Increase In Vision Impairment Linked To Higher Prevalence Of Diabetes

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Main Category: Eye Health / Blindness
Also Included In: Diabetes
Article Date: 12 Dec 2012 - 12:00 PST Current ratings for:
Increase In Vision Impairment Linked To Higher Prevalence Of Diabetes

Nonrefractive visual impairment, not due to needing glasses, has increased significantly among Americans in recent years, and the higher incidence of diabetes may be responsible.

The finding came from new research, conducted by a team at the Johns Hopkins University School of Medicine, Baltimore, and was published in JAMA, December 12 issue.

Background information in the report stated: "It is estimated that more than 14 million individuals in the United States aged 12 years and older are visually impaired (<20/40). Of these cases, 11 million are attributable to refractive error."

The most frequent reasons Americans experience nonrefractive visual impairment are:

Prior research has demonstrated that people with visual impairment often have diabetes. Since the eye is one of the main organs impacted by diabetes, patients can develop certain visual conditions.

"The prevalence of diagnosed diabetes has increased among adults in recent years, rising from 4.9 percent in 1990 to 6.5 percent in 1998, 7.9 percent in 2001, 10.7 percent in 2007, and 11.3 percent in 2010," the authors explained.

The researchers, led by Fang Ko, M.D., set out to evaluate the prevalence of nonrefractive visual impairment and the risk factors associated with the condition.

Data was gathered and analyzed from the National Health and Nutrition Examination Survey (NHANES), a representative sample of the American population.

Questionnaires, physical exams, and laboratory tests were given to 9,471 and 10,480 subjects aged 20 and older in 1999-2002 and 2005-2008 respectively.

Participants were considered to have nonrefractive visual impairment when their visual acuity was less than 20/40 when measured by an autorefractor - a tool which evaluates a person's refractive error.

Results showed that the prevalence of nonrefractive visual impairment increased 21%, from 1.4% in 1999-2002 to 1.7% in 2005-2008. They also found that non-Hispanic whites experienced a 40% increase, from 0.5% to 0.7%.

The factors that were linked to nonrefractive visual impairment included: povertyolder agelower education leveldiabetes diagnosed at least 10 years agoThe only risk factor that increased in prevalence between the 2 time periods analyzed was diabetes. The incidence of diabetes with more than 10 years since diagnosis increased 22% overall, from 2.8 percent to 3.6 percent. Among non-Hispanic whites aged 20-39, the prevalence of diabetes increased 133%, from 0.3% to 0.7%.

The researchers concluded:

"We report a previously unrecognized increase of visual impairment among U.S. adults that cannot be attributed to refractive error. If the current finding becomes a persisting trend, it could result in increasing rates of disability in the U.S. population, including greater numbers of patients with end-organ diabetic damage who would require ophthalmic care. These results have important implications for resource allocation in the debate of distribution of limited medical services and funding. Continued monitoring of visual disability and diabetes, as well as additional research addressing causes, prevention, and treatment, is warranted."

Written by Sarah Glynn
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our eye health / blindness section for the latest news on this subject. Prevalence of Nonrefractive Visual Impairment in US Adults and Associated Risk Factors, 1999-2002 and 2005-2008
Fang Ko, Susan Vitale, Chiu-Fang Chou, Mary Frances Cotch, Jinan Saaddine, David S. Friedman
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Brown Adipose Tissue Beneficial For Metabolism And Glucose Tolerance

Main Category: Diabetes
Also Included In: Obesity / Weight Loss / Fitness
Article Date: 12 Dec 2012 - 1:00 PST Current ratings for:
Brown Adipose Tissue Beneficial For Metabolism And Glucose Tolerance

Joslin Diabetes Center scientists have demonstrated that brown adipose tissue (BAT) has beneficial effects on glucose tolerance, body weight and metabolism. The findings, which may lead to new treatments for diabetes, appear in the upcoming issue of the Journal of Clinical Investigation.

Unlike the more prevalent white adipose tissue (WAT or white fat) which stores fat, BAT (or brown fat) burns fat to produce heat. Studies in mice and humans have suggested that BAT also plays a role in regulating body weight and metabolism. This has made BAT the focus of considerable interest among scientists and pharmaceutical companies who are investigating ways to use BAT as a treatment for obesity.

The Joslin researchers were interested in learning whether BAT is involved in glucose metabolism and uncovering the mechanisms underlying BAT's effects on metabolism and body weight. The study involved the transplantation of BAT from male donor mice into the visceral cavities of mice which were fed a standard or high-fat diet.

By eight to twelve weeks following transplantation, the BAT-transplanted mice fed a normal diet showed improved glucose tolerance, increased insulin sensitivity, lower body weights and decreased fat mass. Three control groups, which had a WAT transplant, a glass bead implant or surgery without transplantation, did not show any metabolic improvements. "We were able to establish that BAT transplantation affects metabolism. This study provides further evidence that BAT is a very important metabolic organ and a potential treatment for obesity-related diseases such as diabetes, metabolic syndrome and insulin resistance," says lead author Kristin I. Stanford, PhD, a postdoctoral fellow in the Section on Integrative Physiology and Metabolism.

The mice fed a high-fat diet also exhibited beneficial effects from BAT transplantation, including improved glucose metabolism, decreased body weight and a complete reversal of insulin resistance resulting from excess fat consumption. Previous studies of BAT transplantation in mice, which transplanted BAT in a different location and had a shorter duration, did not show beneficial effects.

The transplanted BAT affected metabolism throughout the body by increasing levels of circulating Interleukin-6 (IL-6). The researchers also found that BAT transplantation increased norepinephrine and FGF-21. IL-6 has been shown in previous studies to increase energy production and decrease body weight. When the researchers transplanted BAT from donor mice genetically engineered not to produce IL-6, the mice who received the transplants showed no metabolic improvements. "This is the first study to demonstrate that an increase in BAT significantly increases levels of circulating IL-6. It suggests that an increase in BAT-derived IL-6 improves glucose metabolism throughout the body," says senior author Laurie J. Goodyear, PhD, head of the Section on Integrative Physiology and Metabolism.

The researchers are following up on the study by "looking into other ways BAT may have beneficial metabolic effects and further investigating the functions of IL-6 and other BAT-derived hormones," says Dr. Goodyear. Dr. Stanford is studying the relationship between BAT and type 1 diabetes (T1D), based on data from a collaborator that suggests that BAT may help control glucose in T1D.

Dr. Goodyear and the research team are very interested in using their findings to develop new therapies for diabetes. "We hope that manipulating BAT will help people with type 1 and type 2 diabetes," says Dr. Goodyear.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our diabetes section for the latest news on this subject.
Study co-authors include: Roeland J. W. Middelbeek, Kristy L. Townsend, Ding An, Eva B. Nygaard, Kristen M. Hitchcox, Kathleen R. Markan, Kazuhiro Nakano, Michael F. Hirshman, Yu-Hua Tseng, all of Joslin Diabetes Center.

The study was funded by the National Institutes of Health.

Joslin Diabetes Center

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Blood Glucose Levels And BMI In Very Obese Children Improved By Metformin

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Diabetes;  Pediatrics / Children's Health
Article Date: 13 Dec 2012 - 0:00 PST Current ratings for:
Blood Glucose Levels And BMI In Very Obese Children Improved By Metformin

Metformin therapy has a beneficial treatment effect over placebo in improving body mass index (BMI) and fasting glucose levels in obese children, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). The study showed reduction in BMI was sustained for six months.

Childhood obesity has increased globally over the last two decades and it is linked to an increase in the diagnosis of type 2 diabetes in childhood, previously a condition that was only diagnosed in adults. Metformin is a first line drug for type 2 diabetes, and has been used for many decades. In adults metformin delays the onset of type 2 diabetes, but there is no evidence that the drug has a similar effect on children.

"Our findings provide evidence that a treatment course of metformin is clinically useful, safe and well-tolerated in obese children who are at risk for type 2 diabetes," said Deborah Kendall, MD, of Royal Manchester Children's Hospital in the United Kingdom and lead author of the study. "Metformin may also provide stimulus for lifestyle changes and potentially reduce long-term risk for type 2 diabetes and its associated health problems."

This prospective, randomized, double-blind, placebo-controlled trial was conducted at six pediatric endocrine centers in the United Kingdom and involved 151 obese children and young people with hyperinsulinemia and/or impaired fasting glucose or impaired glucose tolerance. Study participants received either metformin or placebo daily for six months. This trial is the largest of its kind to focus on metformin in obese non-diabetic children and young people.

"Our results show that metformin can improve BMI and blood glucose levels in obese children, but longer term effects such as reduction in the incidence of type 2 diabetes need further study," noted Kendall.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject.
Other researchers working on the study include: R. Amin, F. Ivison, A. McGovern, L. Tetlow, P. Clayton and C. Hall of Royal Manchester Children's Hospital; T. Barrett of Birmingham Children's Hospital, UK; P. Dimitri, J. Wales and N. Wright of the University of Sheffield, UK; M. Kibirige of The James Cook University Hospital, UK; V. Mathew of Hull Royal Infirmary, UK; K. Matyka and H. Stirling of University Hospital Coventry and Warwickshire National Health Service Trust, UK; and A. Vail of the Centre of Biostatistics, UK.

The article, "Metformin in Obese Children and Adolescents: The MOCA Trial," appears in the January 2013 issue of JCEM.

The Endocrine Society

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Body's Food Clock Upset By Holiday Overindulgence

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Main Category: Nutrition / Diet
Also Included In: Obesity / Weight Loss / Fitness;  Diabetes
Article Date: 27 Dec 2012 - 2:00 PST Current ratings for:
Body's Food Clock Upset By Holiday Overindulgence

Overindulgence during this feasting season can play havoc with the human body's food clock, researchers from the University of California, San Francisco reported in PNAS (Proceedings of the National Academy of Sciences).

Overeating, changing sleeping patterns, and significant changes in eating habits over the holiday period can upset the body's "food clock", a collection of genes and molecules that interact with one another and keep the human body on a metabolic even keel. The UCSF scientists inform that their new study helps reveal how this clock functions on a molecular level.

If our eating habits change, PKCy, a protein, is crucial in resetting the food clock.

Louis Ptacek, MD. and team showed that lab mice which were given food during their sleeping hours will eventually adapt their food clock and start waking up at the "sleep time feeding time", and run around in anticipation of food. However, mice which do not have the PKCy gene never adapt, and continue sleeping right through their sleep-time meal.

A desynchronized food clock may be associated with the pathology underling certain diseases and disorders, such as metabolic syndrome, diabetes and obesity, the authors explain. They added that their study has implications for understand the molecular bases for such conditions.

Dr. Ptacek wrote that this may also explain why obesity is more common among "night-owls" than "morning larks".

Dr. Ptacek added:

"Understanding the molecular mechanism of how eating at the "wrong" time of the day desynchronizes the clocks in our body can facilitate the development of better treatments for disorders associated with night-eating syndrome, shift work and jet lag."

Biological clocks are as complicated as mechanical clocks. Behind a mechanical clock one can find flywheels, cogs, reciprocating counterbalances and several other moving parts. Biological clocks consist of many interacting genes that switch on or off in an orchestrated way to keep time during each 24-hour period.

In the majority of living beings, biological clockworks depend on the circadian oscillator (a master clock) which keeps track of time and coordinates the body's biological processes with the rhythm of a 24-hour day and night cycle.

Master clocks exist in most life forms, including mustard greens, mice and humans. Over the last ten years, scientists have discovered many of their inner workings, and identified several genes whose cycles are linked to the clock. They have discovered how in mammals, our circadian rhythms are controlled by a tiny sport in the brain, called the "superchiasmatic nucleus".

The researchers know that apart from the master clock, human bodies have other clocks which operate in parallel throughout the day. The food clock is one of these - it is not tied to one specific spot in the brain, but rather several sites in different parts of the body.

The food clock helps our bodies make the most of what we eat. It regulates the genes that are involved in everything, from absorbing nutrients in our intestines to their dispersal in the bloodstream. Our food clock is designed to anticipate our eating patterns.

Even before we start a meal, our bodies start turning on some of these genes and switching others off, in preparation for a burst of nutrition. This is why we get bouts of hunger as our eating times approach.

Experts have known that if our eating patterns change, our food clock can be reset. If we eat at odd times or to excess, the food clock adapts. However, it was not until very recently that scientists understood how the food clock operated on a genetic level.

Dr. Ptacek and team discovered how the food clocks work at a molecular level. PKCY binds to BMAL, another molecule, and stabilizes it, resulting in a shift in the clocks timing.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our nutrition / diet section for the latest news on this subject. “PKC? participates in food entrainment by regulating BMAL1”
Luoying Zhang, Diya Abrahama, Shu-Ting Lin, Henrik Oster, Gregor Eichele, Ying-Hui Fu, and Louis J. Ptácek PNAS December, 2012 vol. 109 no. 50 20679-20684. doi: 10.1073/pnas.1218699110 Please use one of the following formats to cite this article in your essay, paper or report:

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posted by Frankie Obrien on 28 Dec 2012 at 1:23 pm

This concept complicates the issue of eating-when and how much. It sidesteps the subject of hunger as a trigger- physical hunger that is instinctual to human beings. In general, this sounds like someone wants to find a reason other than the truth.

Other factors are the true culprits of weight gain or "out of balance appetite", unless there is a thyroid problem or other medical reason for excessive eating. Anyway, so what if a person eats a bit excessively around the holidays? As long as the excessive eating doesn't become a regular routine, one can recover from those extra calories easily.

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'Body's Food Clock Upset By Holiday Overindulgence'

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Cholesterol Helps Regulate Key Signaling Proteins In The Cell

Main Category: Cholesterol
Also Included In: Biology / Biochemistry
Article Date: 30 Dec 2012 - 0:00 PST Current ratings for:
Cholesterol Helps Regulate Key Signaling Proteins In The Cell

Cholesterol plays a key role in regulating proteins involved in cell signaling and may be important to many other cell processes, an international team of researchers has found.

The results of their study are reported in the journal Nature Communications.

Cholesterol's role in heart disease has given it a bad reputation. But inside the thin membrane of a cell, the tight regulation of cholesterol at high levels (30 to 40 percent) suggests that it plays an important role in cellular processes, says Wonhwa Cho, professor of chemistry at the University of Illinois at Chicago and principal investigator on the study.

Cho and colleagues had previously found evidence that cholesterol was directly interacting with many proteins found in the interior of the cell. The interaction seemed necessary for the proper functioning of these proteins.

"This was quite a surprising finding," said Cho, because cholesterol resides within the membrane, sandwiched between its inner and outer face. Cell biologists had thought it could only interact with other biomolecules within the membrane.

In the new study, Cho and his colleagues showed how cholesterol interacts with a scaffolding protein, one of a class of proteins that plays an important role in cell signaling. The researchers showed that cholesterol binds to a region on the protein molecule where one of its signaling partners also binds -- and that disrupting cholesterol binding to the protein makes it unable to activate its partner.

The researchers describe in detail how the protein hooks onto and reaches inside the membrane to find and bind cholesterol.

Cho believes that this strategy for interacting with cholesterol may be used by many interior cellular proteins and offers an insight into what is known about the importance of cholesterol to well-functioning cells.

Much of the existing data on the cholesterol-related regulation of cellular processes had been difficult to interpret, he said.

"This is a major finding that will help people understand how cholesterol may regulate other cellular processes," Cho said.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cholesterol section for the latest news on this subject. Ren Sheng, graduate student in chemistry at UIC, was first author of the paper. Other authors are Yong Chen, Ewa Stec, Heather Melowic, Nichole Blatner and Moe Tun, all of the UIC chemistry department; Morten Kallberg and Hui Lu of the UIC bioengineering department; Heon Yung Gee, Yonjung Kim and Min Goo Lee of the Yonse University College of Medicine in Seoul; Takahiro Fujiwara and Akhiro Kusumi of Kyoto University in Japan; and Ji Hye Hong and Kwang Pyo Kim of Konkuk University in Seoul.

This study was supported by the Chicago Biomedical Consortium with the support of the Searle Funds at the Chicago Community Trust; National Institutes of Health grant GM68849; the World Class University program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology; and a grant from the National Project for Personalized Medicine, part of the Korea Health 21 R&D Project of the Korean Ministry of Health and Welfare.

University of Illinois at Chicago

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Good Response From Pre-Diabetic Patients For Self-Directed Lifestyle Interventions

Main Category: Diabetes
Also Included In: Obesity / Weight Loss / Fitness;  Primary Care / General Practice
Article Date: 12 Dec 2012 - 1:00 PST Current ratings for:
Good Response From Pre-Diabetic Patients For Self-Directed Lifestyle Interventions

Efforts to help overweight patients avoid diabetes through lifestyle changes need not rely on intensive, one-on-one focused programs, a new clinical study from the Stanford University School of Medicine and the Palo Alto Medical Foundation Research Institute has found.

The study, published in the Archives of Internal Medicine, opens up a practical way for primary care physicians to help their patients at high risk for developing diabetes.

Researchers have known for 10 years that intensive intervention programs led by lifestyle coaches to encourage weight loss through healthier diet and exercise help reduce type-2 diabetes incidence. The Diabetes Prevention Program clinical research study, the results of which were published in 2002, found this strategy led to a 58 percent decrease in the incidence of type-2 diabetes, a result that surpassed the benefit of drug treatment.

The new study - headed by Jun Ma, MD, PhD, an associate investigator at the research institute and an affiliate member of the Stanford Prevention Research Center - builds off the DPP's strategy but makes full use of online resources and, in one group, a take-home DVD. If implemented, the new interventions could increase the accessibility and reach of existing educational, coach-based diabetes prevention programs, and free up time for primary care doctors, who are often frustrated with high patient loads that prevent them from providing the individualized care these patients need.

"The big issue in diabetes prevention is how to take what clearly worked for DPP - which was very intensive and one-on-one focused - and get it to the point where it could be established as a program in large group practices," said Randall Stafford, MD, PhD, professor of medicine at the Stanford Prevention Research Center and a senior investigator on the study.

Diabetes currently affects 25.8 million people in the United States, or 8.3 percent of the population. The disease is a major cause of heart disease and stroke, and is the leading cause of kidney failure, nontraumatic lower-limb amputation and new cases of blindness among adults. In 2007, diabetes-related medical costs in the United States were estimated at $174 billion. Effective health interventions that reach a maximum amount of pre-diabetic patients - those at the highest risk for developing diabetes - are urgently needed to curb the burden of the disease.

What the DPP sported in effectiveness, it lacked in its ability to broadly reach patients at the level of primary care. In the new study, Ma and Stafford set out to determine whether restructuring the DPP to take advantage of online connectivity and health monitoring could be achieved without sacrificing the benefits seen in the original program.

Pre-diabetic patients were recruited from Palo Alto Medical Foundation and randomized into three groups: a coach-led group intervention, a self-directed DVD intervention or usual care. In addition to offering practical ways to start eating healthier foods and exercising more, the curriculum in both the coach-led and DVD-based interventions also focused on the mental and behavioral strategies necessary to make the changes stick. This lifestyle instruction was delivered over a three-month intensive intervention phase.

Following the first three months of intervention, the participants regularly received encouraging messages to help them follow through with what they had learned in the initial intervention phase. During this 12-month maintenance phase, participants received supportive emails within an electronic health-record system, and monitored their health goals through the publicly available American Heart Association's Heart360 website. The primary outcome tested in the study was a change in body mass index (a calculation based on a person's height and weight), although other factors, including weight loss, waist circumference, blood pressure and blood glucose, were also measured.

The results show that participants responded to both the coach-led and self-directed interventions, although the coach-led group fared slightly better. At the beginning of the study, the participants had an average BMI of 32; a BMI of 30 or more is considered obese. After the 15-month trial, the average drop in BMI was 2.2 for the coach-led group, 1.6 for the self-directed group and 0.9 for the group that received usual care. The average weight loss was 13.9 pounds for the coach-led group, 9.9 pounds for the self-directed group and 5.3 pounds for usual care. Both interventions also led to a dip in waistline circumference as compared to the usual-care group.

Though the study was too small to generate statistically significant findings along gender lines, they turned up a hint of a gender difference: While men responded with equal success to both the coach-led and self-directed interventions, women responded better to the coach-led approach.

Stafford points out that the suggested differences between genders highlights the need for options when it comes to lifestyle interventions. "It suggests that a one-size-fits-all program isn't necessarily what we need. We need some way to offer people different styles of intervention," said Stafford.

Narrow demographics were a primary limitation of the study. Participants were all from a single clinic in Silicon Valley, and a large majority were white (78 percent), college-educated (97 percent) and earned more than $75,000 per year (88 percent). Stafford acknowledged the limited demographics of the study, but said he hopes that similar lifestyle interventions will work in more diverse populations. His group is currently conducting a National Institutes of Health-funded study testing the effectiveness of weight-loss interventions in a low-income, Latino population.

If implemented, the approaches - especially the self-directed DVD - could extend the reach and lower the cost of lifestyle intervention programs. In addition to the cost-benefit of the intervention programs themselves, the real savings will come from diabetes prevention. "Diabetes is an expensive disease to treat and its complications are both personally devastating and societally costly," said Stafford. If patients respond to self-directed programs by losing a modest amount of weight, this could be enough to prevent or significantly delay the onset of type-2 diabetes in high-risk populations, ultimately reducing the burden of this chronic disease.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our diabetes section for the latest news on this subject.
Other Stanford co-authors were instructors Veronica Yank, MD, and Lisa Rosas, PhD. They also collaborated with other researchers at the Palo Alto Medical Foundation Research Institute.

The study was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the American Heart Association, as well as internal funding from the Palo Alto Medical Foundation Research Institute.

Stanford University Medical Center

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'Good Response From Pre-Diabetic Patients For Self-Directed Lifestyle Interventions'

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In The Battle Against Heart Disease, Stroke, Unhealthy Behaviors Could Slow Progress

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Stroke;  Heart Disease;  Public Health
Article Date: 17 Dec 2012 - 0:00 PST Current ratings for:
In The Battle Against Heart Disease, Stroke, Unhealthy Behaviors Could Slow Progress

Poor eating and exercise habits could be the game-changer in the fight against heart disease and stroke deaths, according to the American Heart Association's "Heart Disease and Stroke Statistical Update 2013," published in the American Heart Association journal, Circulation.

"Americans need to move a lot more, eat healthier and less, and manage risk factors as soon as they develop," said Alan S. Go, M.D., chairman of the report's writing committee and chief of the Cardiovascular and Metabolic Conditions Section of the Kaiser Permanente Northern California Division of Research in Oakland. "If not, we'll quickly lose the momentum we've gained in reducing heart attack and stroke rates and improving survival over the last few decades."

Between 1999 and 2009, the rate of deaths from cardiovascular disease (CVD) fell 32.7 percent, but still accounted for nearly one in three deaths in the nation. That's 2,150 people dying from CVD each day - about one death every 40 seconds.

In 2010, the American Heart Association set a goal to improve cardiovascular health of all Americans by 20 percent and reduce heart disease and stroke deaths 20 percent by 2020.

However, according to projections in the 2013 report, heart health may only improve by 6 percent if current trends continue. The biggest barriers to success are projected increases in obesity and diabetes, and only modest improvements in diet and physical activity. On a positive note, smoking, high cholesterol and high blood pressure rates are projected to decline.

Among heart disease and stroke risk factors, the most recent data shows: More adults age 20 and over are obese (34.6 percent) than normal or underweight (31.8 percent); 68.2 percent are overweight or obese. Among children ages 2-19, 31.8 percent are overweight or obese. Thirty-two percent of adults report no aerobic activity; 17.7 percent of girls and 10 percent of boys, grades 9-12, report fewer than an hour of aerobic activity in the past week. 13.8 percent of adults have total cholesterol of 240 mg/dL or higher. Thirty-three percent of adults have high blood pressure; African-Americans have among the highest prevalence of high blood pressure (44 percent) worldwide. 8.3 percent of adults have diagnosed diabetes, and 8.2 percent have undiagnosed diabetes; 38.2 percent have prediabetes. Despite four decades of improvement, 21.3 percent of men and 16.7 percent of women age 18 and over still smoke cigarettes; 18.1 percent of students in grades 9-12 report cigarette smoking.

"As the leader in the fight against heart disease and stroke, we are taking a more aggressive and innovative approach, including taking some pages from the playbooks of the public health sector," said Donna Arnett, Ph.D., president of the American Heart Association and chairperson of the Department of Epidemiology at the University of Alabama at Birmingham School of Public Health. "We're focusing on population-based ways to improve health factors for all Americans."

Some of these include: Working with healthcare systems to support and reward providers who help patients improve their health behaviors and manage their health risk factors. Working with insurers to cover preventive health services and reward positive health behaviors and medication adherence. Working with the education community to make changes in schools that support healthy diets and physical activity for children. Building comprehensive worksite wellness programs. Building healthier communities with improved access to healthier foods and green space for physical activity. The association has a wide range of programs and policy initiatives aimed at improving cardiovascular health through risk factor prevention and health care quality, Arnett said. Information on improving your heart health can be found at http://www.MyHeartMyLife.org.

"In this race against time, it will take nationwide efforts driven by communities and systems - a patient-by-patient approach alone won't do it," Arnett said. "But we're optimistic that if we increase our efforts for improvements in prevention and reductions in risk factors, we can be successful - we can save lives."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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