Air Pollution Reduces Children's Lung Function

New data from the Children's Health Study suggests that pollutants from vehicle emissions and fossil fuels hinder lung development in children and may limit breathing capacity for a lifetime.

The study funded by NIH includes 1,759 children as they progressed from the 4th grade to the 12th grade. This is the longest study (over 8 years) ever conducted on air pollution and children's health. It shows that current levels of air pollution have adverse affects on lung development in children between the ages of 10 and 18.

Over the 8 year period, children living in the most polluted communities had significant reductions in lung function (forced expiratory volume) compared to children living in communities with cleaner air. It is believed that chronic inflammation, caused by air pollutants in the the small airways on a daily basis, results in impaired lung development. Air pollutants may also dampen the growth of alveoli, the tiny air sacs in the lungs. For further information read the NIH News report, Sept. 8, 2004.

Bottom line: If you want your children to have healthy lungs for a lifetime, air quality inside and outside your home needs to be good! Keeping children away from cigarette smoke and household allergens is also helpful.

Source: NIH News, Sept. 8, 2004

International Study Identifies 9 Major Coronary Risks

The new report from the international INTERHEART study has identified 9 modifiable risk factors for heart disease that are responsible for 90% or more of all heart attacks world wide. The study includes people from every inhabited continent, 52 nations. The researchers state that the 9 risk factors identified apply across all geographic regions and ethnic groups of the world, men and women, and young and old. They have identified 9 easily measured risk factors that are associated with 90% of the risk of experiencing a heart attack.

Here are the 9 risk factors in order of their importance of predicting a heart attack and their odds ratio (OR, think of it as your odds of getting a heart attack. An OR of 2.0 means you are twice as likely to have a heart attack. An OR of 0.5 means you have half the risk.)

• High blood lipids, ratio of ApoB/ApoA1 (similar to the ratio of bad cholesterol to good cholesterol) -- OR = 3.87, comparing top 20% of people  with the highest ratio with the bottom 20% with the lowest ratio. This was the strongest predictor of having a heart attack increasing risk by nearly 4 times in the highest risk ratio category.
• Current smoking -- OR = 2.95, meaning smokers are nearly 3 times more likely to have a heart attack than non-smokers.
• Diabetes -- OR = 3.08
• High blood pressure -- OR = 2.48
• High psychological stress score -- OR = 2.51. Stress score was derived from questions relating to perceived stress from work, home, finances, depression, and locus of control. This is a new risk factor that usually is not included in accessing coronary risk.
• Abdominal obesity, measured by waist girths -- OR = 2.24 comparing the top 1/3 of people with the highest waist girth to the 1/3 with the lowest waist girth. This means that people with high abdominal obesity were more than twice as likely to have a heart attack than lean people.
• Fruit and vegetable intake -- OR = 0.70. This means than people who eat more fruits and vegetables daily have a 30% decreased risk of a heart attack versus those who don't eat many fruits and vegetables daily.
• Regular exercise -- OR - 0.72. This means that over 1/4th of all heart attacks could potentially be prevented if people exercised regularly.
• Moderate alcohol intake (e.g. 3-4 times per week). A moderate intake was somewhat protective but of all the risk factors, it had the least predictive value. In people who ate more fruits and vegetables, exercised regularly, maintained a healthy weight, and didn't smoke, use of alcohol added little additional protection, less than 1% benefit.

Family history of heart problems was also identified as a risk factor but when it was included with all the other 9 risk factors it added little (only 1%) additional predictive value.

Multiple Risks. When several risk factors are combined, the risk jumps dramatically. For example, persons who smoke, have high blood pressure, and diabetes are 13 times more likely to have a heart attack than persons without these risks.  If you add the high risk ratio ApoB/ApoA1(bad to good cholesterol), the risk jumps to 42 times higher than those with no risks!

The bottom line. By eliminating risk factors you can prevent 90-94% of most heart attacks.  Prevention must be the primary defense against coronary heart disease, the world's leading cause of early death.

Source:Yusuf S, et al.  INTERHEART Study, Lancet published online Sept. 3, 2004

BMI, Physical Activity, and Health Care Costs

With the high cost of health insurance (up 11.2% this year), employers are looking for ways to slow down the rapid increase in health care costs. A study conducted by the University of Michigan on 23,490 employees at General Motors (GM) reveals the high cost of being sedentary and/or being overweight. Here is what they found for the following conditions (adjusted for age, gender, and other risks):

• Inactive employees had about $250 more in health care costs/year than active employees
• Overweight employees (BMI 25-29.9) had $186 more in health claims yearly than normal weight employees, and obese employees (BMI 30+) cost $488 more per year than those in the healthy weight range (BMI <25).
• Employees with a chronic disease (e.g. allergy, arthritis, or back pain) had health care claims of $760 more per employee than those who didn't have a chronic problem.
• Female employees had $961 more in health claims per year than male employees.
• Increasing age was a significant factor for increased health care claims. Costs increased by 3% for each increase of one year in age.
• Employees with 2 or more high risk factors cost $754 more per year than those with only 0-1 risk factors. Risk factors linked to higher claims included:
  - Smoking
  - Use of seat belts less than 100% of the time
  - High alcohol intake (more than 14 drinks per week)
  - Blood pressure of 140/90 or higher
  - Cholesterol level of 240 mg/dL or higher
  - HDL cholesterol less than 35 mg/dL
  - "Fair to Poor" self-rated physical health status
  - High stress score
  - Life satisfaction rated "partly satisfied or not satisfied"
• Employees who were obese (BMI 30+) AND sedentary had health care claims over $800 more per year than employees who were not overweight and were active.
• Obese employees who were sedentary had health claims of $498 more per year than obese employees who were moderately active.

The researchers estimated that GM could save nearly $800,000 per year if all obese employees would simply exercise moderately, 3 or more days per week, even if they didn't lose weight.

Regarding the benefit of physical activity, researcher's concluded that more frequent physical activity is associated with less likelihood of having chronic disease or risk factors and lower claims for all weight levels. They estimated that if all employees exercised regularly the company would save $7.1 million dollars every year.

Summary: "Wellness programs at the worksite make it easy to reach all employees at work and have the potential to be effective in improving employees' health status and substantially saving health care costs."

Reference: Wang F, et al, BMI, Physical Activity, and Health Care Costs, Journal of Occupational and Environmental Medicine 46:428-36, May 2004

Patients Need More Help to Stop Smoking

Smoking causes some 440,000 premature deaths yearly at a cost of $157 billion in health-economic related costs. In national surveys, seven in ten smokers say they desire to quit. Yet most don't. Nicotine is a strong, addicting substance and it's not easy to quit. How do you know if you have a strong nicotine addiction? Here are two questions that can help you decide.

1. Do you smoke at least 20 cigarettes a day?
2. Do you usually have a smoke within 30 minutes of rising?

If you answer yes to either question, you likely have a high nicotine dependence. Taking nicotine replacement therapy (NRT) can help you quit. A recent review of 103 studies on quitting smoking found that people who tried NRT were 50% to twice as likely to quit than those who didn't. People taking the medication Bupropion had even better results. About 1 in 4 patients using either of these pharmacotherapies eventually quit smoking. Most smokers make several attempts first before they succeed. Just don't give up! Adding psychosocial therapies increases success even more. If you want to stop smoking, ask your doctor for help.

For further information on the health effects of smoking, see the Surgeon General's 2004 report on the Health Consequences of Smoking. The CDC also has an excellent web site for help in stopping smoking. The University of New Jersey also has an excellent tobacco dependence program providing the latest information on quitting methods, training for health professionals wanting to help people quit, and information on tobacco research.

Reference: Lynne Lamberg, Patients Need More Help to Quit Smoking, JAMA 292:1286, Sept 15, 2004

Drinking Impacts Mental Health

Frequent alcohol drinking in midlife is linked to mild mental impairment in old age a study in the British Medical Journal reports. The study included  1,018 men and women whose mental and physical health were monitored for 23 years (a very long study).

Participants who drank frequently (defined as several times a month) were twice as likely to develop mild cognitive impairment as those who drank infrequently (less than once per month). Infrequent drinkers had an even lower risk for mild dementia than non-drinkers.

The level of drinking was particularly important for individuals who had a genetic tendency for dementia. In this group, the more people drank, the higher their risk of dementia. Compared to non-drinkers, infrequent drinkers were 2.3 times more likely to develop dementia, and frequent drinkers were 3.6 times more likely to develop dementia.

The authors conclude, "Our current data indicate that frequent alcohol drinking has harmful effects on the brain, and this may be more pronounced if there is genetic susceptibility. We therefore do not want to encourage people to drink more alcohol in the belief that they are protecting themselves against dementia."

Source: British Medical Journal 329:539-42, Sept 2004

Value of Cardiac Rehabilitation

When a person has experienced a heart attack, their likelihood of a future heart problem is naturally quite high, that is, unless they participate in a cardiac rehabilitation program. Dr Rogers from the Mayo clinic studied 1,821 people who experienced a heart attack and compared outcomes three years later for those who participated in cardiac rehabilitation and those who didn't.

Those taking cardiac rehabilitation get special interventions designed to enhance heart health including supervised exercise, education on healthy eating and weight loss if needed, counseling on stress management, and general support on making lifestyle changes.

After three years, of those not participating in cardiac rehabilitation only 64% survived while 95% of those taking cardiac rehabilitation were still alive and well. Those taking cardiac rehabilitation had a 56% reduction in risk of dying. In fact, their mortality rate was similar to that of other people in their community of the same age who never had a heart attack.

One observation was that women did not participate in cardiac rehabilitation as often as men. Their participation rate was only 55% that of men in spite of the fact that heart disease is the number one killer of women.

If you have a heart problem or are at very high risk for a heart problem (have high cholesterol, excessive weight, diabetes, or very high blood pressure) you may want to inquire at your local hospital or from your doctor about participating in a cardiac rehabilitation program. It could save your life and undoubtedly will help you feel better and enhance your quality of life.

Source: Roger V, et al. Cardiac Rehabilitation, Jour of the American College of Cardiology, Sept. 1, 2004

Top 10 Diseases Linked to Rising Costs

What diseases are responsible for the rising cost of health care in the United States? Here is a list of the top 10 which are responsible for at least 50% of increased costs in the last 15 years (and the % increase they are responsible for):

• Heart disease (8.1%)
• Lung disease (5.6%)
• Mental disorders (7.4%)
• Cancer (5.4%)
• Hypertension (4.2%)
• Trauma (4.6%)
• Stroke (3.5%)
• Arthritis (3.3%)
• Back problems (3%)
• Diabetes (2.4%)

Recognizing where the majority of increased health care costs are coming from allows for the development of strategies to reduce increases in health care costs in future years. Here are two obvious strategies:

1. Reduce the prevalence of these diseases by emphasizing prevention (a good wellness program). For example, reducing excess weight will reduce the prevalence of 7 of these 10 leading diseases: heart disease, cancer, hypertension, stroke, arthritis, back problems, and diabetes. Likewise, increased physical activity can help prevent these same diseases  plus help  improve mental health (exercise helps people handle depression and anxiety.)

2. Promoting disease management. People who get good medical care have fewer complications resulting in fewer hospitalizations and other costly treatments. The cost effectiveness of disease management has been widely demonstrated for heart disease (see article on cardiac rehab in this newsletter), high blood pressure, diabetes, and many other chronic conditions.

Both of these solutions, however, require a proactive approach rather than waiting and intervening only when acute medical conditions arise.

Source: Thorpe K, et al. "Health Spending", Health Affairs, Aug. 25, 2004

Junk Food One-Third of U.S. Diet

A public health nutritionist from the University of California analyzed the diets of 4,700 adults who reported everything they ate in the past 24 hours. She was alarmed at the major contribution of calories from "junk food" or "empty calorie" foods. Here are some of the findings:

• Sweets and desserts, soft drinks (7% of calories), and alcoholic beverages account for one-fourth of all calories eaten (lots of calories, few nutrients).
• Chips and fruit flavored drinks (mostly sugar) add another 5% of calories eaten. This means that nearly one-third of all the calories Americans eat come from "junk foods" devoid of nearly all nutrients other than calories.
• Hamburgers, pizzas, potato chips and fries were next and are especially high in saturated fat and calories.
• Fruits and vegetables accounted for only 10% of calories eaten. These foods, major contributors of vitamins a minerals, were in short supply.

The researchers point out that people eating this way can be obese and still be undernourished. They suggest that rather than just telling people to eat less, we need to tell them to eat differently!

Source: Block G et al, Journal of Food Chemistry and Analysis, June 2004

Fitness Verses Obesity for Heart Health

Women who are obese are nearly always advised to lose weight to prevent heart problems but are not always instructed to start a fitness program. A new study on women and heart health indicates that physical activity is even more important for preventing heart problems than weight loss.

Researchers at the University of Florida studied 936 women who were referred for coronary angiography, a procedure to determine if the arteries in the heart were plugged by atherosclerotic plaques. They also measured their level of physical activity and weight levels using both body mass index (BMI) and waist girth measures. What they found was surprising.

• Neither BMI nor waist girth measures of obesity were independently linked to angiographic measured coronary artery disease (clogged arteries) when adjusting for fitness level.
• Physical fitness scores, however, were independently associated with less angiographic coronary artery disease, fewer coronary risk factors, and fewer adverse coronary events after 3.9 years of follow-up in women at all levels of weight (normal, overweight, or obese).
• These results suggest that fitness may be more important than overweight or obesity for cardiovascular risk in women.

The researchers suggest that evaluation of fitness levels should be an important part of risk assessment when evaluating women for heart disease. They also recommended that interventions aimed at increasing physical fitness should be encouraged for all women for preventing or managing coronary heart disease. Focusing on weight loss alone fails to address the more important lack of physical fitness among overweight individuals.

The bottom line. What this means is that if you are overweight and are at high risk for heart disease or already have a heart problem, it is good to lose excess weight, but it's most important to improve your fitness level with regular physical activity such as walking 30+ minutes, 5 or more days each week. People of normal weight but with low fitness status are also at high risk and need a fitness program. Be sure to get your doctor's guidance in starting your physical activity program.

While this study was conducted on women, fitness has also been found to be the best predictor of cardiovascular risk in men.

Reference: Wessel T, et al. Relationship of Physical Fitness vs Body Mass Index with Coronary Artery Disease, Journal of the American Medical Association 292:1179-87, Sept 8, 2004

Stress is a Predictor of Heart Attacks

In a large international study including 14,767 people in 52 countries, stress was identified as a significant factor linked to increased risk of a heart attack. Researchers defined stress as, "Feeling irritable, filled with anxiety, or as having sleeping difficulties as a result of conditions at work or home."

Persons experiencing stress at work or home often or for "several periods" were 1.45 times more likely to have a heart attack than those who seldom experienced stress. Person who were under continual stress at work or home were 2.17 times more likely to have a heart attack. High levels of stress in people's lives contributed to about 33% of heart attacks, a contribution similar to obesity.

Psychosocial factors linked to increased risk of heart attacks included:

• High levels of stress at work
• High levels of stress at home
• Strong financial stress
• Stressful life events (2 or more major events in the past year)
• Feeling depressed

One factor, locus of control, showed that people who had more control over their lives had a lower risk of heart disease. Combining all of the factors: stress at home, work, financial, feeling sad or blue, and having stressful life events increased the risk of a heart attack by 2.5 times. These risks were consistent in all 52 countries. The prevalence of stress varied from country to country, but if present, the increased risk was similar throughout the world.

The country with the lowest percent of people with a high stress score was China (7.7%) and North America had the highest percent of people (35.3%) with a high stress score.

It appears that learning to better manage stress in your life, or living in such a way as to minimize stress, is a positive way to improve heart health and enjoy a happier life.

Reference: Rosengren A, et al. Association of psychosocial risk factors with risk of acute myocardial infarction, The Lancet 364:953-62, Sept. 11, 2004

2005 Dietary Guidelines Released

The government updates the Dietary Guidelines for Americans every 5 years. They recently released their guidelines for 2005. Here they are in a nutshell.

• Consume a variety of foods within and among the basic food groups while staying within energy needs.
• Control calorie intake to manage body weight.
• Be physically active every day.
• Increase daily intake of fruits and vegetables, whole grains, and nonfat or low-fat milk and milk products.
• Choose fats wisely for good health.
• Choose carbohydrates wisely for good health.
• Choose and prepare foods with little salt.
• If you drink alcoholic beverages, do so in moderation.
• Keep food safe to eat.

Each guideline has several pages of supportive research for each statement and additional guidelines. You can see these in their "Executive Summary" report (see Featured Links below).

Body and Soul

The government is initiating a new faith-based health initiative called "Body and Soul -- A celebration of Healthy Eating and Living." It is sponsored by the National Cancer Institute (NCI) and is designed especially for African Americans. NCI is offering African American churches a new, comprehensive program guide and training materials to help them incorporate the program into their activities. Their objective is to encourage healthier eating, eating 5-9 servings of fruits and vegetables daily, and being more physically active.

African Americans are at high risk for cancer and many other serious and often fatal diseases, including high blood pressure, diabetes, heart disease, and stroke. They have the highest rate of diagnosis and death from cancer overall than any other ethnic or minority group in the United States. A diet rich in fruits and vegetables promotes good health and can help lower the risk for cancer and some other illnesses. Yet on average, African Americans eat only about three servings a day.

'Body & Soul' works by combining pastoral leadership, church-wide activities, a church environment that supports healthy eating, and peer counseling. To order a free copy of the Body & Soul guide, churches can
call 1-800-422-6237. For more information, please visit http://www.5aday.gov .

NIH News Release, Sept. 21, 2004

QuickFacts Important health facts you need to know and share.

Depression. Depressive disorder is responsible for as many as one of every five visits to primary care doctors; it occurs everywhere and affects members of all ethnic groups. The rates of depression are increasing, and the disorder in nearly twice as common among the poor as among the wealthy. If you or a loved one is suffering from depression, ask your doctor for help. Depression is treatable.  New England Journal of Medicine 351:951, Sept 2, 2004

High blood pressure. High blood pressure is on the rise in the United States, up 30% in last 10 years. An estimated 65 million Americans now have high blood pressure, nearly one-third of all adults. An analysis by Milliman Consultants and Actuaries found that treatment of the 19 million Medicare patients with uncontrolled high blood pressure would result in 115,000 fewer cases of strokes and 106,000 fewer heart attacks. This would save 77,000 lives! If your blood pressure is 140/90 or higher, get help from your doctor! If you have pre-hypertension (120/80 to 139/89) make lifestyle changes now to prevent serious health problems down the road. If you don't know what your blood pressure is, get it checked! High blood pressure kills!   Reuters news release Sept. 14, 2004 (see NIH News Release on high blood pressure)

Underage alcohol drinking high. A survey by NIH on drinking habits of American youth says that underage drinking is "at disturbingly high levels." The survey revealed that "12% of 8th-graders have consumed five or more drinks on a single occasion within the past two weeks." The survey also showed that nearly 30% of 12th graders report drinking five or more drinks in a row in the past two weeks. 48.6% of all 12th graders report drinking alcohol during the last month. These rates are fairly stable over the last few years but indicate a serious health problem contributing to motor vehicle accidents and deaths, behavior problems, suicide, and experimenting with other drugs.   NIH News Release, Institute on Alcohol Abuse and Alcoholism, released Sept. 14, 2004

Life expectancy and health care costs. Some people have worried that healthy living that results in a longer life may increase overall health care costs for the elderly so a group of researchers looked at this problem. They found that a person in good health and with no functional limitations at age 70 can expect to live about another 14.3 years on the average in America. Their health care expenses during these last years will be about $136,000. A 70 year old person with poorer health (at least one limitation in activities of daily living) will live about 3 fewer years but their overall health care costs will be higher, about $145,000. The researchers  concluded, "Our study shows clearly that for the elderly, better health results in longer life but not in higher health care expenditures."  Lubitz J, et al. Health, Life Expectancy, and Health Care Spending among the Elderly, New England Journal of Medicine 349:1048-55, Sept. 11, 2003

Education level and health status. One of the best indicators of good health and longevity is the amount of education a person acquires. For example, persons with a college degree vs those without a high school diploma, are 1/3 as likely to smoke, nearly 3 times more likely to exercise regularly, and are much less likely to be obese. Thus college graduates are about half as likely to die early from heart disease or from any cause of death compared to those without a high school diploma. If you want your kids and grand kids to be healthy, be sure they get a good education, and model healthy living!   New England Journal of Medicine, Sept 9, 2004

Kiwi fruit. Eating 2-3 kiwi daily can significantly lower risk of blood clotting (similar to aspirin use) and blood fat levels (by 15% in 28 days) according to new research from the University of Oslo, Sweden. Dr. Duttaroy summarized their findings by saying, "The results of our study are quite promising and are an indication that kiwi fruit is an excellent choice for people trying to improve heart health through diet."   Duttaroy A, et al. Platelets 15:287-292, Aug 2004  (Read abstract)

Coffee and bladder cancer. Coffee is back in the news. A Canadian study found that men who drank 4 or more cups of coffee daily had significantly higher risk (77% increased risk) of bladder cancer and the more coffee they drank, the higher the risk. They also confirmed that smoking increased the risk for bladder cancer (3.3 times higher risk). The researchers estimate that 17% of all bladder cancers were caused from coffee and 51% from smoking cigarettes. The increased risk of bladder cancer from coffee was similar to exposure to asbestos and other industrial chemicals.  Ugnat A, Bladder Cancer Risk, Chronic Diseases in Canada 25 (2), 2004  (read article)

Soy protein lowers cholesterol. The use of soy can help lower cholesterol levels according to a double-blind placebo controlled clinical trial. Subjects ate 25 g of soy protein daily for 8 weeks or 25 g of milk protein. Those receiving the soy had a 10-12% decrease in LDL cholesterol levels (no change in HDL or triglycerides). This is equivalent to about 3 servings of soymilk daily or a little less than 1 cup of soy beans. They found that less refined soy sources (with the soy fiber intact) was twice as effective in lower cholesterol as isolated soy protein.   Hoie LH, et al. Soy Protein, European Journal of Nutrition, April 5, 2005 (pp 1-7) (read abstract)

A high fat diet helps keep HDL levels high.  A new study on diet and HDL levels showed that a diet higher in fat helped improve HDL levels (which is protective to the heart) while a low fat diet resulted in a drop in HDL cholesterol. The state University of New York fed a group of subjects either a low fat diet (19% of calories as fat), or a high fat diet (50% of calories from fat). After 3 weeks on the low or high fat diet, blood cholesterol levels were tested. Average HDL levels were 54 mg/dL on the low fat diet but rose to 63 mg/dL on the high fat diet. There was no change in total or LDL cholesterol, blood fats, or other coronary risk markers. Eating healthy fats (nuts, olives or olive oil, avocado, unhydrogenated vegetable oils) can lower your risk of heart disease.  Meksawan K, et al. Low and High Fat Diets, Journal of the American College of Nutrition 23:131-40, April 23, 2004

Soft Drinks Linked to Diabetes. A large study published in the Journal of the American Medical Association this month links soda pop and other sweetened drinks to an increase in obesity and risk of diabetes. The study included over 50,000 women. Women who drink 1 soft drink per day or more are twice as likely to get diabetes as women who seldom drink soda pop. Even after adjusting for other diabetes risk factors, soda pop still remained as an independent risk factor for diabetes. Frequent intake of sweetened drinks contributes to a larger intake of calories and weight gain due to the large amounts of rapidly absorbed sugars. Pure fruit juice consumption was not linked to diabetes risk. The authors concluded with a warning to the nation, "Public health strategies to prevent obesity and type 2 diabetes should focus on reducing sugar-sweetened beverages consumption."  Schulze MB, et al. Sugar sweetened beverages and diabetes in women, Journal of the American Medical Association 292:927-34, Aug 25, 2004

What's New?

Healthy Eating Guidelines. Do you need a few slides to promote the value of plant foods in your next cookery series? Healthy Eating Guidelines is available in three separate formats: a CD, a Poster, and a Brochure. Each features a New Food Pyramid with its emphasis on plant foods and their benefits that have become evident in much scientific research lately.

The CD and accompanying Manual ($75.00) contain 11 presentations with handouts. One presentation has 114 Power Point slides with speaker notes for each. Ten presentations are short (10-24 PP slides). Each is based on a food category in the pyramid:

• Choosing whole, plant-based foods
• Healthy weight
• Physical activity
• Fruits and Vegetables
• Healthy Fats
• Whole grains
• Nuts and Legumes
• Healthy protein foods
• Lower fat dairy foods or soymilk
• Healthy carbohydrates

Poster. The 8.5x11 4-color Poster includes food serving sizes and other health guidelines. Call for prices 503/656-7446 ext 233 or order on-line.

Tri-fold Brochure. The brochure features each of the ten healthy eating guidelines. Call for prices 503/656-7446 ext 233 or order on-line.

The New Food Pyramid emphasizes:

• Daily exercise and weight control
• Fruits and vegetables in abundance
• Whole grain breads and cereals every day
• Healthy fats as vegetable oils and as olives, avocados, nuts, etc.
• Daily legumes with their vegetable proteins and high soluble fiber
• Daily nuts with their healthy fats
• Low fat milk and yogurt or fortified soy milk in place of high fat dairy

Healthy Recipes

Here are some new ideas to try in your home.

• Ways to make vegetables more interesting: Green Beans Greek Style, Broccoli with Almond Sauce, and  Company Beets or Carrots.
• Try these tasty Polynesian Bars!

Featured Health Links 

Health Costs Summary, 2004  Health Insurance Benefits Survey Report for 2004.

Asthma Basics by National Institutes of Health. Here are practical suggestions for reducing asthma symptoms. How to create a dust free bedroom by NIH.

New Fitness Site. Here is a new web site by NIH to help people get started with an exercise program. It is especially designed for the common person. It's easy to read, graphic, and available in Spanish or English.

Tobacco and Cancer resource site by the University of Texas, MD Anderson Cancer Center. One-third of their patients have tobacco related cancers. This site is a great resource to help people be tobacco free.

2005 Dietary Guidelines resource site. A wealth of information for people teaching nutrition classes. Designed for health professionals. For a brief overview, review the "Executive Summary."

September is National Cholesterol Education Month. See NIH's Cholesterol Education Kit. It is designed for health professionals but also is loaded with information anyone can use and learn from.

Heart Healthy Cookbook. Looking for ways to eat more healthfully? Take a look at some of the recipes in the new NIH Heart Cookbook. It is free on the Internet. A 145 page pdf.

Featured Power Point Slides

You can download these slides and use them in your health presentations. To save a file click on 'Files' (top, left hand side of browser), click on 'Save As', specify your folder to save it in, type in a file name, and save it. To view the slide you need Microsoft Power Point software program or the MS PP Viewer, free from Microsoft.

• Weight, fitness, and health care costs - Data from the GM study (3 slides).
• Flu shots -- In a large study of 140,000 seniors, flu shots dramatically cut mortality rates (1 slide)
• Glycemic Index of Oats -- The glycemic index varies considerably based on how refined or processed a food is. Compare glycemic index (GI) of various forms of oats to standards for good health.
  (4 slides)
• Dietary Guidelines -- A listing of the new dietary guidelines released by the department of Health and Human Services for 2005. (1 slide).