The University of Rhode Island’s Department of Kinesiology and Department of Nutrition and Food Sciences are looking for 30 volunteers to take part in a 10-week study on weight loss and physical activity.Overweight adults ages 60 to 75 are sought for the study, which will look at the effect of weight loss and physical activity on an individual’s physical function and heart risk factors. The U.S. Department of Agriculture has provided $100,000 for the URI Dietary Education and Active Lifestyle (UR-IDEAL) Study, being conducted at URI by Matthew Delmonico, assistant professor of kinesiology, and Ingrid E. Lofgren, assistant professor of food science and nutrition.

Candidates may qualify if they are overweight or obese, are not involved in a regular exercise program, and have remained within 10 pounds of their weight over the last four months. They must also attend regular meetings and physical activity sessions on the URI Kingston campus.

The weight-loss program will include nutritional counseling, while half of the participants will be randomly selected to participate in supervised resistance training. Participants will also undergo mild physical testing involving such activities as a 400-meter walk around a track, and will be tested for cholesterol, glucose and insulin levels, DNA analysis, muscle strength, physical functioning and body composition.

For more information, phone (401) 874-4956 or e-mail urideal@etal.uri.edu

(c) 2008 Providence Journal. Provided by ProQuest Information and Learning. All rights Reserved.

By Abram KatzRegister Science Editor

Chocolate is great stuff.

Aside from its captivating flavor, it seems to increase blood flow to the heart and brain, protects the body against damaging metabolic products and helps protect pregnant women against a potentially lethal condition called pre-eclamsia.

But before you stock up on chocolate bars, chocolate chip cookies, chocolate cake, chocolate ice cream, chocolate-covered strawberries, chocolate-encased cherries, Kisses and M&Ms, keep one important fact in mind.

What we call chocolate is only palatable because it contains a hefty percentage of sugar and cocoa fat.

Unadorned chocolate looks innocent, but is fantastically bitter.

So, you can eat all of the unsweetened chocolate you want, you just can’t eat the sweet variety unless you’re under doctor’s orders to gain weight and boost triglycerides and cholesterol.

Pity.

It’s not clear which of the 600 or so chemicals in chocolate are responsible for the unappetizing flavor. What interests scientists are the compounds they’re finding in the fruit of the cacao tree, Theobromacacao.

The list includes stimulants, marijuanalike chemicals, antioxidants, and apparent antidepressants.

The most familiar of the chemicals are caffeine and theobromine. Theobromine is almost chemically identical to caffeine, but is a much more modest stimulant.

In addition to giving chocolate-eaters a lift, theobromine also seems to protect pregnant women against pre-eclampsia, according to investigations by research scientist Elizabeth Triche, associate director of the Center for Perinatal, Pediatric, and Environmental Epidemiology at Yale University.

Pre-eclampsia affects about 5 percent to 8 percent of pregnancies and is characterized by high blood pressure and protein in the urine. Women may also experience swelling, sudden weight gain, headaches and vision problems.

The Preeclampsia Foundation estimates the syndrome kills about 76,000 women annually worldwide.

Triche and colleagues screened more than 10,000 women to find 1,681 who reported consuming more than five servings of chocolate a week.

Of this group, umbilical cord data was available for 1,346. Triche found that those women with higher levels of theobromine in their cord blood had a significantly lower risk of developing pre- eclampsia.

“It appears that chocolate may protect against pre-eclampsia,” Triche said.

“We’re not sure why. Chocolate does affect the cardiovascular pathway,” she said.

Triche said theobromine appears to be the protective factor, but chocolate contains about 600 plant compounds, including flavonoids, which seem to help defend the body against heart disease and cancer. Moreover, determining how much chocolate a person has consumed is difficult, she said. Products containing cocoa powder are ubiquitous, so researchers decided to use theobromine levels as a proxy measure.

Research is further complicated by the mysterious nature of pre- eclampsia and related hypertensive disorders, she said.

“No one knows what causes it,” Triche said. Inadequate blood circulation in the placenta is one theory. This adds plausibility to the chocolate effect, because chocolate is known to dilate, or widen, blood vessels.

Flavonols, a subset of flavonoids, are also believed to relax blood vessels and reduce oxidative stress.

Oxidative stress is a constant problem because highly reactive oxygen molecules are produced as a byproduct or metabolism.

These “free radicals” cause damage to DNA, mitochondria and cell walls unless they are neutralized. The body has several mechanism to dowse free radicals. Vitamins C and E also help.

A little chocolate can’t hurt.

There is evidence that chocolate is good for men, too. Preliminary studies suggest compounds in chocolate may reduce blood pressure in men, and increase sensitivity to insulin, which would help offset the effects of type II diabetes.

Of course, chocolate is not the only source of flavonoids. They are present in green tea, red wine, red beans, blueberries, cranberries, avocados, whole wheat bread, and many other fruits and vegetables. Ounce for ounce, chocolate is near the top.

Chocolate is suspected of having many other wonderful properties, based mostly on insubstantial studies or projects paid for by Mars and other chocolate companies:

A–Chocolate may contain a natural antidepressant. Not only does it contain tryptophan, the precursor for the neurotransmitter serotonin, it also bears a compound called anandamide, a cannabinoid- like substance naturally made in the brain. These chemicals, N- oleothanolamine and N-linoleoylethanolamine, also appear to inhibit the breakdown of anandamide. Critics point out that to have any effect, a person would have to eat a large amount of chocolate.

A–Chocolate seems to carry a group of chemicals called tetrahydro-beta-carbolines, also apparently present in wine, beer and liquor. This may contribute to the chocolate euphoria that overcomes some “chocoholics.”

A–Beyond all of that, chocolate is thought to release endorphins, the brain’s own pain-killing self-medication. It even seems to keep platelets from sticking together, thus, supposedly, reducing the risk of heart attack and stroke.

In fact, chocolate has been getting such good press that some people, generally at the behest of chocolate manufacturers, are making fabulous claims, such as chocolate increases longevity, does not add weight and is good for all.

Triche said that the darker the chocolate, the higher the level of apparently beneficial compounds, and the less sugar, cocoa butter and milk - the fattening stuff.

So, how much chocolate should we be eating? (Everyone in Switzerland eats about 21 pounds of it a year).

“We don’t know how much chocolate one must eat” to benefit from its seemingly beneficial compounds, Triche said.

An epidemiologist at Harvard University suggests four to five servings of raw cocoa a day, not something many people would tolerate.

Abram Katz can be reached at akatz@nhregister.com.

(c) 2008 New Haven Register. Provided by ProQuest Information and Learning. All rights Reserved.

Source: New Haven Register Publication date: 2008-07-17MILFORD — The Arthritis Foundation’s exercise program, a free, low-impact class, will be presented for six weeks at Carriage Green, 77 Plains Road. A kickoff for the class will take place at 2 p.m. July 31. The classes will be held at 10 a.m. Tuesdays and Thursdays beginning Aug. 5. Participants may register by calling 874-4408.

Participants will able to exercise either sitting down or standing up during the one-hour class. The exercises are gentle on the joints and have been proved in research studies to reduce arthritis pain and improve ability to do more daily activities, the center said.

The program is being offered through the Arthritis Foundation, northern and southern New England and Benchmark Assisted Living, which operates Carriage Green.

Breastfeeding week

NEW HAVEN — Yale-New Haven Children’s Hospital is celebrating World Breastfeeding Week, Aug. 1-7, with many educational and awareness activities.

The theme is “Mother Support: Going for the Gold.” Events for the week include:

A–Aug. 1: service, 3-4:30 p.m., on the Harkness patio and lawn on Cedar Street, to honor Barbara Ackerman, R.N., lactation consultant and pioneer, who died last year.

A–Aug. 4: information available on the second floor of the hospital’s Atrium north octagon from 10 a.m.-2 p.m. There will be raffles, prizes and a short quiz on breastfeeding.

A–Aug. 5: WELL’s breastfeeding mother’s support group meets from 10 a.m. to noon at 300 George St. at the Institute for Excellence. Expectant and breastfeeding mothers of babies up to a year-old are invited. Register at www.ynhh.org or call 688-WELL.

For details, call 688-WELL.

(c) 2008 New Haven Register. Provided by ProQuest Information and Learning. All rights Reserved.

While the industry is devising new ways to get children active, parents and fitness instructors should be mindful that a “workout” for a child is different from that of an adult.”One common mistake that is made in the industry is that programs designed for kids treat them like they were mini-adults when they aren’t, either mentally or physically,” says Jonathan Ross, a personal training and fitness consultant in Washington and the American Council on Exercise’s personal trainer of the year.

Many new equipment pieces being produced are just miniature versions of adult weight-training machines with straps and pads that only work one muscle at a time, Ross says. But training a child like an adult can lead to overload on still-developing nerves, bones and muscles.

“A child’s bones, muscles and joints aren’t capable of the intense resistance programs adults usually do,” Ross says. “Their attention spans are shorter, and they are aren’t naturally drawn to repetitive, consistent effort. Plus, the bulky equipment gets away from the natural randomness of the way kids move and are active.”

Ross says a child can be trained at any age, as long as the program meets the unique physical and mental characteristics present in that stage of their development.

“Fitness is more of an adult concept,” Ross adds. “Kids only know movement. They just go out and play and don’t think about carving out a separate time in their day just for exercising. It has to be explained how to devote time to physical activity.”

Here is a list of Ross’ “dos and don’ts” regarding fitness programs for kids:

– If working with a trainer, a child has to be mature enough to follow instructions. A 3-year-old, for example, wouldn’t do well in a class where his parent wasn’t present to supervise and discipline.

– Stay away from heavier resistance training and concentrate on mostly free weights. Do activities such as squats, push-ups or lunges that work large muscle groups and require multijoint movement.

Train for skill first, strength next and then endurance. A high level of fun is a must and can be achieved by adding fitness toys, including balance disks and multicolored balls.

– Be careful with aerobic training because children have smaller hearts that have to beat much faster in order to get a benefit from the exercise. To benefit from traditional cardiovascular training, an exerciser needs to have 10 to 20 minutes of sustained activity. However, it’s very difficult for a child to maintain that kind of intensity long enough to make aerobic training useful for them.

Instead of sustained aerobic activity, aim for games that involve running and stopping or chasing.

Take a look at Ross’ “Family Fit Plan” at familyfitplan.com. His program is designed to get parents and kids playing together as a form a of exercise activity. It’s structured enough to get results but not so controlled that it’s no longer fun.

“Jogging doesn’t make sense for a kid,” Ross says. “Most kids can chase a ball or another person all day long, but to force them to run without having a purpose seems very counterintuitive to their brain.”

(c) 2008 Deseret News (Salt Lake City). Provided by ProQuest Information and Learning. All rights Reserved.

While the industry is devising new ways to get children active, parents and fitness instructors should be mindful that a “workout” for a child is different from that of an adult.”One common mistake that is made in the industry is that programs designed for kids treat them like they were mini-adults when they aren’t, either mentally or physically,” says Jonathan Ross, a personal training and fitness consultant in Washington and the American Council on Exercise’s personal trainer of the year.

Many new equipment pieces being produced are just miniature versions of adult weight-training machines with straps and pads that only work one muscle at a time, Ross says. But training a child like an adult can lead to overload on still-developing nerves, bones and muscles.

“A child’s bones, muscles and joints aren’t capable of the intense resistance programs adults usually do,” Ross says. “Their attention spans are shorter, and they are aren’t naturally drawn to repetitive, consistent effort. Plus, the bulky equipment gets away from the natural randomness of the way kids move and are active.”

Ross says a child can be trained at any age, as long as the program meets the unique physical and mental characteristics present in that stage of their development.

“Fitness is more of an adult concept,” Ross adds. “Kids only know movement. They just go out and play and don’t think about carving out a separate time in their day just for exercising. It has to be explained how to devote time to physical activity.”

Here is a list of Ross’ “dos and don’ts” regarding fitness programs for kids:

– If working with a trainer, a child has to be mature enough to follow instructions. A 3-year-old, for example, wouldn’t do well in a class where his parent wasn’t present to supervise and discipline.

– Stay away from heavier resistance training and concentrate on mostly free weights. Do activities such as squats, push-ups or lunges that work large muscle groups and require multijoint movement.

Train for skill first, strength next and then endurance. A high level of fun is a must and can be achieved by adding fitness toys, including balance disks and multicolored balls.

– Be careful with aerobic training because children have smaller hearts that have to beat much faster in order to get a benefit from the exercise. To benefit from traditional cardiovascular training, an exerciser needs to have 10 to 20 minutes of sustained activity. However, it’s very difficult for a child to maintain that kind of intensity long enough to make aerobic training useful for them.

Instead of sustained aerobic activity, aim for games that involve running and stopping or chasing.

Take a look at Ross’ “Family Fit Plan” at familyfitplan.com. His program is designed to get parents and kids playing together as a form a of exercise activity. It’s structured enough to get results but not so controlled that it’s no longer fun.

“Jogging doesn’t make sense for a kid,” Ross says. “Most kids can chase a ball or another person all day long, but to force them to run without having a purpose seems very counterintuitive to their brain.”

(c) 2008 Deseret News (Salt Lake City). Provided by ProQuest Information and Learning. All rights Reserved.

As the presidential campaign debate over health care intensifies, I am often asked by patients to comment on the ongoing health care crisis. Like many of my patients, I also am frustrated by the decrease in access to quality care in our nation.Americans need greater access to high-quality, affordable care. Yet, in just the past 18 months, the Augusta area has lost at least six primary care physicians who have given up their medical practices. We simply cannot achieve needed reforms in quality, safety and cost if patients do not have access to family doctors, internal medicine doctors and pediatricians to provide the first level of contact in our health care system.

A good example of the potential access problems ahead is seen in Massachusetts, which recently instituted universal coverage via a new state law requiring residents to have health insurance. Officials initially estimated that this law would result in 150,000 uninsured persons seeking care; the actual demand came closer to 350,000. The New York Times now reports that the state’s primary care physicians do not have the capacity to manage the unexpectedly high demand for their services.

Such gaps in access to health care are largely because of the lack of focus on primary care in the United States health care system. According to a recent report from the American College of Physicians, which represents 120,000 internists, primary care - the backbone of the nation’s health care system - is at grave risk of collapse.

As our population grows older and lives longer, we will require the kind of care that primary care doctors do best: preventing illness and managing chronic conditions. The ACP predicts that by the year 2025, our country will need 44,000 additional primary care physicians.

Ideally, everyone should have access to a primary care physician for ongoing medical care. Extensive research by Barbara Starfield of Johns Hopkins University and others has shown that good primary care improves health among our population in a variety of ways, including longer life expectancy and fewer deaths from heart disease, stroke, infant mortality and low birth weight. The stronger a nation’s primary care orientation, the fewer early deaths from asthma, bronchitis, emphysema and pneumonia. In 2005, Starfield reported that increasing the supply of primary care physicians by just one doctor per 10,000 people (a 12 percent increase) could result in as many as 127,000 fewer deaths per year.

Instead, our nation is losing primary care physicians and falling behind countries whose health care systems are based on primary care. The average life expectancy of Americans is shorter than that of Canadians, Japanese and the populations of Western Europe. A recent analysis of 19 industrialized nations shows that despite spending the most money per person on health care, the United States has the highest death rate from treatable conditions. In terms of populations actually reaping the benefits of medical progress, countries with primary care-based systems are dramatically outpacing the United States.

Primary care providers currently comprise only 36 percent of the physician workforce in the United States, compared to other advanced countries, where 50 percent to 70 percent of all physicians are in primary care. Sadly, this trend does not appear to be improving.

According to 2005 figures, one in five doctors who entered primary care in the early 1990s is no longer practicing. This exodus has contributed to shortages and, as a direct result, patient frustrations.

Coordinating one’s own care can be challenging, especially for older patients with many chronic conditions. They may see a cardiologist for a heart problem, an orthopedist for knee pain and an endocrinologist for diabetes, with no single physician to oversee their care or advocate for them in our complex system. Meanwhile, an increasing number of people are misusing the emergency room for problems such as sore throats and chronic back pain, which crowds out real emergencies while increasing the cost of their care and decreasing the quality of service they receive.

Our country’s reimbursement system must bear some of the blame for the primary care shortage we are experiencing. Throughout much of our health care system, providers are paid more for procedures than for “cognitive services,” such as counseling patients in self- care, helping them make good health care decisions and coordinating care among specialists. A specialist performing surgery or a diagnostic test earns up to 10 times more than a family doctor who spends the same amount of time caring for a patient with diabetes or asthma. From 1995 to 2003, primary care providers worked increasingly longer hours yet saw a 10 percent drop in their inflation-adjusted income. While family physicians are not in it for the money, we can do the math, and it is clear that such disparities make primary care less attractive to future physicians.

In an effort to sustain their incomes, many primary care providers have become more like entrepreneurs than physicians. Some have set up “boutique practices,” catering to wealthier patients who see value in paying a premium for guaranteed comprehensive care that will result in better health outcomes. Other physicians have dropped out of primary care altogether and now work in any of the growing number of specialized settings, such as surgery clinics. Some have simply picked up the pace, crowding more and more patients and procedures into their already full schedules. As a result, they have less time for quality interactions with patients and are living a high-pressure, workaholic lifestyle that few would recommend. This message is not lost on upcoming physicians: Since 1998, more than half of all family practice residency programs have gone unfilled.

Solving the current crisis in health care will require everyone’s leadership. Patients must demand better health care with universal coverage for all citizens. The medical community must bring about restructuring of the payment system to reward better outcomes and facilitate growth in the overall percentage of primary care physicians in the United States. Medical schools and health care industry leaders must train and retain adequate numbers of primary care physicians and continually improve technology to enhance communication with each other and ensure that our health care system is sufficient to our population’s growing needs.

All doctors - those in primary care and specialty care alike - should support these actions, rising to the level of professionalism and altruism that will improve the health of the populations we are entrusted to serve.

(The author is a family physician with, and the former CEO of, the Center For Primary Care. He has been practicing family medicine in the Augusta area since he joined CPC in 1995.)

Originally published by Robert M. Clark, D.O. Guest Columnist.

(c) 2008 Augusta Chronicle, The. Provided by ProQuest Information and Learning. All rights Reserved.

NATIONAL Heart Institute dietetics and food services senior manager MARY EASAW-JOHN and senior dietitian FOONG PUI HING analyse the meals of two families to see if they are getting enough nutrition.Generally, the Lim family’s diet is well balanced with all the food groups present.

There is variety in their cooking methods, such as stir frying, soup and frying.

Fat content is presumably low (at less than 30 per cent) except for days with western meals.

There is adequate fibre intake except for lunch on July 15 and 19 when they did not have any vegetables. The family should consider salads with western meals to get their fibre.

The Lim family should be wary about the sodium content in their diet as it may be high due to frequent use of sauces and canned items.

They can better control their sodium intake by not adding salt to the dishes that use sauces. The Lims should also limit canned food to just once a week.

Based on their weekly shopping bill of RM421.28, each person is spending about RM15 for food per day, which is reasonable based on the recommended three meals and one snack.

However, this does not include money spent on eating out, for example, on weekends and school meals for the children.

It would have provided for a better analysis if they had recorded this amount too.

For the Ganesa family, there is limited variety in the meal preparation and types of vegetables eaten. There is inadequate fibre intake: only one serving of fruit per day. They should increase this.

The family only spends RM103 per week, including eating out.

This means each person is only spending RM3.70 per day, which is not adequate for basic meals (unless they are fasting on Tuesdays and Fridays, which is common among Hindus).

(c) 2008 New Straits Times. Provided by ProQuest Information and Learning. All rights Reserved.

SIR - Here we go again - another anti-soya frenzy. This time it’s based on a very small study of overweight men experiencing fertility problems - hardly typical.This study looked at 99 men (72 per cent of whom were overweight or obese) attending a fertility clinic.

Nearly half of them (42 per cent) had normal sperm but those consuming the most soya foods had a lower sperm count.

The researchers report that this effect was more pronounced in the larger men.

They suggest that higher levels of oestrogen produced in body fat could make reproductive organs more sensitive to oestrogen and oestrogen-like chemicals in the diet. However, plant oestrogens are far less potent than animal hormones.

Why doesn’t anyone research the effects of consuming the hideous cocktail of 35 hormones (including oestrogen) and 11 growth factors (including IGF-1, linked to several cancers) that we find in cows’ milk?

A bit of publicity on how two thirds of retail cows’ milk comes from pregnant cows, when hormone levels in the milk are markedly elevated, would be more helpful in terms of protecting human health than attacking soya - a healthy, nutritious food that has been consumed by millions of people for hundreds of years.

DR JUSTINE BUTLER Vegetarian & Vegan Foundation

(c) 2008 Western Mail. Provided by ProQuest Information and Learning. All rights Reserved.

Ohio State University Medical Center researchers say there is a direct link between air pollution and its impact on high blood pressure, or hypertension.The researchers exposed rats to levels of airborne pollutants humans breathe everyday, noting the levels were still considerably below those found in developing countries such as China and India, and in some parts of the United States.

The researchers found that exposure to air pollution, over a 10-week period, elevates blood pressure in those already predisposed to the condition.

We now have even more compelling evidence of the strong relationship between air pollution and cardiovascular disease, or co-author Sanjay Rajagopalan said in a statement.

Recent observational studies in humans suggest that within hours to days following exposure, blood pressure increases.

The results are published online ahead of print in Arteriosclerosis, Thrombosis, and Vascular Biology.

The Mediterranean diet high in plant foods and olive oil and low in red meat, dairy products, trans fatty acids and alcohol has already been shown to have a role in preventing heart disease. Now it appears to reduce the chances of developing type 2 diabetes, according to a new preliminary study conducted in Spain and published recently in the British Medical journal. Type 2 diabetes is linked to obesity as well as heart disease. The research team led by M. A. Martinez-Gonzalez at the University of Navarra, Pamplona, recruited nearly 14,000 healthy university graduates who were initially free of diabetes. The study was designed to answer two questions: Would people adhere to the diet? If so, would it make a difference in terms of who goes on to develop diabetes? Despite having a relatively high total fat content, the Mediterranean diet would be expected to provide at least some protective benefit.All the participants had their dietary habits assessed at the start of the study when they completed detailed food-frequency questionnaires. Every two years they were expected to complete follow-up questions about diet, lifestyle, risk factors and medical conditions. Whenever a participant reported that he or she had been diagnosed with diabetes, the diagnosis was confirmed by the researchers during the follow-up period.

After following the participants for over four years, Martinez- Gonzalez and colleagues concluded, “Our prospective … study suggests that substantial protection against diabetes can be obtained with the traditional Mediterranean diet.” The operative word here is suggests, as this study would be regarded by other researchers as preliminary due to the fact that it relied on self- reporting.

Maryann Napoli, Center for Medical Consumers (c) 2008

Copyright Center for Medical Consumers Jun 2008

(c) 2008 HealthFacts. Provided by ProQuest Information and Learning. All rights Reserved.