Even 1 Soda a Day Can Hike Your Diabetes Risk

A soda a day? That's not so bad—a 150-calorie blip, burned off with a brisk half-hour walk. But it's not only your waistline that's at stake. A study released today in the journal Diabetes Care found that people with a daily habit of just one or two sugar-sweetened beverages—anything from sodas and energy drinks to sweetened teas and vitamin water—were more than 25 percent likelier to develop type 2 diabetes than were similar individuals who had no more than one sugary drink per month. Since the overall rate of diabetes is roughly 1 in 10, an increase of 25 percent raises the risk to about 1 in 8. One-a-day guzzlers in the study also had a 20 percent higher rate of metabolic syndrome, a collection of indicators such as high triglyceride levels suggesting that diabetes is not far off.

"Previous studies have shown that sugar-sweetened beverages are strongly associated with weight gain," says lead author Vasanti Malik, a research fellow in the Harvard School of Public Health Department of Nutrition, who says the decision to examine the relationship between sugar-sweetened beverages and risk of diabetes was "the logical next step."

[To Cut Diabetes-Related Heart Risks, Diet and Exercise May Beat Drugs]

The researchers conducted a study of studies—a meta-analysis—to reach their conclusions. They identified eight studies with enough data to let them check for a link between sugary drinks and type 2 diabetes and three similar studies of metabolic syndrome. The largest diabetes study, which followed more than 91,000 American women ages 24 to 44 for eight years, made the strongest case for a relationship, and it wasn't just because higher consumption of sweetened drinks added excess calories that turned into pounds. While weight gain is a known diabetes risk factor, the diabetes-beverage link persisted even after adjusting for that. "Other factors independently put you at risk for developing diabetes," says Malik.

The main one is spikes in blood glucose and insulin because sweetened drinks are often consumed quickly and in large quantities and their sugar content is rapidly absorbed. Frequent spiking can lead to insulin resistance, inflammation, and hypertension—often precursors to diabetes. High-fructose corn syrup, the sugar in many sweetened drinks, is emerging as possibly riskier than other sugars because it seems to produce more belly fat. Fat that accumulates around the middle is closely tied to high blood pressure and other cardiovascular problems.

Americans love sweetened drinks. Consumption climbed to an average of 142 calories a day, or nearly one 12-ounce can of soda, in 2006, from 65 in the late 1970s. And many people down far more than that, notes Frank Hu, a senior author of the study and a professor of nutrition and epidemiology at Harvard, which puts them at a much greater risk of diabetes. A report from the Centers for Disease Control and Prevention released earlier this week projects that by 2050, 1 in 3 Americans will develop the disease. "Soft drink consumption has significant public health implications in terms of the diabetes epidemic," says Hu.

[Why Diabetes May Triple by 2050]

Earlier this year the American Heart Association issued a recommendation advising consumers to set a limit on sweetened drinks of 450 calories a week, or three 12-ounce sodas, in a 2,000-calorie diet. Calorie-counting is a convenient way to keep track, but it can be misleading. "Consumers are overly focused on calories," says Constance Brown-Riggs, a spokesperson for the American Dietetic Association, who would like people also to understand that a 12-ounce can of soda contains the equivalent of 15 teaspoons of sugar. "They think it's not that bad, without taking into consideration the other components that are putting them at risk."

Type 2 diabetes and metabolic syndrome aren't the only risks of a one-a-day habit. In a 2004 study published in the Journal of the American Medical Association of 88,000 women followed for 24 years, those who guzzled two or more sugary drinks a day had a risk of coronary artery disease 35 percent higher than non-guzzlers, even after adjusting for other unhealthy lifestyle factors. "You receive no benefits out of drinking these beverages," says Malik, who lists additional hazards from dental cavities to gout. "It's a wake-up call for the American public."

A soda a day? That's not so bad—a 150-calorie blip, burned off with a brisk half-hour walk. But it's not only your waistline that's at stake. A study released today in the journal Diabetes Care found that people with a daily habit of just one or two sugar-sweetened beverages—anything from sodas and energy drinks to sweetened teas and vitamin water—were more than 25 percent likelier to develop type 2 diabetes than were similar individuals who had no more than one sugary drink per month. Since the overall rate of diabetes is roughly 1 in 10, an increase of 25 percent raises the risk to about 1 in 8. One-a-day guzzlers in the study also had a 20 percent higher rate of metabolic syndrome, a collection of indicators such as high triglyceride levels suggesting that diabetes is not far off.

"Previous studies have shown that sugar-sweetened beverages are strongly associated with weight gain," says lead author Vasanti Malik, a research fellow in the Harvard School of Public Health Department of Nutrition, who says the decision to examine the relationship between sugar-sweetened beverages and risk of diabetes was "the logical next step."

[To Cut Diabetes-Related Heart Risks, Diet and Exercise May Beat Drugs]

The researchers conducted a study of studies—a meta-analysis—to reach their conclusions. They identified eight studies with enough data to let them check for a link between sugary drinks and type 2 diabetes and three similar studies of metabolic syndrome. The largest diabetes study, which followed more than 91,000 American women ages 24 to 44 for eight years, made the strongest case for a relationship, and it wasn't just because higher consumption of sweetened drinks added excess calories that turned into pounds. While weight gain is a known diabetes risk factor, the diabetes-beverage link persisted even after adjusting for that. "Other factors independently put you at risk for developing diabetes," says Malik.

The main one is spikes in blood glucose and insulin because sweetened drinks are often consumed quickly and in large quantities and their sugar content is rapidly absorbed. Frequent spiking can lead to insulin resistance, inflammation, and hypertension—often precursors to diabetes. High-fructose corn syrup, the sugar in many sweetened drinks, is emerging as possibly riskier than other sugars because it seems to produce more belly fat. Fat that accumulates around the middle is closely tied to high blood pressure and other cardiovascular problems.

Americans love sweetened drinks. Consumption climbed to an average of 142 calories a day, or nearly one 12-ounce can of soda, in 2006, from 65 in the late 1970s. And many people down far more than that, notes Frank Hu, a senior author of the study and a professor of nutrition and epidemiology at Harvard, which puts them at a much greater risk of diabetes. A report from the Centers for Disease Control and Prevention released earlier this week projects that by 2050, 1 in 3 Americans will develop the disease. "Soft drink consumption has significant public health implications in terms of the diabetes epidemic," says Hu.

[Why Diabetes May Triple by 2050]

Earlier this year the American Heart Association issued a recommendation advising consumers to set a limit on sweetened drinks of 450 calories a week, or three 12-ounce sodas, in a 2,000-calorie diet. Calorie-counting is a convenient way to keep track, but it can be misleading. "Consumers are overly focused on calories," says Constance Brown-Riggs, a spokesperson for the American Dietetic Association, who would like people also to understand that a 12-ounce can of soda contains the equivalent of 15 teaspoons of sugar. "They think it's not that bad, without taking into consideration the other components that are putting them at risk."

Type 2 diabetes and metabolic syndrome aren't the only risks of a one-a-day habit. In a 2004 study published in the Journal of the American Medical Association of 88,000 women followed for 24 years, those who guzzled two or more sugary drinks a day had a risk of coronary artery disease 35 percent higher than non-guzzlers, even after adjusting for other unhealthy lifestyle factors. "You receive no benefits out of drinking these beverages," says Malik, who lists additional hazards from dental cavities to gout. "It's a wake-up call for the American public."

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Blood Pressure Treatment on Rise in Younger Adults, Says CDC Report

Kristen Pessalano just turned 23, but has been on blood pressure medication for more than two years. Pessalano, a New Yorker who works in public relations, found out she had high blood pressure while getting a physical before heading abroad for an internship.

"[I] got upset when I first found out because I automatically associated it with people who are overweight or old," said Pessalano. "I would have never associated high blood pressure with someone my age, especially when I appeared to be totally healthy."

Pessalano has a lot of company, according to a new report by the Centers for Disease Control and Prevention. The report finds that while the percentage of Americans who have high blood pressure has remained steady over the past decade at 30 percent, the number of younger adults -- ages 18 to 39 -- who have high blood pressure and take medication to treat it has significantly increased from 27.6 percent in 1999 to 2000 to 49.1 percent in 2007 to 2008.
Doctors say they're not surprised because of other health problems that plague younger adults.

"I'm not surprised that more and more young people are being treated for high blood pressure since the incidence of obesity, a contributing cause for high blood pressure, is increasing in this age group," said Dr. Randal Thomas, a cardiologist at the Mayo Clinic in Rochester, Minn.

"With increasing obesity and diabetes in younger populations, clinicians may be more aggressive about recognizing risk factors for cardiovascular disease, like hypertension, and treating it," said Dr. Carol Horowitz, associate professor of medicine at Mount Sinai School of Medicine.

Although the news that she had high blood pressure was unexpected to Pessalano, the CDC report found most people with high blood pressure have become more aware of the condition, which is something physicians say they've noticed in their own practices.

"[I]ndividuals are taking their own health issues more seriously and noticing the increased blood pressure readings," said Dr. R. Scott Wright, also a cardiologist at the Mayo Clinic.

Kristen Pessalano just turned 23, but has been on blood pressure medication for more than two years. Pessalano, a New Yorker who works in public relations, found out she had high blood pressure while getting a physical before heading abroad for an internship.

"[I] got upset when I first found out because I automatically associated it with people who are overweight or old," said Pessalano. "I would have never associated high blood pressure with someone my age, especially when I appeared to be totally healthy."

Pessalano has a lot of company, according to a new report by the Centers for Disease Control and Prevention. The report finds that while the percentage of Americans who have high blood pressure has remained steady over the past decade at 30 percent, the number of younger adults -- ages 18 to 39 -- who have high blood pressure and take medication to treat it has significantly increased from 27.6 percent in 1999 to 2000 to 49.1 percent in 2007 to 2008.
Doctors say they're not surprised because of other health problems that plague younger adults.

"I'm not surprised that more and more young people are being treated for high blood pressure since the incidence of obesity, a contributing cause for high blood pressure, is increasing in this age group," said Dr. Randal Thomas, a cardiologist at the Mayo Clinic in Rochester, Minn.

"With increasing obesity and diabetes in younger populations, clinicians may be more aggressive about recognizing risk factors for cardiovascular disease, like hypertension, and treating it," said Dr. Carol Horowitz, associate professor of medicine at Mount Sinai School of Medicine.

Although the news that she had high blood pressure was unexpected to Pessalano, the CDC report found most people with high blood pressure have become more aware of the condition, which is something physicians say they've noticed in their own practices.

"[I]ndividuals are taking their own health issues more seriously and noticing the increased blood pressure readings," said Dr. R. Scott Wright, also a cardiologist at the Mayo Clinic.

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Exercise Your Depression Away

Good news all you exercise fanatics.

Researchers have found that the more people engage in physical activity, even very light exercise, during their spare time, the less likely they are to be depressed.

Surprisingly, the study showed that people who exert themselves at work by doing lots of walking or lifting are no less likely to be depressed than people with sedentary jobs.

People who were inactive during their leisure time were almost twice as likely to have symptoms of depression, compared with the most active individuals.

lead author of the study, said the findings underlined the importance of the context in which exercise was taken.

“Our study shows that people who engage in regular leisure time activity of any intensity are less likely to have symptoms of depression,” he said.

“We also found that the context in which activity takes place is vital and that the social benefits associated with exercise, like increased numbers of friends, are more important in understanding how exercise may be linked to improved mental health than any biological markers of fitness.

“This may explain why leisure activity appears to have benefits not seen with physical activity undertaken as part of a working day.”

Good news all you exercise fanatics.

Researchers have found that the more people engage in physical activity, even very light exercise, during their spare time, the less likely they are to be depressed.

Surprisingly, the study showed that people who exert themselves at work by doing lots of walking or lifting are no less likely to be depressed than people with sedentary jobs.

People who were inactive during their leisure time were almost twice as likely to have symptoms of depression, compared with the most active individuals.

lead author of the study, said the findings underlined the importance of the context in which exercise was taken.

“Our study shows that people who engage in regular leisure time activity of any intensity are less likely to have symptoms of depression,” he said.

“We also found that the context in which activity takes place is vital and that the social benefits associated with exercise, like increased numbers of friends, are more important in understanding how exercise may be linked to improved mental health than any biological markers of fitness.

“This may explain why leisure activity appears to have benefits not seen with physical activity undertaken as part of a working day.”

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Identifying Feral Cats in Shelters

Slater MR, Miller KA, Weiss E et al: A survey of the methods used in shelter and rescue programs to identify feral and frightened pet cats, J Feline Med Surg 12:592, 2010.

At least 2.5 million cats enter animal shelters nationwide on an annual basis and at least half are free-roaming cats. Free-roaming cats are defined as any cat living part of the time outdoors. Animal welfare organizations must make disposition decisions on intake of millions of cats each year and it can be difficult to differentiate between feral cats and frightened socialized cats.  This study’s objectives were to learn about methods used to evaluate and categorize incoming cats, amount of time cats are held before assessment, and the level of cooperation between welfare agencies to minimize euthanasia of feral cats. The authors find no widely-accepted criteria or information-gathering guidelines among the responses collected. Only 15% of the 555 respondents had written guidelines. Many respondents indicated that time was the most important element of deciding if a cat was feral or not.  Minimal holding times were highly varied, with 1-3 days cited as the most common holding time among all organizations, especially animal control programs. Approximately half the groups transferred feral cats to trap-neuter-return (TNR) programs at least occasionally. The results of the survey highlight the need for more research to develop focused standardized guidelines for determining feral status early in the shelter intake process. [VT]

Related articles:
Wallace JL, Levy JK: Population characteristics of feral cats admitted to seven trap-neuter-return programs in the United States, J Feline Med Surg 8:279, 2006.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

Slater MR, Miller KA, Weiss E et al: A survey of the methods used in shelter and rescue programs to identify feral and frightened pet cats, J Feline Med Surg 12:592, 2010.

At least 2.5 million cats enter animal shelters nationwide on an annual basis and at least half are free-roaming cats. Free-roaming cats are defined as any cat living part of the time outdoors. Animal welfare organizations must make disposition decisions on intake of millions of cats each year and it can be difficult to differentiate between feral cats and frightened socialized cats.  This study’s objectives were to learn about methods used to evaluate and categorize incoming cats, amount of time cats are held before assessment, and the level of cooperation between welfare agencies to minimize euthanasia of feral cats. The authors find no widely-accepted criteria or information-gathering guidelines among the responses collected. Only 15% of the 555 respondents had written guidelines. Many respondents indicated that time was the most important element of deciding if a cat was feral or not.  Minimal holding times were highly varied, with 1-3 days cited as the most common holding time among all organizations, especially animal control programs. Approximately half the groups transferred feral cats to trap-neuter-return (TNR) programs at least occasionally. The results of the survey highlight the need for more research to develop focused standardized guidelines for determining feral status early in the shelter intake process. [VT]

Related articles:
Wallace JL, Levy JK: Population characteristics of feral cats admitted to seven trap-neuter-return programs in the United States, J Feline Med Surg 8:279, 2006.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

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Connect With Winn!

Winn's goal is to help "Every Cat, Every Day" and we can only do this with your assistance. Stay in touch with our activities and learn how you can become involved in the future of feline health.

Join over 3,000 other cat lovers on our Facebook page.

Follow us on Twitter and help spread the word!

Subscribe to our email newsletter - we promise, no spam :-)
  

Virtual Memorials for special cats loved by special owners

Winn's goal is to help "Every Cat, Every Day" and we can only do this with your assistance. Stay in touch with our activities and learn how you can become involved in the future of feline health.

Join over 3,000 other cat lovers on our Facebook page.

Follow us on Twitter and help spread the word!

Subscribe to our email newsletter - we promise, no spam :-)
  

Virtual Memorials for special cats loved by special owners

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Exercise 'can prevent a cold', a study shows

People who exercise regularly are less likely to get a cold, researchers say.


A study of 1,000 people found that staying active nearly halved the odds of catching cold viruses and, failing that, made the infection less severe.

Experts told the British Journal of Sports Medicine that this could be because exercise helps bolster the immune system to fight off bugs.

But you may not have to actually do much exercise - those who merely think they are fit enjoy the same lower risk.

Adults can expect to suffer two to five colds per year. This latest research suggests there are lifestyle choices you can make to improve your odds of either avoiding them, or suffering too badly from them.

For their study, US researchers asked the healthy volunteers to keep a record of any coughs and sniffles they experienced over a three-month period during the autumn and winter.

The volunteers were also asked to say how frequently in any given week they would do exercise lasting at least 20 minutes and intensive enough to break a sweat.

And they were questioned about lifestyle, diet and recent stressful events, as these can all affect a person's immune system.

Being older, male and married seemed to reduce the frequency of colds, as did eating plenty of fruit.
But the most significant factors that cut colds was how much exercise a person did and how fit they perceived themselves to be.

Feeling fit and being active cut the risk of having a cold by nearly 50%.

People who were physically active on five or more days of the week were unwell with a cold for about five days of the three-month period, compared to nine days for those who did little or no exercise.

And even when they were ill, they suffered less with their symptoms.

The severity of symptoms fell by 41% among those who felt the fittest and by 31% among those who were the most active.

Lead researcher Dr David Nieman and his team, from Appalachian State University in North Carolina, say bouts of exercise spark a temporary rise in immune system cells circulating around the body that can attack foreign invaders.

Although these levels fall back within a few hours, each session is likely to provide an immune boost to fight off infections like the common cold.

Professor Steve Field, chairman of the Royal College of General Practitioners, said: "This is yet more evidence for doing exercise. It reflects what we have believed for some time.

"Exercise makes us feel better and now here's more evidence that it is good for us."

People who exercise regularly are less likely to get a cold, researchers say.


A study of 1,000 people found that staying active nearly halved the odds of catching cold viruses and, failing that, made the infection less severe.

Experts told the British Journal of Sports Medicine that this could be because exercise helps bolster the immune system to fight off bugs.

But you may not have to actually do much exercise - those who merely think they are fit enjoy the same lower risk.

Adults can expect to suffer two to five colds per year. This latest research suggests there are lifestyle choices you can make to improve your odds of either avoiding them, or suffering too badly from them.

For their study, US researchers asked the healthy volunteers to keep a record of any coughs and sniffles they experienced over a three-month period during the autumn and winter.

The volunteers were also asked to say how frequently in any given week they would do exercise lasting at least 20 minutes and intensive enough to break a sweat.

And they were questioned about lifestyle, diet and recent stressful events, as these can all affect a person's immune system.

Being older, male and married seemed to reduce the frequency of colds, as did eating plenty of fruit.
But the most significant factors that cut colds was how much exercise a person did and how fit they perceived themselves to be.

Feeling fit and being active cut the risk of having a cold by nearly 50%.

People who were physically active on five or more days of the week were unwell with a cold for about five days of the three-month period, compared to nine days for those who did little or no exercise.

And even when they were ill, they suffered less with their symptoms.

The severity of symptoms fell by 41% among those who felt the fittest and by 31% among those who were the most active.

Lead researcher Dr David Nieman and his team, from Appalachian State University in North Carolina, say bouts of exercise spark a temporary rise in immune system cells circulating around the body that can attack foreign invaders.

Although these levels fall back within a few hours, each session is likely to provide an immune boost to fight off infections like the common cold.

Professor Steve Field, chairman of the Royal College of General Practitioners, said: "This is yet more evidence for doing exercise. It reflects what we have believed for some time.

"Exercise makes us feel better and now here's more evidence that it is good for us."

Read More

How should value be defined in spine surgery?

Introduction
In a health care economy with limited resources, providers and consumers of health care services need to be accountable for the end result and the cost of care. The value proposition in health care is an analysis of the benefits of care relative to the direct cost and risk of providing the care. Measurement of benefits and costs is challenging, and a consensus on the measures that encompass the relevant components of the value equation has not been reached. Traditional outcome measures in orthopedics including survival, radiographic outcomes, and disease-specific outcome tools do not adequately reflect the patient’s health care experience, or the impact of an intervention on health-related quality of life. Similarly, measuring cost of care is complex, and may encompass both direct costs of treatment and alternative treatments, and indirect costs including time from work or family role, loss of productivity, and cost of caretakers.

The value equation may vary depending on the perspective of the stakeholder in the health care economy. Hospitals and facilities providing care may measure outcome and costs by factors that affect their short-term, single admission interaction, including length of stay, implant utilization, and complications. Third-party payors may focus on a timeframe that is longer that a single admission, and may include factors in the value equation such as readmission within 90 days, or cost of outpatient care. Hospital- and payor-based quality measures may be misinterpreted as measures of outcome or value. Length of stay, surgical times, compliance with antibiotic or thromboembolic prophylaxis, and perioperative complications are process measures that may be useful to compare hospital and provider performance when appropriately matched and stratified. However, they are not useful in measuring a patient’s health care experience, or the impact of an intervention on long-term health-related quality of life. In fact, a focus on quality and process measures alone may be misleading in the pursuit of value in health care, and may provide incentive for counterproductive care strategies that serve the measurement system rather than the patient.

The health care provider and the patient measure outcome by the impact of an orthopedic intervention on health-related quality of life (HRQoL). The timeframe for the patient and provider is a lifetime, rather than a single admission. As Porter and Teisberg wrote in 2006, the right goal for health care delivery is superior patient value, which is measured at the level of specific medical conditions. Measurement of outcomes of care needs to reflect the patient’s long-term health care experience, and the impact of one intervention compared with alternatives on the patients self-assessment of HRQoL.

Introduction
In a health care economy with limited resources, providers and consumers of health care services need to be accountable for the end result and the cost of care. The value proposition in health care is an analysis of the benefits of care relative to the direct cost and risk of providing the care. Measurement of benefits and costs is challenging, and a consensus on the measures that encompass the relevant components of the value equation has not been reached. Traditional outcome measures in orthopedics including survival, radiographic outcomes, and disease-specific outcome tools do not adequately reflect the patient’s health care experience, or the impact of an intervention on health-related quality of life. Similarly, measuring cost of care is complex, and may encompass both direct costs of treatment and alternative treatments, and indirect costs including time from work or family role, loss of productivity, and cost of caretakers.

The value equation may vary depending on the perspective of the stakeholder in the health care economy. Hospitals and facilities providing care may measure outcome and costs by factors that affect their short-term, single admission interaction, including length of stay, implant utilization, and complications. Third-party payors may focus on a timeframe that is longer that a single admission, and may include factors in the value equation such as readmission within 90 days, or cost of outpatient care. Hospital- and payor-based quality measures may be misinterpreted as measures of outcome or value. Length of stay, surgical times, compliance with antibiotic or thromboembolic prophylaxis, and perioperative complications are process measures that may be useful to compare hospital and provider performance when appropriately matched and stratified. However, they are not useful in measuring a patient’s health care experience, or the impact of an intervention on long-term health-related quality of life. In fact, a focus on quality and process measures alone may be misleading in the pursuit of value in health care, and may provide incentive for counterproductive care strategies that serve the measurement system rather than the patient.

The health care provider and the patient measure outcome by the impact of an orthopedic intervention on health-related quality of life (HRQoL). The timeframe for the patient and provider is a lifetime, rather than a single admission. As Porter and Teisberg wrote in 2006, the right goal for health care delivery is superior patient value, which is measured at the level of specific medical conditions. Measurement of outcomes of care needs to reflect the patient’s long-term health care experience, and the impact of one intervention compared with alternatives on the patients self-assessment of HRQoL.

Read More