HEART DISEASE: REDUCE YOUR CHILD'S RISK

Heredity is clearly an important risk factor for conditions such as heart disease, cancer, and diabetes. However, researchers are steadily gathering strong evidence about how diet influence development of diseases. Experts agree that healthy eating habits from an early age can lower the risk of developing several deadly diseases later on. A diet designed to lower the risk of heart disease, diabetes, and other serious diseases is one that benefits the whole family, adults and children alike. 

Risk Factors for Heart Disease 

Heart disease is the number one killer of men and women in the United States and most industrialized countries. The chief risk factors are:

• Smoking
• High blood pressure
• Diabetes
• High blood level of cholesterol
• Physical inactivity
• Obesity
• Family history of early-onset heart disease

Following a Heart-Healthy Diet From an Early Age 

American children and adolescents, on average, eat more saturated fat and have higher blood cholesterol levels than young people their age in most other developed countries. The rate of heart disease tends to keep pace with cholesterol levels. One study found early signs of hardening of the arteries (atherosclerosis) in 7% of children between ages 10 and 15 years, and the rate was twice as high between ages 15 and 20. 

According to the American Heart Association, a heart-healthy diet from an early age lowers cholesterol and if followed through adolescence and beyond, should reduce the risk of coronary artery disease in adulthood.

All children older than 2 years should follow a heart-healthy diet, including low-fatdairy products. For children between the ages of 12 months and 2 years with a family history of obesity, abnormal blood fats, or cardiovascular disease, reduced-fat milk should be considered.

Is There a Family History?

When you and your children first saw your pediatrician, you were probably asked if there was a history of heart or vascular disease in your family. If your children were young, their grandparents were probably relatively young as well and may not have had a heart attack or stroke (even though they may have been headed for one). If heart disease in the grandparents becomes apparent later on, be sure to bring it to your pediatrician’s attention at the next checkup. 

Cholesterol Testing for Adopted Children  

Complete biological family medical histories are not usually available to adopted children and their parents, even for those adopted in open proceedings. To prevent the development of diseases linked to high blood cholesterol levels, adopted children should be screened periodically for blood lipid (fat) levels throughout childhood. 

Additional Information  

• Healthy Active Living for Families
• The 5 Food Groups: Sample Choices
• Overcoming Obstacles to Physical Activity
• What About Fat and Cholesterol? 
• Your Family Health History & Genetics 

Source - 11/21/2015

Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)

6 WAYS OBESITY CAN WEIGH ON THE BRAIN

Obesity not only impacts your physical health; it also impacts your brain. An assistant professor at Texas A&M Health Science Center School of Public Health, who’s received National Institute on Aging funding to study obesity’s effects on brain function in seniors, notes obesity can change the structure of the brain and cause atrophy.

1.     A higher BMI is associated with poorer episodic memory – or difficulty recalling past events – in young adults ages 18 to 35. The findings in a research article published in The Quarterly Journal of Experimental Psychology suggested that people who are overweight may experience memory slightly less vividly or in less detail. Other evidence indicates memory plays an important role in regulating what we eat; and clouded memory can make it harder to watch what one eats and lose weight.

2.     Midlife obesity is associated with a higher risk of dementia. Being obese in one’s 40’s through 60’s is associated with a higher risk of dementia as you age. It’s linked to an increased risk of Alzheimer’s, the most common form of dementia, and a leading cause of death in the US. The true cause is not clear, but it is clear that added pounds negatively affect cardiovascular health, which plays a significant role in brain function.

3.     Obesity in older individuals is associated with changes in brain activity that affect neuromuscular function – including making it harder to grab/grasp onto things. If your grip is not reliable, people can become a much higher risk of falls. It should also be noted, in studies where this information was proposed, obese individuals’ grasping ability was further impaired under stress.

4.     Researchers found obese subjects also expended more mental resources when walking, even though they were able to walk as well as non-obese test subject. And stress further taxed the brain of obese individuals, compared to their normal-weight counterparts. In addition to the physical challenge, the added mental burden of obesity might also lead individuals to tire more quickly.

5.     Being overweight may dull your ability to experience pleasure. One previous study published in the Journal of Neuroscience noted that an area of the brain called the striatum was less activated in women after they had gained weight. The striatum plays a key role in encoding the reward we get from eating certain foods, like those high in sugar that are associated with the release of the brain chemical dopamine, causing us to feel pleasure. In addition to high-fat, high sugar diets leading to being overweight has been associated with this same dulling effect, which experts say can lead a person to overeat to regain that fleeting sense of pleasure.

6.     Obesity raises the risk of depression, and depression can raise the risk of obesity. We definitely know it contributes, and it may also contribute to bipolar disorder.

Health experts say losing weight typically has a positive impact on brain health. Lifestyle changes, including partaking in a heart-healthy diet and exercising regularly, have also proven a beneficial strategy to optimize mental function. As the obesity epidemic rages on, more studies are underway to shed light on those negative effects – and to shed light to help us better understand how to prevent or reverse them. 

1/3 OF THE WORLD IS WHAT?

If you're overweight or obese, you're definitely not alone. In fact, new research shows there are billions of people just like you – and it's concerning the public health community.

A New England Journal of Medicine study, published Monday, finds that more than 2 billion people – or one-third of the world's population – fall into the obese-or-overweight categories, CNN reports. What's more: Their weight is causing them to endure health problems.

The New York Times reports the per capita death rate has ticked up 28 percent since 1990, and40 percent of these deaths occurred among overweight people not heavy enough to be obese. In 2015, extra weight was a factor in 4 million deaths from conditions such as heart disease and diabetes.

More than 710 million people are considered obese, which translates to 10 percent of the global population.

For the purposes of the study, being obese meant having a body mass index of 30 or higher, while being overweight was defined as having a BMI between 25 and 29. The Institute for Health Metrics and Evaluation at the University of Washington led the Gates Foundation-backed study.

The U.S. earned the dubious distinction of having the highest percentage of obese children and young adults relative to the overall population (13 percent), while Egypt had the highest percentage of obese adults, with nearly 35 percent.

Looking beyond percentages at the actual numbers: The U.S. was home to the most obese adults (79.4 million), and China was home to the most obese children (15.3 million).

These findings are unsettling to experts, who worry about the health consequences of the world's expanding waistline. "People who shrug off weight gain do so at their own risk – risk of cardiovascular disease, diabetes, cancer, and other life-threatening conditions," Dr. Christopher Murray, study author and director of the Institute for Health Metrics and Evaluation at the University of Washington, told CNN.

Researchers used data from the Global Burden of Disease study in their analysis, which included 68.5 million people tracked between 1980 and 2015. They reported that in 73 countries, the obese population had doubled since 1980. Women had higher obesity levels than men no matter the age group, a finding that echoes previous research.

So, what comes next?

"We need to control the consequences of obesity much better globally ... and help people who are obese to lose weight," Goodarz Danaei, a professor at the Harvard T.H. Chan School of Public Health who didn't work on the study, told CNN. "That's where we need research and public health interventions."

But such interventions could prove complicated, particularly when it comes to increasing access to healthy food. "Unhealthy foods cost less; healthier foods often cost more. People eat what they can afford," Adam Drewnowsk, director of the Center for Public Health Nutrition at the University of Washington, told The New York Times. He also didn't work on the study.

It remains unclear what rising obesity rates mean for children. "We don't really know what the long-term effects will be if exposed to high BMI over 20, 30, 40 years," Danaei told CNN. "It may be larger than we have already seen."

EXTRA STEPS CAN HELP REDUCE RISK OF DIABETES AND STROKE

Individuals at risk for diabetes can cut their risk for heart attack or stroke by 8% by taking an extra 2,000 steps a day—equivalent to about 20 minutes of moderately paced walking—according to a study of more than 9,000 adults performed by researchers at the University of Leicester and published in the Lancet.

"Two thousand steps seemed to be the magic number," TIME reported ("How Many Steps Does it Take to Avoid a Heart Attack? Researchers Find Out" - December 19, 2013). "Even before the study began, for every 2,000 steps a day one participant tended to walk on average compared to another, he enjoyed a 10% lower rate of heart problems by the end of the year."

Visit www.apta.org for more information! 

8 MILLION AMERICANS DON'T KNOW THEY HAVE WHAT?!

According to the US Centers for Disease Control and Prevention (CDC), a quarter of those in United States living with diabetes do not know they have it. 

An estimated 29.1 million people (9.3%) in the US have diabetes, but roughly 8.1 million of them (27.8%) haven’t been diagnosed. This information, along with a number of other new diabetes statistics, is featured in the CDC’s 2014 National Diabetes Statistics Report, which is based on data from 2012.

The report also found that the diabetes rate for Hispanics (12.8%), non-Hispanic blacks (13.2%), and Native Americans/Alaska Natives (15.9%) were markedly higher than the 7.6% rate of non-Hispanic whites. The diabetes rate among Asians was 9%.

Type II Diabetes, or the type of Diabetes that's acquired by habits and lifestyle choices, is largely correlated with the obesity epidemic that's been taking over the United States for the past 30 years. According to NHANES, almost 70% of Americans are considered to be overweight or obese, as of 2014 - and almost 34% of children are considered to fall within the same category. In 2013, the CDC had to come up with a new category of obesity to accommodate the number of children who were so far off the chart for age and sex-related BMI statistics, that they had to create a "Severely Obese" category, in which children fall within 120 - 160% of the 95th percentile for weight in children their age and height. 

The obesity epidemic is REAL, and it's costing more lives than we realize. In 2015, life expectancy decreased for the first time in almost 40 years, and obesity plays a HUGE role in that. 

Being healthy is a lifestyle choice - one YOU can make for a better future for you and your children! 

WHAT CAN PT DO TO HELP YOU REACH YOUR WEIGHT LOSS GOALS

Obesity is a condition caused by the accumulation of excessive body fat. Nearly 100 million Americans are obese or overweight. Obesity is a worldwide epidemic.

A full 68% of the adult population in the United States currently is estimated to be overweight, and about 36% are obese. It is also estimated that 10% of children in the United States aged 2 to 5 years, 15% of children aged 6 to 11 years, and 16% of adolescents aged 12 to 19 years are overweight. Obesity increases the chance of early death; around 325,000 deaths in the United States each year are attributed to obesity, according to the CDC and NHANES.

Adults and children can be classified as normal, overweight, or obese by calculating their body mass index (BMI) based on their height and weight. For example, adults are considered overweight if their BMI is 25 to 29, and obese if their BMI is 30 or higher.

Obesity may be triggered by genetic, environmental, behavioral, social, physiological, and cultural factors. Sedentary lifestyles and surplus caloric intake are considered to be primarily responsible for the dramatic worldwide increase in obesity during the past 2 decades.

Obesity affects people of all ages, races, and socioeconomic levels. It contributes to many chronic diseases and can even cause early death. It can contribute to joint pain, due to increased stress that excess body weight puts on joints, muscles, and spinal discs. It can also cause a loss of "function"—the ability to perform simple daily activities like walking, climbing stairs, or doing household chores.

Numerous options for treating obesity are available today, including reduced-calorie diets, physical exercise, behavior modification, medication, and surgery. Physical therapists are experts in physical exercise, and can develop individualized physical activity plans for individuals who are overweight or obese to manage weight, prevent the development of obesity, or combat its effects.

What is Obesity?

Obesity is a condition involving the storage of excess body fat brought about by an imbalance between caloric intake (number of calories eaten) and energy expenditure (number of calories burned) occurring over an extended period of time. As little as 100 extra calories per day will lead to a 4.5 kg [10 lb] weight gain each year, which can lead to weight problems over time.

Obesity affects the body in many negative ways and can lead to other health problems, such as:

• cardiovascular disease
• stroke
• diabetes
• high blood pressure
• cancer (breast, liver, endometrial, prostate, and colon)
• osteoarthritis
• lymphedema (swelling of arms and legs)
• breathing problems, including asthma and sleep apnea
• depression

Obese people have difficulty engaging in daily activities due to the increased body weight they carry, their loss of physical conditioning, and their movement limitations.

Modern society, especially in the past 20 years, enables and encourages overeating and acceptance of overeating because there is an abundance of inexpensive, high-calorie foods with poor nutritional value available (i.e., “fast food” and “junk food”). We are also encouraged to consume unreasonably large portions of food with “supersized” fast food options, and advertising of food and eating as a way to bond and celebrate special occasions (“holiday feasting”) may also contribute. The growth of sedentary lifestyles or inactivity also contributes greatly to obesity. We spend more time playing video games instead of playing sports outside, working at desk jobs instead of performing manual labor, and riding in cars instead of walking.

How Does it Feel?

A person who is obese may experience:

• Fatigue when performing simple daily activities.
• Joint pain, especially in the legs and back from increased stress that excess fat and weight put on the joints and muscles of the body.
• Difficulty performing daily activities, such as walking, climbing stairs, or playing physically active games.
• Frustration or depression about the condition and the inability to lose weight.

How Is It Diagnosed?

If you see your physical therapist first, your physical therapist will conduct a thorough evaluation that includes taking your health history. Your physical therapist will also ask you detailed questions about your condition, such as:

• Do you have any joint pain?
• Do you have difficulty with any daily activities?
• How much daily exercise do you get?
• Do you have any other medical conditions or problems?
• Do you take any medication for your obesity or any other condition?
• Have you had any surgery related to your obesity?
• Are you under the care of a physician?
• What are your goals?

Your physical therapist will perform tests, such as motion, strength, coordination, and balance checks to help assess your overall physical ability. Your physical therapist may also perform specific obesity tests, such as calculating your BMI, or measuring your waist circumference, "skinfold" thickness, or percentage of body fat.

Your physical therapist may consult with your physician or other health care providers about your condition, who may order further tests to rule out other medical conditions that may affect the type of physical therapy you receive.

How Can a Physical Therapist Help?

Physical therapists can help people who are obese to be more physically active and fit by teaching them to exercise in pain free and fun ways. The right exercise is very important because it helps burn calories, get rid of fat, preserve muscle tissue, and protect your joints. When you start a fun exercise routine, it also helps you make better choices about your diet.

Your physical therapist will work with you to design a specific treatment program to address your needs, including exercises you can do at home. Aerobic exercise and strength training will likely be included in your program, as they both help in weight loss and weight control. Physical therapists are trained to create safe, effective physical activity programs for people of all ages and abilities, taking into account the Centers for Disease Control and Prevention physical activity recommendations for children and adults.

Physical therapists can also help individuals address any underlying reasons for their unhealthy behaviors; they are trained to identify any barriers to developing healthy habits, setting individual goals, and sticking to the program. Your physical therapist can help you:

Reduce pain. Your physical therapist will design a personalized exercise program to help you safely perform activities with the least amount of pain. Just getting up and getting moving can help relieve pain!

Improve cardiovascular fitness. Your physical therapist will design a "heart-healthy" aerobic exercise program for you, to elevate your body's metabolism and burn more calories. Physical therapists help people, including adults and children with disabilities find fun aerobic activities they can perform at their own comfortable level.

Improve strength. Your physical therapist will teach you exercises to address any muscle weakness you may have, or to improve your overall muscle strength. Building strength in muscles can help burn calories, make daily activities easier, and relieve joint pain. Gentle and low-impact forms of weight training performed with exercise bands can help avoid joint stress.

Improve movement. Your physical therapist will choose specific activities and treatments to help restore normal movement of stiff joints. These might begin with "passive" motions that the physical therapist performs for you, and progress to active exercises that you do yourself.

Improve flexibility and posture. Your physical therapist will determine if any of your major muscles are tight, and teach you how to gently stretch them. Your physical therapist will also assess your posture, and teach you exercises to improve your ability to maintain proper posture. Good posture can make difficult activities easier and less painful, and even improve your breathing.

Increase activity levels. Your physical therapist will discuss your activity goals with you, and design your exercise program to address your individual needs and goals. Your physical therapist will help you reach those goals in the safest, fastest, and most effective way possible.

If Surgery Is Necessary

Gastric bypass or bariatric surgery is sometimes chosen by patients and their doctors to treat severe obesity. Your physical therapist can help you prepare for and recover from surgery by designing and teaching you a preoperative and postoperative physical therapy program. Your physical therapist can guide you through each session, help you avoid injury to joints and muscles, and increase and adjust your program as needed. Preoperative programs often involve strength training and aerobic conditioning, while postoperative programs often start with deep breathing and lower-extremity (legs, ankles, feet) exercises, gently increasing to strength and aerobic training. Your physical therapist will help you minimize pain, regain motion and strength, and return to normal activities in the speediest manner possible after surgery.

Can this Injury or Condition be Prevented?

To help prevent obesity or prevent weight gain after weight loss, your physical therapist will likely advise you to:

• Get moving! Include physical activities you enjoy into your daily routine so you can avoid returning to a sedentary lifestyle.
• Avoid watching TV more than 2 hours per day.
• Don’t use a computer longer than 1 hour without an exercise break. 
• Use your body as much as you can to walk, climb stairs, garden, wash dishes by hand, and other daily activities that keep you moving.
• Educate yourself about nutrition, and especially about portion sizes, to help you understand and control your calorie intake.
• Exercise daily for at least 30 minutes (adults) or 1 hour (children). (This advice also applies to disabled individuals as well as those suffering from most medical conditions.) Always check with your physical therapist or a health care professional before beginning any exercise program.

Be sure to follow the special instructions your physical therapist gives you regarding your specific health conditions.

Your physical therapist will also prescribe a home-exercise program specific to your needs to prevent future problems or injuries. This program can include strength and flexibility exercises, posture retraining, and aerobic conditioning.

OBESITY ACCOUNTS FOR WHAT PERCENTAGE OF US ADULT DEATHS

At a time when more Americans are overweight than ever before, a study published in the American Journal of Public Health suggests that obesity is more deadly than previously estimated.

The study, which examined data from 1986 to 2006, when Americans were comparatively lean, determined that as many as 18% of deaths of individuals aged 40- to 85 are linked to obesity.

As NBC News reported ("Heavy burden: obesity may be even deadlier than thought" - August 15, 2013), many factors increase a person's likelihood of weight problems, from income to level of education. And people who are obese are more likely to have other unhealthy habits, such as smoking and poor diets.

"People who are overweight or obese are far more likely than thinner people to have heart disease, cancer, or diabetes, and to have strokes or heart attacks," NBC reported. "Usually, but not always, fatter people are less fit than thinner people, and exercise can clearly protect you from death and disease."

As experts in human motion, physical therapists at CHAMPION can design fitness programs to help you exercise safely. Give us a call for questions, or to set up an evaluation!

EXTRA STEPS CAN HELP THOSE AT RISK FOR DIABETES AVOID...

...AND LOWER THE RISK OF HEART ATTACKS AND STROKES.

Individuals at risk for diabetes can cut their risk for heart attack or stroke by 8% by taking an extra 2,000 steps a day—equivalent to about 20 minutes of moderately paced walking—according to a study of more than 9,000 adults performed by researchers at the University of Leicester and published in the Lancet.

"Two thousand steps seemed to be the magic number," TIMEreported ("How Many Steps Does it Take to Avoid a Heart Attack? Researchers Find Out" - December 19, 2013). "Even before the study began, for every 2,000 steps a day one participant tended to walk on average compared to another, he enjoyed a 10% lower rate of heart problems by the end of the year."

OBESITY LINKED TO ORTHOPEDIC CONDITIONS

The concept of obesity is a touchy one in today's social atmosphere, and being sensitive so as to not insinuate "fat-shaming" can be very tricky. As society constantly tries to ride the thin line between "fat-shaming" and educating, it is vitally important that everyone, no matter of age or sex, be aware of the risk they implement on their health. 

It is absolutely necessary for men and women, both, to be comfortable in their own skin, and be confident in who they are as a person and what their body looks like.  Finding a self-confidence-boosting activity to add to the daily regimen has not only proven to lead to an increase in dopamine (happy hormone) production, but also a decrease in cortisone (stress hormone) production. Emotional health is a vital portion of overall health status. 

Being comfortable in your own skin was meant to help people understand that their body will not always look like models or even other average individuals. We all respond differently to caloric intake, exercise, and lifestyles. For example, some people were born with incredible metabolisms - and good for them! Many of us are not, however, and we must make adjustments to our mindsets to understand that although we may never be as thin as some, we can be comfortable in our own skin. Medically speaking, however, being comfortable in your own skin is not validating obesity. 

Obesity traditionally has been defined as a weight at least 20% above the weight corresponding to the lowest death rate for individuals of a specific height, gender, and age (ideal weight). 

Twenty to forty percent over ideal weight is considered mildly obese; 40- 100% over ideal weightis considered moderately obese; and 100% over ideal weight is considered severely, or morbidly, obese. More recent guidelines for obesity use a measurement called BMI (body mass index) which is the individual's weight multiplied by 703 and then divided by twice the height in inches. BMI of 25.9- 29 is considered overweight; BMI over 30 is considered obese. Measurements and comparisons of waist and hip circumference can also provide some information regarding risk  factors associated with weight. The higher the ratio, the greater the chance forweight-associated complications. Calipers can be used to measure skin- fold thickness to determine whether tissue is muscle (lean) or adipose tissue (fat).

Much concern has been generated about the increasing incidence of obesity among Americans. Some studies have noted an increase from 12% to 18% occurring between 1991 and 1998. Other studies have actually estimated that a full 50% of all Americans are overweight. The World HealthOrganization terms obesity a worldwide epidemic, and the diseases which can occur due to obesity are becoming increasingly prevalent.

Obesity affects quality of individual patient care, the strain the healthcare system must endure to adjust, possible health insurance coverage, and nearly every organ in the body. People with obesity often have other health problems, including diabetes, heart disease, certain tumors and cancers, and psychiatric disorders. However, the role of obesity in orthopedic conditions and their treatment is less well-publicized.
 

According to orthopedic surgeon William M. Mihalko, MD, PhD, of Campbell Clinic Orthopaedics in Memphis, Tenn., “obesity can accompany a multitude of comorbidities that can have a significant impact on a patient’s outcome from elective orthopaedic surgery.” He and his co-authors of “Obesity, Orthopaedics, and Outcomes,” a study published in the November issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), suggest that even though patients with obesity face higher surgical complication rates, orthopaedic procedures can help minimize pain and improve bone and joint function.
 
The Pains of Excess Weight
Obesity is a strong independent risk factor for pain. Adolescents with obesity were more likely to report musculoskeletal pain, including chronic regional pain, than their normal-weight peers. The disease nearly doubles the risk of chronic pain among the elderly—causing pain in soft-tissue structures such as tendons and ligaments, and worsening conditions such as fibromyalgia in individuals already living with constant pain in their muscles and joints.
 
Obesity and osteoarthritis
Osteoarthritis (OA)—a progressive “wear and tear” disease of the joints—is frequently associated with obesity. Every pound of body weight places four to six pounds of pressure on each knee joint. Research suggests that excess weight increases pressure, or the biomechanical load, on the knees and increases the likelihood of wearing away the cushioning surface of the knee joint, resulting in the development of OA and the need for total knee arthroplasty (TKA). The need for a TKA is estimated to be at least 8.5 times higher among patients with a body mass index (BMI) greater than or equal to 30, compared with patients who have a BMI within the normal range of 18.5 to 24.9.
 
Obesity and Injury
In addition to the increased likelihood of wear and tear on joints, excess weight also affects injury status. The odds of sustaining musculoskeletal injuries is 15 percent higher for persons who are overweight and 48 percent higher for people who are obese, compared to persons of normal weight.
 
Statistically, overweight and obese children also have significantly greater odds of lower extremity injuries and pain than do children of normal weight. Back and lower extremity pain, especially of the knee and foot, are more common among children with obesity.
 
Pre-surgical Considerations
“Although no upper weight limits have been established that would contra-indicate elective orthopaedic surgery, every surgeon must understand the unique risks an obese patient faces and understand how to optimize and treat each of these patients on an individual basis,” says Dr. Mihalko. The study authors recommend that patients with morbid obesity (BMI of 40 or higher) be:

• advised to lose weight before total joint arthroplasty (TJA);
• offered resources for weight loss before surgery; and,
• counseled about the possible complications and inferior results that may occur if they do not lose weight.

While patients with obesity may experience slower recovery and higher risks of surgical complications that can compromise outcomes, outweighing the functional benefits of TJA in some cases, orthopedic interventions still can provide improvements in quality of life for even for extremely obese patients.