“This is the first time cortisol reactivity has been identified as a mediator between depressed mood and obesity in girls,” said Elizabeth J. Susman, the Jean Phillips Shibley professor of biobehavioral health at Penn State. “We really haven’t seen this connection in kids before, but it tells us that there are biological risk factors that are similar for obesity and depression.”

Cortisol, a hormone, regulates various metabolic functions in the body and is released as a reaction to stress. Researchers have long known that depression and cortisol are related to obesity, but they had not figured out the exact biological mechanism.

Although it is not clear why high cortisol reactions translate into obesity only for girls, scientists believe it may be due to physiological and behavioral differences — estrogen release and stress eating in girls — in the way the two genders cope with anxiety.

“The implications are to start treating depression early because we know that depression, cortisol and obesity are related in adults,” said Susman.

If depression were to be treated earlier, she noted, it could help reduce the level of cortisol, and thereby help reduce obesity.

“We know stress is a critical factor in many mental and physical health problems,” said Susman. “We are putting together the biology of stress, emotions and a clinical disorder to better understand a major public health problem.”

Susman and her colleagues Lorah D. Dorn, professor of pediatrics, Cincinnati Children’s Hospital Medical Center, and Samantha Dockray, postdoctoral fellow, University College London, used a child behavior checklist to assess 111 boys and girls ages 8 to 13 for symptoms of depression. Next they measured the children’s obesity and the level of cortisol in their saliva before and after various stress tests.

“We had the children tell a story, make up a story, and do a mental arithmetic test,” said Susman. “The children were also told that judges would evaluate the test results with those of other children.”

Statistical analyses of the data suggest that depression is associated with spikes in cortisol levels for boys and girls after the stress tests, but higher cortisol reactions to stress are associated with obesity only in girls. The team reported its findings in a recent issue of the Journal of Adolescent Health.

“In these children, it was mainly the peak in cortisol that was related to obesity,” Susman explained. “It was how they reacted to an immediate stress.”

The National Institutes of Health supported this work.

Source:
Amitabh Avasthi
Penn State

But a first-of-a-kind study conducted by researchers at the Kaiser Permanente Center for Health Research, Wesleyan University and Rutgers University found that more than 63 percent of participants had stopped binging at the end of the program – compared to just over 28 percent of those who did not participate. The program lasted only 12 weeks, but most of the participants were still binge free a year later. A second study, also published in the April issue of the Journal of Consulting and Clinical Psychology, found that program participants saved money because they spent less on things like dietary supplements and weight loss programs.

“It is unusual to find a program like this that works well, and also saves the patient money. It’s a win-win for everyone,” said study author Frances Lynch, PhD, MSPH, a health economist at the Kaiser Permanente Center for Health Research. “This type of program is something that all health care systems should consider implementing.”

“People who binge eat more than other people do during a short period of time and they lose control of their eating during these episodes. Binge eating is often accompanied by depression, shame, weight gain, loss of self-esteem and it costs the healthcare system millions of extra dollars,” said the study’s principal investigator Ruth H. Striegel-Moore, PhD, a professor of psychology at Wesleyan University. “Our studies show that recurrent binge eating can be successfully treated with a brief, easily administered program, and that’s great news for patients and their providers.”

Binge eating has received a lot of media attention recently because the American Psychiatric Association is recommending that it be considered a separate, distinct eating disorder like bulimia and anorexia. This new diagnosis can be expected to focus more attention on binge eating and how best to treat it, according to the researchers. It also could influence the number of people diagnosed and how insurers will cover treatment.

This randomized controlled trial, conducted in 2004-2005, involved 123 members of the Kaiser Permanente health plan in Oregon and southwest Washington. More than 90 percent of them were women, and the average age was 37. To be included in the study, participants had to have at least one binge eating episode a week during the previous three months with no gaps of two or more weeks between episodes.

Half of the participants were enrolled in the intervention and asked to read the book “Overcoming Binge Eating” by Dr. Christopher Fairburn, a professor of psychiatry and expert on eating disorders. The book details scientific information about binge eating and then outlines a six-step self-help program using self-monitoring, self-control and problem-solving strategies. Participants in the study attended eight therapy sessions over the course of12 weeks in which counselors explained the rationale for cognitive behavioral therapy and helped participants apply the strategies in the book. The first session lasted one hour, and subsequent sessions were 20-25 minutes. The average cost of the intervention was $167 per patient.

All participants were mailed fliers detailing the health plan’s offerings for healthy living and eating and encouraged to contact their primary care physician to learn about more services.

By the end of the 12-week program 63.5 percent of participants had stopped binging, compared to 28.3 percent of those who did not participate. Six months later, 74.5 percent of program participants abstained from binging, compared to 44.1 percent in usual care. At one year, 64.2 percent of participants were binge free, compared to 44.6 percent of those in usual care.

Everyone in the trial was asked to provide extensive information about their binge eating episodes, how often they missed work or were less productive at work, and the amount they spent on health care, weight-loss programs and weight loss supplements. Researchers also examined expenditures on medications, doctor visits, and other health-related services.

The researchers then compared these costs between the two groups and found that average total costs were $447 less in the intervention group. This included an average savings of $149 for the participants, who spent less on weight loss programs, over-the-counter medications and supplements. Total costs for the intervention group were $3,670 per person per year, and costs for the control group were $4,098.

As expected, participants in the intervention group spent less on weight loss programs and over-the-counter medications and supplements.

“While program results are promising, we highly encourage anyone who has problems with binge eating to consult with their doctors to make sure this program is right for them,” said study co-author Lynn DeBar, PhD, clinical psychologist at the Kaiser Permanente Center for Health Research.

Study authors include: Lynn DeBar, John F. Dickerson, Frances Lynch and Nancy Perrin from the Kaiser Permanente Center for Health Research in Portland, Oregon; Ruth H. Striegel-Moore and Francine Rosselli from Wesleyan University; G. Terence Wilson from Rutgers, The State University of New Jersey; and Helena C. Kraemer from the Stanford University School of Medicine.

Source:
Emily Schwartz
GolinHarris International

“People don’t necessarily think of influenza when you include the symptoms of nausea or vomiting, but our study showed that they are common with influenza in pregnancy,” said Dr. Vanessa Rogers, assistant professor of obstetrics and gynecology and lead author of the study, which appears in the May edition of Obstetrics and Gynecology.

“Both physicians and patients should be aware of these findings so treatment is not delayed,” she said. “I think our findings should encourage people to be vigilant and to take symptoms seriously.”

Adults with flu tend not to have nausea or vomiting, according to the Centers for Disease Control and Prevention. These symptoms are more typical in children.

The researchers studied the cases of pregnant women during the 2003-2004 flu season, when the most common strain of influenza caused more severe symptoms than usual. There also were more cases of flu than expected, because the vaccine given that year didn’t match the strain that was predominant.

During that period, 107 pregnant women were diagnosed with flu at Parkland Memorial Hospital in Dallas. Ninety-three percent of the women had a cough, and 89 percent had fever common signs of flu the researchers found. Eighty-five percent had a “profound” elevated heart rate, and 60 percent had nausea and/or vomiting. Although “morning sickness” and nausea are common during pregnancies, the researchers said that reporting any unusual additional symptoms (fever, coughing, elevated heart rate) could help diagnose the disease earlier in these patients.

Nearly two-thirds of the expectant women treated at Parkland were sick enough to require hospitalization. The most common complication was pneumonia, which occurred in 12 percent of the cases.

Despite the illness, there was no significant difference in complications between women with flu and women without flu who gave birth at the hospital during flu season. After birth, the babies also showed no significant difference in complications.

“Early diagnosis and treatment might be the reason our patients did so well,” Dr. Rogers said.

Other UT Southwestern researchers involved in the study were Dr. Jeanne Sheffield, associate professor of obstetrics and gynecology; Dr. Scott Roberts, professor of obstetrics and gynecology; Dr. Donald McIntire, professor of obstetrics and gynecology; Dr. James Luby, professor of internal medicine; Sylvia Trevino, infection preventionist in internal medicine; and Dr. George Wendel, professor of obstetrics and gynecology.

Source: UT Southwestern Medical Center

Successful weight loss in obese individuals is defined as a reduction of 10 percent or more of initial body weight maintained for at least a year. The jury is still out, however, as to whether fast or slow initial weight loss is the best approach for long-term weight control in obese patients. On the one hand, there is evidence that losing weight slowly initially results in continued weight loss, reduced risk of weight regain, and successful long-term weight loss maintenance. On the other hand, it has also been shown that the greater the initial weight loss in obese patients, the larger the total weight loss observed longer term.

Nackers and team’s study examines the association between rate of initial weight loss and long-term maintenance of lost weight, by looking specifically at whether losing weight at a slow initial rate results in larger long-term weight reduction and less weight regain than losing weight at a fast initial rate.

The authors analyzed data for 262 middle-aged obese women who took part in the Treatment of Obesity in Underserved Rural Settings (TOURS) trial. These women followed a six-month lifestyle program encouraging them to reduce their calorie intake and increase their moderate intensity physical activity to achieve an average weight loss of 0.45kg per week. They were then supported for a further year with an extended care program involving contact twice a month in the form of group sessions, telephone contact or newsletters.

Nackers and team split the women into three groups according to how much weight they lost in the first month of the intervention. Women in the FAST group lost over 0.68kg per week; those in the MODERATE group lost between 0.23 and 0.68kg per week; women in the SLOW group lost less than 0.23kg per week in that first month. The authors then looked at the womens’ weight loss at 6 and 18 months, as well as any weight regain.

They found that there were long-term advantages to fast initial weight loss. Fast weight losers lost more weight overall, maintained their weight loss for longer and were not more likely to put weight back on than the more gradual weight losers. In particular, women in the FAST group were five times more likely to achieve the clinically significant 10 percent weight loss at 18 months than those in the SLOW group and those in the MODERATE group were nearly three times more likely to achieve this milestone than women in the SLOW group.

The authors conclude: “Our study provides further evidence that, within the context of lifestyle treatment, losing weight at a fast initial rate leads to greater short-term weight reductions, does not result in increased susceptibility to weight regain, and is associated with larger weight losses and overall long-term success in weight management. We suggest that, within lifestyle weight control programs, substantial efforts should be focused on promoting large rather than small behavioral changes during the initial weeks of treatment.”

Reference:
1. Nackers LM et al (2010). The association between rate of initial weight loss and long-term success in obesity treatment: does slow and steady win the race? International Journal of Behavioral Medicine, DOI 10.1007/s12529-010-9092-y

Guidelines set by the American Congress of Obstetricians and Gynecologists in 2002 recommend pregnant women get 30 minutes or more of moderate exercise daily, or on most days, if they have no medical or obstetric complications. Similar guidelines issued by the Department of Health and Human Services in 2008 suggest pregnant women get at least 150 minutes of moderate intensity aerobic activity per week.

“Physical activity during pregnancy has a number of health benefits,” said Kelly Evenson, Ph.D., research associate professor of epidemiology in the UNC Gillings School of Global Public Health and author of the new study. “It may help prevent gestational diabetes, support healthy gestational weight gain and improve mental health.”

According to the study, women in their first trimester were more likely to meet the physical activity recommendations than those in more advanced stages of their pregnancy, Evenson said. Women with health insurance and non-Hispanic whites were more likely to meet the guidelines than others. Walking was the most common leisure time physical activity reported.

The findings were published in the March 2010 issue of the journal Preventive Medicine.

Evenson said the study would help health-care providers and policymakers better understand which women are getting the exercise they need during pregnancy, and what method of physical activity they are most likely to choose.

“These data could be used to set national objectives, such as with the Department of Health and Human Services’ ‘Healthy People’ initiative,” she said. “By having this data, we can monitor trends over time to determine if more women are getting exercise throughout their pregnancy.”

“Healthy People” involves professionals, policymakers, researchers and the general public in putting together national health objectives to increase the quality and years of healthy life, and eliminate health disparities among people of all ages.

For the study, Evenson and Fang Wen, a programmer in the public health school’s epidemiology department, used data from the National Health and Nutrition Examination Survey collected between 1999 and 2006. The data included interviews with 1,280 pregnant women aged 16 or older. The questionnaire defined moderate intensity activities as tasks that caused light sweating or a slight to moderate increase in breathing or heart rate, and vigorous intensity as activities that caused heavy sweating or large increases in breathing or heart rate.

The proportion of women who were active enough to meet the guidelines’ recommendations was about 23 percent.

The national survey also showed 23 percent of women reported getting some activity going to and from work or school; 54 percent got moderate to vigorous household activity; and 57 percent reported moderate to vigorous leisure activity within a month before the interview. Moderate to vigorous leisure time activity was significantly greater among women in the first trimester compared to third trimester.

For more information on the National Health and Nutrition Examination Survey, visit http://www.cdc.gov/nchs/nhanes.htm.

Source
University of North Carolina at Chapel Hill

The risks were lower for total stroke, clot-related (ischemic) stroke and bleeding (hemorrhagic) stroke, researchers said.

Compared to women who didn’t walk:

• Women who usually walked at a brisk pace had a 37 percent lower risk of any type of stroke and those who walked two or more hours a week had a 30 percent lower risk of any type of stroke.
• Women who typically walked at a brisk pace had a 68 percent lower risk of hemorrhagic stroke and those who walked two or more hours a week had a 57 percent lower risk of hemorrhagic stroke.
• Women who usually walked at a brisk pace had a 25 percent lower risk of ischemic stroke and those who usually walked more than two hours a week had a 21 percent lower risk of ischemic stroke – both “borderline significant,” according to researchers.

“Physical activity, including regular walking, is an important modifiable behavior for stroke prevention,” said Jacob R. Sattelmair, M.Sc., lead author and doctoral candidate in epidemiology at Harvard School of Public Health in Boston, Mass. “Physical activity is essential to promoting cardiovascular health and reducing risk of cardiovascular disease, and walking is one way of achieving physical activity.”

More physically active people generally have a lower risk of stroke than the least active, with more-active persons having a 25 percent to 30 percent lower risk for all strokes, according to previous studies.

“Though the exact relationship among different types of physical activity and different stroke subtypes remains unclear, the results of this specific study indicate that walking, in particular, is associated with lower risk of stroke,” Sattelmair said.

Researchers followed 39,315 U.S. female health professionals (average age 54, predominantly white) participating in the Women’s Health Study. Every two to three years, participants reported their leisure-time physical activity during the past year – specifically time spent walking or hiking, jogging, running, biking, doing aerobic exercise/aerobic dance, using exercise machines, playing tennis/squash/racquetball, swimming, doing yoga and stretching/toning. No household, occupational activity or sedentary behaviors were assessed.

They also reported their usual walking pace as no walking, casual (about 2 mph), normal (2.9 mph), brisk (3.9 mph) or very brisk (4 mph).

Sattelmair noted that walking pace can be assessed objectively or in terms of the level of exertion, using a heart rate monitor, self-perceived exertion, “or a crude estimate such as the ‘talk test’ – wherein, for a brisk pace, you should be able to talk but not able to sing. If you cannot talk, slow down a bit. If you can sing, walk a bit faster.”

During 11.9 years of follow-up, 579 women had a stroke (473 were ischemic, 102 were hemorrhagic and four were of unknown type).

The women who were most active in their leisure time activities were 17 percent less likely to have any type of stroke compared to the least-active women.

Researchers didn’t find a link between vigorous activity and reduced stroke risk. The reason is unclear, but they suspect that too few women reported vigorous activity in the study to get an accurate picture and/or that moderate-intensity activity may be more effective at lowering blood pressure as suggested by some previous research.

Stroke is the third leading cause of death and a leading cause of serious disability in the United States, so it’s important to identify modifiable risk factors for primary prevention, Sattelmair said.

An inverse association between physical activity and stroke risk is consistent across genders. But there tend to be differences between men and women regarding stroke risk and physical activity patterns.

“The exact relation between walking and stroke risk identified in this study is not directly generalizable to men,” Sattelmair said. “In previous studies, the relation between walking and stroke risk among men has been inconsistent.”

The study is limited because it was observational and physical activity was self-reported. But strengths are that it was large and long-term with detailed information on physical activity, he said.

Further study is needed on more hemorrhagic strokes and with more ethnically diverse women, Sattelmair said.

The American Heart Association recommends for substantial health benefits, adults should do at least 150 minutes a week of moderate-intensity or 75 minutes a week of vigorous-intensity aerobic physical activity or a combination.

Co-authors are: Tobias Kurth, M.D., Sc.D.; Julie E. Buring, Sc.D.; and I-Min Lee, M.B.B.S., Sc.D. Individual author disclosures are on the manuscript.

The National Institutes of Health supported the study.

Source:
Birdgette McNeill
American Heart Association

“We found that many women aren’t making the connection between their risk factors and the serious consequences of fractures,” said the lead author Ethel Siris, M.D., director of the Toni Stabile Osteoporosis Center at NewYork-Presbyterian Hospital/Columbia University Medical Center, and the Madeline C. Stabile Professor of Clinical Medicine at Columbia University College of Physicians and Surgeons. “Without a clear understanding of their risks, women cannot begin to protect themselves from fracture.”

This study, part of the Global Longitudinal Study of Osteoporosis in Women (GLOW), which is based at the Center for Outcomes Research at the University of Massachusetts Medical School, was published online by the journal Osteoporosis International on April 2, 2010. The study, conducted at 17 GLOW study sites worldwide, included more than 60,000 postmenopausal women in 10 countries in Europe, North America and Australia.

Results showed that among postmenopausal women diagnosed with osteoporosis a condition associated with a high risk for fractures, as it causes bones to become fragile and more likely to break only 43 percent thought their risk of a fracture was higher than other women their age. Additionally, only one in three (33 percent) women who reported two or more major risk factors for fracture, perceived themselves as being at higher risk for fracture than their age-matched peers.

Because many fractures can be prevented by appropriate treatment, it is important that elevated risk be recognized.

One in two women will suffer an osteoporosis-related fracture after age 50; these fractures often carry with them chronic pain, reduced mobility, loss of independence and in the case of hip fracture, an increased risk of death. Because the likelihood of fractures increases substantially with age, fracture numbers are projected to rise as the population ages. Osteoporosis-related fractures are an international public health problem; in addition to the human suffering associated with these fractures, they also are the source of enormous health-care costs.

Improved education of physicians and postmenopausal women about osteoporosis risk factors is urgently needed, according to the study authors. If left untreated, osteoporosis can progress painlessly until a fracture occurs. Several risk factors for fractures have been identified and should be considered by physicians treating women age 55 and older:

– older age

– low weight

– parental hip fracture

– personal history of fracture (clavicle, arm, wrist, spine, rib, hip, pelvis, upper leg, lower leg, ankle) since age 45

– two or more falls in the past year

– current use of cortisone or prednisone (steroids often prescribed for a number of medical conditions)

– rheumatoid arthritis

– cigarette smoking

– consumption of three or more alcoholic beverages daily

Other risk factors for fractures include a variety of medical conditions and medications. Tools for diagnosis and risk assessment, including bone-density testing and the World Health Organization FRAX fracture risk-assessment tool, are widely available; still, the connection between identified risk factors and serious fracture outcomes is not being made by a majority of women at highest risk.

“We hope the insight we obtain from GLOW will help physicians and patients work together to identify those at risk for fracture and to enhance understanding of the meaning of that risk,” said Siris. “Education is critical if we are to reduce the burden of fractures worldwide.”

GLOW is a prospective, international cohort study of women 55 years of age and older who visited their primary-care physician during the two years prior to enrollment in the study. More than 60,000 women were recruited by more than 700 primary-care physicians in 17 cities in 10 countries (Australia, Belgium, Canada, France, Germany, Italy, Netherlands, Spain, United Kingdom and the United States). GLOW is gathering information on osteoporosis risk factors, treatments, patient behaviors and fracture outcomes during a five-year period. Self-perceived risk of fracture was assessed using a five-point scale ranging from “much lower” to “much higher” risk than other women of the same age.

Of the 28,000 U.S. women participating in GLOW, 3,500 were from New York, enrolled at the Helen Hayes Hospital in West Haverstraw, an affiliate hospital of NewYork-Presbyterian Healthcare System. A quarter (25 percent) of these women reported an osteoporosis diagnosis, 23 percent had a previous fracture, 17 percent were low weight, 37 percent reported recent falls, and 20 percent a parental hip fracture. Despite the high prevalence of risk factors, only 36 percent of women with two or more major risk factors perceived themselves to be at higher risk of a fracture than their peers. This failure by women to appreciate their personal risk of fracture presents a barrier to them receiving appropriate management and safe and effective treatments.

GLOW is supported by a grant from The Alliance for Better Bone Health (formerly Sanofi-aventis and P&G Pharmaceuticals, now Sanofi-aventis and Warner Chilcott) and is being directed by the Center for Outcomes Research, University of Massachusetts Medical School.

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the most comprehensive medical research enterprise in New York City and State and one of the largest in the United States. Columbia University Medical Center is affiliated with NewYork-Presbyterian Hospital, the nation’s largest not-for-profit hospital provider.

NewYork-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 230,000 visits to its emergency departments more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, NewYork-Presbyterian Hospital/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

About the Center for Outcomes Research (COR)

COR is based at the University of Massachusetts, Worcester, Mass. The mission of COR is to collect and evaluate data that reflect real-world practices and outcomes and to provide physicians with confidential reports that allow comparison of their practices to evidence-based performance standards

Source: Columbia University Medical Center

The analysis of this large Atherosclerosis Risk in Communities (ARIC) Study, which appears in the August issue of Journal of Lipid Research, was carried out by Keri Monda and colleagues at North Carolina and Baylor. They found that over a 12 year period, all individuals who increased their exercise by about 180 metabolic units per week (equivalent to an additional hour of mild or 30 minutes of moderate activity per week) displayed decreased levels of triglycerides and increased levels of the “good” HDL cholesterol. However, statistically significant decreases in the “bad” LDL cholesterol were only observed in women, with particularly strong effects in menopausal women and African-American women. And total cholesterol levels were only significantly decreased in African-American women.

The authors speculate that these novel differences may arise from hormonal differences between the sexes, especially considering the extra effects seen post-menopause. The racial differences observed may stem from genetic variations that require further exploration.

The authors do also note that their exercise data was assessed by questionnaire and this was non-scientific, though the particular methodology used has been extremely reliable in other studies. They also note that all evaluated participants were healthy, so these results cannot be generalized to individuals with diabetes or those on cholesterol-lowering medications.

From the article: Longitudinal impact of physical activity on lipid profiles in middle-aged adults: the Atherosclerosis Risk in Communities Study, by Keri L. Monda, Christie M. Ballantyne and Kari North

Source:
Nick Zagorski
American Society for Biochemistry and Molecular Biology

Half of women fit into two other categories, the study says, and were found to be the least likely to be leaning toward fat. Both types of women in those groups are concerned about nutrition and like to eat healthy.

“The basic attitude that people have about food is related to the likelihood that they’re at risk for obesity and weight gain,” said researcher Dennis Degeneffe, a study co-author.

The study, which appears in the December issue of the journal Health Education & Behavior, placed 200 women into five groups based on their attitudes about food. The women had an average age of 46, were well-educated (two-thirds had a four-year degree or higher) and 86 percent were white.

The researchers then compared the groups of women by measurements such as percentage of body fat, waist size and body mass index (BMI).

Those deemed to be “concerned about nutrition” (determined to eat well) and “creative cooks” (focused on food for their families) scored the lowest in the weight categories. “Impulsive eaters” and “guilt-ridden dieters” scored the highest, with “busy cooking avoiders” in the middle.

“Women in the middle group tend to lead busy lifestyles and are often preoccupied with other activities and responsibilities, with eating generally taking a back seat,” said Degeneffe, a research fellow at the University of Minnesota’s Food Industry Center.

Cynthia Sass, a registered dietitian and author in New York City, said the categories defined in the study “truly parallel what I see with my clients and women I talk to regarding how food and nutrition fit into their lives.”

“I have found that women who have a big responsibility to take care of their families appear to do less well at taking care of themselves, food-wise,” she said. In some cases, she said, food helps them to feel rewarded and cope with their lives.

She urges them to focus on their own needs “because taking better care of themselves will help them have the physical and emotional wellness they need to continue taking care of their families.”

Treating these kinds of women can be tough, said Lona Sandon, an assistant professor at the University of Texas Southwestern and national spokesperson for the American Dietetic Association. “Health and nutrition may be important to them, but convenience often wins,” she said. “It is very challenging to come up with solutions to help these women lose weight if they are not willing or able to give up something else in their life.”

Health Education & Behavior, a peer-reviewed journal of the Society for Public Health Education (SOPHE), publishes research on critical health issues for professionals in the implementation and administration of public health information programs. For information, contact Laura Drouillard at (202) 408-9804.

Sudo, N, et al. Relationship between attitudes and indicators of obesity for midlife women. Health Education & Behavior 36(6), 2009.

Source: Health Behavior News Service

The Times notes that high doses of radiation can increase the risk of breast cancer but that mammograms use a low dose. However, the same genetic mutations that increase the risk of breast cancer in some women might also make them more susceptible to cancer caused by radiation, according to Marijke Jansen-van der Weide, who presented the findings at the annual meeting of the Radiological Society of North America. The results are “particularly troubling” because doctors urge high-risk patients to begin breast cancer screening earlier in life, the Times reports. The researchers stressed that the new findings are not conclusive and that the issue needs more study.

The researchers examined data from six previous studies on about 5,000 high-risk women. They found that women who had mammograms or chest X-rays prior to age 20, or who had had at least five radiation exposures, were two-and-one-half times more likely to develop breast cancer than women who had had no exposure.

“For high-risk women, it’s important to weigh the benefits and risks of mammography with their doctor and come together on a screening strategy, and to keep in mind that at a young age you can use an alternative screening technique like MRI,” Jansen-van der Weide said. Robert Smith, director of cancer screening for the American Cancer Society, questioned the authors’ methodology, adding that MRIs are not a suitable substitute for mammograms. Smith said that MRIs and mammograms can both miss tumors and that the best approach for high-risk women is to use the two tests together (Grady, New York Times, 12/1).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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