New license plate would promote outdoor recreation, support environmental education programs; 900 buyers needed to start

A new "Let's Go Outside" license plate is being offered to give Kentucky motorists the opportunity to promote the health and environmental benefits of outdoor recreation.

First Lady Jane Beshear unveiled the license plate June 10. She said that encouraging children to play outside will help improve their health and noted that "Kentucky has one of the highest childhood obesity rates in the nation," reports to The Lane Report.

Proceeds from the specialty plate will support the work of the Kentucky Environmental Education Council, including coordinating the Kentucky Green and Healthy Schools program and certifying professional environmental educators.

“Kentuckians have said in surveys that children not spending enough time outside is a major concern,” KEEC Executive Director Elizabeth Schmitz said. “One of our goals is to encourage children to embrace the outdoors and to teach them the importance of a clean environment for our health and preservation."

The Kentucky Environmental Education Council needs 900 applications, each accompanied by a $25 donation, before any plates will be manufactured.

Submitting the application does not obligate you to purchase the plate, but your donation will be credited toward the purchase of a plate once they are in production. If not enough applications are received, your $25 will be considered a tax-deductible donation.

A link to download the application is available at www.keec.ky.gov/LetsGoOutside.

Clay County 4th and 5th graders participate in UK research of circadian rhythms and obesity, little studied in children

The University of Kentucky recently partnered with over 100 fourth and fifth grade students in two Clay County schools to study the relationship between circadian rhythms and weight in children.

Sydney Sester, a fifth grade student at Manchester Elementary School, said in a UK news release that in addition to learning more about science and helping others by contributing to research, participating in the study showed her the importance of maintaining a healthy weight and eating well.

"It made me want to be more responsible with food and be patient with what I eat and only eat when I'm hungry," she said.

The project, "Circadian Rhythm Parameters and Metabolic Syndrome Associated Factors in Young Children," also known as the Clay County Clock Study, is led by Dr. Jody Clasey, associate professor of kinesiology and health promotion, and Dr. Karyn Esser, professor of physiology.

The research team says it hopes to learn about the relationship between circadian rhythms, eating, and activity behaviors and the incidence of overweight and obesity in children.

And while the team is in the process of analyzing the data, Esser told a group at the 10th annual Center for Clinical and Translational Science conference in March that early data show 33 percent of the students in the study are considered obese, their initial blood pressure measurements are on the high end of normal, and the students are less active on weekends and nights than during the school week.

The data was gathered through electronic devices that the students wore for seven days to measure activity, heart rate and skin temperature. The students also kept a daily journal to record their sleep and eating activities each day.

Previous studies have shown that disrupting an adult's circadian rhythm is associated with increased risk for metabolic disease, which is a combination of chronic health conditions that puts a person at a higher risk of heart disease and diabetes. Similar research with children has been limited.

Esser noted that "Clay County and many of the counties in Appalachia have a much higher rate of these chronic diseases."

She also said that while it is known that light exposure affects the body clock, recent findings show that the time that we do activities, like exercising and eating, also contribute to circadian health, and that this is also likely true in children.

This research "could not only influence an individual, but school start times, activity intervention, just so many different areas from personal practice or behavioral choices to public policy, all for the metabolic or physiological good of the individual or collective body," Clasey said.

Obesity and depression may contribute to daytime sleepiness

Obesity and depression, not just lack of sleep, contribute to daytime drowsiness, according to Penn State College of Medicine researchers. Daytime drowsiness or sleepiness affects up to 30 percent of the U.S. population. It can reduce work productivity and cause car accidents. According to the States of Obesity report, 33.2 percent of Kentucky adults are obese.

The Penn State study used physiologic sleep data to show a connection between obesity and depression or sleepiness. Study participants filled out a comprehensive sleep history and physical examination and were evaluated in a sleep laboratory. "Obesity and weight gain predicted who was going to have daytime sleepiness," said Julio Fernandez-Mendoza, assistant professor of psychiatry at the Sleep Research and Treatment Center. "Weight loss predicted who was going to stop experiencing daytime sleepiness, reinforcing the causal relationship."

Body mass index and sleepiness association was independent of sleep duration, so obese people might be sleepy during the day regardless of how much sleep they get. Obesity is also associated with sleep apnea. The chief reason heavy people are more tired is that fat cells create immune compounds called cytokines that make one sleepy.

According to the study, depressed people have daytime drowsiness because they have trouble falling asleep and often wake up during the night. "The mechanism that we believe is playing a role here is hyperarousal, which is simply going to bed and being to alert; in other words, people with depression feel fatigued but do not necessarily fall asleep during the day, Fernandez-Mendoza said.

The study showed that a one-size-fits-all method for treating daytime drowsiness will not be effective. Daytime sleepiness doesn't always mean a person doesn't get enough sleep, Fernandez-Mendoza said. "The main causes of a sleepy society are an obese society, a depressed society and, to some extent, people who have a physiological disorder. By looking at our patients more closely, we can start personalizing sleep medicine."

One of every three U.S. adults have a combination of risk factors that increase their risk for heart disease and diabetes

More than one-third of adults in the U.S. have a combination of health conditions that put them at higher risk of heart disease and diabetes, and this condition affects nearly half of adults aged 60 and older, according to a new study recently published in the Journal of the American Medical Association.

Image: healthyanswers.com

This combination of health conditions, when found in one person, is called metabolic syndrome. It includes abdominal obesity, high blood pressure, increased fasting glucose levels and abnormal cholesterol levels.

The study collected data gathered by the federal Centers for Disease Control and Prevention from adults 20 and older from 2003 to 2012. It found that about a third had a metabolic symdrome in 2011-12, and nearly half of those 60 and older did. Among those 20 to 39, the rate was 18 percent.

The study report says these were "concerning observations" because of the country's aging population. Hispanics, at 39 percent, were found to have the highest prevalence of metabolic syndrome among ethnic groups. Women had a higher prevalence than men in all age groups.

The American Heart Association says the best way to control the risk factors contributing to metabolic syndrome are to lose weight and increase physical activity. It also encourages patients to routinely monitor their weight, blood glucose, cholesterol and blood pressure and treat these risk factors according to established guidelines.

Most Kentuckians don't think insurance rates should be higher for the obese, but are divided on increasing smokers' rates

By Melissa Patrick
Kentucky Health News

By a very small margin, Kentuckians think insurance rates should be higher for smokers if the insurance company provides a free smoking cessation program, but most don't think rates should be higher for those who are overweight, says the latest Kentucky Health Issues Poll.

The poll, taken Oct. 8 to Nov. 6, found that 50 percent of Kentucky adults said it would be justified to set higher insurance rates for people who smoke, while 45 percent said it wouldn't be justified. Five percent were undecided. This finding was basically the same whether the person had insurance or not.

The poll's margin of error was plus or minus 2.5 percentage points, which applies to each number, so the results were right on the error margin. That means in 19 of 20 cases, the results would be the same if the entire adult population of Kentucky were asked the question.

The poll found that most Kentuckians who have never smoked (63 percent) said insurance companies should not set higher insurance rates for people who smoke. Former smokers, at 51 percent, were less likely to agree with that opinion.

With about 27 percent of Kentuckians smoking, Kentucky leads the nation in smoking percentage, lung cancer and lung cancer deaths, which collectively come with a price tag.

Smoking cost the state $1.92 billion a year for health-care expenditures directly as a result of tobacco use, which amounts to $988 million a year in total taxpayer cost from smoking-related expenses, or $591 per household, Wayne Meriweather, chief executive officer of Twin Lakes Regional Medical Center in Leitchfield, representing the Kentucky Hospital Association, told legislators in December.

The poll also found that the majority of Kentucky adults, 67 percent, think it is unjustified to set higher insurance rates for people who are significantly overweight. Opposition was higher, 77 percent, among those who reported being in fair or poor health; among those who said they were in excellent or very good health, only 58 percent were opposed.

Kentucky ranks fifth in the nation for adult obesity, with one in three Kentuckians considered obese, according the "States of Obesity" report. This also comes with a price tag.

A study in the American Journal of Health Promotion found that a morbidly obese employee costs his or her employer approximately $4,000 more in health care and related costs every year than an employee of normal weight.

The poll was sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati, and was conducted by the Institute for Policy Research at the University of Cincinnati. It surveyed a random sample of 1,597 adults via land lines and cell phones.

Federal dietary guidelines recommend cutting back on red and processed meat, sugar and refined grains

The Department of Agriculture and the Department of Health and Human Services have released proposed 2015 Dietary Guidelines for Americans. The guidelines, released every five years, "provide authoritative advice about consuming fewer calories, making informed food choices, and being physically active to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health," says USDA.

It shouldn't come as a surprise that the 2015 guidelines recommend eating healthier foods, while cutting back on less healthy alternatives. "The committee basically recommended Americans take up a diet that is higher in vegetables, fruits, whole grains, low- or non-fat dairy products, seafood, legumes and nuts," Chris Clayton reports for DTN The Progressive Farmer. "We should cut back on red and processed meats and sugar-sweetened foods, drinks and refined grains. And we should be moderate in our alcohol."

Recommended cutbacks of certain foods have not gone over well with those food producers, who met this week to give feedback on the Dietary Guidelines Advisory Committee's recommendations, Clayton writes. The North American Meat Institute argued that "lean meat, poultry, red and processed meats should all be part of a healthy dietary pattern because they are nutrient-dense protein."

Shalene McNeill, a nutritionist for the National Cattlemen's Beef Association, "told the committee that its recommendation to exclude lean meat ignores decades of nutrition science," Clayton writes. McNeill said Americans should be encouraged to eat more lean meat, along with fruits, vegetables and whole grains. Grain, sugar and milk producers also expressed displeasure with the proposed rules.

Most nutritionists have embraced the proposed rules, but say the key is getting people to adopt them, Andrea McDaniels reports for The Baltimore Sun. Among those rules is limiting sugar intake to 200 or less calories, or 10 percent of total calories, per day. Currently, Americans get about 13 percent of their calories, or 268 calories, from added sugar.

"On the flip side, some foods once shunned are now accepted," McDaniels writes. "Research has found that cholesterol-high foods are no longer believed to contribute to high blood cholesterol, so people can now indulge in shrimp, eggs and other foods that were once off limits, the panel said. Rather than focus on cholesterol, people should curb saturated fat to about 8 percent of the diet."

The panel also said "up to five cups of coffee a day are fine, so long they are not flavored with lots of milk and sugar," McDaniels writes. "The panel also singled out the Mediterranean diet—rich in fish and chicken, fruits and vegetables, nuts, whole grains, olive oil and legumes—for its nutritional value."

Beshear cites signs toward better health: kids are more active and getting more dental care; adults are getting more screenings

Kentucky Health News

Kentucky is moving toward achieving the broad, ambitious goals for better health that Gov. Steve Beshear laid out when he started the "Kyhealthnow" initiative in February 2014, his office says.

"More Kentuckians have health insurance, are covered by smoke-free policy, can access physical activity resources, seek care for heart disease and cancer prevention, and get dental services" since the initiative began, Beshear said in a press release.

The program builds on federal health reform, which has made Medicaid or private insurance available to hundreds of thousands of Kentuckians, many of whom were previously uninsured and unable to afford health coverage. According to a Gallup Poll released in February, 9.8 percent of Kentucky’s population is uninsured, down from 20.4 percent in 2013.

Kyhealthnow targets seven major health goals to be met by 2019, focusing on increasing health insurance coverage; reducing the smoking rate and tobacco use; lowering the prevalence of obesity; lowering cancer deaths; reducing cardiovascular disease; treating and reducing dental decay; and reducing drug overdoses and mental health issues in Kentucky.

The report said more adults have been screened and identified as having high blood pressure and are able to control their hypertension, and more adults have had their cholesterol checked.

Significantly more children on Medicaid are being seen by dentists, and the number of children enrolled in Medicaid receiving two fluoride dental varnishes per year has increased. The state has given money to five health departments for dental-hygiene programs, and will fund five more this year. "These programs broaden access to hygiene services, such as cleanings, screening and referrals, by providing staff and resources to supply mobile units to deliver care in schools," the release said.

School districts are showing an increase in the amount of time devoted to physical activity, the state reports. The Comprehensive School Physical Activity Program has been implemented at proficient or distinguished levels at all grade levels in 515 of the state's 746 elementary schools, 186 of the 329 middle schools and 109 of the 228 high schools. Also, more schools report they are using body-mass index data to inform school wellness policy.

The state health department is using federal funds to implement physical activity and obesity-prevention curricula in early-childhood care centers. "The goal is to develop healthy habits in children before the age of 5 and prevent obesity," the news release says.

To increase physical activity and deter obesity among older children and adults, the state is establishing “trail towns.” Morehead and Olive Hill were recently certified by the state Office of Adventure Tourism and eight more are expected to be certified this year. The Dawkins Trail, an ongoing rail-to-trail project in Eastern Kentucky, has reached a length of 18 miles.

Diabetes management has improved among adults, and a study of Medicaid patients showed an overall decrease in those with poor diabetes control, the release said. State employees now have easier access to the nationally recognized Diabetes Prevention Program, which helps people who are at risk of developing diabetes reverse the onset of the disease.

Dr. Stephanie Mayfield, the state health commissioner and vice chair of Kyhealthnow, has emphasized the importance of reducing tobacco use to make Kentuckians healthier. Beshear has expanded the ban on tobacco products and e-cigarettes on executive branch properties, making Kentucky one of only five states in the country with such a policy. Smoking bans exist in 24 communities, 37 school districts and 51 college or university campuses.

Kyhealthnow, chaired by Lt. Gov. Crit Luallen, includes people from many areas of state government who develop innovative strategies for addressing the state’s health woes and challenge local governments, businesses, schools, nonprofits and individuals to take meaningful steps toward improving health in their communities, the release said.

Student loses 175 lbs. in 14 months after gastric-sleeve surgery

Elizabeth Whitt and Don McNay

Elizabeth Whitt, an Eastern Kentucky University communications major from Richmond, Ky., decided to have gastric sleeve weight loss surgery when she was 19, and now, 14 months later, she has lost 175 pounds, Don McNay writes for The Huffington Post. McNay had the same surgery on Dec. 1 last year and has lost 70 pounds since then. He is writing a book called Project 199: My Business Plan to Lose 175 Pounds because he wants to drop from his original weight of 377 pounds to 199.

While McNay had the surgery at age 55 as a last chance to avoid an early death, Elizabeth had the surgery in college, when most people are not thinking about death. Dr. Derek Weiss at Bluegrass Bariatric in Lexington, Ky., operated on both of them. Weiss said that "doing weight loss surgery on a teenager had been rare before the gastric sleeve became more common as the risk of complications is lower than the other surgeries," McNay writes. Weiss said that "LSG is a tool. It limits the amount you can eat very successfully. But I think all LSG patients who succeed can take most of the credit themselves; they chose what to eat (and drink) and how much to exercise."

Whitt before (above) and after (below) with her health team

McNay talked with Whitt because although he had interviewed many experts already, he wanted to hear from someone who had been through the surgery. Whitt said the surgery has allowed her to be much more energetic and active. McNay asked Whitt how she was dealing with the sudden surge of attention from people who are drawn to success. She said she doesn't pay attention to men who express interest in her now but didn't talk to her when she was overweight. Whitt also noted that her parents did not support her having surgery until she presented them with research showing the benefits.

Michael and Debi Benson, the president and first spouse at EKU, said Whitt babysits their three children. President Benson said, "Debi and I are very grateful for Elizabeth and have marveled at her physical transformation. This change has allowed her inner beauty, which has always been radiant and contagious, to shine through even more."

"It took all of my forcus and courage to have the surgery at age 55," McNay writes. "There is no way I would have undertaken it at age 19. . . . When I weigh in at 199 pounds and hit the same 175 weight loss number that Elizabeth hit, I will say one thing for certain: she has been my inspiration. And my hero." (Read more)

Humana plan members can join Weight Watchers free for six months, get 'a significant discount thereafter,' companies say

Humana Inc. and Weight Watchers International Inc. are teaming up to help employers attack the rising level of obesity and its health-related impacts.

Employees in Humana-managed, employer-sponsored health plans now have free and discounted access to Weight Watchers through an integrated wellness program built into their health plan, the first program of its kind, the two companies said in a news release.

Plan members who want to lose weight can join Weight Watchers free for six months, "and at a significant discount thereafter," the release said. "Weight Watchers helps people adopt a healthier lifestyle that results in achieving and learning to maintain a healthy weight."

Remke Markets, a family-owned grocer with 12 locations in Kentucky and Ohio, is offering the program to its 900 employees.

“What I like about this program is that it actively connects people who want to get to a healthy weight with a trusted, well-known and effective program, and then helps make it affordable,” President Matthew Remke said. “The health risk that extra weight poses for our associates and their families is reason enough to want to attack the problem, but there are also serious consequences of an unhealthy workforce for an employer trying to compete in a tough marketplace.”

Churches add fitness facilities as part of ministry outreach, community service; Louisville's Walnut Street church led the way

More churches are beginning to see health and fitness facilities as potential ministry niches, which can positively influence surrounding communities. Walnut Street Baptist Church in Louisville was a pioneer, building a six-story health facility including bowling alleys in the late 1950s and early 1960s, church consultant George Bullard told Jeff Brumley of Baptist News Global.

Now health ministries have been "making a comeback as a variety of social and religious trends in America converge," Brumley reports. "There is absolutely an opportunity for new forms of church centered around fitness," said Travis Collins, the director of mission advancement and Virginia regional coordinator for Fresh Expressions US.

Creative Commons photo by jerronlife

Secular organizations that promote fitness often promote health-focused ministries and programs. For example, Houston-based nonprofit Health Fitness Revolution released a list of the 20 Fittest Churches in Texas. Samir Becic, the organization's founder, said, "Spiritual awareness is one of the key components of healthy lifestyle that impacts the whole body and rejuvenates the spirit." Many of the churches on the list have fitness classes, nutrition and senior programs and sports leagues. Some also have facilities for fitness and health.

Second-Ponce de Leon Baptist Church in Atlanta has a 70,000-square-foot facility with a indoor pool and track, weight room, cardio center and even personal trainers. The church website says, "It is our desire that all who use our facility or participate

in our activities will have the opportunity to hear that Jesus Christ loves them and desires to have a personal relationship with them," the church website says.

Besides building fitness centers, churches are promoting good health in other ways. "Another wave in recent years is that of church members, often led by pastors, uniting to lower blood pressure, drop pounds and tone up as a team," Brumley writes. Christianity Today reported in 2013 that churches from Indiana to Virginia were making fitness pledges, and 250 members of Central Baptist Church in Northern Virginia said they lost 12,000 pounds collectively. (Read more)

Researchers blame Walmart, other bulk suppliers for part of obesity epidemic

Part of the rise of obesity in America can be linked to the availability of cheap food sold in bulk from warehouse stores like Walmart, says a study released this week by researchers from Georgia State University, the University of Iowa, the University of Virginia and the University of Louisville, . Wal-Mart is the biggest retailer in the U.S. and a staple of many rural areas.

"We live in an environment with increasingly cheap and readily available junk food. We buy in bulk. We tend to have more food around. It takes more and more discipline and self-control to not let that influence your weight," Charles Courtemanche, assistant professor of economics at Georgia State, told Danielle Paquette of The Washington Post.

Obesity in America has surged from 1960, when 13 percent of adults were obese, to 2012, when 35 percent of adults were, Paquette writes. The first Walmart store opened in 1962, the first Sam's Club in 1983 and the first Walmart supercenter in 1988. In addition to Walmart, numerous other warehouse-style stores, like Target and Costco, have followed Walmart's lead by selling in bulk.

The study found that opening an additional Walmart store "per 100,000 residents increased an area’s average body mass index by 0.24 units, or 10.8 percent of the sample obesity rate," Paquette writes. Researchers wrote, “These estimates imply that the proliferation of Walmart supercenters explains 10.5 percent of the rise in obesity since the late 1980s.” (Read more) (Growth of Wal-Mart since 1962)(Growth of Walmart since 1962)

Are nutrition rules for schools and day-care centers too much regulation, or steps in the right direction, toward better health?

Commentary by Melissa Patrick
Kentucky Health News

The Paducah Sun's editorial on Jan. 20 said the Obama administration has overstepped its bounds by expecting child day-care centers to follow stricter nutrition standards. The newspaper also called for relaxation of the requirements of the 2010 Healthy, Hunger-Free Kids Act, as Republicans hope to to when the law comes up for reauthorization this year. (The editorial is behind a paywall.)

The editorial does what any good editorial should do: stirs up a bit of controversy and makes you think a bit harder. Do you agree with the editorial's views that these nutrition standards impose "too much regulation," or are you thinking,"We have to try something to combat obesity and the best place to change health behaviors is with children?"

What most everyone probably agrees on is that we have a problem: too many fat, unhealthy children who will become fat, unhealthy adults, perpetuating a chronic health epidemic that is sweeping across Kentucky and the nation. "The heaviest children are getting even heavier" and "overweight or obese preschoolers are five times more likely than normal-weight children to be overweight or obese as adults," says the Obesity Society website.

Nationwide, one in five children is overweight and more than one in three adults are obese, according to the Centers for Disease Control and Prevention. Kentucky leads the nation in both adult and child obesity, ranking fifth for adult obesity; first for high-school obesity; eighth in obesity of 10- to 17-year-olds; and sixth in obesity among 2- to 4-year-olds in low-income families, according to the States of Obesity report. These statistics don't even include the number of adults or children who are simply "overweight."

The World Health Organization says chronic disease is the leading killer in our world, with two-thirds of all deaths worldwide a result of conditions such as heart disease, cancer, diabetes and respiratory infections in 2012. Kentucky, once again, leads the way in each of these conditions.

Kentucky ranks eighth in the nation for heart-disease deaths; 17th for diabetes; fifth for high blood pressure; and first for smoking, lung cancer and lung cancer deaths.

The editorial says, "The food police are on the march again." Is it too much regulation, or could these "police" represent a concerned government trying to solve a major health-crisis that is only getting worse?

In making the day-care proposal, Agricuture Undersecretary Kevin Concannon wrote, "Providing children access to nutritious food early in life helps instill healthy habits that can serve as a foundation for a lifetime of healthy choices.”

The Department of Agriculture proposal calls for new nutritional guidelines for child and adult day-care programs, after-school programs and people who live in shelters that are part of USDA's Child and Adult Day Care Food Programs.

The guidelines would follow the Healthy, Hunger-Free Kids Act guidelines followed in schools, which require more fruits and vegetables, more whole grains, less fat and sugar, and limit calories according to age.

What seems to aggravate Sun Editor Jim Paxton the most are the proposal's suggestions to ban on-site frying and the qualification of tofu, a soybean curd, as a meat alternative. It said that while the program was originally set up to combat malnutrition, it now has decided "a little starvation is not a bad thing; ergo, tofu instead of fried chicken."

The editorial suggests that day-care facilities could no longer have french fries or fried chicken, but it fails to mention that both items could be offered with a more healthful preparation in the oven. And tofu, a cheap, low-fat protein source, would be added as an option, not a requirement.

The recommended way to lose weight is to decrease calories, eat healthful foods, and increase activity. The nutritional requirements suggested in this program include two of these efforts.

The editorial reminds us that some students are "turning up their noses at the new offerings," that "student participation in school meal programs is down," and says pre-school programs are concerned that the same thing will happen to them.

However, schools say they are tweaking their menus to find healthful foods that the kids like and purchase newer whole grain products that don't taste any different than the processed grains the kids are used to.

So, is it too much regulation or a new way to improve the health of children that will take time and tweaks to perfect?

The editorial says the Sun supports nutrition education and healthy choices on the school menu, but that the "primary responsibility for combating childhood obesity lies with parents and the rules they set in the home."

But what the editor fails to consider is that one out of three adults, many whom are parents, are obese, and are the ones responsible for teaching these lessons.

Too much regulation or a step in the right direction? You decide.

Research suggests eating only during a nine- to 12-hour time period can help maintain healthy weight

For a long time, scientists supposed that eating after midnight was unhealthy, but now a study has provided support for the notion. When scientists prevented mice from eating whenever they wanted, the animals avoided obesity and metabolic issues—even when the diet was unhealthy, Ben Wiseman reports for The New York Times.

In a previous study, researchers at Salk Institute for Biological Studies in San Diego began studying mice eating patterns. The mice in the study that were permitted to eat whenever they wished gained weight and became unwell, while the mice who were only permitted to eat during an eight-hour window didn't gain much weight or develop metabolic problems.

The new study, which was published in the journal Cell Metabolism in December, Salk scientists provided groups of mice with one of four diets: high-fat, high-fructose, high-fat and high-sucrose and regular mouse food. "Some of the mice in each dietary group were allowed eat whenever they wanted throughout their waking hours; others were restricted to feeding periods of nine, 12 or 15 hours," Wiseman writes. The caloric intake for all the mice was the same.

Some of the mice in the time-restricted groups were allowed to eat whenever they wanted on weekends, and some of the eat-anytime mice were moved to the restricted groups halfway through the study. At the end of the study, the mice that ate whenever they pleased became obese and metabolically ill, but the time-restricted mice stayed healthy. The mice switched from the former group to the latter lost some of the weight they'd gained, Wiseman writes.

Though scientists don't know exactly why eating during a designated timeframe helps prevent weight gain, Dr. Satchidananda Panda, who oversaw the studies, and his colleagues think it has to do with the body's internal clock. "Meal times have more effect on circadian rhythm than dark and light cycles," Panda said. Circadian rhythm influences the function of many genes in the body that have to do with metabolism.

These studies have only been performed using mice, but Panda believes the results could apply to humans. He suggests that people only eat within a 12 hour—or shorter—window each day. The clock begins with the first thing a person eats in the morning. (Read more)

Another study suggests that lack of walking and other physical activity damages blood vessels and causes many health issues

If you are looking for a reason to commit to daily exercise in 2015, here are two: The U.S. surgeon general says most of us only exercise about half the recommended amount to be healthy, and a new study shows that this lack of activity damages our blood vessels, which contributes to much of what ails us.

Research at the University of Missouri School of Medicine, published in Medicine and Science in Sports and Exercise, found that going from high (10,000 steps a day) to low levels of daily physical activity (5,000 steps a day) for just five days decreases the function of the inner lining of the blood vessels in the legs, according to a news release from the university.

“The impairment we saw in just five days was quite striking,” Paul Fadel, associate professor of medical pharmacology and physiology at the university, said in the release. “It shows just how susceptible the vascular system is to physical inactivity.” Previous studies have found that a decrease in blood-vessel function is linked to early cardiovascular death and hypertension.

Kentucky is the ninth most inactive state, with almost one-third (30.2 percent) of Kentuckians reporting in a national survey that they did not engage in physical activity or exercise during the previous 30 days other than doing their regular jobs, according to the State of Obesity report.

A collective New Year's resolution by Kentuckians to increase their physical activity, if kept, would help improve almost every health issue that plagues our state: obesity, diabetes, high blood pressure, heart disease. Kentucky ranks fifth in obesity, 17th in diabetes and fifth in hypertension, and is projected to have more than 1 million cases of heart disease by 2010, the report says.

“Inactivity is typically going to lead to people being overweight and obese,” Fadel said. “The next step after that is insulin resistance, which leads to Type 2 diabetes and cardiovascular disease.”

So, how much activity do we need to keep our blood vessels healthy? 10,000 steps every day, says the surgeon general. But the reality is that most of us only take 5,000 steps a day, which is considered a low activity level. The research for this study is based on 30 minutes of moderate activity a day.

“We need to teach and explain to people about the physiology of their bodies and the physiology of the disease process and help them understand that inactivity plays a foundational role in the disease process,” John Thyfault, associate professor of nutrition and exercise physiology at the university, said.

“Then we give them behavioral tools, like pedometers, to monitor and help them achieve higher physical activity so they start to see and feel health improvements. These studies are proof we need to get people to understand their activity every day plays a role in their health, and that their health is not simply a matter of body weight and how they look in the mirror.”

Kentucky drops two spots in America's Health Rankings, based on data since 2012 or earlier

Kentucky dropped two spots in the 25th annual America's Health Rankings report this year and finds itself once again as one of the bottom five healthiest (or unhealthiest) states.

Since the rankings were first released in 1990, with the exception of 2008 when it ranked 39th, Kentucky has ranked in the bottom 10 states for health. This year it ranks 47th.

The rankings are based on data gathered in the last two to three years, or even earlier, a fact state officials noted as they mentioned the Patient Protection and Affordable Care Act.

"While we have made much headway in the last year, we still have much work to do," said a statement from the Cabinet for Health and Family Services. "We expect that Kentucky’s statistics will begin to improve over time as the full effect of the ACA is reflected in future rankings. However, this change may take time, as Kentucky will be compared to other states that may more quickly see their health outcomes improve.”

Gov. Steve Beshear has made changing health behaviors to create a healthier population a priority for the state. He initiated the Kyhealthnow initiative, which established seven major measurable goals to improve the health status of Kentuckians over the next five years. He has also banned the use of tobacco products on most state properties.

Kentucky's latest ranking should come as no surprise since the state ranks in the bottom five states for eight of the measures: smoking, drug deaths, obesity, children in poverty, preventable hospitalizations, poor mental health days, poor physical health days and cancer deaths. Additionally, it ranks in the bottom 10 states for physical inactivity, air pollution, cardiovascular deaths and premature deaths.

Kentucky has already shown an improvement in smoking. While Kentucky still ranks second in smoking, fewer Kentuckians are smoking. In the past two years, smoking has decreased by 9 percent to 26.5 percent from 29 percent. In 1990, 35.3 percent of Kentuckians smoked.

"The decline in smoking rates stands out as a significant health improvement over the past 25 years," says the American Health Rankings news release. "Cigarette smoking is still associated with one of every five deaths in the United States, making it the leading cause of preventable death in the country."

Kentucky, like the rest of the nation, is getting fatter and becoming more sedentary.

Kentucky ranks fifth in obesity, with 33.2 percent of its adults having a body mass index of 30.0 or higher. In 1990, only 12.2 percent were obese. Kentucky doesn't fare much better with physical inactivity, ranking ninth with 27.4 percent reporting inactivity in the last 30 days.

Nationwide, obesity rates increased by 7 percent to 29.4 percent from 27.6 percent and the percentage of adults reporting inactivity in the last 30 days increased to 23.5 percent from 22.9 percent.

Kentucky has also seen a steady increase in the percentage of its adults with diabetes. Kentucky ranks 33rd in diabetes, with 10.6 percent of its adults reporting they have been told by a doctor that they have diabetes. In 1996, 3.6 percent of Kentuckians reported having diabetes.

Drug deaths have increased by 30 percent in the last two years, to 24 per 100,000 population from 18. Kentucky ranks third in this measurement.

Kentucky ranks first in four measures: children in poverty (31.8 percent), preventable hospitalizations (94.4 per 1,000 Medicare beneficiaries), poor mental health days (4.5 days reported in the previous 30 days), and cancer deaths (228.3 deaths per 100,000 population).

The number of children in poverty has increased by 36 percent in the past two years (31.8 percent from 23.3 percent).

Kentucky does have a few bright spots on the evaluated health measures including a low prevalence of binge drinking, a low violent crime rate and high immunization coverage among children.

Hawaii, Vermont, Massachusetts, Connecticut and Utah are ranked as the top five healthiest states. Mississippi is ranked 50th this year, preceded by Arkansas (49), Louisiana (48), Kentucky (47) and Oklahoma (46). West Virginia and Alabama moved out of the bottom five.

The report, published by United Health Foundation in partnership with American Public Health Association and Partnership for Prevention, uses data from well-recognized outside sources, such as the Centers for Disease Control and Prevention, American Medical Association, FBI, Dartmouth Atlas Project, U.S. Department of Education and Census Bureau.

To see the Rankings in full, visit www.americashealthrankings.org.

Chain restaurants, theaters, amusement parks and grocery delis must post calorie counts in a year, to fight obesity

McDonald's already posts calorie content on its menus

In an effort to combat the country's obesity epidemic, the Food and Drug Administration issued final regulations Tuesday that will require chains with 20 or more restaurants, movie theaters and pizza parlors to post calorie counts on menus.

"The rules will have broad implications for public health," Sabrina Tavernise and Stephanie Strom report for The New York Times. "As much as a third of the calories that Americans consume come from outside the home, and many health experts believe that increasingly large portion sizes and unhealthy ingredients have been significant contributors to obesity in the United States."

“This is one of the most important public health nutrition policies ever to be passed nationally,” Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, told the authors. “Right now, you are totally guessing at what you are getting. This rule will change that.”

The numbers "could be a pretty big wake-up call," writes Jason Millman of The Washington Post. "The FDA rules are more comprehensive than expected, given the strong industry pushback since the menu labeling provision was included in the 2010 health-care law." The FDA proposed a rule in 2011, but heavy lobbying has delayed its finalization.

"Do people eat healthier when they can see calorie counts?" Milliman asks. "The evidence so far seems mixed. The impact seems to be greater when the calorie count is much higher than what consumers expect. What does seem clear from past studies is that people really are terrible judges of how many calories they consume when they dine out [and] are especially bad judges of the calorie content of the least healthy foods commonly found of restaurant menus."

The rules also cover food in vending machines, amusement parks, alcohol if it is on the menu or a menu board, and some prepared foods in supermarkets. Chain restaurants are defined as food establishments with 20 or more outlets.

The policy will take effect a year from now, "and seems likely to face legal and political challenges from some parts of the food industry, including grocery and convenience stores that sell prepared foods for takeout," the Times reports.

The National Grocers Association told the paper, “Grocery stores are not chain restaurants, which is why Congress did not initially include them in the law. We are disappointed that the FDA's final rules will capture grocery stores, and impose such a large and costly regulatory burden on our members.”

Daren Bakst, a research fellow in agricultural policy at the conservative Heritage Foundation, told the authors that the FDA interpreted the law too broadly. “If Congress wanted to cover any establishment that sells prepared foods, they would have said that,” he said. “No reasonable person is about to confuse a grocery store, convenience store or movie theater with a restaurant.” But retiring Democratic Sen. Tom Harkin of Iowa, who helped create the labeling requirement, said the rule “closely mirrors congressional intent.”

The FDA offered some concessions to grocers, convenience stores, pizza chains and vending-machine owners. For example, pizzerias can define their serving sizes and list calories by the slice, and vending machine owners have been given an extra year to comply.

Brown fat, already known as a super calorie burner,' could also be a key to treating Type 2 diabetes, study shows

Better understanding brown fat could lead to future ways of treating obesity and type 2 diabetes, Abby Phillip reports for The Washington Post.

A recent study published in The Journal of Cell Biology found that brown fat cells are not only great "super calorie burners," burning calories as they help keep the body warm in cold temperatures, but are also a "super vacuum," producing a substance that sucks up excess glucose in the blood and transports that sugar into the brown fat cells, where it can be burned to produce heat, Phillip writes.

For people with type 2 diabetes, whose bodies do not use insulin properly and as a result have high blood glucose levels, these findings could lead to new drugs that can activate brown cells and reduce blood glucose levels without insulin, Phillip reports.

"If you can start the tissue to burn and produce heat, then you can actually in a way take away excess glucose in the blood," Tore Bengtsson, one of the study's authors told Phillip. "Now we actually understand how this production of these glucose transporters work."

Kentucky has the fifth-highest incidence of diabetes and obesity among all the states, with almost one in five Kentuckians diagnosed with diabetes or prediabetes and one in three adults in considered obese. Obesity can lead to the development of Type 2 diabetes.

"The implication of this is normally when you have Type 2 diabetes you have to inject insulin to reduce your blood sugar levels," Bengtsson told the Post. "However you could make a medicine which is not based on insulin signalling. It's a completely new pathway that can be targeted for taking up glucose in the blood."

Bengtsson told the newspaper "that he is working on the next step in the research -- looking for specific ways of activating the cells, which will be crucial for the development of new drugs."

Generals say obesity is a national-security issue, and the main medical reason 73% of Ky. young adults can't join the service

"Obesity is the leading medical reason why 73 percent of our young adults cannot qualify for military service" in Kentucky, two former state adjutants general write in The Courier-Journal. They endorse the Obama administration's nutrition standards for school meals.

"We must turn the tide on the obesity epidemic by instilling good eating and exercise habits from an early age. Good nutrition starts at home, but many kids get up to half of their daily calories at school so it just makes sense to ensure they’re eating healthfully there, too," write Maj. Gens. Michael Davidson and Allen Youngman.

"Unfortunately, there is a misguided effort afoot to enable schools to retreat from these improved nutrition standards," they write. "The move is driven by complaints that some students are having trouble adjusting to the healthier offerings, and that some schools are struggling to procure healthier ingredients and the necessary equipment for preparing the new meals. In response, the USDA is offering significant flexibility to these schools. They permanently removed caps on proteins because of the challenges some schools were facing, and offered flexibility on rules regarding whole grain pasta. They also extended the grant period for funds to help schools meet the new standards, and are providing workshops to help schools that are struggling learn what works from those that are succeeding.

As school-lunch debate puts attention on rejected meals, we might consider a bigger problem: food wasted at home

The new nutrition rules for school meals have led some students to throw away food they're served. Schools across the country are estimated to waste $1.2 billion worth of food every year, based on extrapolations from a study the National Institutes of Health conducted in Boston schools. That's a lot of wasted food and money, but students and their families waste even more food at home, George Jones writes for WFIE-TV in Evansville.

According to the U.S. Department of Education approximately 49.8 million pre-K through 12th-grade students will attend public schools this year. Each student is estimated to waste about $33 worth of federally funded lunches per year. "The average person in the general population wastes almost that much in total meals during one month," Jones reports.

Americans threw away $161 billion worth of food in 2010—nearly one-third of the available food supply, according to the U.S. Department of Agriculture. That means the average person discards $372 worth of food each year, or four times as much as students.

"Sometimes people say it's the family and parents making choices, but it's the larger system we're in that making this problem," aid Pamela Koch, director of the Laurie M. Tisch Center for Food, Education and Policy at Columbia University. "They're working so many hours they think they don't have time to shop and cook healthy. And the most inexpensive foods are the ones that are not the most healthy for them."

Rising obesity rates and fast food consumption show that adults aren't eating well-balanced meals, much less school-aged individuals. The School Nutrition Association supports the rules requiring reduced-fat and fat-free milk and more fruits and vegetables, but "feels serving only whole grain breads and requiring children to take food they don't otherwise each is burdensome for schools," Jones reports.

"You're never going to be able to promote healthy diets for kids if they don't get healthy options across the board," SNA spokeswoman Diane Pratt-Heavner said. "It's the students who are unfamiliar with those healthier choices who are not responding well."

Students part of the Montgomery, Ala., group called E.A.T. (Education, Act Transform) were much more receptive to trying new foods—such as radishes—when they went through the process of planting and harvesting them. "They come here, and now they have an understanding," E.A.T. South Executive Director Denise Blake Green said. "They've seen the cycle—planting, harvesting, cooking, composting. When they leave here, food looks different to them." (Read more)

Experts suggest ways to win public-policy changes to fight obesity

Though the obesity epidemic shows signs of stabilizing, it still carries national security risks—negatively affecting education, agriculture and transportation—and public policy change can incredibly important in reducing obesity, Richard Hamburg, deputy director of Trust for America's Health, said at the Southern Obesity Summit in Louisville Oct. 7.

Kentucky and 42 other states have adult obesity rates of at least 25 percent, according to The States of Obesity.

Leon Andrews, senior fellow of the Institute for Youth, Education and Families discussed work with First Lady Michelle Obama's Let's Move! campaign, in which all 50 states and over 450 school districts are participating. The initiative includes new nutrition standards for school meals and ideas for encouraging exercise. Andrews urged attendees to ask their elected officials to participate in the campaign if they aren't already. Share positive feedback and success stories with elected officials as well instead of just making requests, said Whitney Meagher, project director at the National Association of State Boards of Education. "They need to be reassured that they did a good job and that this is actually working."

Jasmine Hall Ratliff, a program officer for the Robert Wood Johnson Foundation, said every community has a slightly different culture of health, but everyone should have the option to make healthy choices no matter where they live. She recognized that fighting obesity is multifaceted, and children need to both eat better and move more. "There are many communities where access to healthy foods is impossible, and there are no playgrounds. We fund advocacy and policy change at various levels to make access to physical activity and good food the default instead of the exception." She recommended checking out preventobesity.net, a place to access resources and talk with other advocates.

Voices for Healthy Kids, a joint initiative of the American Heart Association and the Robert Wood Johnson Foundation, supports nonprofits working to prevent obesity through public policy, said Kim Milbrath, the initiative's southern regional manager. Its campaign focuses on policy in six areas: improving nutritional quality of snack foods in schools; reducing consumption of sugary beverages; protecting children from unhealthy food marketing; increasing access to affordable healthy foods; increasing access to parks, playgrounds and bike paths; and helping youth-serving programs increase children's physical activities. The initiative is funding projects in nine Southern states but not in Kentucky, at least yet.

Milbrath also offered practical advice for winning policy changes to fight obesity: Make sure you're including and informing the right people, including business groups, parents, school administrators, groups with political power and all those who share the goal. Messages should be carefully constructed to clearly express the purpose of the campaign and to personalize it to the audience's concerns. Recognize that contributions will vary, set clear expectations, decide exactly how the money will be used and include the issues important to the audience, like job creation.