The School Fruit Campaign

THE EUROPEAN COMMISSION HAS LAUNCHED A SCHEME to provide free fruit and vegetables to schools across Europe in a drive to curb child obesity.

The commission aims to spend 90m euros (£71m; $141m) annually on the scheme – a sum to be matched by participating governments, who are yet to approve it.

About 22 million children in the EU are overweight – more than five million of them obese, the commission warns. The figure is expected to rise by 400,000 annually.

The World Health Organization recommends a daily intake of 400g of fruit and vegetables per person. Most of the EU's 27 member states currently fail to meet that target.

"Giving kids good habits at an early age is crucial, as they will carry these into later life," said EU Agriculture Commissioner Mariann Fischer Boel, launching the scheme on Tuesday.

"Too many of our children eat far too little fruit and vegetables and often don't appreciate how delicious they are. "You only have to walk down any high street in Europe to see the extent of the problems we face with overweight kids. Let's do something about it."

Earlier this year the EU's statistics agency Eurostat released data showing a wide divergence in the availability of fruit and vegetables among member states.

The figures, showing averages during the period 2001-2007, revealed British consumers as having the lowest supply of fresh fruit and vegetables, while per capita availability was highest in Greece and France. Retail prices of fruit and vegetables also varied considerably across the EU. In 2006, the prices were about half the EU average in Bulgaria and about one-third above the average in the Republic of Ireland.

:: Story from BBC NEWS

Practising healthy eating pays off for kids—Showing parents how to make their homes a place where children will reach for a banana instead of chips could help preschoolers learn to eat healthier, researchers say.

In a five-year study in rural southeast Missouri, two groups of parents were randomly assigned to participate in either a nutrition education program or a standard education program. Since earlier studies have shown children to like and eat vegetables before age five, the study on 1,300 families focused on that age group.

Both groups received visitors, but the nutrition group received examples of how to teach children the names and colours of various fruits and vegetables, as well as handouts with suggestions for improving the family's diet. During four visits, children were able to choose a variety of fruits and vegetables for breakfast, as well as singalong stories and colouring books. After an average of seven months, the team from Washington University in St. Louis found parents ate significantly more fruits and vegetables, and it paid off for their kids.

When mom or dad ate one more serving of fruit or vegetable per day, the child tended to eat half a serving more, if they were of normal weight, the researchers reported in the July issue of the journal Preventive Medicine. "Overweight children have already been exposed to salty, sweet foods and learned to like them," said study author Debra Haire-Joshu, a professor of social work. "To keep a child from becoming overweight, parents need to expose them early to a variety of healthy foods and offer the foods many times," she added in a release.

The nutrition education program, called High 5 for Kids, aims to help children learn to eat healthy and practise what they've learned, Haire-Joshu said. "H5-KIDS suggests the need for, and promise of, early home intervention for childhood obesity prevention," the study concluded.

Cut calories and stay young—A year-long St. Louis University study of sedentary but healthy late middle-aged people found those cutting 300 to 500 calories per day produced less of the thyroid hormone T3, slowing down age-related tissue deterioration. Researchers say cutting the required calories per day is equivalent to skipping dessert or swapping a Big Mac and fries for a turkey sandwich.

World's Least Healthy Beverage?—Here's the unholy breakdown:

1,560mg sodium (more than a day's worth of Blood Pressure Canada's recommendations)
266g of sugar (66.5 teaspoons – 1.5 cups of SUGAR!)
2,310 Calories (that's the equivalent number of calories in either 15 Twinkies, 8 1/4 Snickers bars, 4.3 Big Mac's, or over 1/2 gallon of Ben and Jerry's ice cream)

Coffee and carbs improve exhausted muscles faster in athletes—After strenuous exercise, muscles recover faster and grow faster when large amounts of caffeine, such as in coffee, are consumed, as long as carbohydrates are also ingested, according to an Australian research study.

Dr. John A. Hawley—a professor of Exercise Physiology at the School of Medical Sciences at the Royal Melbourne Institute of Technology University (RMIT), in Bundoora, Victoria, Australia—was the leader of the study performed on the relationship of exercise and caffeine/carbohydrates.

The results of the Hawley study was published online on May 8, 2008 in the Journal of American Physiology (a publication of The American Physiological Society) under the title High rates of muscle glygogen resynthesis after exhaustive exercise when carbohydrate is co-ingested with caffeine».

The researchers concluded, "We provide the first evidence that in trained subjects, the coingestion of large amounts of caffeine with carbohydrate has an additive effect on rates on post-exercise muscle glycogen accumulation compared to when carbohydrate alone is consumed."

Glycogen is known to be the muscle's primary fuel source during exercise. It is now known to be replenished more rapidly when athletes ingest both carbohydrate and caffeine (which is commonly found in coffee, tea, chocolate, and cola drinks) following exhaustive exercise.

Hawley states, "If you have 66 per cent more fuel for the next day's training or competition, there is absolutely no question you will go farther or faster." [American Physiological Society: post-exercise caffeine helps muscles refuel»]

The researchers are now pursuing a similar experiment where lower levels of caffeine will be used to see if the same results can be produced. this action is being taken because large amounts of caffeine taken all at once can have adverse side effects such as sleeplessness and anxiousness.

Is Thin Too Expensive?

by Yoni Freedhoff, Weighty Matters
visit Weighty Matters website »

I REALIZE THAT AT FIRST GLANCE that may look like an odd question.
Recent research however, suggests that it might not be.

A recent study, by Pablo Monsivais and Adam Drewnowski published in the December 2007 issue of the Journal of the American Dietetic Organization, looked at the relative cost per calorie of 372 "low energy dense" foods and "high energy dense" foods between 2004 and 2006.

Low energy dense (good for you) foods would be foods that gram per gram have fewer calories. Fruits and vegetables would be the staples of the low-energy dense shopper.

High energy dense (bad for you) foods gram per gram have more calories and tend to therefore be foods high in fat and/or sugar. This is often the realm of junk food.

Ready for the important and even somewhat surprising results?

Low energy dense (good for you) foods are much more expensive than high energy dense foods, and while that may not surprise you, the difference in cost may: The least energy dense foods cost $18.16/1,000 kcal as compared to only $1.76/1,000 kcal for foods that were the most energy dense.

Also incredibly important to note, inflation affected low energy dense and high energy dense foods very differently with the 2-year price change for the low energy dense foods being +19.5%, whereas the price change for the high energy dense foods being _1.8%.

So in summary, not only are low energy dense foods far more expensive, their comparative inflation rate over the course of the past two years was 400% higher than the general rate of food inflation and more than 2000% higher than the junkiest of foods.

Put another way, based on a 2,000 Calorie per day diet, if you choose primarily high energy dense foods your Calories will cost you $3.52 a day as compared with a diet consisting primarily of low energy dense foods that will cost you $36.32 a day.

Any wonder why we're getting bigger?

Wanna guess how long it'll be before the government steps in and subsidizes our health food baskets?

Never?

We're in really big trouble.

Coffee can save you!—Your morning coffee (and any you drink later) may reduce your risk of premature death. Two to three cups a day cut it by 18 per cent in women and 3 per cent in men, according to a new study of more than 100,000 people. And the more everyone drank, the lower the risk. Credit may go to coffee's antioxidants, which seem to fend off cardiovascular disease. That's on top of the other health goodies we know are in this brew:

• 4 cups (32 ounces) of java a day can cut your diabetes risk by a third, possibly by improving insulin's effects.
• 3 cups (24 ounces) a day protects your brain, dropping your risk of Parkinson's disease by 40 per cent and Alzheimer's disease by 20 per cent.
• 2 cups (16 ounces) a day keeps your liver healthy, as it filters out pollutants, makes protein, warehouses extra carbs and vitamins, and helps produce bile needed to digest fat.

Many of these benefits also come from decaf. Just be sure you make coffee with a paper filter; the paper traps a compound that otherwise increases lousy LDL cholesterol. If regular-strength brew is what you groove to, get some extra calcium, because caffeine makes you excrete this bone builder. For every 8 ounces of coffee, get an extra 40 milligrams of calcium. Conveniently, that's almost the amount in 2 tablespoons of skim milk.

Products containing nuts linked to childhood asthma—Peanut butter among culprits, study suggests :: Sharon Kirkey, Canwest News Service

Pregnant women who eat a peanut butter sandwich a day could significantly increase their child's risk of developing asthma, a new study shows.

Dutch researchers who followed more than 4,000 expectant mothers found babies born to those who ate nut products daily were 50 per cent more likely to develop wheezing, shortness of breath or doctor-diagnosed asthma before their eighth birthday compared to babies whose mothers rarely — fewer than three times a month or never — consumed nut products while pregnant.

The finding held even after taking into account the child's diet and other factors, such as whether someone smoked in the house.

Experts caution it's too soon to recommend pregnant women avoid peanut butter because the finding needs to be confirmed by others. But it adds to what is known as the "fetal programming theory," which holds that stresses in the womb may affect a child's physical health for life. In this case, a mother's diet during pregnancy may affect the development of her baby's airways and immune system.

"It does spark the concern that what the mother eats may affect the child in utero, vis-a-vis the possibility of having asthma," says Dr. John Heffner, past president of the American Thoracic Society. The study appears in the July issue of the society's American Journal of Respiratory and Critical Care Medicine.

No link was found between eating nuts during pregnancy and an increased risk of the baby having a peanut allergy. "But that does not mean there is definitely no relation," says lead author Saskia Willers. Other studies have been contradictory.

"The watchword is, everything in moderation," says Heffner, professor of medicine at Oregon Health and Science University in Portland. The increased asthma in children was found only in those born to mothers who ate nut products once a day, or several times a day.

"I might advise moms not to stay away from nuts, which are a wonderful source of a balanced, nutritional diet, but avoid overly excessive ingestion on a daily basis," Heffner says.

Peanuts are broken down into certain chemicals that can trigger an allergic response. While the mother may not be allergic to those breakdown products herself, "they might get across the placenta or diffuse from the mother's bloodstream through the amniotic fluid."

More Evidence That Diets Don't Work—As if we needed a reminder that diets mostly fail, The New England Journal of Medicine has published a new report on an intense, tightly controlled experiment involving more than 300 moderately obese people.

After two years of effort the dieters lost, on average, 6 to 10 pounds. The study, funded in part by the Atkins Research Foundation, seemed designed to prove that low-carb diets trump low-fat diets. But in the end, all it really showed is that dieters can put forth tremendous effort and reap very little benefit.

Dr. Dean Ornish, a proponent of low-fat diets, is critical of the study design, particularly the fact that the so-called "low-fat" diet group was really only a moderate-fat diet that included about 30 percent of calories from fat.

The New England Journal report also affirmed something many women have believed all along — that low-carb diets work better for men than women. Male low-carb dieters lost about 11 pounds, compared to about 9 pounds on a Mediterranean diet. Women low-carb dieters lost only about 5 pounds, compared to about 14 on the Mediterranean diet.

Should 8 Year Olds be on Cholesterol Lowering Medication?

by Yoni Freedhoff, Weighty Matters
visit Weighty Matters website »

IN CASE YOU HADN'T HEARD, last week the American Academy of Pediatrics recommended » that kids between the ages of 2 and 10 be screened for cholesterol problems if they have risk factors for problems therein.

Risk factors would include strong family histories, obesity, high blood pressure or diabetes.

The Academy goes on to recommend that for kids over 8 with high cholesterol, medications be considered.

On the one hand, perhaps that makes sense. We know high cholesterol to be a risk factor for heart disease and these kids therefore have at least two risk factors. Presumably lowering cholesterol will therefore reduce long term cardiac risk in these children.

The problem is, given that generally we haven't been treating 8 year olds with cholesterol lowering medications, we actually don't know that there will be a long term benefit, we just assume there will be one and that there won't be any surprising long term complications from starting these drugs during years that their bodies and brains are developing.

On the other hand, by giving these kids drugs, at least in kids whose secondary risk factor is not a strong family history (in which case they may well have genetically high cholesterol levels), we're not addressing the root cause of their effectively middle-aged bodies – lifestyle.

Given that 8 year old kids don't cook for themselves, don't shop for food for themselves, don't pack their own lunches for themselves and all in all live the way their parents have taught and allowed them to live, I think it's a crying shame that there's no pill that we can prescribe to their parents to help them learn, set, live and lead better examples.

And . . .



Shocker – Kids' Foods aren't Healthy

Maybe that's why we're recommending they take cholesterol lowering medications at age 8?

A study », published in the July edition of Obesity Reviews, looked at 367 food products targeting Canadian children (products whose packaging had a cartoon on the front of the box and/or were tied to children's movies, TV shows or toys). The products did NOT include obviously unhealthy fare such as candy, soft drinks and baked goods. What the study analyzed was the food claims made on the label versus the actual product's nutritional value.

The results?

89% of products were classifiable as of, "poor nutritional quality" due to high levels of fat, sodium or sugar.

More importantly, 62% of those products deemed of poor nutritional quality had front of label claims (Health Check?) that made positive nutritional comments about the contents of the package.

The lesson learned here?

Our government needs to do more to regulate health claims on foods. Busy parents with or without a background in nutrition don't necessarily have the time (especially with kids in tow), to analyze each food label for themselves while shopping in a supermarket. Canada needs a robust front of package labeling program based on evidence based nutrition like ONQI » to help protect Canadians against the outlandish claims that Health Canada allows on our food packaging.

And we need it yesterday.

Regular Walking Protects the Masai

SCIENTISTS HAVE LONG BEEN PUZZLED by how the Masai can avoid cardiovascular disease despite having a diet rich in animal fats. Researchers at Karolinska Institutet believe that their secret is in their regular walking.

There is strong evidence that the high consumption of animal fats increases the risk of developing cardiovascular disease. Many scientists have therefore been surprised that the nomadic Masai of Kenya and Tanzania are seldom afflicted by the disease, despite having a diet that is rich in animal fats and deficient in carbohydrates.

This fact, which has been known to scientists for 40 years, has raised speculations that the Masai are genetically protected from cardiovascular disease. Now, a unique study by Dr Julia Mbalilaki in association with colleagues from Norway and Tanzania, suggests that the reason is more likely to be the MasaiÕs active lifestyle.

Their results are based on examinations of the lifestyles, diets and cardiovascular risk factors of 985 middle-aged men and women in Tanzania, 130 of who were Masai, 371 farmers and 484 urbanites. In line with previous studies, their results show that the Masai not only have a diet richer in animal fat than that of the other subjects, but also run the lowest cardiovascular risk, which is to say that they have the lowest body weights, waist-measurements and blood pressure, combined with a healthy blood lipid profile.

What sets the Masai lifestyle apart is also a very high degree of physical activity. The Masai studied expended 2,500 kilocalories a day more than the basic requirement, compared with 1,500 kilocalories a day for the farmers and 891 kilocalories a day for the urbanites. According to the team, most Westerners would have to walk roughly 20 km a day to achieve the Masai level of energy expenditure.

The scientists believe that the Masai are protected by their high physical activity rather than by some unknown genetic factor.

"This is the first time that cardiovascular risk factors have been fully studied in the Masai," says Dr Mbalilaki. "Bearing in mind the vast amount of walking they do, it no longer seems strange that the Masai have low waist-measurements and good blood lipid profiles, despite the levels of animal fat in their food."

Journal reference: Mbalilaki et al. Daily energy expenditure and cardiovascular risk in Masai, rural and urban Bantu Tanzanians. British Journal of Sports Medicine, 2008; DOI: 10.1136/bjsm.2007.044966

If you're a non-smoker, risk of stroke goes up if you're married to a smoker—Nonsmokers married to smokers have a greatly increased chance of having strokes, according to a U.S. study showing yet another hazard from secondhand smoke.

Being married to a smoker raised the stroke risk by 42 per cent in people who have never smoked compared to those married to someone who never smoked, the researchers said.

This jumped to 72 per cent for former smokers married to a current smoker, according to the study published in the American Journal of Preventive Medicine.

Former smokers who were married to smokers had a stroke risk similar to people who themselves were smokers.

"Quitting smoking helps your own health and also the health of the people living with you," Maria Glymour of Harvard School of Public Health in Boston and Columbia University in New York, who led the study, said in a telephone interview.

The study involved 16,225 people aged 50 and up who had never had a stroke. They were followed for an average of nine years.

Glymour said there is accumulating evidence about the number of health problems linked to secondhand smoke.

Previous research had suggested that secondhand smoke increases the risk of stroke, but Glymour said stroke risk has been studied more extensively in smokers than in people exposed to secondhand smoke.

People who breathe in secondhand smoke also have a higher risk of lung cancer, nasal sinus cancer, respiratory tract infections and heart disease, among other conditions.

A 2006 U.S. surgeon general's report said secondhand smoke contains hundreds of chemicals known to be toxic or cancer-causing. These include formaldehyde, benzene, vinyl chloride, arsenic, ammonia and hydrogen cyanide.

For this study, smoking involved cigarettes and not pipes or cigars. It looked at health consequences for the spouses of smokers, but not at the long-term stroke risk in children of smokers due to secondhand smoke.

Daycare can make little Charlie a little chubby—Daycare can make babies fat, contributing to childhood weight problems, according to a U.S. study.

Researchers found that infants cared for by someone other than mom or dad were more apt to be exposed to "unfavourable" feeding practices and to gain more weight during their first year of life, given solid food earlier than breast-fed babies.

"Parents may want to have enough communication with child-care providers about when, what and how to feed their babies during their stay in daycare, which is important to avoid potential risk of overfeeding or underfeeding at home," said Juhee Kim of the University of Illinois at Urbana-Champaign.

Kim and Karen E. Peterson of Harvard School of Public Health, Boston, analyzed data on child-care arrangements, feeding practices, and weight gain collected for 8,150 nine-month-old infants. More than half of these children received regular care from someone other than a parent.

The researchers found that the roughly 40 per cent of infants placed in child care at less than three months of age were less likely to have been breastfed and were more likely to eat solid foods earlier than infants cared for by their parents.

There is evidence from other studies to suggest that breastfeeding may lower a child's risk of becoming overweight and that the early introduction of solid foods may increase the risk.

They also found that infants in part-time child care (about half of the group) gained 175 grams more weight during 9 months than infants who were cared for by their parents.

Infants cared for by relatives gained 162 grams more weight, had a higher rate of early introduction to solid foods and were less likely to ever be breastfed.

"Overwhelming and consistent data support the notion that early weight gain during infancy is a strong risk factor for (becoming) overweight in childhood and adulthood," Kim and Peterson note.

They also point out that the number of working moms of young children has more than doubled in the U.S., from 24 per cent in 1970 to 57 in 2000.

Do Pedometers Work?

 by Dr. Arya Sharma  
visit Dr. Sharma's website »

ONE READER ASKED if there was any evidence
that asking patients to wear pedometers actually works.

The simple answer is: Yes, it does!

This answer is based on a meta-analysis of pedometer-based walking interventions and weight loss by Caroline Richardson and colleagues from the University of Michigan, published earlier this year in the Annals of Family Medicine.

For this meta-analysis, Richardson and colleagues searched 6 electronic databases and contacted pedometer experts to identify pedometer-based walking studies without a dietary intervention that reported weight change as an outcome. Nine studies met the inclusion criteria. Cohort sample size ranged from 15 to 106, for a total of 307 participants, 73% of whom were women and 27% of whom were men. The duration of the intervention ranged from 4 weeks to 1 year, with a median duration of 16 weeks.

The pooled estimate of mean weight change from baseline using a fixed-effects model and combining data from all 9 cohorts was -1.27 kg (95% confidence interval, -1.85 to -0.70 kg). Longer intervention duration was associated with greater weight change. On average, participants lost 0.05 kg per week during the interventions.

So, evidently, pedometer-based walking programs do result in a modest amount of weight loss, whereby longer programs lead to more weight loss than shorter programs.

Two important messages here:

1. By themselves, pedometers are hardly the greatest obesity intervention (actually, even more intense exercise, despite its many health benefits, is by itself highly over-rated as a weight-loss strategy).

2. As with all obesity management strategies, any intervention should be aimed for life—using a pedometer for a few weeks or even months is probably useless, as the weight would simply come back the minute your patient stops using it.

In case anyone is wondering why bother if the weight loss is so modest: the point is not the weight loss—the point is that any increase in physical activity, if sustained, is more likely to prevent weight regain, than any regimen that is based on caloric restriction alone. A pedometer is simply the simplest tool to objectively self-monitor physical activity (sure, accelerometers are even better, but cost 10-100 times as much).

Tip: ask you patient to invest in a decent device—the cheaper, the more prone to inaccuracy and frustration - a good device will cost around $20-30—money well spent!

Running Can Slow the Ageing Process

ORUNNING ON A REGULAR BASIS can slow the effects of ageing, a study by US researchers shows.

Elderly joggers were half as likely to die prematurely from conditions like cancer than non-runners.

They also enjoyed a healthier life with fewer disabilities, the Stanford University Medical Center team found.

Experts said the findings in Archives of Internal Medicine reinforced the importance that older people exercise regularly.

The work tracked 500 older runners for more than 20 years, comparing them to a similar group of non-runners. All were in their 50s at the start of the study.

Nineteen years into the study, 34% of the non-runners had died compared to only 15% of the runners.

Both groups became more disabled with age, but for the runners the onset of disability started later—an average of 16 years later.

The health gap between the runners and non-runners continued to widen even as the subjects entered their ninth decade of life.

Running not only appeared to slow the rate of heart and artery related deaths, but was also associated with fewer early deaths from cancer, neurological disease, infections and other causes.

And there was no evidence that runners were more likely to suffer osteoarthritis or need total knee replacements than non-runners—something scientists have feared.

At the beginning of the study, the runners ran for about four hours a week on average. After 21 years, their weekly running time had reduced to around 76 minutes, but they were still seeing health benefits from taking regular exercise.

Lead author Professor James Fries, from the University of California at Stanford, said: "The study has a very pro-exercise message. If you had to pick one thing to make people healthier as they age, it would be aerobic exercise.

"The health benefits of exercise are greater than we thought."

Age Concern says many older people do not exercise enough.

Figures show more than 90% of people in the UK over 75 fail to meet international guidelines of half-an-hour moderate intensity exercise at least five times a week.

Gordon Lishman, director general, said: "This research re-confirms the clear benefits of regular exercise for older people.

"Exercise can help older people to stay mobile and independent, ensure a healthy heart, keep weight and stress levels under control, and promote better sleep.

"While younger people are barraged with encouragement to lead healthier lifestyles, the health needs of older people are often overlooked."

Dr. Yoni Freedhoff: Obesity expert and medical director of the Bariatric Medical Institute in Ottawa, Dr. Freedhoff is one of Canada's most outspoken nutrition watchdogs and appears regularly in national media to advocate for healthier living.

Dr. Arya Sharma: Widely recognized as one of Canada's leading obesity experts, Dr. Sharma was recently appointed Professor of Medicine & Chair in Obesity Research and Management at the University of Alberta in Edmonton, Canada. Dr. Sharma passionately believes in educating the public on this chronic disease.

Speakwell has obtained permission from both of these Doctors to reproduce some of their material in our WELL Newsletter. Please visit their sites.