December 31 , 2011 - Zeitgeist 2011 (and, Zeitgeist 2010)
And, from Seasons of the Farmington Valley's "The Year in Review":
Connecticut officials, led by Malloy, persuaded Jackson Laboratories to build a large new facility in Farmington. The company has produced millions of mice for research and now specializes in mouse-human chimeras, which blur the genetic distinctions between mice and people. What could go wrong? .....The state was hit by Arborgeddon, a freak snowstorm in no way connected to the previous bombogenesis, hurricane, earthquake, tornado, or cougar invasion. Halloween was canceled, work was canceled, electricity was canceled, school was canceled, cable was canceled, life was canceled. Rosa DeLauro held several press conferences to point out she was not in Italy.
November was canceled. Source: http://www.seasonsofthefarmingtonvalley.com/magazine/essay.shtml; thanks, Maria
December 30 , 2011 - NIH's Mixed Methods Research
Research has become much more complicated in recent years because Life has become too complicated to study simplistically. Also, given the realities of funding (less and less), researchers must find ways to conduct research in cost-effective ways. This includes conducting massive studies, across many geographic locations, involving a variety of entities, from academic institutions to health service providers, etc., etc.
To accurately capture and analyze the data being collected, as replication will become almost an impossible endeavor, new research methodologies are being developed. Such methodologies integrate existing methods in new ways, or, namely, mixed methods.
The National Institutes of Health defines mixed methods research as a research approach or methodology:
"focusing on research questions that call for real-life contextual understandings, multi-level perspectives, and cultural influences;
employing rigorous quantitative research assessing magnitude and frequency of constructs and rigorous qualitative research exploring the meaning and understanding of constructs;
utilizing multiple methods (e.g., intervention trials and in-depth interviews);
intentionally integrating or combining these methods to draw on the strengths of each; and
framing the investigation within philosophical and theoretical positions."
The NIH has released this comprehensive guidance document about mixed methods research for researchers who are interested in NIH-funding opportunities. Click on the graphic to access the site. For more information, see Research Resources on the Internet
December 29 , 2011 - U.S. Regional Economics Analysis Project
The U.S. Regional Economics Analysis Project Web site offers a wealth of state-based economic data along such parameters as: Population, Personal Income, Per Capita Income, Employment, Total Industry Earnings, Average Earnings Per Job. You generate tables and graphs to highlight state comparisons, etc. Click on the graphic to check out the site.
December 28, 2011 -
FDA's Communicating Risks and Benefits: An Evidence-Based User's Guide
Here is a hefty resource guide (242 pages) released by the FDA about risk communication. If you don't know this area at all, reading this is a good place to start. Public Health professionals are constantly on the front lines dealing with emergency situations of all kinds that affect the general public. It does require art and skill to share information about the situation without necessarily causing a panic, which worsens the situation. Learn how to do it right.
CDC has released its latest edition of its Yellow Book, the definitive guide to international travel. Everything you need to know to travel safely can be found in this manual. You can buy a hardcopy or access it for free online! Just click on the graphic to get to the table of contents. It is also available on Useful Sites - Destinations , which also has travel information.
December 26, 2011 - ATSDR's Toxic Substances Portal
The Agency for Toxic Substances and Disease Registry has redesigned its Toxic Substances Portal to make it more accessible to everyone. Here you can find information on virtually any kind of chemical you may come across. It will provide you with basic information about what the chemical is, how it affects the environment, how you may be exposed to it, how it affects your health and what you can do about it. Just click on the graphic to get to the "ToxFAQs" page, which is the index. You can also order the CD ROM if you want from this page.
On October 6th, Dutch researchers reported in the Journal of Clinical Endocrinology & Metabolism that shift work may increase the risk of heart disease.
"Younger shift workers have elevated levels of stress-related cortisol that may place them at increased cardiovascular risk,
In a group of shift workers who were less than 40 years of age, hair cortisol levels were significantly higher at 48.53 pg/mg hair (95% CI 36.56-64.29) compared with 26.42 pg/mg hair in day workers (95% CI 22.91-30.55; P<0.001),
...body mass index (BMI) was significantly higher in young shift workers compared to their day-worker counterparts, ...noting that "cortisol may contribute to the increased prevalence of obesity and cardiovascular risk that is found in shift workers."
There also were no significant differences in hair cortisol levels between shift workers and day workers in the older group
...older shift workers suffered from less stress than their younger colleagues or simply adjusted better to unconventional hours. Also, sleep patterns and circadian rhythms change as people age, which may have muted the impact of shift work on cortisol levels."
Citation source: Manenschijn L, et al. "Shift work at young age is associated with elevated long-term cortisol levels and body mass index" JCEM 2011; DOI: 10.1210/jc.2011-1551.
P.S. I will continue my exploration into what is known about Sleep, and how it affects our health, in January, as I will be busy working to transition the Web site into the new year. For the coming week, I will finish off this year's blog with a look at some cool resources from a variety of agencies that deal with Public Health issues.
December 22, 2011 - Female Shift Workers and Diabetes
"...an association between rotating night shift work and the risk of developing type 2 diabetes among nurses followed up for up to two decades (the Nurses' Health Study). The risk increased with the numbers of years working rotating shifts.
Although there was weight gain associated with shift work, changes in BMI (as well as other lifestyle factors such as smoking and physical activity) mediated only part of the observed association.
Women who worked a rotating night shift had an increased risk of type 2 diabetes that was not completely explained by an increase in body mass index (BMI),
Compared with women who did not rotate at least three nights a month, those who had less than 10 years of shift work...saw a 5% excess risk for type 2 diabetes. That risk climbed to 40% after a decade of shift work,
Excess risk rocketed to almost 60% for those who had put in 20 years or more,
Other studies have suggested that rotating night shift work is associated with an increased risk for obesity and metabolic syndrome, both of which are conditions related to type 2 diabetes,
Rotating night shifts were defined as working at least three nights a month in addition to days and evenings in that same month.
...night shift work was also associated with an elevated risk for obesity and excessive weight gain during the follow-up period. Again, each five-year increase in shift work was linked with an increase of 0.17 units in BMI and 0.45 kg in weight.
..., beyond BMI, a reason for the link between shift work and type 2 diabetes may be "chronic misalignment between the endogenous circadian timing system and the behavior cycles." This misalignment has been pegged as a reason for metabolic and cardiovascular disorders, including increases in glucose and insulin,
Citation sources: Hu FB, et al "Rotating night shift work and risk of type 2 diabetes: Two prospective cohort studies in women" PLoS Medicine 2011; 8(12); Kivim�ki M, et al "Shift work as a risk factor for future type 2 diabetes: evidence, mechanisms, implications, and future research directions" PLoS Medicine 2011; 8(12); as reported on: http://www.medpagetoday.com/Endocrinology/Diabetes/30040
Perhaps, one of the most disruptive causes of not getting enough sleep is shift work. Health care workers, especially nurses, have been working around the clock for decades. With the current economic climate, more and more people have been joining the ranks of shift workers, to the detriment of our health. For the next few postings I will be exploring what researchers have been finding out about the health of those who work the night shift.
In Medscape's "Tuning In to Circadian Rhythms: Impact on Your Patient's Health," researchers reported on shift workers have a higher risk for developing cancer, especially breast cancer among women.
Circadian Rhythm Sleep Disorders (CRSDs): The most common one that everybody has experienced is jet lag disorder, if you're crossing time zones. What happens is that your sleep pattern becomes out of synchrony with the environment that you are in, so that you want to be sleeping, even though it is daylight outside in your new environment. A variation on that is shift work disorder. If people are working nights, they are working at a time everybody else is sleeping. Then typically what they do on the weekends is try to be like everybody else and try to sleep at nighttime on the weekends. Consequently their sleep pattern is moving all the time.
Any type of work pattern that interferes with the normal sleep-wake pattern has a propensity for causing shift work disorder. These people are going to be tired when they are working. They want to be alert at work, but they are not. They are tired and sleepy. When they want to be able to sleep during the daytime, they have difficulty being able to fall asleep. Their whole circadian pattern is disrupted.
There are very different types of shifts. There are people who are on a steady shift (same time of day, 5 days a week, week after week). There are those who, as you say, tend to rotate their shifts. People may rotate in a counterclockwise direction, which is not good. Generally, if a shift goes from a night shift to a day shift and back to an evening shift, that is much better than going in the opposite direction. People have greater difficulty being able to deal with shifts that move in the other direction.
...shift workers and individuals with circadian misalignment are at increased risk for cardiovascular disorders including hypertension and heart disease, as well as gastrointestinal disorders, peptic ulcer disease, and cognitive disorders.
...there are also safety consequences. One of the most interesting findings that has come to the forefront is an increased association of stroke and cancer in shift workers, so much so that the World Health Organization has classified shift work as a potential carcinogen. In Denmark, they are considering shift work as an occupational hazard.
there were large epidemiological studies. What they found was that, specifically for breast cancer, [women shift workers were] about 1.5-2 times more likely to get breast cancer. Very importantly, the risk was higher the longer they worked in the shift work time.
...when you disturb the sleep-wake pattern, it produces so many changes in the body that affect so many metabolic, hormonal, endocrine, and inflammatory factors. Disruption of a sleep-wake pattern can be potentially carcinogenic,...
Partially it is because melatonin, which is a hormone that is produced by the pineal gland during the night, is being suppressed. There is some indication that melatonin can have anticancer properties.
Citation source: Tuning In to Circadian Rhythms: Impact on Your Patient's Health. Bradley P. Fox, MD; Michael J. Thorpy, MB, ChB; Phyllis F. Zee, MD, PhD; as reported at http://www.medscape.org/viewarticle/742367_transcript
In November, 2011, Brown University researchers reported:
"In adolescents and younger college students,...sleep is a neurologically important process during which the fast-growing brain becomes better organized.
Many neural connections forged earlier in life during rapid growth are pruned away if they are no longer needed, and new pathways are established to the parts of the brain that are responsible for such things as planning, organizing, and abstract thinking.
...college students who report inadequate sleep also report lower grades and more trouble with coursework. Still other studies have found an association between poor sleep and elevated alcohol use. The literature also supports associations between poor sleep and depressed mood and poorer physical health.
...teens lose sleep simply because they are caught between two immutable forces: biology and the school schedule. That's probably why one lesson that college students learn quickly is to avoid early classes.
Students are left to exercise their judgment about when to sleep, and their decisions are based more on what to do while awake than when to sleep.
Caffeine is no more a substitute for sleep than are CliffsNotes for reading original works of literature.
...many students can at least get by with not getting enough sleep. But it is especially important that those who are struggling academically, medically, or psychologically receive guidance on how to improve their sleeping habits."
According to U.S. Bureau of Statistics data, as reported on its "Back to College 2010" page (#1), college students were reported as getting 8.4 hours of sleep. I doubt that this reflects the reality of the average college student. And, while I am unsure about the methodology used to report #2, this is probably more reflective of the average college student's experience with sleeping, when you ask them why they don't sleep. This second scenario is supported by more recent university studies that are looking at the sleep habits of today's college students, and with the students I have in my Wellness classes.
According to a University of Cincinnati August 30 news release about a 200 undergrad college students living on campus:
"Many U.S. college students aren't getting the recommended seven to eight hours of sleep per night, a problem that could affect their ability to learn,
"...only 24 percent said they got at least seven to eight hours of sleep. More than half (55 percent) said they slept less than seven hours, and 21 percent slept more than eight hours.
Lack of sleep can impair concentration and memory,
"Sleep helps us save energy. It repairs cells in the body. And it's key for memory consolidation,"
"During sleep, the brain acts like a hard drive on a computer. It goes in and cleans up memories and makes connections stronger, and it gets rid of things it doesn't need,"
"So if a student is sleep deprived, it affects the whole process. Students aren't able to learn, they're not able to remember, it's harder to concentrate and it affects mood. They're working their way through college and they're not maximizing their learning potential."
Financial concerns and poor time and stress management were among the factors college students said hindered their ability to get enough sleep.
Citation source: University of Cincinnati, news release, Aug. 30, 2011, as reported 9/10 by HealthDay
Teens who don't get enough sleep has been reported to practice health-risk behaviors:
Researchers found that 68.9 percent of adolescent responders reported insufficient sleep on an average school night.
Students who reported insufficient sleep were more likely to engage in the health-risk behavior than students who reported sufficient sleep.
Insufficient sleep was associated with the 10 health-risk behaviors examined below:
Drank soda or pop 1 or more times per day (not including diet soda or diet pop)
Did not participate in 60 minutes of physical activity on 5 or more of the past 7 days
Used computers 3 or more hours each day
In a physical fight 1 or more times
Current cigarette use
Current alcohol use
Current marijuana use
Currently sexually active
Felt sad or hopeless
Seriously considered attempting suicide
Citation source: Relationships between hours of sleep and health-risk behaviors in US adolescent students http://www.sciencedirect.com/
science/article/pii/S0091743511002878, as reported http://www.cdc.gov/media/releases/2011/a0926_insufficient_sleep.html
The American College of Chest Physicians reports in its 10/20/2011 news release:
"Teens who don't get enough sleep may find themselves putting on extra pounds and boys, in particular, may be at risk for obesity,
...the average sleep time on weekdays (for high school teens) was 6 hours 32 minutes for males and 6 hours 30 minutes for females. The average sleep time on weekends was 9 hours 10 minutes for males and 9 hours 22 minutes for females.
Average body mass index (or BMI, a measurement that takes into account height and weight) was 3.8 percent higher for males who slept 7 hours or less on weekdays than for those who slept more than 7 hours, and 4.7 percent higher for females who slept 7 hours or less on weekdays than for those who slept more than 7 hours,
...getting less than 8 hours sleep per night was associated with obesity in male teens, with the fewest hours of weekday sleep associated with the highest BMI.
"Sleep is food for the brain. When teens do not get enough sleep, they fall asleep in class, struggle to concentrate, look and feel stressed, get sick more often, and do not meet their obligations due to tiredness,"
"Teens who sleep fewer than eight hours may also consume more calories than those who sleep more than eight hours. Therefore, they have a higher risk for obesity and associated health problems, including high blood pressure, heart disease and stroke,"
...lack of sleep causes a decrease in the hormone leptin (which tells the brain when you're full) and an increase in the hormone ghrelin (which stimulates appetite).
"When you don't get enough sleep, it drives leptin levels down, which means you don't feel as satisfied after you eat. Lack of sleep also causes ghrelin levels to rise, which means your appetite is stimulated, so you want more food," "The two combined can set the stage for overeating, which in turn may lead to weight gain."
Citation source: American College of Chest Physicians, news release, Oct. 20, 2011; HealthDay
According to a University of Barcelona 9/15/2011 news release:
"When 6-year-old children go to bed late and sleep less than nine hours each night, their academic skills suffer along with their memory and motivation,
"Most children sleep less than is recommended for their intellectual development, which is hindered because the lack of sleep cannot be recovered.
...the lacking hours of sleep distorts children's performance in linguistic knowledge, grammar and spelling rules, and key aspects in the organization and comprehension of texts,.... They are basic skills, meaning that if the pupil, due to a lack of sleep, develops problems in this area, it could have a repercussion on all subjects,"
"Nowadays, there is great concern because children are glued to the television, computers and videogames, but the same importance is not given to them going to bed at the same time every night,"
...primary school kids should have good bedtime routines and healthy sleep habits that include at least nine hours of shut-eye each night to help ensure they perform their best in school."
Citation source: As reported by HealthDay 9/19/2011
"The FDA and the Federal Trade Commission said over-the-counter weight-loss products containing human chorionic gonadotropin (HCG) are fraudulent and illegal, and the agencies have told seven manufacturers to stop selling them.
...an FDA official said it did not appear that oral HCG offers any extra benefit.
"There is no substantial evidence HCG increases weight loss beyond that resulting from the recommended caloric restriction,"
The recommended diets call for daily calorie intake as low as 500 calories, low enough to create a risk of malnutrition, electrolyte imbalance, cardiac arrhythmias, and gallstone formation,
The warning letters sent to manufacturers of the products note that HCG has not received FDA approval for any weight-loss indication.
The substance is approved as an injectable drug for certain forms of female infertility and is therefore clearly subject to FDA regulation.
If the companies do not do so voluntarily, the FDA and FTC threatened to forcibly halt their operations.
Many of these products are labeled as homeopathic remedies, but they are illegal whether the word "homeopathic" is used or not,
If the product is marketed or meets federal standards to qualify as a drug, but is not FDA approved, it cannot be sold legally,
The seven companies receiving the warning letters, in addition to HCG Diet Direct, included Nutri Fusion Systems, Natural Medical Supply (doing business as HCG Complete Diet), HCG Platinum, Theoriginalhcgdrops.com, and HCG-miracleweightloss.com.
Citation source: FDA Yanks HCG Weight-Loss Agents from Market; http://www.medpagetoday.com/ProductAlert/OTC/30042
A University of Australia study reported in October 1st SLEEP:
"Children who went to bed late and got up late were 1.5 times more likely to become obese than those who went to bed early and got up early.
Furthermore, late-nighters were almost twice as likely to be physically inactive and 2.9 times more likely to sit in front of the TV and computer or play video games for more hours than guidelines recommend.
...mornings are more conducive to physical activity for young people than nights, which offer prime-time TV programming and social networking opportunities. This relationship between time of day and available activities might explain why more sedentary and screen-based behaviors were observed with later bedtimes,
�...sleep patterns of adolescents are fundamentally different from children and adults, and that it is normal for adolescents to stay up very late and sleep in late in the morning,� ...this sleeping pattern is associated with unfavorable activity patterns and health outcomes, and that the adolescents who don�t follow this sleep pattern do better.�
Early-bed/early-risers went to bed 70 to 90 minutes earlier, woke up 60 to 80 minutes earlier and accumulated 27 minutes more moderate to vigorous physical activity each day than late-risers.
On a broad scale, late-bed/late-risers replaced about 30 minutes of moderate to vigorous physical activity with 30 minutes of sedentary behavior each day, relative to the early-bed/early-rise group.
Body-mass index (BMI) scores were higher in late-risers than early-risers, and late-risers were more likely to be overweight or obese."
December 8, 2011 -
U.S. Lack of Sleep Statistics, 2008
Map of Sleep Insufficiency
* Age adjusted to 2000 projected U.S. population.
� Determined by response to the question, "During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?"� Determined by response to the question, "During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?"
Graphic source: http://www.cdc.gov/sleep/data_statistics.htm
Americans are just not getting enough sleep. With the way the economy is, it is no wonder no one can sleep fitfully.
According to 2008 Behavioral Risk Factor Surveillance System data, the United States age-adjusted* percentage of adults who reported 30 days of insufficient rest or sleep� during the preceding 30 days indicate we are not sleeping enough. What's interesting are the geographic variations. Hmm. Not saying anything, but just take a look at all the maps. These are maps of obesity and diabetes.
Sleep is a necessity as it is the only time that our immune system can re-energize after working non-stop while we are awake. And, if our immune system can't re-energize, it will not be able to protect us, and we end up getting sick. So, for the coming days this blog will explore what we know about sleep and sleep deprivation. I am hoping it will be interesting, but not enough to keep you awake all night...
Physical activity contributes to fitness in many ways, through weight loss, which in turn improves sleep. At a recent Obesity Society meeting, researchers reported on intervening with those who suffered from obstructive sleep apnea.
An intensive lifestyle intervention to get obese patients with type 2 diabetes to lose weight had long-lasting effects on obstructive sleep apnea as well, according to results from an ancillary study to the Look AHEAD trial.
Those with an apnea-hypopnea index of less than 5 were considered free from obstructive sleep apnea. Scores of 5 to less than 15 were considered mild, 15 to less than 30 moderate, and 30 or more severe.
The mean score was 20.5. Only 13.4% of the patients did not have obstructive sleep apnea. Another 33.5%, 30.5%, and 22.6% had mild, moderate, and severe symptoms, respectively.
After one year, patients undergoing the intensive lifestyle intervention lost an average of 24 pounds, whereas those in the control group had no weight loss (P<0.0001).
Although the change in apnea-hypopnea index was significantly related to the weight change, there was still a significant reduction in symptoms even after the change in weight was accounted for (P=0.001).
That indicates that the intervention had an effect on obstructive sleep apnea that was separate from the weight loss, Foster said.
"The likely hero, I think, is fitness," he said, noting that another study has shown that even in the absence of weight loss, changes in fitness can drive changes in apnea-hypopnea index."
Citation source: Foster G, et al "Effects of weight loss on severity of obstructive sleep apnea in obese patients with type 2 diabetes: four-year results of the Sleep AHEAD study" OBESITY 2011; Abstract 95-OR; as reported at http://www.medpagetoday.com/MeetingCoverage/OBESITY/28925
"Circa 1900: From Monkeys to Humans
Between 1884 and 1924, somewhere near modern-day Kinshasa in West Central Africa, a hunter kills a chimpanzee. Some of the animal's blood enters the hunter's body, possibly through an open wound. The blood carries a virus harmless to the chimp but lethal to humans: HIV. The virus spreads as colonial cities sprout up, but deaths are blamed on other causes.
1981: First Cases Recognized
In June, the CDC publishes a report from Los Angeles of five young homosexual men with fatal or life-threatening PCP pneumonia. Almost never seen in people with intact immune systems, PCP turns out to be one of the major "opportunistic infections" that kill people with AIDS. On the Fourth of July, the CDC reports that an unusual skin cancer -- Kaposi's sarcoma or KS -- is killing young, previously healthy men in New York City and California."
Today, AIDS remains uncurable, but current treatment, if started early, can prolong life. The key is early diagnosis, which means those who are at risk should be screened regularly for HIV. According to the CDC,
An estimated 1.2 million people are living with HIV in the United States. Of those, as many as 1 in 5 people (about 240,000) don't know they have HIV.
CDC recommends that all Americans between the ages of 13-64 be tested for HIV at least once as part of regular medical care. Others at greater risk (those with more than one sex partner, who inject drugs or are a men who has sex with other men) should get tested once a year or more often.
Testing early can lead to timely care and treatment that can improve the health of a person with HIV and prevent giving the virus to others. Without testing, people who have HIV and don't know it won't be able to get care and treatment. They also will be at greater risk for serious health problems and early death with HIV, and can give the virus to others without knowing it.
The "2008 Physical Activity Guidelines for Americans" is the most current
national guidance regarding physical activity. Key Guidelines include:
Children and Adolescents (aged 6-17)
Children and adolescents should do 1 hour (60 minutes) or more of physical activity every day.
Most of the 1 hour or more a day should be either moderate- or vigorous-intensity aerobic physical activity.
As part of their daily physical activity, children and adolescents should do vigorous-intensity activity on at least 3 days per week. They also should do muscle-strengthening and bone-strengthening activity on at least 3 days per week.
Adults (aged 18-64)
Adults should do 2 hours and 30 minutes a week of moderate-intensity, or 1 hour and 15 minutes (75 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. Aerobic activity should be performed in episodes of at least 10 minutes, preferably spread throughout the week.
Additional health benefits are provided by increasing to 5 hours (300 minutes) a week of moderate-intensity aerobic physical activity, or 2 hours and 30 minutes a week of vigorous-intensity physical activity, or an equivalent combination of both.
Adults should also do muscle-strengthening activities that involve all major muscle groups performed on 2 or more days per week.
Older Adults (aged 65 and older)
Older adults should follow the adult guidelines. If this is not possible due to limiting chronic conditions, older adults should be as physically active as their abilities allow. They should avoid inactivity. Older adults should do exercises that maintain or improve balance if they are at risk of falling.
Citation source: "At-A-Glance: A Fact Sheet for Professionals" http://www.health.gov/paguidelines/factsheetprof.aspx
I love it when HRSA.gov releases its annual report on women's health. In its 2011 report I discovered that Americans are in pretty sad shape.
Here is a graphic about the percentage of American men and women, by age group, who get adequate exercise. As defined, it would mean 21 minutes of moderately intensive exercise a day, and only 15% of women and 21% of men get this!!! In general, women do not get enough exercise, regardless of age, and it gets worse as we get older. No wonder we have an obesity epidemic! Obviously, health is not a priority to many people, but everyone will learn that there is a price to pay as we get older - heart disease, cancer, other chronic diseases, and probably the worse one - type 2 diabetes.
Then again, it is never too late to get started. Why not start today? Go and take a brisk walk for a half an hour and see what you have been missing. It will do you a world of good. For more information, see Fitness
November 28, 2011 - Thank you, Southern Connecticut State University, for the 2011 Outstanding Alumna of the School of Health and Human Services Award!
Betty with Dr. Gregory. Paveza, Dean of the School of Health and Human Services, Southern Connecticut State University
Photo: Lee Jung
November 25, 2011 - Map of Global Inactivity, 2008
How pervasive is physical inactivity? Unfortunately, very. Here is an April, 2011 World Health Organization (WHO) global map of insufficient physical activity for 2008. WHO defines insufficient physical activity activity as "less than 5 times 30 minutes of moderate activity per week, or less than 3 times 20 minutes of vigorous physical activity per week or equivalent."
Well, I have come up with 32 reasons (all research-based) for why it is important to exercise. I am sure that I can keep on going, but I think all these reasons from the past couple of months should convince you that exercise is important for our health and wellness, for our mind and body and the spirit as well. Not only does it create physiological changes to the brain itself, but it helps release chemicals that affect how the brain works that elevates our mood, helps us to learn and to cope better with life, among other things, as dealing with whatever diseases that ail us. And, the best thing is, you don't need money to gain these benefits, all you need is the willingness to not forget to break a sweat.
Here is the final reason from research about why it is important to keep on exercising, to keep on moving. After all, what would happen when the heart stops moving(beating)? On August 1st, the University of Missouri researchers reported:
"...physical inactivity is the primary cause of chronic diseases such as diabetes, obesity and fatty liver disease and that even people who set aside time for exercise regularly but are otherwise sedentary, may not be active enough to combat these diseases.
Inactivity, in addition to the availability of high-caloric food has led to an increased rate of metabolic dysfunction in Americans.
...people who have inactive lifestyles are at increased risk for type 2 diabetes and obesity.
...negative physiological changes associated with a higher risk for type 2 diabetes, occur in people who transition from high amounts of activity (greater than 10,000 steps a day) to inactivity (fewer than 5,000 steps each day).
If people spend the majority of their time sitting, even with regular periods of exercise, they are still at greater risk for chronic diseases,
"If people can add some regular movement into their routines throughout the day, they will feel better and be less susceptible to health problems. In the long term, they may not see big changes in the mirror, but they will prevent further weight gain.
...nonalcoholic fatty liver disease (NAFLD) is a relatively new epidemic related to the recent increase in obesity and physical inactivity rates. The disease, which is the most common chronic liver condition among U.S. adults, occurs when excess fat accumulates in the liver.
This change disrupts glucose regulation and contributes to insulin resistance and type 2 diabetes. NAFLD progresses more rapidly in young people than in adults and has become more common in children.
Everyone should try to take at least 10,000 steps a day,...It doesn't have to happen all at once, but 500 to 1,000 steps every few hours is a good goal. Small changes can increase the number of steps people take in their daily routines. Changes might include taking the stairs instead of the elevator, walking to a coworker's office rather than calling, or planning time for short walks throughout the day."
In a recent American Heart Association conference presentation, researchers reported:
"Drinking two or more sugar-sweetened beverages a day may boost a woman's risk for developing heart disease and diabetes -- even if this habit isn't causing her to pack on extra pounds,
...the risks posed by sugar-sweetened sodas and flavored waters may be independent of weight gain.
Middle-aged women who drank two or more sugary beverages a day were close to four times as likely to have high levels of dangerous blood fats called triglycerides and impaired blood sugar levels (known as "prediabetes'), when compared with women who drank less than one sugar-sweetened beverage a day.
...women who drank two or more sodas a day also had more belly fat, but not necessarily more weight. Belly fat, or abdominal obesity, poses greater health risks than fat in other areas of the body because it lies deep inside and can produce hormones and other substances that negatively affect blood pressure, cholesterol and insulin production.
Add these perils together and you've got so-called metabolic syndrome, a cluster of risk factors that has been linked to heart disease, diabetes and stroke.
The same findings were not seen among men. There's no consensus on why sugar-sweetened beverages did not affect men in the same way, but it may be that women require less energy for metabolism than men,...They have smaller bodies, less muscle mass and need fewer calories than men,"
The bottom line is that cutting back on sugar-sweetened beverages is an easy way to improve health,
"Our soda habit is something we have total control over," ..."There are a lot of things that keep us healthy that are hard work and difficult, but cutting back on sweetened drinks isn't one of them."
Citation source: Christina Shay, Ph.D., MA., assistant professor, University of Oklahoma Health Sciences Center, Oklahoma City; Nov. 13, 2011, presentations at American Heart Association annual meeting, Orlando, Fla.; as reported in HealthDay.
For more information, see A HREF="Nutrtition.htm">Sodas
November 21, 2011 -
Gratitude is always a good thing because it helps us to keep Life in perspective. We take so many things for granted that we don't appreciate what we have until we don't have it anymore.
I like Research!America's annual "Public Health Thank You Day" because it puts what is my greatest love, Public Health, on the forefront, even if it's just for one day a year.
Here's a great video that shows the scope of Public Health.
A re-posting of my 2009 blog entry: Here are some of things we can be thankful for, with many thanks to all the Public Health Professionals, at all levels of practice, who have dedicated their careers to protecting the Public's Health in a variety of ways...
Waking up this morning from clean bedding that is not contaminated by pathogens;
Using a bathroom so human waste is disposed of properly;
Being able to drink water from the faucet without getting some disease;
Being able to eat breakfast without getting some disease;
Dropping off your kids in schools knowing they won't get sick because everyone got their immunizations;
Driving to work and not being exposed to harmful emissions from motor vehicles;
Going to work and spending the day in an environment that won't make you sick;
Going to lunch and eating in a restaurant that's been inspected;
Going for a walk and not being exposed to second-hand smoke or rotting garbage;
Getting a haircut and knowing those cutting your hair have been licensed;
Going to see health care professionals and knowing they are competent because they are licensed to practice;
Going to any health care facility and knowing they are licensed;
Going to bed and feeling safe because disaster preparedness exists at every level of government.
November 18, 2011 - Reason #32 - Physical activity reduces the effect of the obesity gene
Now we really have no excuse to not exercise. A November 1st PLoS Medicine article reports:
"The genetic predisposition to obesity due to the fat mass and obesity associated (FTO) gene can be substantially reduced by living a physically active lifestyle
Physical activity reduces the effect of the obesity gene...the effect of the FTO gene on obesity risk is nearly 30% weaker among physically active than in physically inactive adults.
This finding holds an important public health message relevant to health care professionals and the wider public as it challenges the widely-held view that obesity is in my genes and not amenable to lifestyle changes. On the contrary, this study shows that even those genetically predisposed can reduce their risk of becoming obese by being physically active.
...in general, carrying a copy of the FTO gene increases the risk of becoming obese. However, the effect of the FTO gene on obesity risk was 27% less pronounced in individuals who were physically active (1.22 fold) compared with those who were physically inactive (1.30 fold).
Our findings are highly relevant to public health. They emphasize that physical activity is an effective way of controlling body weight, particularly in individuals with a genetic predisposition towards obesity.
Citation source: Kilpelinen TO, Qi L, Brage S, Sharp SJ, Sonestedt E, et al. (2011) Physical Activity Attenuates the Influence of FTO Variants on Obesity Risk: A Meta-Analysis of 218,166 Adults and 19,268 Children. PLoS Med 8(11): e1001116. doi:10.1371/journal.pmed.1001116; http://www.stonehearthnewsletters.com/physical-activity-reduces-the-effect-of-the-obesity-gene/benefits-exercise/
November 17, 2011 - Reason #31 - 150 minutes of exercise is good, 300 minutes of exercise a week is even better
According a recent meta-analysis reported in Circulation: Journal of the American Heart Association, researchers have been able to show that more exercise is better.
...individuals who did not meet the 150-minute threshold, but did exercise regularly, also had a significantly lower CHD risk compared with sedentary study participants.
"...people who exercise for the recommended 150 minutes of moderately intense physical activity weekly had a 14% reduction in the risk of coronary heart disease (CHD) compared with individuals who reported no physical activity;
Increasing the weekly total to 300 minutes reduced CHD risk by 20% compared with sedentary people,
"The present study provides quantitative data supporting the 2008 Physical Activity Guidelines for Americans, which recommend the equivalent of 150 minutes per week of moderate-intensity physical activity for health and 300 minutes per week for additional benefits and encourage any amount of activity for those unable to meet the minimum,"
Pooled analysis of relative risk by sex showed that women derived greater benefit from physical activity. The analysis showed a 22% reduction in CHD risk among men and a 33% reduction among women.
Individuals who attained the advanced guideline recommendation of 300 minutes of activity weekly had a relative risk of CHD of 0.80 (95% CI 0.74 to 0.88) versus inactive individuals.
Any physical activity proved to be better than no physical activity....
attaining an activity level that was 50% of the recommended minimum - Those individuals had a 14% reduction in CHD risk compared with inactive people
People whose total activity time was five times greater than the minimum had a 25% lower CHD risk compared with people who reported no physical activity.
Citation source: Physical Activity and Public Health: Updated Recommendation for Adults From the American College of Sports Medicine and the American Heart Association; US DHHS 2008 Physical Activity Guidelines for Americans; http://www.medpagetoday.com/Cardiology/Prevention/27829
November 16, 2011 - Reason #30 - 3 hours of vigorous exercise a week can reduce a man's heart attack risk by 22%
Harvard School of Public Health researchers reported in the 10/4/11 issue of Medicine & Science in Sports & Exercise:
"..about 38 percent of that decreased risk was due to the beneficial effects of exercise on a man's levels of "good" high-density lipoprotein (HDL) cholesterol.
Three hours of vigorous exercise a week can reduce a man's heart attack risk by 22 percent.
"Men who suffered a nonfatal heart attack or died from coronary heart disease had less 'good' cholesterol, more 'bad' [LDL] cholesterol and were more likely to have high blood pressure, high cholesterol and diabetes."
Citation source: Medicine & Science in Sports & Exercise, news release, Oct. 4, 2011; HealthDay
November 15, 2011 - Lock up prescription medications
Here is something you can do about prescription opioid abuse - if you take prescription medications, lock them up.
According to the FDA: "Every year thousands of children are hospitalized and some die after taking medicine not meant for them. Teens share stolen prescription drugs at "pharm parties" and toddlers are tempted by colorful pills that look like candy.
In this Consumer Update video, FDA pharmacist Connie Jung explains how you can prevent harm by locking your medicine up." (Source: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm272905.htm)
November 14, 2011 - Prescription Opioid Abuse on The Rise
In 2006, age-adjusted death rates for poisoning deaths involving opioid analgesics ranged from 1.8 to 15.6 deaths per 100,000 population among the states. In 16 states, the rate was statistically significantly higher than the U.S. rate of 4.6 deaths per 100,000 Graphic & text source: http://www.cdc.gov/nchs/data/databriefs/db22.htm
Substance abuse has taken an ugly turn in the U.S. According to the 11/2 MMWR report,"Vital Signs: Overdoses of Prescription Opioid Pain Relievers --- United States, 1999--2008"
"Overdose deaths involving opioid pain relievers (OPR), also known as opioid analgesics, have increased and now exceed deaths involving heroin and cocaine combined.`
The epidemic of overdoses of OPR has continued to worsen. Wide variation among states in the nonmedical use of OPR and overdose rates cannot be explained by underlying demographic differences in state populations but is related to wide variations in OPR prescribing.
By 2010, enough OPR were sold to medicate every American adult with a typical dose of 5 mg of hydrocodone every 4 hours for 1 month.
"Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from overdoses involving these drugs more than those who die from heroin and cocaine combined.
Overdoses involving prescription painkillers a class of drugs that includes hydrocodone, methadone, oxycodone, and oxymorphone are a public health epidemic.
These drugs are widely misused and abused. One in 20 people in the United States, ages 12 and older, used prescription painkillers nonmedically (without a prescription or just for the "high" they cause) in 2010.
I was appalled to find out that a judge ruled that the FDA cannot post the graphic warnings on cigarette packs:
"U.S. District Judge Richard Leon ruled in Washington on Monday that it's likely Big Tobacco will succeed in a lawsuit to block the new warning labels, so he stopped the requirement until after the lawsuit is resolved. That could take years.
The cigarette makers that sued the FDA are R.J. Reynolds Tobacco Co., Lorillard Tobacco Co., Commonwealth Brands Inc., Liggett Group, and Santa Fe Natural Tobacco Co. They say their products have had medical warnings for more than 45 years, adding they have never filed a legal challenge against them until the new images were approved."
I do not agree with this judge's opinion because it is the duty of the FDA to protect the Public's Health, and the FDA should be allowed any means possible to warn the Public of the negative health outcomes associated with cigarette smoking, second-hand smoke and third-hand smoke. Such warnings make perfect sense, because it would be seen by those who need to see it the most - the smokers who spend lots of money buying cigarettes. Smoking is the most preventable cause of death and morbidity, which includes heart disease, lung disease and numerous cancers.
Such warnings have been posted on cigarette packs around the world, why not here in the U.S.? Smoking not only ruins the health of those who smoke, but it ruins the environment and the air in which we all live in.
November 10, 2011 - Reason #29 - 7,500 Steps a day can help reduce cardiovascular risk factors
Researchers at the American College of Sports Medicine (ACSM) 58th Annual Meeting report:
"A physical activity target of 7500 steps a day is a realistic goal for patients with acute coronary syndrome, and can help them reduce cardiovascular risk factors.
"According to [ACSM] recommendations, individuals in cardiovascular secondary prevention should perform 6500 to 8500 daily steps to achieve a fair exercise energy expenditure,"
"The maintenance over time of a daily-steps target is very important for achieving an optimal impact on cardiovascular risk factors," ..."Our study showed some beneficial effects of the maintenance of 7500 steps per day, or more, after 12 months on the lipid profile and waist circumference."
"It's important to remember there is a dose response beneficial impact of physical activity. For more benefit on cardiovascular risk factors, one must increase daily steps to more than 7500."
"Traditionally, we think of 10,000 steps per day as being the target goal, so to see that even with fewer steps there is significant improvement is great information,"
"Other studies have shown sort of a linear relationship, in which the more exercise patients do, the better it is for them,..the fact that just 7500 steps has been shown to provide a benefit because this is a doable amount for most people."
The recommended level of physical activity for adults after hospitalization for acute coronary syndrome is at least 7500 steps per day.
A physical activity level of at least 7500 steps per day in adults after hospitalization for acute coronary syndrome is linked with improved HDL cholesterol level, triglyceride level, ratio of total cholesterol to HDL cholesterol, and waist circumference after 12 months."
Citation source: Target of 7500 Steps a Day Lowers Risk for Acute Coronary Syndrome; http://www.medscape.org/viewarticle/744451
Includes a table of popular herbal supplements and interactions with common heart medications. What's most important is to let your doctor know about EVERYTHING you are taking so they can make a determination as to whether or not it is safe to take. It's probably better to not take any herbal supplements at all since they are not regulated by the FDA.
On November 4th, the Mayo Clinic Foundation released,"Herbal supplements may not mix with heart medicines."
"At least a quarter of adults who take prescription medications also take dietary supplements, including herbal supplements. That number is even higher among adults older than age 70 three-quarters report using both prescription medications and dietary supplements.
Yet many herbal supplements interact with medications for cardiovascular disease which are widely prescribed for older adults. The chances of herbs and drugs interacting are high.
...8 of the 10 most widely used supplements interact with the blood-thinning medication warfarin (Coumadin). Here are just a few of the herbal supplements that can affect warfarin:
According to the CDC's Breast Cancer: Rates of New Cases and Deaths Page, updated 10/17/2011, "Mammograms are the best method to detect breast cancer early."
Not counting some kinds of skin cancer, breast cancer is the most common cancer in women in the United States. Breast cancer is the most common cause of death from cancer among Hispanic women, and the second most common cause of death from cancer among white, black, Asian/Pacific Islander, and American Indian/Alaska Native women.
In the United States in 2007 (the most recent year for which statistics are available), 202,964 women were told they had breast cancer, and 40,598 women died from it.
...white women had the highest incidence rate for breast cancer. Black women had the second highest incidence rate, followed by Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native women. On the other hand, black women had the highest death rate for breast cancer, followed by white, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander women.
A mammogram is an X-ray of the breast. Mammograms are the best method to detect breast cancer early when it is easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from breast cancer.
Data source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2007 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2010; http://www.cdc.gov/features/dsBreastCancerTrends/
Japanese research presented at the American College of Sports Medicine (ACSM) 58th Annual Meeting reports:
Regular physical activity remains the key to the prevention of atherosclerosis progression, even when patients are also receiving intensive lipid and glucose management through medication and diet.
...those doing less exercise had significantly higher levels of pulse wave velocity at 5 years than those doing more exercise (14% increase; P = .002).
"Pulse wave velocity, an index of arterial stiffness, is known to predict cardiovascular mortality in patients with ischemic heart disease,"
Previous studies have shown that physical activity benefits arterial stiffness and mortality in patients with ischemic heart disease, but the role of exercise when patients are already receiving treatment has not been clear,
"This is the first report that regular physical activity prevented atherosclerotic progress, even in ischemic heart disease patients receiving aggressive lipid- and glucose-lowering therapy,"
"Patients will come in and say, 'I'm on medication for my cholesterol and my blood pressure is okay, so I don't need to exercise,' but they need to know that there's an added benefit to exercise that we don't even know about."
Citation source: American College of Sports Medicine (ACSM) 58th Annual Meeting: Abstract 2788. Presented June 3, 2011; reported at http://www.medscape.org/viewarticle/744909
August 1st meta-analysis reported in Circulation concluded:
"...14% and 20% CHD risk reduction observed with the minimum and advanced recommended amounts of exercise, ... those who were physically active at levels lower than the minimum recommended also had a significantly lower risk of CHD, compared with those who did nothing.
There was an inverse linear association between the duration of exercise and the risk for CHD. The relative risk for CHD for individuals who exercised for 150 minutes/week vs the referent group was 0.86 (95% CI, 0.77 - 0.96), but this same relative risk among individuals who performed 300 minutes of exercise per week was 0.80 (95% CI, 0.74 - 0.88).
The relative risk for CHD for individuals who exercised for 750 minutes/week was 0.75, and even adults who only burned 275 kcal/week in exercise (approximately 75 minutes/week of exercise) experienced a relative risk of 0.86 (95% CI, 0.76 - 0.97).
...those able to participate in 750 minutes per week of moderate intensity exercise (five times the minimum recommended amount) had around a 25% reduction in risk of CHD.
Citation source: Sattelmair J, Pertman J, Ding EL, et al. Dose response between physical activity and risk of coronary heart disease. A meta-analysis. Circulation 2011; DOI: 10.1161/CIRCULATIONAHA.110.010710. Available at: http://circ.ahajournals.org; as reported in Medscape: First Meta-Analysis To Quantify Benefits of Exercise on CHD Risk
The peer-reviewed journal, Investigative Ophthalmology & Visual Science (IOVS), recently reported that physical fitness could have a positive effect on eye health by reducing the risk of glaucoma.
"...higher levels of physical exercise appear to have a long-term beneficial impact on low ocular perfusion pressure (OPP), an important risk factor for glaucoma.
...moderate physical exercise performed approximately 15 years previously is associated with a 25% reduced risk of low OPP.
...there is certainly an association between a sedentary lifestyle and factors which increase glaucoma risk."
While there have been a large number of studies that have examined the effect of physical activity on intraocular pressure (IOP) and on blood pressure -- the two components of OPP -- this is the first time the relationship between physical activity and OPP has been investigated,
"Before now, the only modifiable risk factor for glaucoma was IOP, altered by medication, laser or surgery," ..."We believe our study points toward a new way of reducing glaucoma risk, through maintaining an active lifestyle. This is a way that people can participate in altering their risk of glaucoma and many other serious health problems."
On 10/10/2011, the American Academy of Orthopedic Surgeons issued the press release,"Herbal Supplements May Cause Dangerous Drug Interactions in Orthopaedic Surgery Patients," which identified the following interactions that dietary supplements have:
Herbal products marketed for osteoarthritis also can pose serious risks when combined with prescription medications. For example:
Glucosamine, chondroitin and flavocoxid can affect clotting agents;
Black cohosh can interact with the cancer drug tamoxifen; and
Cat's claw can interact with clotting agents, blood pressure medications and cyclosporine.
Many of the most popular herbal supplements used today can have serious side effects when combined with prescription medicines. For example:
Feverfew (used for migraine prevention), ginger, cranberry, St. John's Wort and ginseng can interact with the anti-clotting drug warfarin;
Feverfew, ginger, and gingko can interact with aspirin;
Garlic can interfere with anti-clotting medications and the immunosuppressant drug cyclosporine (prevents transplant rejection);
Valerian (used as a sedative) can intensify anesthetics; and
St. John's Wort can interact with immunosuppressive drugs and potentially lead to transplant rejection.
Here's another reason to exercise. An April 2nd presentation at the American College of Cardiology (ACC) 2011 Scientific Sessions, researchers report:
"...being physically active over the course of a lifetime can "preserve the heart's youthful elasticity."
"You have to use it or lose it. It is never too late to start exercising. Exercising twice a week can prevent age-related loss of cardiac mass, while exercising four to five times a week can rebuild cardiac mass.
...while higher cardiac mass has not directly been shown to cause better outcomes, it is associated with increased levels of fitness, which has been shown to be associated with better outcomes.
...if we can identify people in middle age and get them to exercise four to five times a week, this may go a very long way in preventing some of the major heart conditions of old age, including heart failure."
Citation source: American College of Cardiology (ACC) 2011 Scientific Sessions. Presented April 2, 2011; as reported in Medscape's Regular Exercise Can Help Preserve/Build Heart Mass
"Regular aerobic exercise worked just as well as relaxation therapy or the antiepileptic drug topiramate in preventing migraine headaches...
"This non-pharmacological approach may therefore be an option for the prophylactic treatment of migraine in patients who do not benefit from or do not want daily medication,"
...non-pharmacological options were free from adverse events and the exercise group increased oxygen uptake, which is very positive.
"From a wider health-based perspective, it should be stressed that patients with migraine are less physically active than the general population, and that exercise has positive effects in terms of general well-being and the prevention of disease."
Citation source: Exercise as migraine prophylaxis: A randomized study using relaxation and topiramate as controls
http://cep.sagepub.com/content/early/2011/09/01/0333102411419681; Reuters Health; HealthDay
October 26, 2011 -
Reason #22 - Exercise improves the health of those with chronic kidney disease
"...regular exercise can significantly improve physical fitness, cardiovascular measures, some nutritional parameters, and health-related quality of life. The results apply to patients across the spectrum, from those with early chronic kidney disease lasting more than 3 months, to those on dialysis, to those who received kidney transplants.
"[I]n adults with CKD the following exercise regimen is recommended: four to six months supervised, regular (three sessions/week), high intensity mixed cardiovascular and resistance training lasting 30 to 90 minutes. To maintain this peak effect the patient has to continue with the regular exercise training intervention."
Improvement in several areas of physical fitness, particularly aerobic capacity...and walking capacity...was striking.
Citation source:Cochr Datab System Rev. Published online October 5, 2011. Abstract; http://www.medscape.com/viewarticle/751229?sssdmh=dm1.724644&src=nldne
October 25, 2011 - Are you over 55, obese and have a family history of diabetes?
Who is at risk for developing type 2 diabetes? There are many algorithms out there to identify risk factors, etc., but I think the latest 3-question tool from the Louisville Metabolic and Atherosclerosis Research Center in Kentucky is the simplest to use:
"Individuals who were 55 or older, were obese -- with a body mass index (BMI) greater than 30 -- and had a family history of diabetes had a 19.9% risk of developing type 2 diabetes over five years of follow-up;
Younger individuals with a BMI less than 25 and no family history of the disease, however, had an almost negligible five-year risk (0.3%)."
Citation source: Bays H, et al "Adiposity, age, and family history as a simplified prediction of future diabetes mellitus from the SHIELD study" OBESITY 2011; Abstract 810-P; as reported in Medpage Today
So, what does this mean? Well, there's not much we can do about age or family history, but we can do something about weight. So, if you are 55 or older and have a family history of diabetes, then you should strive to eat healthy and exercise daily to maintain normal weight, and if you are overweight, lose it.
The British Medical Journal recently released a study about the issue of conflicts of interest of those who sit on guidelines panels. This is a medical ethics issue because conflicts of interest taint the credibility of medical guidelines being developed that are then used to guide the delivery of medical care.
"The study exposes the problem of incomplete disclosure and highlights the important relationship between sponsorship of guidelines and presence of conflict of interest.
The prevalence of conflict of interest (COI) between clinicians and industry has been a topic of concern for the medical profession for more than two decades.
One area in which the presence of COI may be particularly concerning is the development of clinical practice guidelines, as their freedom from bias is important.
Although most organisations that produce guidelines have adopted COI disclosure policies, complete transparency is often not achieved, and may not be enough to prevent panel members' bias from influencing recommendations.
"Our data illustrate the pervasiveness of COI among members of guideline panels and may raise questions about the independence and objectivity of the guideline development process in the United States and Canada," say the authors.
Conflict-free guideline panels are feasible and would help to improve the quality of the guideline development process, they conclude.
"More than half of panel members who gather to write clinical practice guidelines on diabetes and high cholesterol have conflicts of interest
"The concern is that compensation by industry on some of these panels can pose a potential risk of industry influence on the guideline recommendations,"
Clinical practice guidelines are meant to direct health care professionals on how to best care for patients.
In the United States and Canada, most organizations (including nonprofit and governmental bodies) have their own protocol for divulging conflicts of interest.
And recently, the Institute of Medicine (IOM) published recommendations on how organizations should manage conflicts of interest when drawing up guidelines. Among other things, the institute advocated excluding individuals with financial ties to the drug industry.
They focused on two categories only: high cholesterol and diabetes, which account for a lion's share of drug expenditures. Organizations included the American Heart Association, the American Diabetes Association and the U.S. Preventive Services Task Force (USPSTF).
Five of the organizations did not require conflict-of-interest disclosures from panel members,
Among a total of 288 panel members, conflicts of interest were found among 52 percent, overall.
In addition, half of panel chairs had conflicts,
On the other hand, only 16 percent of panel members from government-sponsored guidelines such as the USPSTF declared conflicts, versus 69 percent of non-governmental entities.
The authors noted that unless a particular journal publishing guidelines requires it, USPSTF divulges conflicts of interest only after a Freedom of Information Act request has been filed."
Citation source: Jennifer Neuman, M.D., instructor, department of preventive medicine, Mount Sinai School of Medicine, New York City; Sue Kirkman, M.D., senior vice president, medical affairs & community information, American Diabetes Association; Oct. 10, 2011, American Heart Association statement; Oct. 11, 2011, BMJ, online; HealthDay
According to a National Institute on Drug Abuse-funded study,
"Regular exercise may be a useful strategy for helping prevent the development of panic and related disorder
People with an intense fear of the nausea, racing heart, dizziness, stomachaches and shortness of breath that accompany panic known as "high anxiety sensitivity" reacted with less anxiety to a panic-inducing stressor if they had been engaging in high levels of physical activity,
There is already good evidence that exercise can be of help to people who suffer from depression and anxiety problems,
New study adds to earlier research finding exercise reduces anxiety
exercise may be an effective strategy for the prevention and treatment of anxiety disorders.
The results showed that anxiety reactivity to the stressor was dampened among individuals who have been regularly engaging in high levels of physical activity.
As reported at http://www.stonehearthnewsletters.com/panic-related-disorders-may-be-lessened-with-physical-activity-new-study/mental-health/
According to two July 19th Archives of Internal Medicine reports:
"Older adults who keep active may be helping to reduce their odds of losing their mental abilities;
...those who were the most physically active had a 90 percent lower risk of developing significant cognitive decline, compared with those who had the least physical activity,
...low-intensity physical activity may be important,...just moving around the house, doing chores, walking outside, may also be important for protection against cognitive impairment."
...those with the highest levels of physical activity had the lowest odds of developing any cognitive impairment, compared with those who had the least amount of physical activity.
...women who were most physically active had the lowest rate of developing cognitive decline. In addition, women who took a brisk 30-minute walk every day, or its equivalent, had the lower risk of cognitive impairment.
"As we get older, our brains are probable less able to withstand stress," But exercise improves vascular health,
"Just keeping up walking for an older person is a huge benefit."
Citation source: Laura E. Middleton, Ph.D., Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Research Institute, Toronto; Eric B. Larson, M.D., M.P.H., Group Health Research Institute, Seattle; July 19, 2011, Archives of Internal Medicine; as reported by HealthDay
October 19, 2011 - Reason #19 - Exercise Helps You Do Better in School!
In July 2010, the US HHS and the CDC published,"The Association Between School-Based Physical Activity, Including Physical Education, and Academic Performance" which took a serious look at the benefits of physical activity in school setting, looking physical education, classroom physical activity, recess, extracurricular activities. Did it impact academic performance? Well, it wouldn't hurt to make exercise part of your school day.
Meta analyses show: For the 43 articles reviewed:
A total of 251 associations between physical activity and academic performance were measured.
The most commonly measured indicator of academic performance was cognitive
skills and attitudes (112 of the 251 associations tested).
More than half (50.5%) of all associations tested were positive.
Positive associations were found across measures of academic achievement, academic behavior, and cognitive skills and attitudes.
There were only four negative associations, accounting for 1.5% of all associations tested.
Graphic source: Analysis of Current Population Survey data by Gordon W. Green Jr. and John F. Coder, Sentier Research; http://www.nytimes.com/interactive/2011/10/10/us/declining-household-income.html?ref=us
October 14, 2011 - Reason #17 - Exercise Prevents Osteoporosis
"Exercise is one of the most important things you can do to prevent osteoporosis.
"A total lack of exercise is bad; astronauts and spinal cord injury patients lose bone," says Kenneth Lyles, MD, professor of medicine at Duke University School of Medicine, in Durham, N.C.
These groups are limited in how much they can move and do weight-bearing exercises those that work against gravity, such as walking, jogging, lifting weights, doing push-ups, or climbing stairs. Dr. Lyles tells patients to exercise five to six days a week 30 minutes of both aerobic and strengthening exercise two to three times a week." Source: http://shine.yahoo.com/event/vitality/17-ways-to-fight-osteoporosis-2574734/#photoViewer=2
"...link the regrowth of key adult brain cells (neurogenesis) in two critical areas of the brain to both the benefits of exercise as a stress reducer and also to sexual behavior and reproductive issues.
Until the 1960s, the idea that the adult brain could experience neural cell re-growth was not accepted; research over the next 30 years confirmed that adult brain cells could, and did, in fact, regenerate.
...exercise can improve mood and cognition and has also demonstrated that a deficit in adult neurogenesis may result in depressive disorders.
...one important adult brain area that is a 'neurogenic zone' is the hippocampus, an area involved in memory and emotional regulation...the effect of stress on the hippocampus is well known. Stress, especially depression and post-traumatic brain injury, have been shown to shrink the hippocampus.
...exercise has a link to enhancing hippocampal 'plasticity' and the regrowth of neurons (neurogenesis).
...that hippocampal neurogenesis plays a role in the beneficial effects of exercise in countering stress..
Source citation: Yau, S-K.; Lau, B. W-M.; So, K-F. Adult Hippocampal Neurogenesis: A Possible Way How Physical Exercise Counteracts Stress. Cell Transplantation 20(1):99-111; 2011; as reported on http://www.eurekalert.org/pub_releases/2011-03/ctco-bcr031011.php
October 12, 2011 - October is National Breast Cancer Awareness Month
On August 24, 2011, the Journal of Clinical Psychiatry found:
"Exercise can be as effective as a second medication for as many as half of depressed patients whose condition have not been cured by a single antidepressant medication."
...both moderate and intense levels of daily exercise can work as well as administering a second antidepressant drug,....The type of exercise needed, however, depends on the characteristics of patients, including their gender.
...adding a regular exercise routine, combined with targeted medications, actually can relieve fully the symptoms of major depressive disorder.
...exercise can be as effective as adding another medication. Many people would rather use exercise than add another drug, particularly as exercise has a proven positive effect on a person's overall health and well-being."
By the end of the investigation, almost 30 percent of patients in both groups achieved full remission from their depression, and another 20 percent significant displayed improvement, based on standardized psychiatric measurements.
Moderate exercise was more effective for women with a family history of mental illness, whereas intense exercise was more effective with women whose families did not have a history of the disease. For men, the higher rate of exercise was more effective regardless of other characteristics.
Acording to the World Health Organization "World Mental Health Day raises public awareness about mental health issues. The day promotes open discussion of mental disorders, and investments in prevention, promotion and treatment services."
The U.S. federal agency, Substance Abuse and Mental Health Services Administration (SAMHSA), provides many resources about mental illness and treatment. For more information, see Mental Health Resources
October 7, 2011 - Healthy People 2010 Final Review
Graphic source: 10/4/2011 CDC Vital Signs E-mail
Yes, it is finally here! After 10 years of collective and collaborative effort among all levels of public health, along with service providers from community and non-profit organization to health care providers, we can now evaluate exactly how successful we are in meeting the goals and objectives set up in the early 2000s.
October 6th CDC E-mail announcement: "Health People 2010 Final Review
The Healthy People 2010 Final Review presents a quantitative end-of-decade assessment of progress in achieving the Healthy People 2010 objectives and goals over the course of the decade. This report was compiled by the National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), with considerable input from the Department of Health and Human Service�s lead agencies for the Healthy People initiative. The Healthy People Federal Interagency Workgroup and the Office of Disease Prevention and Health Promotion served in a review capacity.
The Healthy People 2010 Final Review continues the series of profiles of the Nation�s health objectives as an integral part of the Department�s disease prevention and health promotion initiative for the decade that began in 2000. This initiative was unveiled in January 2000 by the Secretary of the Department of Health and Human Services with the release of Healthy People 2010: Understanding and Improving Health and Objectives for Improving Health. This report presents a summary of progress toward achieving the Healthy People 2010 goals of:
Increasing quality and years of healthy life, and
Eliminating health disparities.
This publication provides the final tracking data used to present a quantitative assessment of progress for the 969 objectives in the 28 Healthy People 2010 Focus Areas. A summary of progress for the Healthy People 2010 Leading Health Indicators also is presented. This publication incorporates the modifications to objectives from the 2005 Healthy People 2010 Midcourse Review, includes information about the status of each 2010 objective over the course of the decade, and a crosswalk that illustrates how Healthy People 2010 objectives were transitioned to Healthy People 2020."
CDC Vital Signs highlights the public health issue of drinking and driving as a threat to everyone. "US adults drank too much and got behind the wheel about 112 million times in 2010. Though episodes of driving after drinking too much ("drinking and driving") have gone down by 30% during the past 5 years, it remains a serious problem in the US. Alcohol-impaired drivers* are involved in about 1 in 3 crash deaths, resulting in nearly 11,000 deaths in 2009.
Driving drunk is never OK. Choose not to drink and drive and help others do the same." http://www.cdc.gov/vitalsigns/DrinkingAndDriving/
According to a 9/19/2-11 Mayo Clinic report that reviewed over 1600 research papers:
"Any aerobic physical activity that raises the heart rate and increases the body's need for oxygen may reduce the risk for dementia and slow cognitive decline once it starts,
"exercise sufficient to elevate the heart rate to about 60% of maximum, and done for about 150 minutes a week [divided], would be a good starting recommendation. This is similar to the American Heart Association recommendation."
Resistance exercise, such as weight lifting, also has beneficial effects, "but the literature on that is less extensive at this point in time,"
...significant effects of aerobic exercise in humans have been well documented and include: reduced subsequent risks for dementia and mild cognitive impairment, improved scores on cognitive testing in both normal seniors and those with cognitive impairment, better maintained brain connectivity, measured by functional magnetic resonance imaging, and
increased volumes of both brain cortex and hippocampus (a crucial memory area).
Citation source: Mayo Clin Proc. 2011;86:876-884. Abstract; as reported at http://www.medscape.com/viewarticle/749914?src=mpnews&spon=26
Since September 2010, the Corn Refiners Association, manufacturers of high fructose corn syrup (HFCS), has been petitioning the FDA to change its name to "corn sugar." This is because people are getting wise about avoiding HFCS.
The FDA is not pleased with the attempt at rebranding, but ad campaigns continue. And, on September 15th, Food and Drug Administration has cautioned the corn industry over its ongoing use of the term "corn sugar" to describe high fructose corn syrup, asking them to stop using the proposed new name before it has received regulatory approval."*
Now the consumer advocacy group, Food Identity Theft.com has taken on the fight, asking for the public to make their thoughts known to the FDA about not allowing such a name change, and the FTC about false advertising. There are direct links to the FDA's Citizen Petition, and to the FTC's Complaint Assistant.
According to the American Dietetic Association's "Nutrition and You: Trends 2011" report," television is the primary source of nutrition information for the general population! Unfortunately, most of the "nutrition information" on TV is mostly in the form of advertisements, for junk food.
According to a 7/14/2011 Associated Press report,"Companies Propose Curbing Junk Food Ads for Kids"
The nation's largest food companies say they will cut back on marketing unhealthy foods to children, proposing their own set of advertising standards after rejecting similar guidelines proposed by the federal government.
The new standards, which will allow companies to advertise food and beverage products to children if they meet certain nutritional criteria, could force some brands to change recipes to include less sodium, fat, sugars and calories.
The group's proposal was pushed along by a government effort to do the same thing. The Federal Trade Commission and several other government agencies were directed by Congress to come up with voluntary guidelines for marketing junk food to children, and those were issued earlier this year. The industry balked at that proposal, saying the voluntary standards were too broad and would limit marketing of almost all of the nation's favorite foods, including some yogurts and many children's cereals.
Not surprisingly, the proposal issued by the government is stricter than the standards the companies are pushing for themselves. Still, FTC Chairman Jon Leibowitz praised the industry guidelines Thursday. He said the government would consider the food companies' initiative as the government develops its own standards.
While the government proposal put broad limits on fats, sugars and sodium that would apply to marketing of all foods, the industry has suggested different guidelines for different foods, saying that is a more practical approach.
The industry guidelines for children's cereals, for example, would allow them to be advertised if they have around 10 grams of sugar a serving, while the formula used by the government would discourage advertising for cereals that have 8 grams of sugars in an equivalent serving. That would mean General Mills would still be able to advertise Honey Nut Cheerios cereal under the industry guidelines but would be discouraged under the voluntary government guidelines. Other sugary cereals such as Trix, Lucky Charms and Count Chocula would also make the cut under the industry numbers.
World Heart Day is a health promotion campaign of the World Heart Federation to raise awareness about heart health, and has been doing so since 2000.
The CDC's 2011 World Heart Day"One World, One Home, One Heart" states, " this year The World Heart Federation calls on individuals to reduce their own and their family's risk of heart disease and stroke. They ask people to take charge of their home's heart health by taking steps such as choosing healthy food options, increasing physical activity, and saying no to tobacco."
Women's Health & Fitness Day is the nation's largest annual health promotion event for women of all ages. This year's event is set for Wednesday, September 28, 2011, and in future years, is always be held on the last Wednesday in September. Women's Health & Fitness Day will also be part of a new National Women's Health & Fitness Week, to be held annually the last week in September. Go out and celebrate it your way - Move!
On September 19th, Medpage Today reported on a randomized trial that shows exercise may help male teenagers quit smoking.
"A tobacco cessation program for West Virginia high school students was 48% more effective at getting kids to quit over six months when it included a physical activity component,
...adding exercise significantly helped boys in the study, who showed a twofold greater likelihood of being tobacco-free at six months than when the program didn't include exercise (36.84% versus 18.42%, P=0.033).
Physical activity may help control withdrawal symptoms and cigarette cravings that make quitting harder and lead to relapse.
Citation sources: Horn K, et al "Effects of physical activity on teen smoking cessation" Pediatrics 2011; 128: e801�e811; as reported at http://www.medpagetoday.com/PrimaryCare/Smoking/28592
According to American Society for Bone and Mineral Research:
"In obese children, 12 weeks of vigorous exercise decreased their body fat while increasing bone formation and insulin sensitivity,
The aerobic exercise intervention resulted in significant dose-response benefits on total and visceral adiposity (P for trend = 0.001),
The exercise program did not appear to change fasting glucose, but on other measures of insulin sensitivity there were benefits, as shown by an upward trend on the Matsuda index (P=0.004) and a downward trend on fasting insulin (P<0.04),
There also was an upward trend for the markers of bone formation osteocalcin and procollagen type 1 amino propeptide (P1NP) (P=0.04 and P<0.001, respectively).
Pollock N, et al "Dose-response effect of vigorous aerobic exercise on bone turnover, insulin sensitivity, and adiposity in obese children: a randomized controlled trial" ASBMR 2011; Abstract 1177.
September 24, 2011 - Today is the Worldwide Day of Play!
Graphic source: Healthy People, Healthy People Newsletter 9/20/2011
We practically have a day for everything, so why not one for Play??? Initially celebrated on October 1, 2005 and started by the US Nickelodeon channels, it has been an annual event except for 2008. Now with the growing obesity rates around the world, the Worldwide Day of Play takes on growing importance.
Yes, we are not playing enough because these days we would just as soon sit in front of a TV or computer and while away hours by being sedentary. Of course, we should be active EVERY DAY, rather than just for one day a year. And, besides, kids shouldn't be the only ones to play, we all should take time out from our daily lives to enjoy the world around us. Just an hour a day of brisk
walking can do wonders!
Right now, I am in the midst of sharing the many reasons why we should be exercising in this blog. Let's join the kids and do some running around!
Duke University Medical Center researchers reported in the 8/25/2011 issue of American Journal of Physiology that:
"Aerobic exercise is better than resistance training if you want to lose the belly fat that poses a serious threat to your health,
...the fat that's deep within the abdomen and fills the spaces between internal organs...called visceral and liver fat -- is associated with increased risk of heart disease, diabetes and some types of cancer.
Aerobic exercise significantly reduced visceral and liver fat and improved risk factors for heart disease and diabetes, such as insulin resistance, liver enzymes and triglyceride levels.
Resistance training didn't deliver these benefits. Aerobic exercise plus resistance training achieved results similar to aerobic exercise alone,
"Resistance training is great for improving strength and increasing lean body mass,"...."But if you are overweight, which two-thirds of the population is, and you want to lose belly fat, aerobic exercise is the better choice because it burns more calories."
Aerobic exercise burned 67 percent more calories than resistance training."
Citation source: Aug. 25 issue of the American Journal of Physiology, as reported by HealthDay
September 21, 2011 - Reason #9 - Exercise Can Prevent Non-alcoholic Fatty Liver Disease (NAFLD) that Contributes Coronary Artery Disease
Graphic source: gut.bmj.com
Houston's Methodist Hospital researchers reported on 4/18:
"Because of the prevalence of obesity in our country, many Americans are expected to develop a serious condition called non-alcoholic fatty liver disease (NAFLD), which can lead to cirrhosis, fibrosis, and in some cases liver failure. It is also one of the best predictors for coronary artery disease.
... nearly 30 million Americans have NAFLD
Most people who have fatty liver disease are more likely to die from a heart attack than cirrhosis of the liver,
NAFLD is fat inside the liver cells. Alcohol, drugs, obesity, lipid disorders and diabetes can all be causes. However, many with this condition suffer from Metabolic Syndrome, a constellation of factors which include a large waist circumference (men greater than 40 inches, women greater than 35 inches), high blood pressure, high triglyceride levels and insulin resistance that heighten the risk of heart attack, stroke and type 2 diabetes.
Much like type 2 diabetes, it can be cured with diet and exercise.
Vigorous exercise, such as weight lifting, swimming, running or aerobics, between 75 and 150 minutes a week with a heart rate of 120 or above will help you tackle this problem,
If you lose 12 percent of your current weight, no matter how much you weigh, you can also eliminate fat from your liver.
Letting it go without evaluation can lead to liver disease, liver cancer, stroke, heart disease and a very difficult life.
According to an April 19th American Heart Association news release:
Healthy lifestyle changes can significantly lower elevated levels of triglycerides, a type of blood fat associated with heart disease and other health problems,
About one-third (31 percent) of adults in the United States have elevated triglyceride levels, defined as more than 150 milligrams per deciliter (mg/dL).
Clinically, new guidelines recommend lowering optimal triglyceride levels to less than 100 mg/dL and using non-fasting triglyceride testing as an initial screen.
These levels can be lowered 20 percent to 50 percent by replacing unhealthy saturated fats with healthy unsaturated dietary fats, being physically active and losing excess weight,
...high triglycerides are often quite responsive to lifestyle measures that include weight loss if overweight, changes in diet and regular physical activity,
recommended dietary changes for people with high triglyceride levels, this includes limiting:
added sugar to less than 5 to 10 percent of calories consumed, or about 100 calories per day for women and 150 calories for men [AHA recommends drinking no more than 36 ounces of sugar-sweetened beverages a week]
trans fat to less than 1 percent of total calories
fructose from both processed and natural foods to less than 50 to 100 grams per day
Adults with elevated triglyceride levels should do moderate-intensity physical activity (such as brisk walking) for at least 150 minutes per week.
Citation source: American Heart Association, news release, April 18, 2011, as reported in HealthDay
September 19, 2011 - The Growing Reality of Poverty in the U.S.
In Sunday's New York Times article,"The Impoverished States of America" (9/17/2011) two editors released this graphic to convey the enormity of poverty in the U.S.
Keep in mind that the way the statistics are presented may be confusing. For example, the state graphics should not be interpreted as representing impoverished states. Those who created these graphics probably wanted to highlight the number of people in each sub-population affected as equivalent to the population of a particular state.
Thus, the number of girls/women who are living in poverty (25.2 million) is greater than the population of Texas, and the number of women who are unemployed (6.6 million) is greater than the population of Arizona.
Regardless, growing poverty and unemployment are impacting the Public's health. For example, people who are unemployed and cannot find work are dealing with the stress by not exercising and overeating, thus contributing to the growing obesity epidemic, which is fueling the rise of type 2 diabetes and cardiovascular disease.
As a result of unemployment, many lost their employment-based health insurance and cannot afford to buy health coverage so health issues are being neglected or not properly managed, thus resulting in worsening or exacerbations of chronic disease conditions. All this compromises quality of life.
Women should get at least 150 minutes of physical activity each week to help reduce their risk of developing type 2 diabetes.
Just one out of four women at high risk for diabetes reported getting at least 150 minutes of physical activity each week, compared to one out of three women not in a high-risk group.
Getting regular physical activity is important to good health, including managing weight and reducing the risk of type 2 diabetes and heart disease.
Adults should get at least 150 minutes each week of moderate physical activity, such as brisk walking, light yard work or casual biking.
...getting at least 150 minutes per week of moderate physical activity and losing 5% to 7% of body weight (10 to 14 pounds for a 200-pound person) can reduce the risk of developing type 2 diabetes by 58% in people at high risk of the disease.
For women with more than a high school education, those at high risk for type 2 diabetes were significantly less likely to get enough physical activity than women not at high risk.
Both poor women and high-income women at risk for type 2 diabetes were significantly less likely to get enough physical activity each week than women from the same economic groups who weren't at risk.
On July 20th the American Journal of Cardiology reported:
Walking, jogging, and cycling may be key in the battle against metabolic syndrome, whereas weight lifting doesn't help on its own
...aerobic exercise yielded greater benefits for weight, waist circumference, triglycerides, and overall metabolic syndrome score, with significant benefits on all counts for the combination of aerobics and weights.
From a practical perspective, though, doing both types of exercise wasn't significantly more effective than aerobics alone,
...aerobic training alone was the most efficient mode of exercise for improving cardiometabolic health,"
Citation source: Resistance Exercise in Individuals With and Without Cardiovascular Disease: 2007 Update : A Scientific Statement From the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism; http://www.medpagetoday.com/Cardiology/MetabolicSyndrome/27650
"There are two main types of exercise, anaerobic and aerobic exercise.
Anaerobic exercise involves lifting weights or using exercise bands. Activity usually lasts for a shorter duration and involves intense activity done in short bursts. Anaerobic exercise is commonly known as resistance training and the goal is to build muscle and increase strength
"Research has proven that weight lifting (anaerobic exercise) may benefit people with diabetes. This type of exercise is known as resistance training.
Aerobic exercise works the large muscle groups in the arms and legs. Examples of this include: jogging, brisk walking, swimming, biking, dancing, biking and rowing. Aerobic exercise gradually increases the heart and breathing rates.
Aerobic exercise is usually recommended for most diabetic patients because of the proven benefits to the cardiovascular system (heart, lungs, and blood vessels).
September is National Childhood Obesity Awareness Month
"Childhood obesity is a major public health problem. In the US, 17% of children are obese, and certain groups of children are even more severely affected by this problem. Nearly 27% of Mexican-American boys are obese, and nearly 30% of non-Hispanic black girls are obese.
There is no single or simple solution to childhood obesity. It is influenced by many different factors, including a lack of access to healthy food and drinks as well as limited opportunities for physical activity in the places where children live, play and learn. Working together, states, communities, and parents can help make the healthy choice the easy choice for children and adolescents." (Source: 9/7/2011 Healthy People, Healthy Places Newsletter)
Public Health hasn't been this "exciting" in Hollywood circles since....the "Rise of the Planet of the Apes" (still playing in the theaters) which deals with genetic experiments gone awry. That film's final rolling credits probably set the stage for "Contagion." (For more about genetic experiments gone awry, check out "Splice.") While movie critics are viewing this film as the new "Outbreak" for the 21st century, there have been other movies referencing Public Health.
Have you seen Elia Kazan's 1950 "Panic in the Streets" about a killer infected with the pneumonic plague and goes on to threaten New Orleans with an epidemic? The film went on to win an Oscar for writing. Or, how about 1978's "Invasion of the Body Snatchers" (which was a remake of 1956 film of the same name), in which a San Francisco health inspector and friend discover funny happenings in the course of his daily work? Sleeping has never been the same.
Or, more recently, the "28 Days/Weeks/Months Later" sci-fi films about a mysterious, incurable virus that spreads throughout the UK and then to the world and the extremes taken to contain the virus. So, this film is nothing really new. For the true cinephiles, the most interesting tidbit about this film is the reunion of the "Talented Mr. Ripley" cast (for those who play movie trivia).
And, of course, this does not include the dozens of movies about AIDS/HIV, of which the best, at least to me, is Darrell Roodt's 2004 "Yesterday" film which shows how AIDs affects the life of an African woman (named Yesterday), and her family - heartbreaking.
Well, Public Health doesn't need Hollywood to make the work of public health professionals exciting but it's nice that it is getting some exposure about the importance of Public Health in our daily lives. Many times the work of Public Health is taken for granted, and only when something goes terribly wrong do we then become aware of how vital Public Health is for protecting the lives of everyone (e.g., recent devastation of U.S. eastern states from the VA earthquake and Hurricane Irene).