Thursday, June 28

HealthTip: Passing a Kidney Stone

(HealthDay News) -- A kidney stone is a hard mass created by crystals that have separated from the urine.

Most kidney stones will pass on their own, and surgery usually isn't necessary.

The U.S. National Kidney and Urologic Diseases Information Clearinghouse offers these suggestions if you have a kidney stone:

Drink plenty of water to help flush the kidney stone from the body. Two to three quarts per day is recommended.
Take an over-the-counter pain medication.
Call your doctor if you see blood in your urine, have extreme back or side pain that does not subside, or have a fever or chills.
Once the stone has passed, try to save it to give to your doctor for testing ...more

Health Tip: Saving a Knocked-Out Tooth

(HealthDay News) -- If your child has a permanent tooth knocked out, it should be considered a dental emergency, the Nemours Foundation advises.

The tooth is most likely to survive if it is properly placed back in the socket within 30 minutes of the injury.

Here are the foundation's suggestions for what to do if a child's permanent tooth is knocked out:

Find the tooth, and only handle it by the crown (the part that you'd see in a person's mouth), never by the root.
Immediately rinse the tooth (don't scrub it) with saline solution or milk. Don't use tap water, which typically contains chlorine, unless that's all that's available.
If your child is old enough to hold it there, place the tooth gently back in its socket.
If your child is young, store the tooth in a cup of milk, or hold it in your mouth between your cheek and lower gum.
Go immediately to your dentist or local emergency room.
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Tainted toothpaste had wider reach than thought: report


NEW YORK (Reuters) - Chinese-made toothpaste tainted with a potentially poisonous chemical was distributed to more places in the United States than initially thought, the New York Times reported on Thursday.

About 900,000 tubes of toothpaste containing diethylene glycol, an ingredient in antifreeze, were distributed to hospitals for the mentally ill, prisons, juvenile detention centers and some hospitals serving the general population, the Times said.

Initial reports said the tainted toothpaste was most likely to be found in discount shops.

Officials in Georgia and North Carolina were replacing the toothpaste with products made outside China, according to the report. Hospitals in South Carolina and Florida also reported receiving Chinese-made toothpaste, it said.
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Tiger Woods discusses fitness routine


NEW YORK - Tiger Woods has talked about tailoring practice sessions around being a father. That also means finding time for workouts that can last up to three hours as many as six days a week, which he describes in the August issue of Men's Fitness magazine.

For the first time, Woods and trainer Keith Kleven offer detail and insight into a fitness regimen that has enabled the world's No. 1 player to add nearly 30 pounds of muscle since he left Stanford in 1996 after his sophomore year.

"Pound for pound, I put him with any athlete in the world," Kleven told the magazine.

The routine is built around stretching up to 40 minutes before each session, core exercises, endurance runs of 7 miles and speed runs of 3 miles, along with weight training. But while Woods is competitive on the golf course, he said he doesn't have an ego in the weight room.
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Monday, June 25

Echinacea 'halves risk of catching cold'


PARIS (AFP) - Echinacea, a medicinal herb that came to prominence thanks to its use by Sioux Indians, can more than halve the risk of catching a cold, a wide-scale study has confirmed.
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Taking echinacea supplements can reduce the risk of a cold by 58 percent and may also shorten the duration of a cold almost one and a half days, according to the paper, published on Sunday in the July issue of the journal The Lancet Infectious Diseases.

The study is a "meta-analysis" comparing the outcome of 14 published trials using echinacea.

One of the trials combined with echinacea with vitamin C, which showed the two together reduced the incidence of a cold by 86 percent.

Friday, June 22

McDonald's Mum on Trans-Fat-Free Fries



Those French fries you order at a McDonald's Corp. restaurant may be the trans-fat-free version, but unless you're in New York City you can't be sure.

The fast-food giant told New York health authorities last Friday that all 254 of its outlets in the five boroughs have switched to a new cooking oil that brings the fries into compliance with a requirement that restaurant food be virtually free of artery-clogging trans fat by July 1...more via AP News

Wednesday, June 20

CDC: Antiques can pose mercury hazard


ALBANY, N.Y. - Careful with that antique clock. It could pose a mercury hazard. The silvery, skittering, and toxic liquid can be found in some antiques. Mirrors can be backed with mercury and tin; Clock pendulums might be weighted with embedded vials of mercury; and barometers, thermometers and lamps may have mercury in their bases for ballast.

The problem is that mercury in old items can leak, particularly as seals age or when the items are moved, according to a study by the Centers for Disease Control and Prevention.

Ask Ann Smith, whose heirloom clock's pendulum leaked mercury onto the carpet of her gift store in rural Delhi, N.Y., as a cleaner moved it.
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Health Tip: Feeding Picky Eaters

(HealthDay News) -- Many children are finicky about what they'll eat. If you're attempting to coax a picky eater to try more foods, follow these suggestions from the University of California, San Francisco:

Give your child a variety of foods to choose from, including a fruit, vegetable, protein and starch. Don't only offer foods you know your child will eat.
Don't give your child too many high-calorie drinks, which could fill her up and keep her from wanting to eat.
Stick to a meal schedule, so that your child will be hungry at mealtime.
Keep meals pleasant, in an environment free of TV, argument or stressful conversation.
If your child won't eat, don't prepare a different meal just to satisfy her. She'll have another opportunity to eat at her next meal in a few hours. Continue offering your child foods that she has once refused. Her eating habits may change.
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Tuesday, June 19

Study finds staggering cost of treating diabetics


NEW YORK (Reuters) - One out of every eight U.S. federal health care dollars is spent treating people with diabetes, a study found, and advocates are calling for the creation of a government post to oversee coordination of spending on treatment and prevention among federal agencies.

The study, based on federal spending data from 2005, looked at various government health programs to determine how much was spent on diabetics versus non diabetics. It found it cost the U.S. government $79.7 billion more to treat people with the disease, or some 12 percent of the $645 billion in total federal health care spending projected that year.

The National Changing Diabetes Program (NCDP) study was being released at a briefing with the Congressional Diabetes Caucus on Tuesday. The study, conducted by Mathematica Policy Research for NCDP -- a coalition of diabetes thought leaders, including physician organizations and disease advocacy groups -- included all federally-funded programs that have an impact on diabetes prevention and treatment
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Fiber Funk?

Soluble. Insoluble. Viscous. Fermentable. Fiber's many forms can confuse the most ardent health nut and even nutrition professionals debate the precise benefits of each type. Thankfully, then, a series of recent studies have lifted one clear message above the noise: Don't fret the categories, but focus on total fiber; getting lots of it from unprocessed plants will lower your risk of health problems well into your golden years.

That message has been taken to task by a French study. When researchers examining close to 6,000 people associated fiber intake with high blood pressure, cholesterol and other risk factors for cardiovascular disease, they came up with a complex latticework of benefits by type and source of fiber. For example, fiber from cereals was linked to lower body mass index and blood pressure while fiber from dried fruit and nuts was associated with a lower waist-to-hip ratio.
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Nuts and your heart: Eating nuts for heart health


It sounds a little — pardon the pun — nutty, but there's growing recognition that eating nuts as part of a healthy diet is good for your heart. Nuts, which contain unsaturated fatty acids and other nutrients, are a great snack food, too. They're cheap and easy to store.

The type of nut you eat isn't that important. Walnuts, almonds, hazelnuts, you name it, almost every type of nut has a lot of nutrition packed into a tiny package. If you have heart disease, eating nuts instead of a less healthy snack can help you more easily follow a heart-healthy diet.

Dr. Gerald Gau is a Mayo Clinic preventive cardiologist and is a specialist in internal medicine and cardiovascular diseases. He's been involved with the National Cholesterol Education Program Coordinating Committee, which develops national cholesterol guidelines. He shares his insights on the heart-health benefits of eating nuts.

Can eating nuts help your heart?

It sure looks that way. Most studies on people who eat nuts as part of a heart-healthy diet have found that nuts lower the LDL, low-density lipoprotein or "bad," cholesterol level in the blood.
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Protect your child's environmental health

We all want to protect the planet. After all, our children's future is at stake, as well as our own. But for most moms and dads, hybrid minivans and solar panels are out of reach — and who has the energy to give up diapers or dishwashers?

The good news is, small changes can make a big difference. We went to top environmental experts to get their best tips for busy parents and parents-to-be. Their advice will help you leave the world a healthier place for your child and save you money to boot. What could be better than that?

Here are 7 ways to protect your child's environmental health:

Can the pesticides

"Pregnant women and children are especially vulnerable to pesticides and should avoid them whenever possible," says NRDC's Solomon. Young kids who are exposed to pesticides are at greater risk of developmental delays and childhood cancers, specifically leukemia and brain tumors. At the top of Solomon's list to avoid: flea dips and collars, bug bombs, roach spray, and pesticides on lawns and gardens, which can be tracked into the home and which run off into local streams and waterways. "To keep fleas at bay," says Solomon, "wash pet bedding in hot water every two weeks, vacuum often, bathe your pet with pet shampoo, and flea comb regularly." If that doesn't work, Solomon recommends oral pest control like Advantage for fleas or Frontline for ticks.
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Sleep Myths

Do we really need eight hours of sleep per night?

Not necessarily, but that’s the average for healthy adults. According to the National Institutes of Health, when healthy adults are given unlimited opportunity to sleep they are on the pillow eight to eight-and-a-half hours a night. Most sleep experts recommend between seven and nine hours to be at one’s optimum performance mentally and physically.

The amount of sleep needed to be at one’s best is called “basal sleep” time. Basal sleep is forever in competition with “sleep debt,” which is the total sleep we lose due to certain sleep disorders, restless partners or screaming infants (but parents cherish every waking moment … right?). We constantly need basal sleep to pay down our sleep debt.

Most people have an innate sense of whether they’re getting enough shut-eye (for a quick evaluation of your own sleep status, check out the Epworth Sleepiness Scale). According to the Sleep In America poll, Americans in 2005 averaged almost seven hours per night, while back in 1910 we averaged nine hours. What would you give up for an extra two hours of sleep tonight?
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Tainted toothpaste still in local stores


An informal survey of nine discount "dollar" and "99-cent" stores in Paterson, Passaic and Clifton conducted by the Herald News Sunday turned up four that were still selling potentially contaminated tubes of counterfeit Colgate toothpaste, days after a federal recall.

On June 13, the U.S. Food and Drug Administration issued a recall order for the fake Colgate, explaining that MS USA Trading Inc. of North Bergen was recalling all 5-ounce tubes of Colgate because they may be contaminated with diethylene glycol, or DEG, a potentially poisonous chemical ingredient used in some anti-freeze. The counterfeit product was distributed in New Jersey, New York, Pennsylvania and Maryland.
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Thursday, June 14

The Cost of Obesity – Squeezing Texas Employers

In a 2007 report from the Texas Controller of Public Accounts, it was pointed out that 64% of Texans are overweight or obese. It is estimated that obesity cost Texas employers an estimated $3.3 billion in 2005 and the future does not look good. Research indicates that 42% of fourth graders are overweight, along with 39% of eighth graders, and 36% of eleventh graders. If this prevalence of obesity continues to rise at the current rate, obesity could cost Texas businesses $15.8 billion by 2025. To help control the problem of obesity, in 2007 the Texas Legislature introduced legislation aimed at instituting physical education in public schools. In addition, nearly all school districts have removed unhealthy foods with minimal nutritional value from cafeterias and vending machines.

Source: www.window.state.tx.us/specialrpt/obesitycost/

Obese Employees File Twice as Many Workers’ Comp Claims

A new study of almost 12,000 Duke University employees found that obese workers filed nearly twice as many workers’ comp claims; had 7 times higher medical costs associated with these claims, and 13 times more lost work days due to injury / illness than non-obese employees. In addition, obese workers in high-risk jobs had the highest medical claims of all employees. Employees with a body mass index (BMI) of 30 or more were considered obese. The study found that workers with a BMI of 40 had nearly 12 workers’ comp claims per 100 workers, compared with about 6 claims per 100 workers with a normal BMI (18.5-24.9). Obese workers lost an average of almost 184 work days per 100 workers, compared with just over 14 per 100 for those with an average BMI. Obese employees had an average medical cost claim of $57,019 per 100 workers, compared with $7,503 for non-obese employees. Source: Duke University News Release – Robert Prelot – 4/23/07

Not all dieters put the pounds back on

Dieters: This news should make your day.
The conventional wisdom is that dieters regain most of the weight they lose. But a growing body of research, including data released today, suggests some dieters keep the pounds off, especially if they exercise regularly and don't watch a lot of TV.

Researchers with the Centers for Disease Control and Prevention examined weight reports of 1,310 adults who were overweight or obese and had lost at least 10% of their highest weight. They were participants in the National Health and Nutrition Examination Survey, a nationally representative sample of adults who reported their current weight, their weight the year before and their highest weight ever.

Researchers found that over the course of one year, more than half of those surveyed regained less than 5% of their body weight. One-third regained more than that percentage, according to the findings in July's American Journal of Preventive Medicine.
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Study confirms heart benefits of whole grains


NEW YORK (Reuters Health) - Americans should bulk up on whole grains like oatmeal, barley and brown rice to help lower their risk of clogged arteries, heart attacks and strokes, according to researchers.

In a review of seven major studies, the researchers found that higher whole grain intake was consistently linked to a lower risk of heart disease and stroke. On average, adults who ate 2.5 servings of whole grains per day were nearly one-quarter less likely to develop cardiovascular disease than their peers who rarely consumed whole grains.

Whole grains are believed to benefit the heart in a number of ways. The fiber and other nutrients in whole grains may help lower cholesterol, blood sugar and insulin levels, as well as improve blood vessel functioning and reduce inflammation in the circulatory system. ...more

Obese Employees Cost Companies More

Maintaining a normal body weight may no longer be just a matter of personal health. New research shows that it pays for companies to promote healthy lifestyle choices among its employees. According to a recent study out of Duke University Medical Center, obese employees cost companies more money than their fit counterparts—in lost workdays, higher medical costs, and more workers' compensation claims.

In conducting the study, researchers looked at the records of 11,728 employees of Duke University who received health risk appraisals between 1997 and 2004 to determine if there was a relationship between body mass index and the rate of workers' compensations claims (body mass index, or BMI, takes into account a person's height and weight and is considered the most accurate indicator of obesity). The researchers found that obese workers filed twice as many workers' compensations claims as workers who fell within the recommended BMI range.

Obese workers averaged 11.65 claims per 100 workers, compared to 5.8 claims per 100 for non-obese employees. As a result, obese employees had seven times higher medical costs, for an average of $51,019 per 100 employees. The most common causes of injury among obese workers were falls, slips, and attempts to lift something.
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Diet of Hypertensive Adults Is Getting Worse: Just 22% Following the DASH Diet

May 21, 2007 (Chicago, IL) - New research presented this week has shown that fewer and fewer people with hypertension are following the Dietary Approaches to Stop Hypertension (DASH) diet, a diet that is part of the lifestyle changes recommended for all hypertensive patients in the national guidelines.

Presenting these discouraging findings here at the American Society of Hypertension 2007 Scientific Sessions, lead investigator Dr Phillip Mellen (Wake Forest University School of Medicine, Winston-Salem, NC) said the dietary quality of hypertensive adults has deteriorated since the DASH diet became incorporated in the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) guidelines, and there are significant differences in accordance rates by age, ethnicity, and education.

"We appear to be improving, somewhat, with respect to awareness of hypertension and with respect to treatment of hypertension as well," said Mellen. "But these data are consistent with what we're seeing in the broader population, that the dietary patterns are getting worse over time. . . . We might be getting better at medicines but neglecting nonpharmacologic ways to treat hypertension."
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Tuesday, June 12

Survey For CIGNA Suggests Health Perception Gap

A new survey commissioned by CIGNA HealthCare shows a majority of Americans think they're in very good to excellent health, but that they're probably too optimistic - and maybe a little bit in denial.

The phone survey of 1,000 adults in February, released Monday, found that 57 percent rated themselves in very good or excellent health. Yet when asked how they think other people view them, the picture starts to look less rosy.

For instance, 54 percent said others would say they need to lose at least 10 pounds. The Centers for Disease Control and Prevention, however, estimates that two thirds of U.S. adults are actually overweight or obese, health insurer CIGNA said.

"A whopping 75 percent" agree they'd be viewed by others as being in good physical shape, according to the survey, which was conducted by Yankelovich Inc. for Bloomfield-based CIGNA HealthCare. But only 49 percent think others would view them as exercising vigorously at least three days a week.
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Diabetes drug Avandia caused concern 5 years ago

WASHINGTON - Federal investigators warned nearly five years ago that the diabetes drug Avandia might be causing heart failure, according to an internal government memo released Tuesday by a consumer group.
Investigators also raised concerns about Actos, a similar drug used to treat Type 2 diabetes.

Separately, in fast-moving developments in the latest drug safety investigation, a senior Republican senator said he learned that the Food and Drug Administration's safety office recommended the strongest possible warning for Avandia -- only to be overruled.

"The FDA didn't take that advice," said Sen. Charles Grassley, R-Iowa, a critic of the agency. "Instead, the warning about congestive heart failure risks with this drug is currently buried."
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Diabetes Drug Found to Raise Heart Attack Risk

A drug commonly used to control diabetes increases the risk of heart attacks and possibly death, researchers reported yesterday in the latest episode to raise safety concerns about a widely prescribed drug.

The drug, Avandia, which about 1 million Americans take to keep their blood sugar at safe levels, boosts the risk of a heart attack by 43 percent and may increase the risk of dying from a heart attack or stroke by 64 percent, the analysis found.

A new study reported that GlaxoSmithKline's drug Avandia, used to treat Type 2 diabetes, increased heart attack risk by 43 percent. (By Jb Reed -- Bloomberg News)

"This is very concerning," said Steven E. Nissen of the Cleveland Clinic, who conducted the analysis with colleague Kathy Wolski. The report was released early by the New England Journal of Medicine because of the public health implications. "When you have a drug widely used in a population with a high inherent rate of heart disease, it's very, very concerning."
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U.S. Women Lagging Behind Men for Cholesterol Control

WEDNESDAY, May 16 (HealthDay News) -- Women in the United States are much less likely than men to have their LDL ("bad") cholesterol controlled to recommended levels, a new study finds.
Elevated LDL cholesterol levels increase the risk of cardiovascular disease, the leading cause of death for both women and men in the United States.

Researchers at the National Committee for Quality Assurance (NCQA) looked at 11 measures of cardiovascular disease and diabetes prevention, treatment and risk factors among patients in 46 commercial managed care plans and 148 Medicare plans.
On most of the measures, women had equal or better outcomes than men.
However, women were up to 10 percent less likely than men to have their cholesterol levels under control. The researchers said the findings suggest that women and their doctors may underestimate women's risk for high cholesterol and heart disease, resulting in poorer cholesterol control.
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Vitamin D, omega-3s might cut eye disease risk

CHICAGO - Taking vitamin D and eating fish — especially those high in omega-3 fatty acids — may reduce the risk of the most common cause of blindness among the elderly, researchers said on Monday.

Doctors do not know how to prevent age-related macular degeneration, the leading cause of blindness after age 60, but two studies in the Archives of Ophthalmology suggest nutrient-based treatments may help.

Age-related macular degeneration or AMD occurs when the macula, an area at the back of the retina, breaks down over time. The central vision of the eye becomes blurred.
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Monday, June 11

Fewer U.S. Women Get Breast Cancer Test

After rising steadily for decades, the proportion of U.S. women getting mammograms to screen for breast cancer has dropped for the first time, federal researchers are reporting today.

The overall rate at which women are undergoing regular mammograms fell 4 percent between 2000 and 2005, marking the first significant decline since use of the breast X-rays started expanding rapidly in 1987, the study by the National Cancer Institute and the Centers for Disease Control and Prevention found.

The reasons remain unclear, but researchers speculated that it could be due to factors such as increasingly long waiting times to get appointments, waning fears about breast cancer, the drop in hormone use after menopause, and the ongoing debate over the benefits and risks of the exams.
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Beware fat that sneaks up inside you

LONDON -- If it really is what's on the inside that counts, then a lot of thin people might be in trouble.

Some doctors now think that the internal fat surrounding vital organs like the heart, liver or pancreas -- invisible to the naked eye -- could be as dangerous as the more obvious external fat that bulges underneath the skin.

"Being thin doesn't automatically mean you're not fat," said Dr. Jimmy Bell, a professor of molecular imaging at Imperial College, London. Since 1994, Bell and his team have scanned nearly 800 people with MRI machines to create "fat maps" showing where people store fat.

According to the data, people who maintain their weight through diet rather than exercise are likely to have major deposits of internal fat, even if they are otherwise slim. "The whole concept of being fat needs to be redefined," said Bell, whose research is funded by Britain's Medical Research Council.
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Study: Vitamins Tied to Prostate Cancer

WASHINGTON -- There's more worrisome news about vitamins: Taking too many may increase men's risk of dying from prostate cancer.

The study, being published Wednesday, doesn't settle the issue. But it is the biggest yet to suggest high-dose multivitamins may harm the prostate, and the latest chapter in the confusing quest to tell whether taking various vitamins really helps a variety of conditions _ or is a waste of money, or worse.

A new study says taking too many vitamins may increase men's risk of dying from prostate cancer. The study doesn't settle the issue, but it's the biggest yet to suggest high-dose multivitamins may harm the prostate. (AP GRAPHIC) (AP)

Government scientists turned to a study tracking the diet and health of almost 300,000 men. About a third reported taking a daily multivitamin, and 5 percent were heavy users, swallowing the pills more than seven times a week.

Within five years of the study's start, 10,241 men had been diagnosed with prostate cancer. Some 1,476 had advanced cancer; 179 died.
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Study: Gingseng May Help Fight Cancer

CHICAGO -- The first scientific tests of some popular alternative medicine products hint that American ginseng might lessen cancer fatigue and that flaxseed might slow the growth of prostate tumors.

But a big study proved shark cartilage worthless against lung cancer, and doctors said people should not take it.

The research was reported Saturday at an American Society of Clinical Oncology conference.

The ginseng and flaxseed studies are small and preliminary, and specialists warned against making too much of them because the substances tested are not the same as what consumers find on store shelves.
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Many Americans Confused About Cancer: Survey


THURSDAY, May 17 (HealthDay News) -- The first national survey in a generation to look at Americans' feelings on cancer prevention finds widespread confusion about the disease.
"We found that almost half of the American public believes that 'it seems that almost everything causes cancer,' about one in four feel there's not much one can do to lower the chances of getting cancer, and three out of four felt there were so many recommendations, it's hard to know which ones to follow," said study author Jeff Niederdeppe, a Robert Wood Johnson Foundation Health & Society Scholar at the University of Wisconsin, Madison.
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Long workouts best for raising good cholesterol

NEW YORK (Reuters Health) - People who want to boost their "good" HDL cholesterol levels with exercise will have to put in at least two hours of physical activity each week, an analysis of 25 studies shows.

And the longer each exercise session, the greater the effect, Dr. Satoru Kodama of Ochanomizu University in Tokyo and colleagues found.
While the effect of exercise in increasing levels of HDL cholesterol is well known, studies have had varying results, Kodama and his team note in the Archives of Internal Medicine.
To clarify the relationship between the intensity and duration of exercise sessions and magnitude of HDL cholesterol reduction, the researchers analyzed 25 different randomized controlled trials looking at exercise and good cholesterol.
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Study spots gaps in Americans' diet and health IQ


NEW YORK (Reuters Health) - Ninety percent of Americans say breakfast is an important part of a healthy diet, but just 49 percent manage to eat breakfast every day, a new survey shows.

And only 11 percent know the amount of calories they should consume daily to maintain a healthy weight, according to the International Food Information Council (IFIC) Foundation's second annual Food & Health Survey. "The only good thing is more people tried to guess than last year," Susan Borra, the president of the Washington, DC-based IFIC Foundation, told Reuters Health.
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Monday, June 4

Soccer moms beware: more may not be better

CHICAGO (Reuters) - Doctors should urge children involved in competitive sports to take plenty of time off to avoid physical injuries and mental strain, the American Academy of Pediatrics said on Monday.

Overtraining, burnout and injuries caused by overuse of muscles "are a growing problem in the United States," the group said in a report published in its monthly journal "Pediatrics."

Even though childhood obesity is grabbing headlines, the report said, organized and recreational athletics has boomed and now involves between 30 million and 45 million children ages 6 to 18 in the United States.
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Doctors say roller shoes injuring kids

CHICAGO - Trendy wheeled sneakers that let kids zip down sidewalks, across playgrounds and through mall crowds could also send them rolling into emergency rooms on a stretcher, say doctors who blame a rash of injuries on the international craze.

It's called "heeling," named after Heelys, the most popular brand. They're sold in 70 countries and are so hot that their Carrollton, Texas, maker, Heelys Inc., recently landed atop BusinessWeek's annual list of fastest growing companies.
But doctors from Ireland to Singapore have reported treating broken wrists, arms and ankles; dislocated elbows and even cracked skulls in children injured while wearing roller shoes.
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