Newswise — Chicago, Ill. - Elementary and middle school students who are given at least 25 minutes to eat lunch are more likely to choose fruits and consume more of their entrees, milk, and vegetables according to a new study released in the Journal of the Academy of Nutrition and Dietetics. Each day, over 30 million U.S. students receive a free or discounted meal thanks to the National School Lunch Program. For children from low-income households, these meals can account for almost half of their daily caloric intake, so it is vitally important for schools to find ways to improve student selections and consumption and limit food waste. This new study examined the association between the length of the lunch period and the food choices and intake of students. Data for the study were collected on six nonconsecutive days throughout the 2011 to 2012 school year as part of the MEALS study, a large, school-based randomized controlled trial. The MEALS study was a collaboration between the nonprofit organization Project Bread and the Harvard T. H. Chan School of Public Health to improve the selection and consumption of healthier school foods. Researchers conducted a plate waste study, which is the gold standard for assessing children’s diets. Investigators found that when kids have less than 20 minutes of seated time in the cafeteria to eat lunch, they were significantly less likely to select a fruit when compared to peers who had at least 25 minutes to eat lunch (44% vs 57%, respectively). Furthermore, the study found that children with less than 20 minutes to eat lunch consumed 13% less of their entrees, 10% less of their milk, and 12% less of their veggies when compared to students who had at least 25 minutes to eat their lunch. This indicates that kids who were given less time at lunch may be missing out on key components of a healthy diet such as fiber-rich whole grains and calcium. “Policies that improve the school food environment can have important public health implications in addressing the growing socioeconomic disparities in the prevalence of obesity and in improving the overall nutrient quality of children’s diets,” explained lead investigator Juliana F. W. Cohen, ScD, ScM, Assistant Professor, Department of Health Sciences, Merrimack College, North Andover, MA, and Adjunct Assistant Professor, Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA. “This research suggests that enabling students to have sufficient time to eat their meals can help address this important issue.” According to the study, another challenge kids face is the minutes they must use during their school lunchtime period for activities besides eating or sitting. Many students spend a considerable amount of time traveling to the cafeteria and then waiting in line to get their lunch. After taking this into account, some children in the study had as little as 10 minutes to eat their lunch. “Although not all schools will be able to accommodate longer lunch periods, several other factors have been cited as areas where schools can improve the amount of time students have to eat,” said Cohen. “Increasing the number of serving lines, more efficient cashiers, and/or an automated point of sale system can all lead to enhanced efficiency for students going through lunch lines.” With this research, investigators have shown that there is an association between the amount of time a student is given to eat and how much food they are likely to consume. A shorter lunch period means that children are in danger of missing out on important calories they rely on during the school day. In addition, studies have shown that consuming food too quickly is associated with a decrease in satiety, which can lead to overeating and contribute to obesity. Because of this, having insufficient time for lunch is especially precarious as kids are learning the eating habits they’ll take with them into adulthood. As schools search for ways to increase student consumption of entrees, fruits, and vegetables, offering kids more time to eat may be the key to better choices. “Policies that enable students to have at least 25 minutes of seated time might lead to improvements in students’ diets and decrease plate waste in school cafeterias,” concluded Cohen. “These findings provide evidence that policies at the district, state, or national level may be warranted to ensure all children have sufficient time to eat their meals in schools.” To learn more click here
Newswise — A diet rich in vitamin C could cut risk of cataract progression by a third, suggests a study being published online today in Ophthalmology, the journal of the American Academy of Ophthalmology. The research is also the first to show that diet and lifestyle may play a greater role than genetics in cataract development and severity. Cataracts occur naturally with age and cloud the eye’s lens, turning it opaque. Despite the advent of modern cataract removal surgery, cataracts remain the leading cause of blindness globally.1 Researchers at King’s College London looked at whether certain nutrients from food or supplements could help prevent cataract progression. They also tried to find out how much environmental factors such as diet mattered versus genetics. The team examined data from more than 1,000 pairs of female twins from the United Kingdom. Participants answered a food questionnaire to track the intake of vitamin C and other nutrients, including vitamins A, B, D, E, copper, manganese and zinc. To measure the progression of cataracts, digital imaging was used to check the opacity of their lenses at around age 60. They performed a follow-up measurement on 324 pairs of the twins about 10 years later. During the baseline measurement, diets rich in vitamin C were associated with a 20 percent risk reduction for cataract. After 10 years, researchers found that women who reported consuming more vitamin C-rich foods had a 33 percent risk reduction of cataract progression. Genetic factors accounted for 35 percent of the difference in cataract progression. Environmental factors, such as diet, accounted for 65 percent. These results make the study the first to suggest that genetic factors may be less important in progression of cataract than previously thought.How vitamin C inhibits cataract progression may have to do with its strength as an antioxidant. The fluid inside the eye is normally high in vitamin C, which helps prevents oxidation that clouds the lens. More vitamin C in the diet may increase the amount present in the fluid around the lens, providing extra protection. Researchers noted that the findings only pertain to consuming the nutrient through food and not vitamin supplements. “The most important finding was that vitamin C intake from food seemed to protect against cataract progression,” said study author Christopher Hammond, M.D., FRCOphth, professor of ophthalmology at King’s College London. “While we cannot totally avoid developing cataracts, we may be able to delay their onset and keep them from worsening significantly by eating a diet rich in vitamin C.”
Newswise — Resistance and endurance exercises affect the body very differently. These differences suggest that adapting to exercise involves many processes, but scientists have observed that one gene in particular, peroxisome proliferator-activated receptor-gamma coactivator PGC-1α, controls many of them. New research in Physiological Reports shows that although both resistance and endurance exercises activate the PGC-1α gene, the adaptation processes stimulated are not the same and depend on the type of exercise. Proteins run the body: They turn processes on or off or speed them up or slow them down. The body has many different proteins, and the instructions to make them are written on sections of DNA, referred to as genes. Different genes code for different proteins, but different proteins can also come from the same gene. Called isoforms, these proteins are produced when only part of the gene’s code is read. The PGC-1α protein turns on other genes. Several studies have shown that isoforms of PGC-1α exist and that the isoform produced depends on the exercise. In this new study, researchers at the University of Jyväskylä in Finland comprehensively examined the isoforms present shortly after exercising and the genes those isoforms turned on. Samples were taken from the thigh muscles of healthy men after they performed high-intensity resistance exercises or moderate-intensity endurance exercises. The researchers found that both endurance and resistance exercises produced isoforms PGC-1α exon 1b, PGC-1α exon 1b’ and truncated PGC-1α, while only endurance exercise produced PGC-1α exon 1a isoform. Endurance exercise activated genes that stimulated growth of new blood vessels and increased endurance. Resistance exercise also activated a gene that promoted blood vessel growth, along with a gene that encouraged muscle growth. “Our results support that gene expression responses of PGC-1α isoforms may have an important role in exercise-induced muscle adaptations,” the researchers stated. The study “PGCâ€1 isoforms and their target genes are expressed differently in human skeletal muscle following resistance and endurance exercise” is published in the October issue of Physiological Reports, a joint journal of the Physiological Society and American Physiological Society.
Newswise — Women with apple-shaped bodies – those who store more of their fat in their trunk and abdominal regions – may be at particular risk for the development of eating episodes during which they experience a sense of “loss of control,” according to a new study from Drexel University. The study also found that women with greater fat stores in their midsections reported being less satisfied with their bodies, which may contribute to loss-of-control eating. This study marks the first investigation of the connections between fat distribution, body image disturbance and the development of disordered eating. “Eating disorders that are detected early are much more likely to be successfully treated. Although existing eating disorder risk models comprehensively address psychological factors, we know of very few biologically-based factors that help us predict who may be more likely to develop eating disorder behaviors,” said lead author Laura Berner, PhD, who completed the research while pursuing a doctoral degree at Drexel. “Our preliminary findings reveal that centralized fat distribution may be an important risk factor for the development of eating disturbance, specifically for loss-of-control eating,” said Berner. “This suggests that targeting individuals who store more of their fat in the midsection and adapting psychological interventions to focus specifically on body fat distribution could be beneficial for preventing eating disorders. The study, titled “Examination of Central Body Fat Deposition as a Risk Factor for Loss-of-Control Eating,” was published in the American Journal of Clinical Nutrition. Berner is now a postdoctoral research fellow at the Eating Disorders Center for Treatment and Research at UC San Diego Health. Michael R. Lowe, PhD, a professor in Drexel’s College of Arts and Sciences, was a co-author, along with Danielle Arigo, PhD, who was a postdoctoral research fellow at Drexel and is now an assistant professor of psychology at the University of Scranton; Laurel Mayer, MD, associate professor of clinical psychiatry at the Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute,; and David B. Sarwer, PhD, professor of psychology in Psychiatry and Surgery at the Perelman School of Medicine at the University of Pennsylvania as well as director of clinical services at the Center for Weight and Eating Disorders. Mounting evidence suggests that experiencing a sense of loss-of-control during eating – feeling driven or compelled to keep eating or that stopping once one has started is difficult – is the most significant element of binge-eating episodes regardless of how much food is consumed, according to the researchers. “This sense of loss of control is experienced across a range of eating disorder diagnoses: bulimia nervosa, binge eating disorder and the binge-eating/purging subtype of anorexia nervosa,” said Berner. “We wanted to see if a measurable biological characteristic could help predict who goes on to develop this feeling, as research shows that individuals who feel this sense of loss of control over eating but don’t yet have an eating disorder are more likely to develop one.” “This sense of loss of control is experienced across a range of eating disorder diagnoses: bulimia nervosa, binge eating disorder and the binge-eating/purging subtype of anorexia nervosa,” said Berner. “We wanted to see if a measurable biological characteristic could help predict who goes on to develop this feeling, as research shows that individuals who feel this sense of loss of control over eating but don’t yet have an eating disorder are more likely to develop one." Using a large dataset that followed female college freshman for two years, the researchers preliminarily investigated whether body fat distribution is linked to body dissatisfaction over time and increases risk for the development or worsening of loss-of-control eating. The nearly 300 young adult women completed assessments at baseline, six months and 24 months, that looked at height, weight and total body fat percentage and where it’s distributed. Participants, none of whom met the diagnostic criteria for eating disorders at the start of the study, were assessed for disordered eating behaviors through standardized clinical interviews in which experiences of sense of loss of control were self-reported. In this sample, the researchers found that women with greater central fat stores, independent of total body mass and depression levels, were more likely to develop loss-of-control eating and demonstrated steadier increases in loss-of-control eating episode frequency over time. Women with a larger percentage of their body fat stored in the trunk region were also less satisfied with their bodies, regardless of their total weight or depression level. The findings indicate that storage of body fat in trunk and abdominal regions, rather than elsewhere in the body, is more strongly predictive of loss-of-control eating development and worsening over time, and that larger percentages of fat stored in these central regions and body dissatisfaction may serve as maintenance or exacerbation for loss-of-control eating. “Our results suggest that centralized fat deposition increased disordered eating risk above and beyond other known risk factors,” said Berner. “The specificity of our findings to centralized fat deposition was also surprising. For example, a one-unit increase in the percentage of body fat stored in the abdominal region was associated with a 53 percent increase in the risk of developing loss-of-control eating over the next two years, whereas total percentage body fat did not predict loss-of-control eating development.” According to Berner, more research is needed to explain the mechanism behind these findings, though she speculates that there are a number of reasons why this might happen. “It’s possible that this kind of fat distribution is not only psychologically distressing, but biologically influential through, for example, alterations in hunger and satiety signaling,” she said. “Fat cells release signals to the brain that influence how hungry or satiated we feel. Our study didn’t include hormone assays, so we can’t know for sure, but in theory it’s possible that if a centralized distribution of fat alters the hunger and satiety messages it sends, it could make a person feel out of control while eating.” The findings may apply to other disordered eating behaviors beyond loss-of-control eating, but more research is needed. “Body fat distribution hasn’t been studied in disorders characterized by binge-eating behaviors as much as it has in anorexia nervosa,” said Berner. “The participants in our sample didn’t develop eating disorder diagnoses within the two year period that we studied them, but this study suggests that future research should investigate whether individuals with greater central fat stores are more likely to develop bulimia nervosa and binge eating disorder."
Newswise — ANN ARBOR, Mich. — If you don’t have health insurance, or your insurance coverage still leaves you with big bills, hospitals are supposed to let you know if you qualify for free or reduced-price care, and to charge you fairly even if you don’t. That is, if they want to keep their tax-free nonprofit status under the Affordable Care Act’s new Section 501(r) rules. But a new study from the University of Michigan Institute for Healthcare Policy and Innovation finds many nonprofit hospitals have room to improve. Writing in the October 29 issue of the New England Journal of Medicine, the researchers report results from their review of Internal Revenue Service forms submitted by more than 1,800 nonprofit hospitals nationally. They looked at records for 2012, the first year hospitals had to comply with the ACA’s requirements and the most recent year for which data were available. A mixed bag of findings IHPI post-doctoral fellow Sayeh Nikpay, Ph.D., MPH and IHPI director John Z. Ayanian, M.D., MPP, call hospitals’ performance “far from perfect”. Their key findings: • Nearly all (94 percent) of the hospitals reported having a written charity care and emergency care policies, to guide them on deciding which patients could get free or reduced-price care. Though the ACA doesn’t tell hospitals which patients to offer discounts to, or how generous to be, it does say they must have such policies and make them known. • Only 29 percent of the hospitals reported they had begun charging uninsured and under-insured patients the same rate that they charged private insurers or Medicare. Such rates are often far lower than the “chargemaster” rates hospitals set as the starting point for negotiating with insurers about how much they will actually accept. • Only 42 percent of the hospitals reported they were notifying patients about their potential eligibility for charity care before attempting to collect unpaid medical bills. The ACA requires such notifications to give patients a chance to apply to get some or all of their costs written off. • One in five hospitals had not yet stopped using extraordinary debt-collection steps when patients failed to pay their medical bills. Such steps, such as reporting patients to credit agencies in ways that can damage their credit scores, placing liens on their property or garnishing their wages, are now banned. • Hospitals in states that have not expanded Medicaid reported having less generous charity care policies, and were less likely to have a policy about notifying patients of charity care options before they left the hospital. In general, patients have to be poorer to get free or discounted care in these states than in states that have expanded Medicaid. • Only 11 percent of hospitals reported having conducted a community health needs assessment in the past three years as of 2012. Such assessments, to identify pressing health issues in the population they serve, don’t necessarily affect charity care. Playing by the rules? Nonprofit hospitals are exempt from paying most taxes, which was valued at $24.6 billion in 2011. In return, they must justify their nonprofit status to the IRS each year by showing how much care they write off for those who cannot pay. When Congress wrote the ACA, they sought to use the tax tools available to them to reduce hospitals’ use of aggressive methods to pursue payment, and perhaps to prevent individual bankruptcies or credit score damage caused by medical bills. Though hospitals had to report for tax year 2012, the federal government did not issue final language about exactly how to comply and penalties for non-compliance until 2014. Nikpay and Ayanian will continue to study the issue as new IRS data become available. They are already working on 2013 data. “Hospitals are generally complying with the part of the rules that require they establish charity care policies and publicize them, but this may not impact the amount of charity care they provide,” says Nikpay, who is also a visiting scholar at the University of California, Berkeley. “So far, it appears many aren’t complying with the part of the rules that could increase their charity care.” Ayanian, a professor at the U-M Medical School with joint appointments in public policy and public health, says physicians and patients should familiarize themselves with policies at their hospitals. “Financial protection for patients is an under-recognized component of the ACA, and it’s important that hospitals are required to have policies, that they disclose these policies, and that they enable people to apply for help in a timely way,” he says. “This will be most important for patients living in states that have not expanded Medicaid to cover people with lower incomes. Hospitals in those states will likely experience additional demand for charity care because they now need to publicize their charity care policies and comply with other IRS provisions.” With these added requirements, hospitals may start to pull back on how generous they make their charity care policies – and Section 501(r) of the ACA does not set standards for that, Nikpay notes. As more Americans enroll in insurance plans that have high deductibles, they may find they need to ask for financial relief after a hospital stay. Even a single person earning $40,000 a year, or a family of four with an income of $80,000, might qualify for discounted care from many hospitals. Reference: New England Journal of Medicine, DOI: 10.1056/NEJMp1508605
Newswise — Women need to maintain good health years before they become pregnant. After all, healthy women are most likely to give birth to healthy babies. A web-based app, www.healthymomshra.com, can now help women gauge the level of their health and learn what changes they can make to enhance not only their own wellbeing, but also the health of any babies born to them in the future. “Our goal with the app is to encourage good health practices in women so they will be healthy for pregnancies, planned or unplanned,” said Adam T. Perzynski, PhD (Twitter: @ATPerzynski), director of the Patient Centered Medical Lab, and a sociologist with the Case Western Reserve University School of Medicine and MetroHealth Center for Health Care Research and Policy team, that developed the Healthy Moms Health Risk Assessment prototype at www.healthymomshra.com. Much infant mortality can be traced to low birth weight or early gestational birth age of newborns, which is often related to the poor health of the mother. The developers of the web-based app sought to help women reverse the major risk factors that negatively affect them in the categories of health habits, social support, driving safety, substance use, tobacco use, mental health, physical health, environmental risks, ethnicity, age and neighborhood of residence. The online Healthy Moms Health Risk Assessment features a user-friendly test where each question, regardless of a yes or no answer, is greeted with encouraging, helpful tips across the categories of health risks. All answers are based on Centers for Disease Control and Prevention (CDC) guidelines firmly grounded in scientific evidence. The test concludes with a report of the woman’s individual health risk in the categories. The report is color coded from green to red, so the more green the report, the better the test-taker’s health. “The main difference with this app is that it focuses on the preconception phase rather than exclusively on pregnant women,” Perzynski said. “Up to 50 percent of pregnancies are unplanned, so it’s important that a woman engage in healthy behaviors to prepare for the fact that she might become pregnant at some point.” Armed with latest wellness information from CDC for women, the Case Western Reserve team used flexible and scalable cloud-based computing environment to develop an app that would provide immediate, useful answers and offer a summary scorecard. The Healthy Moms Health Risk Assessment app was so impressive that it won an honorable mention at the recent Cleveland Medical Hackathon competition where the Case Western Reserve team vied with other teams to develop the best innovation to address an unmet health care need. “In many cases, mothers have health issues before they become pregnant, and those health issues can be challenging to resolve once they are pregnant,” Perzynski said. “We tailored our app to help women consider how health behaviors, activities and social circumstances might affect the health of a baby should a pregnancy happen, with the goal of empowering women to make healthy choices.”
Newswise — A new study in mice by researchers at Fred Hutchinson Cancer Research Center has found that a specialized type of immunotherapy — even when used without chemotherapy or radiation — can boost survival from pancreatic cancer, a nearly almost-lethal disease, by more than 75 percent. The findings are so promising, human clinical trials are planned within the next year. The study, led by Drs. Sunil Hingorani and Phil Greenberg, both members of the Clinical Research Division at Fred Hutch, tested the immunotherapy on mice genetically engineered to grow pancreatic tumors very similar to those of human pancreatic cancer. The mouse model, developed by Hingorani, already has led to a first-in-humans clinical trial that is showing early promise in some patients with advanced pancreatic cancer. Pancreatic cancer is notoriously difficult to treat, said Hingorani, because it recruits the body’s natural systems to construct both a tough physical barrier around tumors as well as an immune-cloaking device that keeps other, disease-fighting immune cells from recognizing the cancer. Unlike any other cancer, pancreatic tumors are able to survive with a significantly decreased blood supply. As a consequence, chemotherapy, commonly administered via the bloodstream, has a difficult time getting inside. The tumors not only commonly grow quite large before patients will ever notice something is wrong, but they are very prone to metastasize, or spread to other sites in the body. The investigators’ new study, published Thursday in Cancer Cell, breaches pancreatic cancer’s physical and immunological walls by using immunotherapy, a type of treatment that harnesses or refines the body’s own immune system, to recognize and destroy cancer cells. The researchers devised a therapy using T cells, disease-fighting immune cells, that they engineered in the lab to recognize and attack pancreatic cancer. T-cell therapy is showing promise as a treatment for several types of blood cancers, based on early results from Fred Hutch and other research centers, but aiming these cells at solid tumors like pancreatic cancer has historically proven more difficult, Hingorani said. Part of the challenge comes from the access to tumor cells — or lack thereof. T-cell therapy is administered through the bloodstream, like chemo. It’s easy enough to see why solid tumors may present more of a challenge to treat with this kind of immunotherapy than blood cancers such as leukemia and lymphoma. The researchers didn’t think the engineered T cells would stand a chance against pancreatic cancer on their own. But they needed somewhere to start, Greenberg said. But to their surprise, the T cells — engineered to recognize and kill cells bearing a protein called mesothelin, which is overproduced by virtually all pancreatic tumors — got into the mice’s tumors and started attacking them. In the mouse model of the disease — which is actually slightly more aggressive than the human version, Hingorani said — animals that received T cells engineered to recognize a non-cancerous protein survived on average 54 days after their cancer became detectable. Those that received the mesothelin-directed cells lived an average of 96 days, a 78 percent bump. Although the researchers weren’t expecting to take this first version of the T-cell therapy to clinic, that’s now their plan. Their team has already built the human version of the special T-cell protein that recognizes mesothelin. They’re planning to launch a phase 1 clinical trial to test the therapy’s safety in patients with advanced pancreatic cancer within the next year. “As best we can tell, this would be a better therapy than anything that exists for pancreatic cancer right now,” Greenberg said. “It’s hard to be this optimistic without ever having treated a pancreatic cancer patient with this [therapy], but the biology of what we’re doing looks so remarkably true and good.” The study was funded in part by the National Institutes of Health, the Giles W. and Elise G. Mead Foundation and Juno Therapeutics.
Newswise — A federally funded analysis of MRI scans of the aging hearts of nearly 3,000 adults shows significant differences in the way male and female hearts change over time. Results of the research, led by investigators at Johns Hopkins, do not explain exactly what causes the sex-based differences but they may shed light on different forms of heart failure seen in men and women that may require the development of gender-specific treatments, the scientists say. “Our results are a striking demonstration of the concept that heart disease may have different pathophysiology in men and women and of the need for tailored treatments that address such important biologic differences,” says senior study author João Lima, M.D., M.B.A., a professor of medicine and radiological science at the Johns Hopkins University School of Medicine and director of cardiovascular imaging at its Heart and Vascular Institute. The research, published online Oct. 20 in the journal Radiology, is believed to be the first long-term follow-up using MRI showing how hearts change as they age. Previous studies have assessed heart changes over time using ultrasound, but, the researchers say, MRI scans tend to provide more detailed images — and more reliable information — about the structure and function of the heart muscle. In both sexes, the main heart chamber, the left ventricle — which fills with and then forces out blood — gets smaller with time. As a result, less blood enters the heart and less gets pumped out to the rest of the body. But in men, the study reveals, the heart muscle that encircles the chamber grows bigger and thicker with age, while in women, it get retains its size or gets somewhat smaller. “Thicker heart muscle and smaller heart chamber volume both portend heightened risk of age-related heart failure but the gender variations we observed mean men and women may develop the disease for different reasons,” says lead investigator John Eng, M.D., associate professor of radiological science at the Johns Hopkins University School of Medicine. A condition that affects more than five million Americans, heart failure is marked by the gradual “floppiness” and weakening of the heart muscle and eventual loss of pumping ability. To lower the risk, cardiologists often prescribe medications designed to reduce the thickness of the heart muscle over time and boost cardiovascular performance. But the finding that in women, the heart muscle tends to shrink or remain the same size means they may not derive the same benefit from such treatments, researchers say. The research team cautions that its study was not designed to find what exactly fuels the differences in cardiac physiology between the sexes but says this “fascinating discrepancy” demands further investigation to figure it out. For the study, researchers analyzed MRI scans performed on nearly 3,000 older adults, ages 54 to 94, without preexisting heart disease. Participants were followed between 2002 and 2012, at six hospitals across the United States where each one of them underwent MRI testing at the beginning of the study and once more after a decade. The MRI scans provided researchers with 3-D images of the heart’s interior and exterior, allowing them to determine the size and volume of the heart muscle. Adding these to the already known density of the muscle, they were able to calculate its weight. Over a period of 10 years, the weight of the heart’s main pumping chamber — the left ventricle — increased by an average of 8 grams in men and decreased by 1.6 grams in women. The heart’s filling capacity — marked by the amount of blood the left ventricle can holds between heartbeats — declined in both sexes but more precipitously so in women, by about 13 milliliters, compared with just under 10 milliliters in men. The differences in size, volume and pumping ability occurred independently of other risk factors known to affect heart muscle size and performance, including body weight, blood pressure, cholesterol levels, exercise levels and smoking. The study is part of an ongoing, long-term project called the Multi-Ethnic Study of Atherosclerosis (MESA), which is following nearly 7,000 men and women of different ethnic backgrounds across the country. The study was designed to enroll adults with no symptoms of heart disease to determine who develops heart disease or heart failure, what factors precipitate the disease and who is more likely to die from it. Other institutions involved in the study include the University of Washington; the University of California, Los Angeles; Wake Forest Baptist Medical Center; Brigham and Women’s Hospital; the National Heart, Lung, and Blood Institute; Vanderbilt University; and Columbia University. The research was funded by the National Heart, Lung, and Blood Institute under grants N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169, and by the National Center for Research Resources under grants UL1-TR-000040 and UL1-RR-025005. Fast facts: --Men’s and women’s hearts don’t grow old the same way. --Aging hearts: Gender matters. --Gender differences in heart aging may underlie sex differences observed in heart failure. --Research points to need for gender-tailored treatments for age-related heart failure.
Newswise — In their quest for healthy eating, many Americans are turning to restrictive diets – from vegan to Paleo to low-carb – that they believe are the most “pure” or beneficial. But when people decide to go beyond these and severely limit the types of foods they consume, they could be putting themselves at risk for nutritional deficiencies. People who obsessively refine and restrict their diet to conform to their ideal of what is healthy could be suffering from orthorexia nervosa – which translates from Greek as “correct appetite.” Although not an officially recognized disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), orthorexia can be likened to clinically defined eating disorders, such as anorexia nervosa, says Charlotte Markey, a Rutgers University–Camden psychologist who teaches a course titled “The Psychology of Eating” and studies eating behaviors, body image and weight management. She is the author of Smart People Don’t Diet: How the Latest Science Can Help You Lose Weight Permanently. Rutgers Today spoke with Markey about this condition, how to identify it and how it is best treated. Rutgers Today: What is orthorexia? Markey: Orthorexia is a form of maladaptive eating that can begin with good intentions: People start eliminating foods they consider “impure” or “bad” – sweets, sugars, carbohydrates – and before they know it, they are eating a highly limited diet. They think there is room for improvement and that they can always eat “healthier.” They cut out sugar, then salt, then wheat, then dairy, and so on. They become obsessed with what they should not be eating and keep whittling down the foods they will allow – which often impacts them socially since food is such a part of our social experiences. Since they think they are doing the “right” thing, they don’t question that there might be a negative impact to their health. Rutgers Today: What are the dangers of orthorexia? Markey: What people don’t realize is that many of those foods they are restricting, like carbohydrates, which are an important source of energy, really do serve a function. When diets become so restrictive, more than nutritional deficiencies can result: Orthorexics also can experience low energy and are at risk for depression. In severe cases, orthorexia eventually leads to malnourishment when critical nutrients are eliminated from the diet. Rutgers Today: Can orthorexia be linked to other disorders clinically defined by the DSM-5? Markey: In the past edition of the DSM, there was a category called “Eating Disorders Not Otherwise Specified.” This classification would likely include people, like orthorexics, who are obsessed with food and how they eat. Anorexia nervosa can be similar psychologically to orthorexia in the respect that they are both a restrictive obsession when it comes to food – it’s just that orthorexics are more concerned with the quality of food rather than quantity. Anorexics eat far fewer calories than orthorexics, who oftentimes look “normal” in terms of weight. Rutgers Today: How can people tell if they or someone they love is orthorexic? Markey: The nutritional effects of this extreme dieting are not often obvious, but behavioral changes can be a red flag. What differentiates orthorexics from people who, say, avoid GMOs, are vegan or consume only organic foods, is that the quest for a healthy diet takes over their lives. They spend an inordinate amount of time thinking about food or they avoid social situations so as not to be tempted to eat the foods they are restricting. It’s time to be concerned when someone’s life is being negatively affected or there is evidence of the person being distraught. Rutgers Today: How is orthorexia treated? Markey: I advise a two-pronged approach to treatment. A registered dietitian can assess whether a person is being deprived of key nutrients and, if so, help him or her structure a diet that is more rounded. The person should also find a counselor who specializes in eating disorders. Often, when people engage in negative eating patterns there is an underlying mental health issue. Maladaptive eating behaviors can be linked with depression, addictions and even anxiety disorders such as obsessive compulsive disorder, which can be treated successfully with both medication and cognitive-behavioral therapy. While we want people to eat healthily, we don’t want any eating pattern to become such an obsession that it detracts from their psychological, and even physical, health. For more information or to interview Charlotte Markey, contact Patti Verbanas at 848-932-0551 firstname.lastname@example.org