The recently released 2014 U.S. Centers for Disease Control and Prevention (CDC) self-reported obesity maps illustrate a less than healthy picture, especially for the Midwest, which at 30.7 percent had the highest prevalence of obesity in the nation.
The maps show also that:
• No state had a prevalence of obesity less than 20 percent.
• Five states and the District of Columbia had a prevalence of obesity between 20 percent and less than 25 percent.
• Nearly half (23) states, Guam and Puerto Rico had a prevalence of obesity between 25 percent and less than 30 percent.
• Nineteen states, including Missouri at 30.2 percent, had a prevalence of obesity between 30 percent and less than 35 percent.
• Three states (Arkansas, Mississippi and West Virginia) had a prevalence of obesity of 35 percent or greater.
• After the Midwest, the regions with the highest prevalence of obesity were the South (30.6 percent), the Northeast (27.3 percent) and the West (25.7 percent).
To view the maps, visit cdc.gov/obesity/data/prevalence-maps.html.
Natural sleep aid
Before reaching for the sleeping pills, adults who struggle to get a good night’s sleep might want to first try something entirely natural, like a walk in the park.
University of Illinois researchers found that men as well as all people aged 65 and older who have access to natural surroundings report better sleep than those who do not.
Professor Diana Grigsby-Toussaint worked with scientists from the University of Illinois and the New York School of Medicine to analyze data on more than 250,000 adults who responded to a U.S. Centers for Disease Control and Prevention survey, looking for a connection between days of insufficient sleep and access to green space.
Asked about sleep quality in the previous month, respondents most commonly reported less than one week of poor sleep. However, those who reported they had experienced insufficient sleep 21-29 days in the previous month consistently had lower odds of access to green space and natural surroundings than those who slept poorly for less than a week.
Interestingly, the relationship between access to green space and good sleep was much stronger among men than women, although nature appeared to serve as a sleep aid for women older than 65.
Speculating on the findings, Grigsby-Toussaint said living near green space encourages higher levels of physical activity. She surmised that women may take less advantage of natural amenities due to safety concerns but said more research is needed.
“If there is a way for persons over 65 to spend time in nature, it would improve the quality of their sleep – and the quality of their life – if they did so,” she concluded. “And specifically, our results provide an incentive for nursing homes and communities with many retired residents to design buildings with more lighting, create nature trails and dedicated garden spaces, and provide safe outdoor areas that encourage outdoor activity for men and women.”
The study was published in Preventive Medicine.
Most people will be victims of at least one diagnostic error – an inaccurate or delayed medical diagnosis – a report commissioned by the federal government warns.
According to information released last month by the Institute of Medicine (IOM), the study found that while accurate diagnosis is key to quality healthcare, efforts to reduce diagnostic errors have been limited, and changes are needed.
National Academy of Medicine President Victor J. Dzau called the report “a serious wake-up call” and said diagnostic errors “are a significant contributor to patient harm.”
John Ball, chairman of the committee that did the study, said the problem is complex because so many people can be involved in a patient’s diagnostic process.
“The stereotype of a single physician contemplating a patient case and discerning a diagnosis is not always accurate, and a diagnostic error is not always human error,” he said. “Therefore, to make the changes necessary to reduce diagnostic errors in our healthcare system, we have to look more broadly at improving the entire process of how a diagnosis is made.”
Acknowledging that there is no easy fix to the problem, the IMO called for more effective teamwork among healthcare workers, patients and their families, calling patients and families “critical partners” in improving diagnoses.
To help patients more effectively participate in the diagnostic process, the report includes a “Checklist for Getting the Right Diagnosis” that gives patients advice on how to tell their story well, be a good historian, keep good records, be an informed consumer, take charge of managing their healthcare, follow up with clinicians and encourage clinicians to consider other potential explanations for their illness.
For more information, visit national-academies.org.
Time to eat
Recently implemented federal guidelines improved the nutritional quality of school lunches, but limited time at the lunch table is keeping some kids from eating healthfully.
Harvard School of Public Health researchers found that students given fewer than 20 minutes to eat lunch ate significantly less of their entrees, milk and vegetables than those with more time.
“We were surprised by some of the results because I expected that with less time, children may quickly eat their entrée and drink their milk but throw away all of their fruits and vegetables,” study author Eric Rimm said. “Not so; we found they got a start on everything, but couldn’t come close to finishing with less time to eat.”
Noting that schools might not be able to lengthen lunch periods, the researchers suggested that school administrators look for ways to move students more quickly through the lunch line, such as adding another line or implementing an automated checkout system.
Coffee and the clock
A jolt of caffeine a few hours before turning in for the night will turn back the body’s clock about one hour, according to new research.
University of Colorado scientists studied the effects of caffeine on five people who lived for 49 days in a lab with no clock and no knowledge of outdoor light to indicate the time of day.
Some participants were given the equivalent of a double espresso and others were given a placebo three hours before going to sleep. Researchers checked levels of the hormone melatonin for all participants because a rise in melatonin causes sleepiness.
Melatonin levels rose about 40 minutes later in participants who drank the espressos than in those who were given placebos.
Researcher Dr. John O’Neill said while the effect of coffee on sleep was established a long time ago, until now, caffeine’s impact on the body clock was a mystery.
“Our findings also provide a more complete explanation for why it’s harder for some people to sleep if they’ve had a coffee in the evening – because their internal clockwork thinks that they’re an hour further west,” O’Neill said.
Researchers noted that the body clock, or circadian rhythm, operates in every cell in the body, allowing us to adapt to the cycle of night and day. Disruption of the body clock is caused by shift work, jet lag and other factors and can increase the risk of some cancers, heart disease, type 2 diabetes and some neurodegenerative disorders.
A recent article in the New England Journal of Medicine offers important tips for everyone who flies.
Noting there is no way for airlines to prepare for every medical contingency, William J. Brady, M.D., author of the article, said travelers need to think ahead and use good judgment.
“If you’re not feeling well, if you’re ill, if you’re just getting over an illness, if you’re just developing an illness, if you’ve been injured on the way to the airport or recently, if you’ve just had surgery, in situations like that you need to realize that you’re going up in an environment that can be compromising medically,” Brady said. “Be smart. If you just had surgery, you probably shouldn’t be flying unless you just have to be flying and have medical approval. If you are developing a high fever and a cough and you’re scheduled to fly somewhere, don’t do that. You’re putting yourself and potentially others near you at risk. Don’t get on an aircraft and have a bad event occur just because you’re in a rush to get somewhere.”
More smoke, more gain
Heavy smokers and obese smokers who kick the habit are likely to pack on more pounds than lighter and lighter-weight smokers who give up cigarettes.
A study at Penn State College of Medicine looked at data on more than 12,000 people, looking at individuals’ smoking habits and body mass index before they quit smoking and their weight change over a 10-year period.
The study found that for those who smoked fewer than 15 cigarettes a day, there was no measurable difference in the 10-year weight gain between those who quit and those who did not. However, people who smoked 25 or more cigarettes per day gained about 23 pounds in the 10 years after quitting, and people who were obese before giving up cigarettes gained an average of 16 pounds. (Total average weight gain for all participants actually was greater than the reported numbers because the study took into account the fact that everyone tends to gain weight over time.)
Susan Veldheer, lead author of the study, said the findings are good news for light to moderate smokers who want to quit but are concerned about gaining weight.
“It means that in the long term, quitting smoking will not make that big of an impact on their weight,” she said.
And while gaining upwards of 15 pounds might deter some smokers from quitting, Veldheer noted that quitting smoking is the “single most important thing” smokers can do for their health.
“That being said, for heavy smokers and obese smokers, it may be a good idea to work on quitting smoking while also making other healthy lifestyle changes to control their weight,” she said.