Exercise, diet habits improving among youth: study

By Genevra Pittman

NEW YORK (Reuters Health) - Over the last decade, U.S. kids and teenagers have started getting slightly more exercise and reduced their television watching, a new study suggests.

Using surveys conducted in middle and high schools, researchers also found increases in the number of days youth reported having breakfast each week and in how often they ate fruits and vegetables. Those trends have corresponded to a leveling off in obesity rates, but not a decline, the study showed.

"I would like to believe that all the public health efforts focusing on increasing physical activity and increasing fruit and vegetable consumption are having an effect, because that seems to be a pattern," Ronald Iannotti, the lead author on the study from the University of Massachusetts Boston, said.

"The fact that (obesity) is leveling off, that's a surprise and a major change from the steady increase that we've seen over time," Iannotti, who worked on the study while at the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland, said. "This is great news."

He and co-author Jing Wang analyzed surveys given to a nationally-representative sample of students in sixth through tenth grades in 2001-2002, 2005-2006 and 2009-2010 as part of the Health Behavior in School-aged Children study. Each survey period included responses from between 9,000 and 15,000 adolescents.

The researchers found "encouraging" trends on measures of most diet and lifestyle habits.

For example, the number of days each week that kids reported being physically active for at least 60 minutes increased from 4.3 in 2001-2002 to 4.5 in 2009-2010, with similar trends among boys and girls. Likewise, youth reported eating breakfast on three school days each week on the first survey and 3.3 days on the last.

The average number of hours students spent watching TV each day fell from 3.1 to 2.4, with drops in both weekday and weekend viewing.

Frequency of fruit and vegetable consumption also rose slightly over time - although it remained at less than one daily serving of each, on average - and consumption of sweets and soft drinks fell.

However, the proportion of survey participants who were overweight or obese, based on their own height and weight reports, did not decrease, the researchers wrote Monday in Pediatrics.

Rates of obesity - defined as body mass index, a measure of weight in relation to height, in the 95th percentile or higher - rose from 10.3 percent in 2001-2002 to 12.7 percent in 2005-2006, then held steady through the final survey.

"This is encouraging, because at least it looks like things have kind of stabilized, and at least they're not going in the wrong direction," Marian Huhman, who studies health communication and health campaigns at the University of Illinois at Urbana-Champaign, said.

"Maybe it just takes a few years for the outcomes of obesity changes to follow from the behavioral changes," she added.

Huhman, who wasn't involved in the study, pointed to the "effort on many, many fronts" that may have led to the positive changes in physical activity, sedentary behavior and diet - such as walk-to-school programs and campaigns targeting food marketing.

However, adolescents "are still largely not meeting the recommendations for amount of screen time, amount of physical activity (and) amount of fruit and vegetable consumption," she said.

Iannotti echoed that concern.

"Although they're increasing, the recommendation is five servings of fruits and vegetables per day. And we're looking at one or two," he told Reuters Health.

"There's still vast room for improvement."

SOURCE: http://bit.ly/cxXOG Pediatrics, online September 16, 2013.

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Exercise, vitamin D may prevent falls: guidelines

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NEW YORK (Reuters Health) - Older adults who are at high risk of falls should have physical therapy and take vitamin D supplements to reduce their chance of injury, according to new recommendations from a government-backed panel.

Falling is "a common problem and it's often overlooked because doctors may not be aware of their patients' fall risk," said Dr. Albert Siu, a professor at Mount Sinai School of Medicine in New York and vice co-chair of the U.S. Preventive Services Task Force (USPSTF), which came out with the recommendations on Monday.

"By asking about falls and by observing the patient in terms of walking, we might be able to asses who might be at risk and who can benefit from preventive measures," Siu told Reuters Health.

Falls are a leading cause of injury among older adults, he added.

According to the new guidelines, published in the Annals of Internal Medicine, 30 to 40 percent of people age 65 or older fall at least once each year, and five to 10 percent of them will have a serious injury such as a hip fracture.

The USPSTF makes recommendations on a range of prevention and treatment issues, and its guidelines on reducing the risk of falls in the elderly had not been updated since 1996.

There has been considerable research done since then on what seniors can do to prevent falls -- and what doesn't seem to work. For instance, correcting vision, wearing a shield called a hip protector, stopping some medications or taking protein supplements do not reduce the risk that someone will have a fall, according to the guidelines.

Vitamin D, exercise and physical therapy, however, are moderately beneficial, reducing the risk of falling by 13 to 17 percent (see Reuters Health report of December 21, 2010).

A 13 percent reduction in falls would mean that instead of 30 out of 100 older adults having a fall each year, that number would drop to 26.

In the USPSTF's review of the evidence on vitamin D, the panel found that to prevent one elderly person from falling, 10 would have to take vitamin D supplements.

Siu said the usual dose is 800 international units (IUs) per day, and studies suggest people should take vitamin D for one year to see any benefit.

For exercise or physical therapy, one person would be spared a fall among every 16 people who participate in a program for 12 weeks.

Siu said there's not one particular exercise regimen that works best for preventing falls, and that people should talk to their doctors about finding an exercise or physical therapy program they'll stick to over the long run.

"I know from experience, if you recommend something someone had very little interest in, it's not going to get done," he said.

Siu said doctors can pick out patients who are at a higher risk of falling by informal assessments, such as watching how steady they are on their feet and asking them whether they've had a fall recently.

Physicians can also use a more formal test that includes timing how quickly people can get up from a chair, walk a few paces and return to the same spot.

The USPSTF recommends against more detailed assessments of these higher risk patients, such as evaluating their balance and if their homes have tripping hazards.

There seems to be only a minor benefit from doing an in-depth examination of risks and how to manage them, according to Siu -- and such an undertaking should be reserved for just those patients that a doctor feels would truly benefit, rather than widely applied to all patients at risk of falling.

SOURCE: http://bit.ly/L9cPi0 Annals of Internal Medicine, May 28, 2012.

Exercise Controls Weight in White Girls Better Than in Black Girls: Study

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WEDNESDAY, June 6 (HealthDay News) -- Exercise appears less likely to prevent obesity among black teenage girls than their white peers, a new study shows.

British researchers who gauged the effect of exercise on more than 1,100 girls, aged 12 to 14, surmised that black teen girls may be less sensitive than white teen girls to the effects of physical activity to prevent obesity.

"Higher levels of physical activity were associated with lower risk of obesity among white girls but not among black girls," wrote study authors James White and Russell Jago.

This is of concern because obesity rates are increasing at a greater rate among black teen girls than other U.S. youths, putting them at greater risk for heart disease, according to background information in the study. Black American girls were 80 percent more likely than white girls to be overweight in 2007-2010, the U.S. Department of Health and Human Services' Office of Minority Health reported. And about four out of five black American women are overweight or obese.

"At present, we don't know whether these differences can be attributed to genetics," said White, a researcher at Cardiff University in Wales. While other studies have found black girls consume more calories than white girls, he said this study took those differences into account, suggesting there may be other reasons. "These may be genetic, but we don't really know," he said.

However, at least one expert believes the study results may reflect lifestyle differences, which can be addressed, not just genetics.

White and Jago, of the University of Bristol in England, evaluated data on girls who participated in the long-running National Heart, Lung, and Blood Institute Growth and Health Study.

The researchers were looking at factors associated with obesity and the development of heart disease risk factors.

For this study, published in the June issue of the Archives of Pediatric and Adolescent Medicine, the research team focused on 538 black girls and 610 white girls for whom they had data on physical activity, obesity and other measures.

The girls' overall level of physical activity was measured for three days with a device that could detect frequency of movement and speed. Their TV viewing hours, height, weight, body-mass index (BMI), percent of body fat and daily calorie intake were also recorded. BMI, a calculation based on height and weight, is a reference used to determine obesity.

At age 12, the activity levels were higher in white girls than in black girls. The black girls had a higher BMI and body fat percentage, and ate more calories daily. They also watched more TV: The median -- meaning half watched more, half watched less -- was 44.3 hours a week for black girls vs. 24.5 for white girls.

Median daily caloric intake was slightly higher for black girls -- 1,912 vs. 1,906 for white girls.

At 12 years of age, 14 percent of the black girls were obese, compared to 4.3 percent of the white girls. At 14 years, 15.6 percent of the black girls and 5.1 percent of the white girls were obese.

That no link was found between physical activity levels and obesity among black girls is consistent with other research showing that fat-burning rates in response to physical activity are lower in black girls during puberty and adulthood than in whites.

Lifestyle issues, rather than genetics, may partly explain the results, said Pete McCall, an exercise physiologist with the American Council on Exercise.

Noting that black girls watch much more TV than white girls, he said, "That would be one area to change." They could shut off the TV and get exercise, "but the neighborhood may not be conducive," he said.

Parent education and income might affect the results, too, McCall speculated. More than half the parents of white girls had a college degree, but fewer than one-quarter of the black girls' parents did. The incomes of white girls' parents were higher, too.

"College education and income levels [of the parents] can play a role in the amount of physical activity a person gets," he added.

The authors noted that the black girls began menstruating earlier than the whites, which could also influence weight gain.

Encouraging black teen girls to exercise is still important, but different approaches may be needed to prevent obesity in black girls, the authors said.

"Our findings require replication before any real recommendations can be made," White said. "They do, however, suggest that black girls should be particularly attentive in controlling their caloric intake."

More information

To learn more about obesity and black Americans, visit the U.S. Office of Minority Health.

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