The world is getting fatter, but Kentucky's rate of obesity is two and a half times the world rate

Take no solace from The Economist, which proclaims in its yearly analysis-and-prognostication issue that this is the year world leaders will take on worldwide obesity because, writes Charlotte Howard, "they will realize something must be done."

So, no, it is not just you, Kentucky. In fact, Howard, the health-care correspondent for the magazine, writes that 30 percent of Mexico's adult population is obese. That is precisely the same percentage of Kentuckians that were considered obese by a Robert Wood Johnson Foundation and Trust for America's Health analysis released in August. (We ranked sixth fattest state nationwide.) It is also the same percentage of Chinese adults that are, as Howard put it, "too wide" -- a term that Howard uses here to include the overweight as well as the obese.

But there is no room to crow here. Kentucky is far ahead of the trend. Only 12 percent of the world counts as obese today. We beat that two and half times over. (The number of Kentuckians who were merely overweight was not calculated or included in the figures in the study.) A study released in September by the same group found that if trends continue, 60 percent of Kentuckians will be obese by 2030. The World Health Organization's estimate of the world's obesity was at 15 percent by 2020.

The Economist folks favors an approach that a democratic path to better health and fiscal sanity, given the health care cost ramifications of obesity. They like a tax on soda -- it's pure sugar, no real nutrition. They like subsidies to make fresh produce cheaper. And they like better school lunches and labeling, labeling, labeling so consumers will make better choices.

Take no solace from The Economist, which proclaims in its yearly analysis-and-prognostication issue that this is the year world leaders will take on worldwide obesity because, writes Charlotte Howard, "they will realize something must be done."

So, no, it is not just you, Kentucky. In fact, Howard, the health-care correspondent for the magazine, writes that 30 percent of Mexico's adult population is obese. That is precisely the same percentage of Kentuckians that were considered obese by a Robert Wood Johnson Foundation and Trust for America's Health analysis released in August. (We ranked sixth fattest state nationwide.) It is also the same percentage of Chinese adults that are, as Howard put it, "too wide" -- a term that Howard uses here to include the overweight as well as the obese.

But there is no room to crow here. Kentucky is far ahead of the trend. Only 12 percent of the world counts as obese today. We beat that two and half times over. (The number of Kentuckians who were merely overweight was not calculated or included in the figures in the study.) A study released in September by the same group found that if trends continue, 60 percent of Kentuckians will be obese by 2030. The World Health Organization's estimate of the world's obesity was at 15 percent by 2020.

The Economist folks favors an approach that a democratic path to better health and fiscal sanity, given the health care cost ramifications of obesity. They like a tax on soda -- it's pure sugar, no real nutrition. They like subsidies to make fresh produce cheaper. And they like better school lunches and labeling, labeling, labeling so consumers will make better choices.

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UK, ARH planning efforts against high rate of heart-disease deaths and limited availability of proper food in Perry County

The death rate from heart disease is nearly twice as high in Perry County (Wikipedia map) as in Kentucky as a whole, so there's no better time than now to announce that the University of Kentucky Medical Center is close to finalizing a three-year agreement with Hazard Appalachian Regional Healthcare Medical Center to provide continuing care, outreach and education to local physicians and county residents, including more and better information about heart-healthy food choices. Bailey Richards of the Hazard Herald reports that this last task is daunting, particularly since availability of good food is an issue in remote parts of the county.

Richards writes that a 2011 study of the heart-healthy food options in Perry County "showed that the area severely lacks low-fat and low-sodium options." Kevin Luley, a registered nurse at the UK Medical Center and winner of the "Heart Health in Rural Kentucky" grant, surveyed all of the restaurants and grocery stores in Perry County and found that most do not have many off-the-shelf options for a healthy diet. Of all of the items available at the restaurants in Perry County, fewer than 6 percent were considered healthy. (Residents can consult their own smartphones for that information. It should also be posted or available upon request.) Of a standard list of produce items, on average only 60 percent were found at the local grocery stores, Luley found. (Read more)

The death rate from heart disease is nearly twice as high in Perry County (Wikipedia map) as in Kentucky as a whole, so there's no better time than now to announce that the University of Kentucky Medical Center is close to finalizing a three-year agreement with Hazard Appalachian Regional Healthcare Medical Center to provide continuing care, outreach and education to local physicians and county residents, including more and better information about heart-healthy food choices. Bailey Richards of the Hazard Herald reports that this last task is daunting, particularly since availability of good food is an issue in remote parts of the county.

Richards writes that a 2011 study of the heart-healthy food options in Perry County "showed that the area severely lacks low-fat and low-sodium options." Kevin Luley, a registered nurse at the UK Medical Center and winner of the "Heart Health in Rural Kentucky" grant, surveyed all of the restaurants and grocery stores in Perry County and found that most do not have many off-the-shelf options for a healthy diet. Of all of the items available at the restaurants in Perry County, fewer than 6 percent were considered healthy. (Residents can consult their own smartphones for that information. It should also be posted or available upon request.) Of a standard list of produce items, on average only 60 percent were found at the local grocery stores, Luley found. (Read more)

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Study: Stroke victims getting younger and, yes, risk factors include obesity, diabetes and high cholesterol

A study conducted on first-ever stroke patients in the Greater Cincinnati and northern Kentucky area may have some devastating repercussions for the nation. The results of the University of Cincinnati research, published this week in the online issue of Neurology, found that the average age of stroke victims has dropped and that this has great implications for lifetime disability. Study author Brett Kissela, MD, with the UC's College of Medicine explained that the rise in risk factors like diabetes, obesity and high cholesterol are the cause. Newswise reports that the study found that strokes among people under 55 made up a greater percentage of all strokes over time, growing from about 13 percent in 1993-94 to 19 percent in 2005. The study was funded by the National Institutes of Health.

"What [the study] means is that even though young people typically feel like they're healthy and that a stroke can't happen to them, the fact is that our study is evidence that that is not true," said Kissela.“The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise. However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease.” (Read more)

A study conducted on first-ever stroke patients in the Greater Cincinnati and northern Kentucky area may have some devastating repercussions for the nation. The results of the University of Cincinnati research, published this week in the online issue of Neurology, found that the average age of stroke victims has dropped and that this has great implications for lifetime disability. Study author Brett Kissela, MD, with the UC's College of Medicine explained that the rise in risk factors like diabetes, obesity and high cholesterol are the cause. Newswise reports that the study found that strokes among people under 55 made up a greater percentage of all strokes over time, growing from about 13 percent in 1993-94 to 19 percent in 2005. The study was funded by the National Institutes of Health.

"What [the study] means is that even though young people typically feel like they're healthy and that a stroke can't happen to them, the fact is that our study is evidence that that is not true," said Kissela.“The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise. However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease.” (Read more)

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Report: Two-thirds of Kentuckians obese by 2030 if trends continue; cost to nation's future unquestionably high

Nearly two-thirds of adults in Kentucky will be obese by 2030 if rates continue to climb as they are now, an analysis reported Tuesday. The level of obesity, defined as being roughly 30 or more pounds overweight, is projected to reach 60.1 percent in Kentucky in 2030, up from 30.4 percent in 2011, according to an analysis commissioned by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation. Nancy Hellmich and Laura Ungar of The Courier-Journal in Louisville report that if states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020, and double again by 2030. Medical costs associated with treating preventable obesity-related diseases could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually. (Read more)

The joint report also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030. Doing so would spare millions of Americans serious health problems, and the country could save billions of dollars in health spending. See the interactive map showing how much improvement could be made if that small change were made here.

The report also features a series of joint policy recommendations from TFAH and RWJF, including full implementation of the Healthy, Hunger-Free Kids Act, protection of the federal health reform law's Prevention and Public Health Fund, and inclusion of additional physical education and activity components in the Elementary and Secondary Education Act. To download the full report, go here. 

Nearly two-thirds of adults in Kentucky will be obese by 2030 if rates continue to climb as they are now, an analysis reported Tuesday. The level of obesity, defined as being roughly 30 or more pounds overweight, is projected to reach 60.1 percent in Kentucky in 2030, up from 30.4 percent in 2011, according to an analysis commissioned by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation. Nancy Hellmich and Laura Ungar of The Courier-Journal in Louisville report that if states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020, and double again by 2030. Medical costs associated with treating preventable obesity-related diseases could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually. (Read more)

The joint report also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030. Doing so would spare millions of Americans serious health problems, and the country could save billions of dollars in health spending. See the interactive map showing how much improvement could be made if that small change were made here.

The report also features a series of joint policy recommendations from TFAH and RWJF, including full implementation of the Healthy, Hunger-Free Kids Act, protection of the federal health reform law's Prevention and Public Health Fund, and inclusion of additional physical education and activity components in the Elementary and Secondary Education Act. To download the full report, go here. 

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Atenolol for Hyperthyroid Cats

Henik, R. A., R. L. Stepien, et al. (2008). "Efficacy of atenolol as a single antihypertensive agent in hyperthyroid cats." Journal of Feline Medicine & Surgery 10(6): 577-582.

Hypertension is a common complication of hyperthyroidism and chronic renal disease in cats. Various drugs may be used to treat feline hypertension, but the drug of choice appears to be amlodipine due to its efficacy and low incidence of adverse effects. However, in cats with hypertension caused by hyperthyroidism, beta-blocking drugs such as atenolol have been suggested to slow the heart rate and block effects of thyroid hormone on the cardiovascular system. While atenolol has been shown to be ineffective in treating hypertension associated with chronic renal disease, it has not been previously investigated for treatment of cats with hyperthyroidism. In this retrospective study, 20 hyperthyroid cats with systolic blood pressure over 160 mmHg were treated with atenolol (1-2 mg/kg, PO, BID). All cats were treated for a minimum of 5 days before reassessment and treatment with radioactive iodine. While both heart rate and systolic blood pressure decreased in the cats, successful clinical control of blood pressure was not achieved in 70% of the cases. The investigators concluded that while atenolol successfully controls heart rate in hyperthyroid cats, the addition of another drug is needed to treat hypertension.
>> PubMed Abstract

Related articles:
Trepanier LA. Pharmacologic management of feline hyperthyroidism. Vet Clin North Am Small Anim Pract. 2007 Jul;37(4):775-88
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Henik, R. A., R. L. Stepien, et al. (2008). "Efficacy of atenolol as a single antihypertensive agent in hyperthyroid cats." Journal of Feline Medicine & Surgery 10(6): 577-582.

Hypertension is a common complication of hyperthyroidism and chronic renal disease in cats. Various drugs may be used to treat feline hypertension, but the drug of choice appears to be amlodipine due to its efficacy and low incidence of adverse effects. However, in cats with hypertension caused by hyperthyroidism, beta-blocking drugs such as atenolol have been suggested to slow the heart rate and block effects of thyroid hormone on the cardiovascular system. While atenolol has been shown to be ineffective in treating hypertension associated with chronic renal disease, it has not been previously investigated for treatment of cats with hyperthyroidism. In this retrospective study, 20 hyperthyroid cats with systolic blood pressure over 160 mmHg were treated with atenolol (1-2 mg/kg, PO, BID). All cats were treated for a minimum of 5 days before reassessment and treatment with radioactive iodine. While both heart rate and systolic blood pressure decreased in the cats, successful clinical control of blood pressure was not achieved in 70% of the cases. The investigators concluded that while atenolol successfully controls heart rate in hyperthyroid cats, the addition of another drug is needed to treat hypertension.
>> PubMed Abstract

Related articles:
Trepanier LA. Pharmacologic management of feline hyperthyroidism. Vet Clin North Am Small Anim Pract. 2007 Jul;37(4):775-88
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Read More

Blood Pressure in Cats

Slingerland, L. I., J. H. Robben, et al. (2008). "Response of cats to familiar and unfamiliar human contact using continuous direct arterial blood pressure measurement." Res Vet Sci 85(3): 575-82.

Blood pressure is an important measure of cardiovascular function that can be affected by both physical and pathological conditions. In cats, diseases such as chronic renal disease and hyperthyroidism may be associated with hypertension. Indirect measurement of blood pressure in cats can be determined in the practice setting using either Doppler or oscillometric machines. Only a few studies have evaluated normal ranges for feline blood pressure, and there are conflicting opinions on criteria for diagnosing hypertension. In this study, continuous direct measurement of arterial blood pressure (ABP) was carried out in 21 healthy cats via catheterization of the common carotid artery. The ABP was measured during rest, alertness, and activity and the response to be petted by familiar and unfamiliar people was also assessed. The mean blood pressure (MBP) in resting cats (114 mm Hg) was lower than in alert cats (123 mm Hg) and active cats (137 mm Hg). The MBP when being petted by a familiar person (145 mm Hg) was higher than during petting by an unfamiliar person (139 mm Hg).
>> PubMed Abstract

Related articles:
Jepson, R., V. Hartley, et al. (2005). "A comparison of CAT Doppler and oscillometric Memoprint machines for non-invasive blood pressure measurement in conscious cats." J Fel Med Surg 7: 147-152.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Slingerland, L. I., J. H. Robben, et al. (2008). "Response of cats to familiar and unfamiliar human contact using continuous direct arterial blood pressure measurement." Res Vet Sci 85(3): 575-82.

Blood pressure is an important measure of cardiovascular function that can be affected by both physical and pathological conditions. In cats, diseases such as chronic renal disease and hyperthyroidism may be associated with hypertension. Indirect measurement of blood pressure in cats can be determined in the practice setting using either Doppler or oscillometric machines. Only a few studies have evaluated normal ranges for feline blood pressure, and there are conflicting opinions on criteria for diagnosing hypertension. In this study, continuous direct measurement of arterial blood pressure (ABP) was carried out in 21 healthy cats via catheterization of the common carotid artery. The ABP was measured during rest, alertness, and activity and the response to be petted by familiar and unfamiliar people was also assessed. The mean blood pressure (MBP) in resting cats (114 mm Hg) was lower than in alert cats (123 mm Hg) and active cats (137 mm Hg). The MBP when being petted by a familiar person (145 mm Hg) was higher than during petting by an unfamiliar person (139 mm Hg).
>> PubMed Abstract

Related articles:
Jepson, R., V. Hartley, et al. (2005). "A comparison of CAT Doppler and oscillometric Memoprint machines for non-invasive blood pressure measurement in conscious cats." J Fel Med Surg 7: 147-152.
>> PubMed Abstract

More on cat health: Winn Feline Foundation Library

Read More

Efficacy of Transdermal Atenolol for Cats

Macgregor, J. M., J. E. Rush, et al. (2008). "Comparison of pharmacodynamic variables following oral versus transdermal administration of atenolol to healthy cats." Am J Vet Res 69(1): 39-44.

Atenolol is often prescribed for cats with certain types of heart disease, most notably some forms of hypertrophic cardiomyopathy. The drug is typically prescribed as 1/4 of a 25 mg tablet every 12 hours. Long term daily administration of oral medication may be very difficult for some owners to achieve. In recent years, there has been great interest in transdermal formulations of medication for cats. Few studies have reported on the efficacy of transdermal gel medications for cats, and of those that have been published the results are not always promising. In this project, atenolol was administered to 7 healthy cats, either orally or as a transdermal gel. Blood levels of atenolol were tested to determine efficacy of the route of administration. The difference between the two routes of administration was significant, with transdermal atenolol providing lower and inconsistent blood levels compared to oral administration.
>> PubMed abstract

Related articles:
Helms, S. R. (2007). "Treatment of feline hypertension with transdermal amlodipine: a pilot study." J Am Anim Hosp Assoc 43(3): 149-156.

Lecuyer, M., S. Prini, et al. (2006). "Clinical efficacy and safety of transdermal methimazole in the treatment of feline hyperthyroidism." Can Vet J 47(2): 131-5. [Free full text article]

More on cat health: Winn Feline Foundation Library

Macgregor, J. M., J. E. Rush, et al. (2008). "Comparison of pharmacodynamic variables following oral versus transdermal administration of atenolol to healthy cats." Am J Vet Res 69(1): 39-44.

Atenolol is often prescribed for cats with certain types of heart disease, most notably some forms of hypertrophic cardiomyopathy. The drug is typically prescribed as 1/4 of a 25 mg tablet every 12 hours. Long term daily administration of oral medication may be very difficult for some owners to achieve. In recent years, there has been great interest in transdermal formulations of medication for cats. Few studies have reported on the efficacy of transdermal gel medications for cats, and of those that have been published the results are not always promising. In this project, atenolol was administered to 7 healthy cats, either orally or as a transdermal gel. Blood levels of atenolol were tested to determine efficacy of the route of administration. The difference between the two routes of administration was significant, with transdermal atenolol providing lower and inconsistent blood levels compared to oral administration.
>> PubMed abstract

Related articles:
Helms, S. R. (2007). "Treatment of feline hypertension with transdermal amlodipine: a pilot study." J Am Anim Hosp Assoc 43(3): 149-156.

Lecuyer, M., S. Prini, et al. (2006). "Clinical efficacy and safety of transdermal methimazole in the treatment of feline hyperthyroidism." Can Vet J 47(2): 131-5. [Free full text article]

More on cat health: Winn Feline Foundation Library

Read More