U.S. researchers say they have identified the precise mechanisms by which binge drinking contributes to increased risk of heart attack and stroke.John Cullen of the University of Rochester Medical Center said that alcoholic beverages contain ethanol, which is mostly converted into acetaldehyde once in the human system at “binge” levels, with the levels of acetaldehyde remaining high for many hours after the binge has ended.

The current study, published in the journal Atherosclerosis, clarified for the first time that binge levels of acetaldehyde cause an important type of immune cell — the monocyte — to become better able to stick to blood vessel walls.

In the past, experts believed that atherosclerosis developed when too much cholesterol clogged arteries with fatty deposits called plaques and when blood vessels became completely blocked, heart attacks occurred, Cullen explained.

Cullen said that today, most believe that the reaction of the body’s immune system, more than the build-up itself, creates heart attack risk. Vessel walls mistake fatty deposits for intruders, akin to bacteria and call for help from the immune system. Monocytes arrive with the goal of preventing infection, but end up causing inflammation that drives blood vessel blockage.

“Binge-drinking has been linked to increased risk for heart disease, and the newer inflammatory model is beginning to explain how,” Cullen said in a statement. “We found acetaldehyde, at levels found in the blood after binge drinking, increased the number of monocytes by 700 percent.”

As people eat, the brain has a way keeping tabs on the fat content of what’s eaten, U.S. researchers report.In studies of rats, one type of lipid produced in the gut rises after eating fatty foods. Those N-acylphosphatidylethanolamines, or NAPEs, enter the bloodstream and go straight to the brain, where they concentrate in a brain region that controls food intake and energy expenditure.

“A lot of gut hormones have an effect on food, but when you give them chronically they lose their effectiveness,” Gerald Shulman of Yale University School of Medicine said in a statement.

Another nutrient-sensing, gut-derived peptide known as CCK leads animals and people to eat smaller meals, but they eat them more often, yielding no change in the overall calories consumed, Shulman said.

“Here, we gave rats NAPE for five days and saw a continuous reduction in food intake and a decline in body weight,” Shulman said. “It suggests NAPE or long-acting NAPE analogs may treat obesity.”

NAPEs are secreted into circulation from the small intestine in response to ingested fat and that systemic administration of the most abundant circulating NAPE, at doses naturally found in the bloodstream, lowers food consumption in rats without making food unappealing to the animals, Shulman said.

The finding were published in the journal Cell.

Q What can we do to prevent vitamin D deficiency?A The American Academy of Pediatrics held its annual conference in Boston recently and announced that it has doubled its recommended amount of vitamin D for infants, children and adolescents. The increase is from 200 IU to 400 IU per day, beginning when an infant is just a few days old.

Vitamin D deficiency is common among all age groups and has long been known to increase a person’s risk for certain conditions, including rickets (weakening of the bones), growth failure, lethargy, irritability, respiratory infections and osteoporosis. In recent years, Type 2 diabetes, some cancers, multiple sclerosis and rheumatoid arthritis have been linked to vitamin D deficiency as well.

Sunlight is the main source of vitamin D, but experts urge people to stay out of the sun and to wear sunscreen and protective clothing.

While most foods are not plentiful in vitamin D, some foods are, including fatty fish, certain fish oils, liver, and egg yolks of chickens fed with vitamin D. If these items are not in your family’s regular diet, talk to your doctor and children’s pediatrician to determine whether or not a supplement is appropriate.

Betsy Wadland is director of development for the Natick, Mass., Visiting Nurse Association, a nonprofit health care organization providing home care to thousands of people throughout the region each year. For more information, call the VNA at 508-653-3081.

(c) 2008 Patriot Ledger, The; Quincy, Mass.. Provided by ProQuest LLC. All rights Reserved.

Great news! You don’t have to starve yourself to get that perfect, fat-free frame. Because even if you lose weight through dieting alone, your body won’t easily burn fat.To rev up your fat-burning engines, focus less on how often you empty your plate and more on how often you walk.

Burn it: When a group of sedentary and overweight older adults recently tested three weight loss systems - exercise only (mostly walking), diet only, and exercise plus diet - the results were predictable. When it came to fat burning, the walkers won hands down over those who simply watched what they ate.

A Little Helps: Just 30 minutes of daily walking gives you a host of health benefits besides extra fat burning, including more disease protection and better stress prevention.

Control your Cravings: The trick to avoiding a candy binge? Surprising as this sounds: Put the minipacks away, and take a small handful from a big bag instead.

Treats in small-size packages can trick even careful eaters into overindulging. In a recent study, people concerned about their waistlines ate more high-calorie snacks when given small bags instead of big ones.

Persuasive Packs: In a recent study, minipacks of foods like candies and little cookies led people to go overboard because they viewed the smaller portions as “healthier” versions of high-calorie treats. And careful eaters were less likely to even open big bags of candy, unlike snack packs. Which means small bags may do a better job of luring you into high-calorie munching in the first place.

Portion Control: According to the study, minis don’t seem to make everyone overeat - only those who are concerned about managing their weight. People who weren’t concerned about gaining weight munched more snacks from large bags than small ones. Either way, what it all boils down to is portion control. And practicing this eating trick can make you a master at it.

(c) 2008 The Times of India. Provided by ProQuest LLC. All rights Reserved.

Nov. 30–Not sure you’re ready to commit to an exercise class — let alone join a gym — as you once again contemplate your New Year’s resolution? Then take a test drive in December, and in the process, you can ward off the traditional weight surge that comes with the holidays.”It’s a great way to see if you’re interested in a gym,” agrees Kira Stewart, who runs one of the facilities where you can take a cheap, no-commitment spin around the block: Your neighborhood parks and rec community center.

There are 40 such centers in the Triangle. Many have weight and fitness rooms, where you can walk a treadmill or lift weights. Most have gyms where you can get in on a pickup basketball game or walk or run laps on a cold day.

All have fitness classes covering a range of exercises, from aerobics to tai chi to yoga.

And for the month of December, some have programs you can sample on a 30-day trial. If you like it, you can continue in the new year, typically for a modest fee.

At Cary’s Herbert C. Young Community Center, for instance, Holiday Workouts will meet Mondays in December, beginning at 6 p.m. The class is taught by longtime aerobics instructor Natalie Cloud, who says the course is good for veterans of hers and other aerobics classes (”I have some die-hard ladies — and gentlemen — who have been with me since 1994″) as well as folks hoping to work some movement into their holidays.

“The class is for all levels,” Cloud says. “I teach at a basic level but show you ways to make it more intense.”

In fact, the class is actually two classes: aerobics — described in the course description as “cardio blast” — from 6 to 7 p.m., and tone and strengthening, from 7:05 to 7:50 p.m.

To underscore the no-commitment aspect, you can pay by the class ($4 for Cary residents, $6 for non-Caryites).

Some community center classes aren’t designed specifically for the holiday calendar, they just work out that way.

At Raleigh’s Lake Lynn Community Center, which backs up to a 2.2-mile greenway around Lake Lynn, there’s a monthlong senior aerobics class (meets Tuesdays and Thursdays, 9 to 10 a.m., $10) and a karate class (Mondays and Wednesdays, 5:30-6:30 p.m., $44).

“That one’s good for getting some of the holiday stress out,” Stewart says of the latter, which teaches the Okinawan Shorin-Ruy style.

There’s also what Stewart calls the center’s “great, undiscovered little secret,” the fitness room. It has treadmills, an elliptical machine, stationary bike, stair machine, weights “and there’s rarely more than two or three people in there,” she says.

It costs $15 a month to use the room, but you only need to commit for a month. And it has hours comparable to those of a commercial gym: 7 a.m. to 10 p.m. weekdays; 9 a.m. to 3 p.m. Saturdays; and 1 to 6 p.m. Sundays.

Don’t know your way around the machines? There’s usually someone at the front desk who will show you around, says Stewart. A personal trainer is also available for $25 a session.

“We definitely see an increase in people coming in after the holidays,” says Stewart.

December, though, is slack time. All the more because most regular programs at Lake Lynn, Herbert C. Young and other community centers take the month off.

It’s a good time to get a head start on next year.

joe.miller@newsobserver.com or 919-812-8450

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Copyright (c) 2008, The News & Observer, Raleigh, N.C.

Distributed by McClatchy-Tribune Information Services.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

DEAR DR. DONOHUE: Is it possible for you to do an article on tennis elbow with suggestions for treatment? I have been diagnosed with it, and I don’t play tennis. I am in much pain. Is there something I can do? My doctor just prescribes stronger painkillers for me. - N.M.ANSWER: Tennis elbow doesn’t belong only to tennis players. It happens to violinists, carpenters, dentists, gardeners and anyone who grips a tool tightly and simultaneously makes twisting movements of the arm. Stand and let your affected arm hang down with the palm of the hand turned forward. With your other hand, feel for a bony projection at the side of the elbow. That projection is the lateral epicondyle, and it’s the place where the extensor forearm muscles attach. Extensor muscles are the ones that bend the wrist upward.

Overuse of those muscles causes tears and other changes in the attaching ligaments. Pain arises on twisting the wrist or holding tightly onto anything. Lifting a carton of milk is a most uncomfortable experience.

Rest cures tennis elbow. You don’t have to keep the elbow immobile. Forgo any motions that hurt.

At this stage, you should be applying heat to the elbow, either moist or dry. Apply it four times a day for 15 minutes each time.

Tylenol is a safe pain reliever. Anti-inflammatory medicines are useful. Motrin, Advil and Aleve are a few examples. Prolonged use of these medicines carries the risk of developing an ulcer.

You might find an elbow brace to be helpful. You can get one at a sporting-goods store or a drugstore. They’re worn at midarm level, and they work by shifting a bit the attachment of the extensor muscles.

A cortisone injection usually stops the pain promptly. After the injection, if the pain has completely gone, continue to rest the wrist for two or three more weeks. A too-quick return to use makes matters worse.

DEAR DR. DONOHUE: Four or five days a week my wife and I walk at the local shopping mall at a fairly good pace. On numerous occasions in the past year, my wife has gotten dizzy while taking the walk.

She is 60 and has a blood pressure of 100/60. Could these low numbers be the cause of this condition? - D.T.

ANSWER: If you have a home blood pressure machine, take her pressure when this happens. These units aren’t expensive.

Her pressure doesn’t cause symptoms at other times, and her numbers are actually healthy ones. However, perhaps they are dipping quite low during the walk. Your wife’s story makes me uneasy. She needs to see the family doctor about this.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853- 6475. Readers may also order health newsletters from www.rbmamall.com.

DEAR DR. DONOHUE: As a teenager, I used to do dips on parallel bars. Do you know the exercise? I’d like to start doing them again, but I’ve forgotten the technique. Can you refresh me? Exactly what muscles does this exercise benefit? - K.J.

ANSWER: Grip the parallel bars firmly and raise yourself upward by straightening the elbows. When you’ve reach the high point, stick there for a few seconds and then lower yourself to the starting position and repeat the process as many times as you can. That won’t be many at first.

You’re exercising your chest muscles - the pectorals, your deltoid muscles, the shoulder muscles and your triceps muscles, the muscles on the back of your upper arms.

DEAR DR. DONOHUE: I am a 16-year-old male. For a couple of months now, I have been having problems with my wrists. They make snapping noises. Could they be dislocated? - B.M.

ANSWER: They’re not dislocated.

Snapping noises at a joint usually come from tendons rubbing against a bone. If there is no pain, then the noises are not a sign of trouble.

(c) 2008 Sun-Journal Lewiston, Me.. Provided by ProQuest LLC. All rights Reserved.

The creators of 26.2 with Donna: The National Marathon to Fight Breast Cancer, have taken their cause to end breast cancer a step further by partnering with MapMyRun.com. The site has created a virtual marathon and half marathon available to anyone worldwide.On November 17th, MapMyRun.com launched 26.2 with Donna as a virtual marathon and half marathon. The site allows anyone, anywhere to register for the marathon or half marathon. Virtual marathon and half marathon participants can run for the cause in their own neighborhood, or anywhere they choose. The virtual marathon and half marathon is a counterpart to the existing full and half marathon events taking place in Jacksonville Beach, Florida on February 15, 2009, where thousands of runners and fans are expected to gather again this coming year for this one of a kind marathon that includes a segment along the beautiful northeast Florida beaches.

“In our inaugural year, we were thrilled to welcome runners from every state and 15 countries to our race in Jacksonville Beach,” said Donna Deegan, race founder and breast cancer survivor. “We expect even larger crowds this year, but in these rough economic times, we realize there are those who would like to help the cause but can’t afford the cost of travel. We are thrilled to partner with MapMyRun.com to make our cause available to everyone who wants to help end breast cancer.”

Virtual marathon and half marathon participants can sign up at MapMyRun.com, create a 26.2-mile route by pointing-and-clicking where they want to run their marathon or half marathon, and collecting data while they run the marathon or half marathon using Nike +, Garmin, Timex, and/or iMapMyRun iPhone GPS data collection devices. Virtual participants’ finish times will be posted on the results page along with participants in the 26.2 with Donna marathon and half marathon runners in Jacksonville one week after the February 15, 2009 race. 26.2 with Donna will send MapMyRun.com participants a finisher T-shirt and completion medal.

For more information, visit: https://secure.mapmyfitness.com/ content/event_registration/donna_runs/register_login or call

904-355-PINK (7465).

About MapMyRun.com:

MapMyRun.com is the flagship site of MapMyFitness, LLC. MapMyFitness, LLC provides active individuals with the tools and community they need to succeed and excel in their athletic pursuits. The MapMyFitness, LLC suite of websites is the premier source for community-based fitness content, tools, calculators, and mapping technologies. MapMyFitness.com users are able to visualize their health and fitness training progress through the use of maps, workout logs, fitness calculators/tools, and user-led community groups. MapMyFitness, LLC includes: MapMyRun.com, MapMyWalk.com, MapMyRide.com, MapMyHike.com, and MapMyTri.com.

About 26.2 with Donna:

Donna Deegan, three-time breast cancer survivor, founded 26.2 with Donna: The National Marathon to Fight Breast Cancer. Last year’s inaugural race drew more than 7,000 runners, raising more than $800,000. 26.2 With Donna is the only marathon in the country dedicated solely to raising money for breast cancer research and to care for underserved women with the disease. For more information on 26.2 with Donna, or to register, visit www.breastcancermarathon.com.

(c) 2008 BUSINESS WIRE. Provided by ProQuest LLC. All rights Reserved.

Thanks to research at the USDA-ARS Children’s Nutrition Research Center (CNRC) in Houston, Texas, led by professor of pediatrics Kendal Hirschi, carrots have been modified to contain more calcium- and this research can potentially be used to add calcium to other crops. The current U.S. recommended average intake of calcium for adults aged 19 to 50 is about 1,000 milligrams daily, and milk is one of the richest sources of calcium. Inadequate dietary calcium, however, is a global concern, particularly in parts of the world that don’t have access to dairy products or where large segments of the population are lactose intolerant or consume a vegetarian diet.A Global Concern

Increasingly, dietary recommendations around the world emphasize the value of adequate intake of plant-based foods. But one major potential problem with shifting to a plant-based diet is that doing so could further reduce consumption of essential nutrients, such as calcium.

Insufficient intake of calcium may lead to osteoporosis, one of the world’s most prevalent nutritional disorders. It’s a condition that reduces bone mineral density and leads to fragile bones in later life. Doctors usually prescribe calcium supplements and exercise, but better calcium uptake and absorption from foods would also have a significant positive global impact on this disease.

Poor diets and exercise habits prevent many people from achieving and maintaining optimal bone health in the United States and elsewhere. To help combat this, Hirschi modified carrots by giving them a gene-from the model plant Arabidopsis thaliana-that encodes a calcium transporter.

CNRC professor of pediatrics Steve Abrams was involved in the subsequent human feeding studies. CNRC plant biologists helped in modifying foods, other than carrots, to have increased calcium levels.

Hirschi notes that CNRC, which is operated by Baylor College of Medicine in cooperation with Texas Children’s Hospital and the Agricultural Research Service, provides a unique research environment. There, it’s possible for scientists to generate genetically modified plants and then conduct careful feeding studies with mice and human volunteers, all in the same building-a one-of-a- kind operation needed for this type of work.

But Can the Body Use It?

While carrots already contain some calcium, it is very minimal. That means that no one could ever eat enough regular carrots to meet the recommended level of calcium.

The goal of the research was to induce carrots to express increased levels of the gene sCAX1, which enables transport of calcium across plant cell membranes. The ultimate goal is to make not only carrots, but also other vegetables and fruits, better sources of calcium. Further, the knowledge gained from this proof- of-principle research helps scientists understand molecular factors that influence plant nutrient bioavailability.

To determine the bioavailability of the calcium in the modified carrots, 30 volunteers-15 females and 15 males of various ethnic backgrounds and in their early to late 20s-ate single meals containing either regular or modified carrots. Both types of carrots were labeled with a stable isotope of calcium. Studies using stable isotopes are extremely safe, and this one allowed researchers to measure calcium absorption quickly.

After 1 day, urine samples were collected for measurement of calcium excretion. After 2 weeks, the volunteers returned to eat another carrot meal, switching from regular to modified, or vice versa, so comparisons could be made. The researchers found that the calcium intake of volunteers who consumed the modified carrots increased by 41 percent, compared to those who ate regular carrots. Though the percentage of calcium absorbed was slightly lower in the modified carrot, the total amount absorbed overall was significantly greater.

“We are always looking at ways to increase the nutrient content in foods,” says Hirschi, who has been working on this type of research for the past 7 years. “This is the first time a genetically enhanced food has been tested in clinical human feeding trials for increased nutrition, and the results were positive: We found we had indeed made a healthier carrot. Obviously, this is a prototype of what we want to develop in the future, but the early work is encouraging.”

What More Calcium Can Do

These findings, published in the January 2008 Proceedings of the National Academy of Sciences, show that it’s possible to improve the amount of bioavailable calcium in a staple food- such as carrots. When applied to a variety of fruits and vegetables, a strategy of increasing the calcium content of those foods that kids like to eat could lead to higher calcium consumption from plant foods alone.

In addition to the nutritional benefits, modifying plant genes to increase calcium levels could also improve plant productivity and extend product shelf life. That’s because calcium has long been used to combat many postharvest issues. For example, apples are immersed in a calcium solution to maintain their firmness during shipping and prolong their shelf life afterwards.-By Alfredo Flores, ARS.

This research is part of Human Nutrition, an ARS national program (#107) described on the World Wide Web at www.nps. ars.usda.gov.

Kendal Hirschi is with the USDA-ARS Children’s Nutrition Research Center, 1100 Bates Ave., Houston, TX 77030; phone (713) 798-7011, fax (713) 798-7171, e-mail kendalh@bcm.tmc. edu.

Copyright Superintendent of Documents Nov/Dec 2008

(c) 2008 Agricultural Research. Provided by ProQuest LLC. All rights Reserved.

CHICAGO — The dietary supplement ginkgo, long promoted as an aid to memory, didn’t help prevent dementia and Alzheimer’s disease in the longest and largest test of the extract in older Americans.”We don’t think it has a future as a powerful anti-dementia drug,” said Dr. Steven DeKosky of the University of Virginia School of Medicine, who led the federally funded study.

Extracts from ginkgo tree leaves have antioxidant and anti- inflammatory effects, but earlier research on ginkgo and memory showed mixed results. Annual U.S. sales of the supplement reached $107 million in 2007, according to Nutrition Business Journal estimates.

Ginkgo has been believed to protect the brain by preventing the buildup of an Alzheimer’s-related protein or by preventing cell- damaging oxidative stress. It’s been used for leg pain, ringing in the ears and sexual dysfunction.

For the new study, appearing in Wednesday’s Journal of the American Medical Association, researchers recruited more than 3,000 people, ages 75 and older, from voter and mailing lists in Maryland, Pennsylvania, California and North Carolina.

Half were randomly assigned to take 120 milligrams of ginkgo biloba twice a day, a typical dose taken by people who think it may help memory. The others took identical dummy pills.

Participants were screened for dementia every six months. After six years, dementia had been diagnosed at a similar rate in both groups; 277 in the ginkgo group and 246 in the group taking the dummy tablets. When the researchers looked only at Alzheimer’s disease, that rate too was similar.

Ginkgo appears relatively safe, DeKosky said. There was no difference in the rate of adverse events such as heart attacks and gastrointestinal bleeding between the groups.

Would ginkgo work better to prevent dementia if people started taking it earlier, say, in middle age? The study didn’t look at that, DeKosky acknowledged, adding that following people for 25 years from middle age to old age would be expensive research. The study also didn’t test whether ginkgo improves thinking and memory in the short term.

Originally published by CARLA K. JOHNSON Associated Press.

(c) 2008 Tulsa World. Provided by ProQuest LLC. All rights Reserved.

An estimated 17,800 people in Cambria and Somerset counties have diabetes, and another 43,000 are at risk of developing the life-altering disease.Sedentary lifestyle and obesity are the main controllable causes of Type 2 diabetes, which has become epidemic in the United States. Between 2005 and 2007, total prevalence shot up more than

13 percent, the American Diabetes Association reports.

Nearly one in five has a significant chance of becoming diabetic.

It is a disease in which the body does not produce or properly use enough insulin, a hormone needed to convert sugar and other foods into energy. In Type 1, formerly called juvenile diabetes, the body produces no insulin.

Type 1 patients must receive insulin injections.

There is no clear cause of Type 2 diabetes, but family history, excess weight and lack of exercise top the list of risk factors.

Patients usually can control their disease with diet and oral medications to control sugar levels in the blood, said Tina Friewald, diabetes educator at Windber Medical Center.

Too much sugar in the blood can damage the circulatory system and other organs, Friewald said.

“Sugar coats red blood cells,” Friewald said. “I heard this from a former patient and I always use this: The blood cells become like sandpaper balls. They irritate your arteries, and that’s what builds up plaque.”

Plaque can restrict blood flow, leading to heart attack and stroke, which kill two-thirds of diabetes patients.

The epidemic of obesity is directly linked to soaring diabetes levels, prompting health-care leaders to focus on education, prevention and control. But it’s an uphill battle in an area where residents’ diets have remained the same since days of hard work in steel mills, coal mines and strenuous housework, said U.S. Rep. John Murtha, D-Johnstown.

“It’s frustrating as hell when you see the percentage of people who are at risk,” said Murtha, who has secured $135 million for diabetes intervention and research since 2004.

The initiatives are run out of Pittsburgh Diabetes Institute and its satellites, including the Conemaugh Diabetes Institute in Johnstown.

“Diabetes is a disease where the patient must be empowered,” Conemaugh manager Carol Harding said.

A 10-hour course on disease management and nutrition helps newly diagnosed diabetes patients take control of their disease, Harding said. The course covers diet and exercise, medicine, complications, label reading and other information.

Similar courses are offered at Windber Medical Center and Somerset Hospital, where diabetes educator Jackie Werder and dietitian Leann John highlight the American Association of Diabetes Educators’ seven self-care behaviors. They are: Healthy eating, being active, monitoring, taking medication, problem solving, reducing risks and healthy coping.

Diabetes patients should monitor blood sugar levels and count calories and fat grams every day, Werder said. She stresses the importance of hemoglobin A1c tests every three months to help physicians see how the disease is being managed.

For many new diabetes patients, Werder said acceptance is a major obstacle.

“It is going to be a lifelong thing,” Werder said. “They have to deal with it. It’s something that changes their whole lifestyle. They have to always be watching. It gets tiring.”

Constant monitoring and vigilance is crucial, said Dr. Linda Siminerio, director of the Pittsburgh Diabetes Institute.

“Diabetes is a 24/7 disease because you have to make decisions all the time,” Siminerio said. “You can’t just go to the doctor three or four times a year to treat diabetes.”

The Conemaugh Diabetes Institute and programs like it are vital, she said. Diabetes educators, dietitians and coaches can help with unexpected developments between doctors’ appointments. Sometimes, medication or diet must be adjusted to prevent complications.

“Places like Conemaugh Diabetes Institute have people there who can help guide you so you aren’t waiting six months to make a change,” Siminerio said.

Important information includes instruction on how to inspect feet for sores or blisters from reduced circulation, Harding said. Sores in the mouth and other areas should also be checked by professionals.

“Infections with diabetes are hard to control,” Harding said. “With diabetes, it’s difficult to heal wounds.”

For those determined to be at risk, the Conemaugh Diabetes Institute offers a

12-week Lifestyle Choices course in prevention that stresses weight loss, healthy eating and exercise. The American Diabetes Association recommends at least 30 minutes of walking or other exercise a day, Harding said.

There are also community programs, a library and guided online services available.

All services start with education, Siminerio said.

“We want to get the word out about diabetes,” she said. “We have diabetes education for patients, diabetes education for providers and diabetes education for the community.”

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To see more of The Tribune-Democrat or to subscribe to the newspaper, go to http://www.tribune-democrat.com.

Copyright (c) 2008, Tribune-Democrat, Johnstown, Pa.

Distributed by McClatchy-Tribune Information Services.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.