. Gregg Fonarow, "This means doing everything necessary to maintain a healthy body weight -- including eating a heart-healthy diet and remaining physically active, and having regular monitoring to ensure healthy blood pressure and blood sugar levels."

The new report indicates that "while there are therapies available once heart failure develops, the most effective strategy is to prevent heart failure in the first place," said Fonarow. He is a professor of cardiology at the University of California, Los Angeles.

Heart failure affects an estimated 5.7 million adults in the United States. The disabling condition occurs when the heart can no longer pump enough blood and oxygen throughout the body.

The U.S. Centers for Disease Control and Prevention says that about half of those who develop heart failure will die within five years.

For this study, Wilkins and his associates analyzed data from four heart studies launched across the United States between 1948 and 1987.

Through 2007-2008, the researchers tracked outcomes for over 19,000 men and women whose heart health was assessed at age 45. The investigators followed another 24,000 whose heart status was determined at age 55.

Heart failure developed in nearly 1,700 participants tested at 45, and in almost 3,000 of those examined at 55, the findings showed.

But men who were free of high blood pressure, diabetes and obesity at 45 went on to live free of heart failure almost 11 years longer than men who had all three conditions. For women, the advantage was about 15 years, the study found.

On average, men and women without any of those three heart risks lived 35 years and 38 years longer, respectively, without developing heart failure.

Similar trends were seen among those assessed at 55, the researchers said.

Of the three heart-failure risk factors cited, diabetes appeared to have the greatest effect. Those without diabetes at 45 lived about nine to 11 years longer without heart failure, compared with those who did have the blood-sugar disease.

According to Fonarow, "this study quantifies the degree to which preventing the onset of high blood pressure, obesity, and diabetes can pay huge dividends in terms of lifelong health free from heart failure, cardiovascular disability, large health care expenditures, and premature cardiovascular death."

Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, noted that to enjoy these benefits, many Americans may first need to adjust their behavior.

"We need to make some pretty intense changes to our eating habits and physical activity," she said.

"The majority of us still come up short on key foods known to support health: fruits, vegetables, whole grains," Sandon said. "Few come anywhere near the recommended amount."

Physical activity is no different, Sandon added. "Many of us spend way too much time in sedentary environments. The 30 to 60 minutes you might squeeze in at the gym a few times a week barely scratches the surface to help support a healthy weight, blood pressure and reduce diabetes risk," she said.

The findings were published online Nov. 28 in JACC: Heart Failure.

More information

There's more on heart failure at the American Heart Association.

SOURCES: John T. Wilkins, M.D., M.S., cardiologist, and assistant professor of medicine, department of preventive medicine, Northwestern University Feinberg School of Medicine, Chicago; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Lona Sandon, Ph.D., RDN, LD, assistant professor, department of clinical nutrition, school of health professions, University of Texas Southwestern Medical Center at Dallas; Nov. 12, 2016, JACC: Heart Failure

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Fast-Food Calorie Labeling Not Working, Study Finds

MONDAY, Nov. 28, 2016 (HealthDay News) -- Does it help to know that a double quarter-pounder with cheese delivers 740 calories? Probably not, a new study suggests.

Starting next May, fast-food chains with more than 20 locations in the United States must display calorie counts on menus. But this study questions whether the well-intended regulations will actually steer customers to less-fattening foods.

Research in Philadelphia, where such rules already exist, indicate as few as 8 percent of fast-food eaters make healthy choices based on menu calorie counts, the study found.

"I believe menu labeling has been an important policy effort to combat a public health problem for which we have few solutions," said study author Andrew Breck.

"The success of such a calorie-labeling campaign, however, requires that target consumers simultaneously see the calorie labels, are motivated to __eat healthfully, and understand how many calories they should be eating," said Breck. He is a doctoral candidate at NYU Wagner Graduate School of Public Service in New York City.

Simply presenting calorie information is not enough, he and his colleagues stressed.

To be effective, nutrition labeling must be clearer and larger. It must also reach regular fast-food eaters -- people who expressed more concern with cost and convenience than nutrition, Breck and his colleagues found.

The trend toward nutrition labeling on fast-food menus began in response to the U.S. obesity epidemic. About 38 percent of adults and 17 percent of teenagers are obese, according to the U.S. Centers for Disease Control and Prevention. Obesity has been linked to a greater risk of high blood pressure, stroke, diabetes, cancer, and other health issues.

Philadelphia in 2010 required fast-food restaurants to post the caloric, fat and sodium content of meals. New York City and Seattle already had similar rules.

But based on interviews with 1,400 people in Philadelphia, Breck's team concluded that significant labeling improvements are needed for such laws to have an impact.

The researchers analyzed responses from about 700 customers at 15 fast-food eateries in Philadelphia and another 700 people interviewed by phone.

Nutrition postings went unnoticed by nearly two-thirds surveyed at the restaurants and one-third questioned by phone, the investigators found.

To increase visibility of calorie content, the study authors recommended increasing the type size or color contrast of calorie information on menus and menu boards.

Making these numbers more apparent could have another effect as well, the researchers suggested.

"We are hopeful that highly visible posting of calorie content on menus may also cause some restaurants to add new, more healthful options to their menus," Breck said.

But customers must first know what their recommended caloric intake should be -- and many don't, the study found.

Less than half of those surveyed at the restaurants correctly estimated the number of calories they should consume daily, Breck said.

To put calorie content into perspective, Breck would like to see statements like this on fast-food menu boards: "2,000 calories a day is used for general nutrition advice, but calorie needs vary."

"Traffic-light or stop-sign type labeling indicating the healthfulness of food items is another example of a policy that has proven successful in laboratory settings in improving consumer choice," Breck said. But whether it would work in real-world settings isn't yet known.

Finally, Breck said, successful nutrition labeling must provide information that differs from consumers' expectations of how many calories foods contain.

Connie Diekman, director of university nutrition at Washington University in St. Louis, said calorie posts are just a start in improving the nation's eating behaviors.

"Awareness is the first step in the change process, so if consumers begin to see the numbers, eventual change is possible," Diekman said.

Motivation is also critical, she said, "and achieving that requires time, education, a desire to change, and an environment that supports the changed behaviors."

As a society, Diekman added, "we have a ways to go to provide an environment that encourages and supports healthy eating."

The study was published online recently in the Journal of Public Policy & Marketing.

More information

For more on health problems related to obesity, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Andrew Breck, Ph.D. candidate, Wagner Graduate School of Public Service, New York University, New York City; Connie Diekman, M.Ed, R.D., director of university nutrition, Washington University in St. Louis; October 2016, Journal of Public Policy & Marketing, online

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Don't Get Stuffed on Thanksgiving

WEDNESDAY, Nov. 23, 2016 (HealthDay News) -- Weight gain is a common problem during the holiday season, but it can be avoided if you have a plan and a bit of self-discipline, a nutrition specialist says.

"Lack of sleep, an abundance of decadent food and the stress of the holidays are the perfect storm for weight gain," Kristen Kizer, a registered dietitian at Houston Methodist Hospital, said in a hospital news release.

"Remind yourself how it feels to overeat and implement a personal wellness plan to get you through the holiday season without adding to your waistline," she advised.

Reduce the amount of food you prepare. Instead of 14 dishes, limit it to seven or eight dishes. Doing so will save time and money and spare you from eating leftovers for the next several days, she added.

"Holiday meals are typically heavy in carbohydrates, so try reducing your carb consumption for the day by replacing mashed potatoes with mashed cauliflower. Your guests probably won't even notice the difference," Kizer said.

Don't add marshmallows or brown sugar to sweet potatoes. Replace unhealthy green bean casserole with fresh steamed green beans with low-fat cheese sprinkled on top or roasted green beans with a little olive oil and fresh garlic.

"Substitute natural applesauce for oil or butter in your dessert recipes. This simple ingredient swap not only adds moisture and flavor to baked goods, but fiber and nutrients," Kizer said.

At parties, choose either alcohol or dessert, but not both.

"Get plenty of sleep. Getting less than six hours of sleep a night causes cravings for starchy, sugary foods and dissolves your resolve to make healthy food decisions. Most health experts recommend at least seven hours of sleep a night to feel fully rested," Kizer said.

Exercise is another important factor in preventing weight gain during the holidays, she noted.

More information

The U.S. Centers for Disease Control and Prevention has more on healthy weight.

SOURCE: Houston Methodist Hospital, news release, Nov. 10, 2016

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TV Snack Ads Make Preschoolers Snack More: Study

MONDAY, Nov. 21, 2016 (HealthDay News) -- Preschoolers who watched "Sesame Street" interrupted by TV ads for a salty snack food ended up eating more of that food soon after, a new study found.

The finding suggests that "young children remain highly exposed to TV advertisements for foods that may contribute to unhealthy dietary patterns," said a team led by Jennifer Emond. She's an assistant professor of pediatrics at Dartmouth College, in Hanover, N.H.

Obesity remains a threat to the health of many American children. And Emond's team pointed out that "energy-dense, nutritionally poor foods" continue to be aggressively marketed to very young children.

Indeed, the average preschooler is exposed to more than three hours of television each day, and "preschoolers viewed 18 percent more TV snack food advertisements from 2010 to 2014," the researchers said.

Does such advertising "work" to get these youngsters to __eat more unhealthy snacks?

To find out, Emond's team monitored 60 kids aged 2 to 5, from New Hampshire and Vermont, as they watched a 14-minute segment of "Sesame Street."

The preschoolers got a filling snack before the show -- so they were not hungry -- and then had unlimited access to snacks during it.

Some of the children watched the "Sesame Street" segment without food commercials, while others watched the show with commercials for a popular salty snack. The ads depicted kids happily playing and eating the snack.

The result: Children who watched the snack commercial "consumed, on average, 29.5 kilocalories more" food afterwards, and "the main effect was driven by a greater consumption of the advertised food," Emond's team wrote.

The researchers believe this shows that food ads prompt kids to eat, even when they're not hungry. Limiting food commercials targeted to children could help kids __eat more healthily and consume fewer unneeded calories, the study authors contended.

Dr. Allison Stakovsky is a pediatrician at Cohen Children's Medical Center in New Hyde Park, N.Y. She said the new findings mirror previous research.

"We already know that television viewing is an important environmental influence on the development of obesity," she said. "Kids who watch more television are more likely to be overweight. Kids who have a television in their bedroom are more likely to be overweight.

"This study shows that food advertising affects preschoolers snacking habits," Stakovsky added, and "these findings further support the American Academy of Pediatrics' recommendation to limit preschoolers media use to no more than one hour a day."

One nutritionist agreed, and said it's up to parents to help steer children towards healthier eating habits.

"Efforts should be made towards eating as a family and focusing on conversation instead of the distraction of TV," said Dana Angelo-White. She's a dietitian and clinical assistant professor at Quinnipiac Univerity in Hamden, Conn.

"Screen time should be limited during meal and snack times, regardless of what type of programming they could be exposed to," White added.

The study appears online Nov. 21 in the journal Pediatrics.

More information

There's more on healhy nutrition for preschoolers at the U.S. Department of Agriculture.

SOURCES: Allison Stakofsky, M.D., attending pediatrician, Cohen Children's Medical Center, New Hyde Park, N.Y.; Dana Angelo-White, RD, clinical assistant professor, Quinnipiac University, Hamden, Conn.; Pediatrics, Nov. 21, 2016

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Choose the Healthy Foods Options This Holiday Season

SUNDAY, Nov. 20, 2016 (HealthDay News) -- Even the best intentions to make healthy food choices during the holidays can be derailed, the American Heart Association cautions.

Eating a diet consisting of fruits, vegetables, lean protein and healthy grains is one of the most important ways to reduce the risk for heart disease and stroke, the association points out.

Fortunately, there are ways to avoid moments of weakness when dining out or going to gatherings, said Rachel Johnson. She is a nutrition professor at the University of Vermont and past chair of the association's nutrition committee.

When dining at a restaurant, the first step is to look at the menu with blinders on.

"Don't even let yourself look at that [unhealthy] section of the menu," Johnson said in an association news release. It's a lot easier to order a salad when menu options loaded with fat and calories aren't up for consideration, she added.

At home, it's also important to anticipate unhealthy cravings. Many people make unwise snack choices when they are relaxing after dinner, said Johnson. Instead of giving in to those cravings, take a walk or call a friend on the phone, she suggested.

It's also a good idea to plan ahead and anticipate food temptations. To increase the chances of making healthy choices, Johnson offers the following tips:

• Store unhealthy foods out of sight. Put these foods away in a cabinet or container that's not transparent. Keep a bowl of fruit on the kitchen counter instead of a cookie jar.

• Buy smaller or individually wrapped portions. Instead of buying a half-gallon of ice cream, choose individually packaged low-calorie frozen treats.

• Brush your teeth right after you eat. Having minty fresh breath will make sneaking another treat less tempting.

• Stock up on sugarless gum. The sweetness of chewing gum can calm cravings for treats with sugar and more calories.

• Don't overdo it. If you do give in to temptation, do so in moderation. Have a small portion and share the rest, or put it away.

More information

The American Academy of Nutrition and Dietetics provides more tips for healthy dining.

SOURCE: American Heart Association, news release

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'Yo-Yo Dieting' Hard on Older Women's Hearts: Study

THURSDAY, Nov. 17, 2016 (HealthDay News) -- Millions of Americans have a lifelong struggle with their waistlines -- dieting, losing weight, but then gaining it back again.

It's a pattern known as "yo-yo dieting," and a new study suggests it does no favors for older women's hearts.

"Women with a normal [weight] who experience yo-yo dieting throughout their adult life are at increased risk of sudden cardiac death and coronary heart disease death," said study leader Dr. Somwail Rasla.

The risk of sudden cardiac death was nearly 3.5 times higher, and the risk for death linked to coronary heart disease was 66 percent higher, according to Rasla. He's an internal medicine resident at Memorial Hospital of Rhode Island in Pawtucket.

Experts have long known that being overweight at midlife is linked with a higher risk of death from heart disease. It can also boost the chances for sudden cardiac death, a condition where the heart's electrical system abruptly stops working.

However, less has been known about how repeatedly gaining and losing weight might affect a person's heart disease death risk.

For the new study, Rasla's team tracked self-reported weight histories from more than 158,000 older, postmenopausal women. The researchers put the women into four categories -- stable weight, steady weight gain, weight loss that was maintained, or the "yo-yo dieting" pattern.

Stable weight was defined as no more than a 10-pound gain or loss over the adult life span, Rasla said.

The women's health was then tracked for more than 11 years.

Over the follow-up, slightly more than 2,500 women died of coronary heart disease and 83 died from sudden cardiac death, a much rarer condition, the study showed.

The women who began the study with a healthy weight -- and then repeatedly gained and lost weight over the years -- had the strongest risk of death from coronary heart disease or sudden cardiac death, the researchers found.

Keeping your weight stable seemed key. For example, the study found no increase in death risk for women who said they gained weight but did not lose it, or for those who lost weight and didn't gain it back.

It should be noted that the study only found an association between yo-yo dieting and heart trouble, not a cause-and-effect connection.

And why would an "up-and-down" weight history be potentially dangerous to the heart? Rasla said that right now he can't explain the findings and that more research is needed.

Also, the study included only women, so he couldn't speculate about how weight cycling might affect men's heart disease risk.

For now, Rasla said, the message seems to be that "maintaining a stable body weight is best for overall health."

One dietitian who reviewed the new findings urged caution in interpreting the study, however.

Connie Diekman is director of university nutrition at Washington University in St. Louis. She believes more research is needed to determine if the connection with sudden cardiac death and coronary artery disease death and yo-yo dieting is, in fact, related or linked with other variables not identified in the study.

"The value that this study provides is the important reminder that 'weight cycling' -- losing, gaining, losing, gaining -- is not a good way to achieve a healthy weight," Diekman said.

For those who want to achieve a healthy weight, she advises focusing on overall lifestyle changes, not crash diets or other quick fixes.

The key: "Learn to balance what you __eat with your activity in a way in which you can maintain it for life," Diekman said.

Rasla was scheduled to present his findings Tuesday at the American Heart Association annual meeting, in New Orleans. Studies presented at medical meetings are viewed as preliminary until published in a peer-reviewed journal.

More information

To learn more about yo-yo dieting and disordered eating, visit the Academy of Nutrition and Dietetics.

SOURCES: Somwail Rasla, M.D., internal medicine resident, Memorial Hospital of Rhode Island, Pawtucket, and Alpert Medical School, Brown University, Providence, R.I.; Connie Diekman, R.D., M.Ed., director, university nutrition, Washington University, St. Louis; Nov. 15, 2016, American Heart Association Scientific Sessions, New Orleans

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Weight-Loss Surgery Tied to Lower Heart Risks

MONDAY, Nov. 14, 2016 (HealthDay News) -- Weight-loss surgery may significantly reduce obese people's risk of heart failure, a new study indicates.

Researchers compared more than 25,800 obese people who had weight-loss (bariatric) surgery with more than 13,700 obese people who tried to lose weight through a program of major lifestyle changes. Both groups had no history of heart failure.

Four years after the start of treatment, the weight-loss surgery group had lost more weight, had a nearly 50 percent lower risk of heart failure, and had lower rates of heart rhythm problems, diabetes and high blood pressure than the lifestyle-changes group, the findings showed.

Both groups had similar rates of heart attack and death, according to the study, which was scheduled for presentation Monday at the American Heart Association (AHA) annual meeting, in New Orleans.

"Our study shows an association between obesity and heart failure, and offers support for efforts to prevent and treat obesity aggressively, including the use of bariatric surgery," senior author Dr. Johan Sundstrom said in an AHA news release.

"Bariatric surgery might affect the incidence of atrial fibrillation, diabetes and hypertension -- known risk factors of heart failure -- explaining the lower risk of heart failure we observed," added Sundstrom, who is a professor of epidemiology at Uppsala University in Sweden.

Sundstrom noted that while the study found that heart failure risk was lower in patients who lost more weight, it does not prove that obesity causes heart failure.

In addition, because the study participants were all from a Scandinavian population, it is unclear whether the findings would relate to a U.S. population, the authors noted in the news release.

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

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

SOURCE: American Heart Association, news release, Nov. 14, 2016

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DNA Isn't Destiny: Healthy Living Can Overcome Genes Linked to Heart Disease

SUNDAY, Nov. 13, 2016 (HealthDay News) -- If your parent or sibling died young from cardiovascular disease, take heart: There are ways you can counter any genetic predisposition to the illness.

New research shows that people can minimize an inherited risk for heart attack by living right -- exercising, eating healthy, staying slim and quitting smoking.

Even with a little effort in these areas, people can cut their high genetic risk of heart disease by more than half, said senior researcher Dr. Sekar Kathiresan, director of the Center for Human Genetic Research at Massachusetts General Hospital in Boston.

But the opposite also is true, Kathiresan warned. People born with a genetic advantage protecting them against heart disease can ruin their good luck through unhealthy lifestyle choices.

"For heart attack at least, DNA is not destiny," Kathiresan said. "You have control over your risk for heart attack, even if you've been dealt a bad hand."

Kathiresan presented his findings Sunday at the American Heart Association's annual meeting, in New Orleans. The study was published simultaneously in the New England Journal of Medicine.

For their research, Kathiresan and his colleagues pooled data on more than 55,000 participants in four large-scale health studies.

The researchers analyzed each person's genetic risk for heart disease using a panel of 50 gene variants previously associated with elevated heart attack risk.

They also judged each person's lifestyle based on four factors: smoking, body weight, diet and exercise.

The requirements to have a good lifestyle were not rigorous, Kathiresan said. The person essentially had to not smoke, not be obese, get physical activity at least one day a week, and regularly meet at least half of the American Heart Association's recommendations for a healthy diet.

"It's safe to say we're not being that aggressive in terms of the lifestyle score," Kathiresan said.

For example, a person could be overweight, but not obese, and still meet the criteria for a healthy lifestyle in this study, he said. People also didn't need to meet current U.S. physical activity guidelines, which call for two and a half hours of moderate physical activity or one and a half hours of vigorous physical activity.

Even these minimal lifestyle changes mattered greatly for people at high genetic risk of heart disease.

The study looked at the risk for a "coronary event" -- heart attack, cardiac arrest or the need for angioplasty or other procedures to open a blocked artery.

A person with high genetic risk and a bad lifestyle had a nearly 11 percent chance of having a coronary event within the next 10 years, the study found. However, a person at high risk who lived well cut the 10-year risk of such a health crisis down to 5 percent, Kathiresan reported.

Lifestyle also mattered for people who won the genetic lottery.

Those with low genetic risk and a good lifestyle had a 3 percent risk of a coronary event over the next 10 years, but a bad lifestyle would drive their risk up to 5.8 percent, Kathiresan said.

"If you've been dealt a good hand, you could really harm yourself by having an unfavorable lifestyle," he said. "You basically take your heart attack rate up into the ranges of the people with the highest genetic risk."

Patients often ask cardiologists whether they should get genetic testing for their heart health risks, and the doctors usually aren't keen on it, said Dr. Martha Gulati, division chief of cardiology at the University of Arizona-Phoenix.

"Once you get those test results, it becomes, 'what do you do with them?' Often you hear from patients, 'Now I'm doomed to this disease,' " said Gulati, who also serves as editor-in-chief of CardioSmart, an online patient education program of the American College of Cardiology. "Their genetics make them feel very negative and helpless."

But this new study shows there is cause for optimism even for those facing the roughest road.

"We can change this with lifestyle," Gulati said. "We always say 80 percent of heart disease is preventable with lifestyle changes. This just gives more evidence; where people at the highest risk of heart disease, there were still things that were modifiable."

Gulati noted that the study does not prove a direct cause-and-effect link between lifestyle and heart health risk, however. She hopes a follow-up clinical trial will be conducted where people are directed in their lifestyle changes, to see how that affects their heart risk.

"That would be, to me, the next study," Gulati said.

More information

For more on a heart-healthy lifestyle, visit the American Heart Association.

SOURCES: Sekar Kathiresan, M.D., director, Center for Human Genetic Research, Massachusetts General Hospital, Boston; Martha Gulati, M.D.; division chief, cardiology, University of Arizona-Phoenix; Nov. 13, 2016, presentation, American Heart Association annual meeting, New Orleans; Nov. 13, 2016, New England Journal of Medicine

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Could C-Section Birth Raise Child's Risk of Obesity?

SUNDAY, Nov. 13, 2016 (HealthDay News) -- Babies delivered via C-section might be at increased risk for childhood obesity, researchers contend.

Compared to vaginally delivered children, cesarean-delivered children seem to have a 40 percent greater risk of becoming overweight or obese by the time they turn 7, the study found.

The risk was even stronger in children born by C-section to overweight and obese mothers, ranging from 70 to 80 percent, said lead researcher Noel Mueller, an assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore.

"We also found that the protective association conferred by vaginal delivery was as strong, if not stronger, among mothers that were overweight or obese, suggesting that vaginal delivery among overweight or obese mothers may help to mitigate the intergenerational transmission of obesity," Mueller said.

Babies pick up beneficial microbes from their mother as they pass through the birth canal, and Mueller and colleagues believe these microbes might help protect a child against obesity.

"There's been consistent evidence which shows vaginally delivered babies have different gut microbiota than C-section-delivered babies," Mueller said. "The different functions of these bacteria may relate to metabolic processes that may either predispose or protect one from obesity."

Childhood obesity has more than doubled over the past 30 years in the United States, according to the Centers for Disease Control and Prevention. The percentage of kids between the ages of 6 and 11 who are obese increased from 7 percent in 1980 to nearly 18 percent in 2012.

For this study, the researchers analyzed data on more than 1,400 full-term deliveries in Boston. About 57 percent of the women who gave birth by cesarean were obese, and 53 percent of those who delivered vaginally were obese.

The researchers checked to see if there were any differences in weight between children born either vaginally or by C-section, following the kids until they were 7 years old on average, Mueller said.

Kids born by C-section were found to have an increased risk of excess weight, the researchers report.

The findings were to be presented Sunday at the American Heart Association annual meeting, in New Orleans. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

One expert said the findings made sense.

"It's certainly reasonable. We know babies born by C-section have differences in their flora compared to those who are born vaginally, and there has been some suggestion that the microbiome [the variety of microorganisms in the body or part of the body] may play a role in the development of obesity," said Dr. Stephen Daniels. He is chair of pediatrics at the University of Colorado School of Medicine and pediatrician-in-chief at Children's Hospital Colorado.

Mueller said the research team is now looking into clinical trials that would expose C-section babies to healthy bacteria from their mother's vagina. These trials could confirm that the association found in this study is actually a cause-and-effect relationship.

"What we would like to do is see if administration of vaginal microbiota to C-section delivered babies could potentially have health benefits," Mueller said.

Another way of testing this association would be to look at children born by emergency C-section following a difficult labor, said Dr. Aaron Caughey, chair of obstetrics and gynecology at Oregon Health & Science University in Portland.

"One would think that children born to women via cesarean after a long labor with ruptured membranes, who should be getting colonized by bacteria, would have a lower risk of obesity than those born to women with a scheduled cesarean and no labor," Caughey said. "I haven't seen such a study done cleanly, and it would help answer this question."

In the meantime, parents of children delivered by C-section should not assume their child is doomed to a life of obesity, Mueller and Daniels said.

"I don't think this is a predetermination in any way," Daniels said. "A risk factor suggests it may increase risk, but it's not creating a certainty."

Breast-feeding has also been shown to help reduce risk of obesity in children, Mueller said. In addition, parents could focus on diet and exercise as a way to help prevent obesity in their offspring, Daniels said.

"Women who deliver by C-section should certainly not feel hopeless, because there are many ways to mitigate any potential increased risk of obesity," Mueller concluded.

More information

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

SOURCES: Noel Mueller, Ph.D., M.P.H., assistant professor, epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore; Stephen Daniels, M.D., Ph.D., chair, pediatrics, University of Colorado School of Medicine, and pediatrician-in-chief, Children's Hospital Colorado, Aurora; Aaron Caughey, M.D., Ph.D., chair, obstetrics and gynecology, Oregon Health & Science University, Portland; Nov. 13, 2016, presentation, American Heart Association annual meeting, New Orleans

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Craving Salt? Your Genes May Be the Reason, Study Suggests

SUNDAY, Nov. 13, 2016 (HealthDay News) -- Some people carry a genetically driven "salt tooth" that could affect how heavily they season their food, potentially endangering their heart, a new study suggests.

Genetic variations cause some people to be more keenly aware of bitter flavors, said lead researcher Jennifer Smith, a doctoral student at the University of Kentucky College of Nursing.

These people are about twice as likely to exceed the daily limit of salt recommended by heart health specialists, according to study findings presented Sunday at the American Heart Association annual meeting in New Orleans.

The research centers on a gene called TAS2R38. Variations of this gene have been shown to enhance a person's perception of bitter flavors.

"We were looking at a gene that codes for taste receptors," Smith said. "People with one genotype will taste bitter more keenly than people who have the other genotype."

Previous studies have shown that people carrying those genetic variations of TAS2R38 are more likely to avoid heart-healthy foods that can taste bitter, like broccoli or dark leafy greens, the researchers said.

Smith decided to test whether this gene would lead people to use more salt in their daily diet. Eating too much salt can lead to high blood pressure, which increases a person's risk for heart attack and stroke.

Her team analyzed the diets of 407 people in rural Kentucky who had two or more heart disease risk factors. The researchers also did genetic testing to see whether participants carried the gene variation that enhances bitter taste.

"We found people who tasted bitter more keenly were in fact 1.9 times more likely to be non-adherent to the sodium guidelines," she said.

U.S dietary guidelines recommend no more than 2.3 grams of salt per day.

The researchers have different theories about why people with these genetic variants seem to __eat more salt.

It could be that they taste salt more intensely and enjoy it more, causing them to prefer heavily salted foods, Smith said.

Or it could be that people use salt to mask the bitter taste of some foods, she added.

"There are alternatives you can use to flavor foods, and we need to begin investigating those," Smith said. "We can start to look if there are different types of spices or seasonings we can add instead of salt to offset the bitter taste. For example, with bitter vegetables, you can use a little bit of sugar rather than salt to offset the bitter."

The findings are fascinating but "very preliminary," said Dr. Lawrence Appel. He's a professor of medicine and director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins Medical Institutions in Baltimore.

"Because bitterness is amplified, these people may need some other flavor alternative to mitigate the gene-induced bitterness," said Appel, a spokesman for the American Heart Association. "But you always need replication [studies], because there are always a lot of chance findings in genetic research. It's definitely what I like to call preliminary science."

Another study presented at the AHA meeting found that most U.S. adults consume too much salt, based on 24-hour urinary tests.

Overall, adults excreted more than 3.6 grams of sodium in their urine on a given day, far higher than the 2.3-gram dietary limit, researchers found. Men excreted about 4.2 grams a day on average; women, 3.1 grams, according to the study.

"We still consume vastly more sodium than we need to, and it does adversely affect blood pressure. Especially as we age, it becomes increasingly important to cut back," Appel said. "Whether or not you have this gene, sodium reduction is good for you."

Research presented at medical meetings is typically considered preliminary, because it has not had the same scrutiny as studies in peer-reviewed journals.

More information

For more on sodium and heart health, visit the American Heart Association.

SOURCES: Jennifer Smith, Ph.D. student, University of Kentucky College of Nursing; Lawrence Appel, M.D., M.P.H., professor, medicine, and director, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore

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