Can the USDA Guidelines Really Lead to Healthier Eating Habits?

/PRNewswire/ -- As National Nutrition month comes to a close, Alere Health, the health management services business of Alere Inc., highlights four ways that the U.S. Department of Agriculture's (USDA) updated dietary guidelines can be used to encourage actionable changes in behavior.

In January, the USDA released the 2010 Dietary Guidelines for Americans (DGA), using the most blunt language to date about the need to confront America's obesity epidemic. The guidelines also include changes that reduce recommended sodium and trans fats levels.

But to Alere, a global company that provides industry-leading health and wellness programs, the most important takeaway is the emphasis on empowering individuals to make changes in behavior. Alere encourages health plans and employers seeking ways to improve health to look beyond the words and focus on practical ways to encourage action. Below is a look at the top four ways the dietary guidelines can encourage practical lifestyle changes:

1. "Empower individuals and families." People are more likely to make lasting changes in behavior if they are truly motivated. The new guidelines emphasize ways to focus on the positive aspects of adopting a healthier lifestyle, building skills to help people "heighten enjoyment of preparing and consuming healthy foods." This includes activities such as gardening, cooking together and eating as a family.

2. Promote "behavior change through environmental strategies." The guidelines acknowledge that many individuals lack the knowledge or motivation to change behavior without support. Given this, it's critical that organizations embrace changes that can make environments more conducive to healthier lifestyles.

3. Advocating a "healthy eating pattern." The guidelines also acknowledge that rigid prescriptions simply don't work when encouraging dietary changes. They emphasize flexible "eating patterns" that accommodate personal preference, cost and availability. Specific dietary recommendations include:

* Mediterranean-style diets: The guidelines cite extensive research on Mediterranean-style diets that emphasize vegetable, fruits and nuts, olive oil and whole grains, with only small amounts of meat products.
* Focus on Nutrient-Dense Foods: The guidelines go into detail about how nutrient-dense foods can help individuals limit their calories, particularly from solid fats and added sugars.

4. "Set the stage for lifelong healthy eating, activity and weight management." The guidelines cite obesity prevention as one of the most urgent public health issues in America. They note that "lifelong habits are developed throughout childhood," and focus on ways to support healthier approach for families. Alere has taken the lead in helping organizations work proactively to provide tools to combat childhood obesity with its Healthy Kids Program. This six-week online program provides parents with specific strategies they can use to improve their family's health.

"When you consider the state of our nation's health, blunt talk and specific guidelines are necessary," says Heather Zeitz, R.D., vice president of health content and programming for Alere. "But the new guidelines demonstrate that the most powerful way to change lifestyle behaviors is with a coordinated, participant-centered approach. At Alere, we recognize the scope of the challenge, but are hopeful that the USDA's call to action will help unite the cause for encouraging real changes that can have a real impact."

To show its commitment to healthy eating, Alere will feature live cooking demonstrations by celebrity chef Carla Hall, a finalist on the TV show Top Chef and now competing on Top Chef's All Stars, at the World Health Care Congress April 4-6 in Washington, D.C. An advocate for healthy cooking, Carla supports Michelle Obama's child obesity campaign by demonstrating healthy cooking in school cafeterias. She will perform a series of demonstrations on April 4 and 5 in booth #203.

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American Heart Association Meeting Report: Physical Activity Decreases Salt's Effect on Blood Pressure

Study Highlights:


-- The less physically active you are, the more your blood pressure rises in response to a high-salt diet.


-- Following a low-salt diet may be particularly important in lowering blood pressure among sedentary people.

 /PRNewswire/ -- The more physically active you are, the less your blood pressure rises in response to a high-salt diet, researchers reported at the American Heart Association's Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention 2011 Scientific Sessions.

"Patients should be advised to increase their physical activity and eat less sodium," said Casey M. Rebholz, M.P.H., lead author of the study and a medical student at the Tulane School of Medicine and doctoral student at the Tulane University School of Public Health & Tropical Medicine in New Orleans. "Restricting sodium is particularly important in lowering blood pressure among more sedentary people."

Investigators compared study participants' blood pressure on two one-week diets, one low in sodium (3,000 mg/day) and the other high in sodium (18,000 mg/day).

The American Heart Association recommends consuming less than 1,500 mg/day of sodium.

If a person's average systolic blood pressure (the top number in the reading, measured when the heart is contracting) increased 5 percent or more from the low-sodium to the high-sodium regimen, the researchers labeled them as high salt-sensitive.

Based on physical activity questionnaires, researchers divided participants into four groups ranging from very active to quite sedentary.

The average increases in systolic blood pressure after switching from low to high sodium, adjusted for age and gender, were:

* 5.27 mm Hg in the least active group
* 5.07 mm Hg in the next-to-lowest activity group
* 4.93 mm Hg in the next-to-highest activity group
* 3.88 mm Hg in the most active group

Compared with the sedentary group, the odds of being salt-sensitive, adjusted for age and gender, fell:

* 10 percent in the next-to-lowest activity group
* 17 percent in the next-to-highest activity group
* 38 percent in the most active group

"In all the analyses we found a dose-response relationship with the more activity, the better," Rebholz said.

The participants were 1,906 Han Chinese adults (average age 38) in the Genetic Epidemiology Network of Salt Sensitivity (GenSalt), a large project to identify genetic and environmental factors contributing to salt sensitivity. Siblings and their parents were invited to become involved in GenSalt if at least one sibling had pre-hypertension (blood pressure between 120/80 and 139/89 mm Hg) or stage-1 hypertension (between 140/90 and 159/99 mm Hg). No one was on blood pressure medication during the study.

The GenSalt project is located in rural China because the homogeneous population makes it more likely that genes influential to blood pressure control will be identified.

"The study needs to be repeated, but I suspect that the relationship between physical activity and salt-sensitivity will apply to other populations," Rebholz said.

Co-authors are: Dongfeng Gu, Ph.D.; Jing Chen, M.D., M.S.; Jian-feng Huang, M.D.; Jie Cao, M.D., M.S.; Ji-chun Chen, M.D., M.S.; Jianxin Li, M.D.; Fanghong Lu, M.D.; Jianjun Mu, M.D.; Jixiang Ma, M.D.; Dongsheng Hu, M.D., M.S.; Xu Ji, M.D.; Lydia A. Bazzano, M.D., Ph.D.; Depei Liu, M.D., Ph.D.; and Jiang He, M.D., Ph.D.

Author disclosures and sources of funding are on the abstract.


Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding. 

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HealthMPowers Teams-up with Blue Cross and Blue Shield of Georgia Foundation to Launch 'Health EmPowers YOU!'

/PRNewswire/ -- Physical education teachers, classroom teachers and school nutrition workers are helping students improve their health-related fitness and eating habits, through a new initiative from HealthMPowers and Blue Cross and Blue Shield of Georgia (BCBSGa) Foundation called "Health EmPowers You!"

A school and home-based educational program, Health EmPowers You! addresses the growing childhood obesity epidemic facing Georgia. Currently, Georgia has the second highest obesity rate with 21.3 percent of Georgia's children ages 10 to 17 years old being obese, according to the 2010 report by Trust for America's Youth and the Robert Wood Johnson Foundation, F as in Fat: How Obesity Threatens American's Future 2010. The initiative will be in 41 schools and will educate more than 20,000 students and their families on ways to integrate physical activity and healthy eating into their lives.

"With Georgia's childhood obesity at an astoundingly high rate, it is imperative we implement the necessary programs to help our children succeed by surrounding them with healthy, supportive environments," said Morgan Kendrick, president of BCBSGa. "The program that HealthMPowers has developed will benefit many Georgia children and help set them on a course for a healthy future."

As with all of HealthMPowers' programming, Health EmPowers You! is science-based and uses a comprehensive, hands-on approach to integrate important nutrition, fitness, and physical activity instruction and skill practice into all aspects of the school environment. Educational materials will be provided to physical education teachers, classroom teachers, nutrition directors, other school support, students and parents to teach and reinforce important lessons.

Health EmPowers You! includes:

* Lesson plans, classroom exercise DVDs and educational resources for teachers,
* Heart health physical education equipment for fitness teachers,
* Newsletters and support materials for parents, and
* A tracking system for students.


This fall, per House Bill 229, all schools in Georgia will be required to provide health related fitness assessments as part of a quality physical education program. Physical education teachers will conduct an annual fitness assessment program with students in first through 12th grade in the areas of aerobic capacity, muscular strength and endurance, flexibility, and body composition. The schools involved in the initial launch of Health EmPowers You! will have early access to fitness assessment information and can begin programming to improve their students' scores. Teachers from each school are already receiving training on the initiative, equipment and resources for successful program implementation.

"Health education must extend beyond the walls of a school building and infiltrate the home and community environments as well," said Christi Kay, executive director of HealthMPowers. "That is why HealthMPowers provides tools and resources to be used at school and at home – to engage students and help them become health advocates to their families and peers."

Childhood obesity can cause many health and psychological issues, according to the Center for Disease Control and Prevention (CDC). Short-term consequences can include poor body image and lower test scores at school while long-term consequences can include diabetes, high blood pressure and respiratory ailments. The CDC reports that nearly 75 percent of every health care dollar spent is due to lifestyle choices that result in chronic illness, which now affects one in four Americans.

In fact, today, March 22, 2011, is the American Diabetes Association's "Alert Day," which is held every fourth Tuesday in March. This one-day "wake-up" call asks Americans to take the Diabetes Risk Test to find out if they are at risk for developing type 2 diabetes. With Georgia recently being named to the "diabetes belt" by the American Journal of Preventive Medicine, the information and resources provided by the Health EmPowers You! initiative can be used to help combat this growing epidemic.

According to data collected by HealthMPowers, its programming has been proven to help increase student fruit and vegetable consumption, improve student cardiovascular fitness scores and create better school health policies.

"HealthMPowers has long recognized the connection between healthy schools, healthy students and healthy communities," Kay said. "Our collaboration with Blue Cross and Blue Shield of Georgia Foundation will expand HealthMPowers' reach throughout Georgia and provide schools and families with the tools and knowledge needed to engage in healthier behaviors."

Schools in Bibb, Jackson, Barrow and Newton counties are involved in the project.

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Georgia Kids 'Kick Butts' on March 23

/PRNewswire/ -- Kids in Georgia will take center stage in the fight against tobacco on March 23 as they join thousands of young people nationwide for the 16th annual Kick Butts Day. Hundreds of events are planned across the nation (for a list of local events see below).

Sponsored by the Campaign for Tobacco-Free Kids, Kick Butts Day is an annual celebration of youth leadership and activism in the fight against tobacco use. Kids are sending two powerful messages on Kick Butts Day: They want the tobacco companies to stop targeting them with marketing for cigarettes and other tobacco products, and they want elected leaders to do more to protect them from tobacco.

In Georgia, health advocates are calling on state leaders to increase the cigarette tax by $1 per pack in order to prevent kids from smoking and raise much-needed revenue to address the state's budget shortfall and fund critical programs such as health care and education. According to a report by the Campaign for Tobacco-Free Kids, a $1 cigarette tax increase in Georgia would have the following benefits:

* Raise $354.5 million in new annual revenue;
* Prevent 79,600 kids from becoming smokers;
* Spur 49,100 current adult smokers to quit;
* Save 38,400 residents from premature, smoking-caused deaths; and
* Save $1.8 billion in health care costs.


"On Kick Butts Day, kids are standing up to the tobacco companies, and elected officials should stand with them by supporting proven tobacco prevention measures," said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. "We know what works to reduce smoking and other tobacco use. Every state should implement these proven solutions, including higher tobacco taxes, well-funded tobacco prevention programs and smoke-free air laws."

Tobacco use is the number one cause of preventable death in the United States, killing more than 400,000 people and costing $96 billion in health care bills each year. While the nation has made significant progress in reducing youth smoking, 19.5 percent of high school students still smoke.

In Georgia, tobacco use claims 10,500 lives and costs $2.25 billion in health care bills each year. Currently, 16.9 percent of the state's high school students smoke, and 42,100 kids try cigarettes for the first time each year.

On Kick Butts Day, kids turn the tables on Big Tobacco with events that range from "They put WHAT in a cigarette?" demonstrations to carnivals to rallies at state capitols. Activities in Georgia include (all events are on March 23 unless otherwise noted):

On March 19 in Savannah , students, parents, community leaders and other youth groups from community centers will participate in a tobacco awareness event at the Blackshear Basketball Complex/Park. Students from the Youth for a Cleaner Environment (YFACE) will hand out literature, balloons, posters and more detailing the dangers of smoking. Time: 10 AM. Location: 820 Wheaton Street, Savannah. Contact: Janice Banks James (770) 283-7591.

In Dalton, students at Dalton Middle School will paint Kick Butts-themed graffiti art on three, large vinyl backgrounds. One background will be placed in the school hallway, one at a downtown restaurant, the Dalton Depot and one at the Walnut Square Mall. Location: 1250 Cross Plains Trail, Dalton. Contact: Cassandra Cutts (724) 859-7774.

Students from the Future Career and Community Leaders of America (FCCLA) Club will sponsor an event in Savannah showing the consequences of smoking where youth will be able to visit various booths and sign a pledge wall. Time: 3 PM. Location: 2025 East 52nd Street, Savannah. Contact: Barbara Baker (912) 236-9511.

In Marietta, a student from Osborne High School will dress as the Grim Reaper, followed by students with anti-smoking signs, and walk through the cafeteria inviting other students to join the silent procession. Students will receive a totem representing their departure from a life of tobacco use. Time: 11:45 AM. Location: 2451 Favor Road, Marietta. Contact: Janet Grenleski (770) 878-0628.

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Depression Can Worsen Knee Arthritis Symptoms in Older Adults

/PRNewswire/ -- Clinical depression can exacerbate the symptoms of knee arthritis beyond what is evident on X-rays, according to a new study from the Journal of Bone and Joint Surgery (JBJS). Patients with mild to moderate knee arthritis are especially affected by depression, the study notes.

"Knee osteoarthritis is a common cause of pain and impairment in older adults," said Tae Kyun Kim, MD, study author and director of the Division of Knee Surgery and Sports Medicine at Seoul National University Bundang Hospital's Joint Reconstruction Center. "Often, the level of arthritic symptoms reported by patients is much more severe than what is represented by X-rays, which can make it difficult for the doctor to treat.

"The results of this study indicate that depression can play a major role in the way patients experience the symptoms of knee arthritis, and that even when X-rays show the arthritis is not severe, patients with depression may report significant pain," Dr. Kim said. "The relationship between pain and depression suggests that both should be considered by physicians when treating patients with knee osteoarthritis, particularly in those with X-rays not indicating severe damage to the joint."

The study included 660 men and women aged 65 years or older who were evaluated for the severity of their knee arthritis on X-rays, as well as symptom severity. Patient interviews and questionnaires were used to assess coincident depressive disorders. The study was conducted as a part of the Korean Longitudinal Study on Health and Aging (KLoSHA).

As expected, the researchers found the levels of pain attributed to knee arthritis were higher in patients whose X-rays indicated greater joint damage; however, they also found depressive disorders were associated with an increase in pain in patients with mild to moderate knee arthritis, even when X-rays did not show significant joint damage.

"When evaluating the results of this study, the contribution of depression to knee osteoarthritis symptoms was almost as important as the damage indicated on X-rays," Dr. Kim noted.

Knee arthritis typically affects men and women over 50 years of age, and occurs most frequently in people who are overweight. Common symptoms include:

* pain or stiffness in or around the knee;
* swelling of the knee;
* limited range of motion when walking or moving the knee; or
* knee weakness or a feeling of instability.


In more severe cases, the knee joint may appear deformed, such as bowlegged or knock-kneed appearance, either bulging outward or toward the side of the leg. Knee replacement surgery is often performed in patients with severe symptoms.

Although studies have indicated depression is not uncommon among older adults, it remains largely underdiagnosed. According to the National Institute of Mental Health (NIMH):

* The risk of depression increases with other illnesses and when ability to function becomes limited.
* Estimates of major depression in older people range from 1 percent to 5 percent among those living in the community, to as high as 11.5 percent in hospital patients and 13.5 percent in those who require home healthcare.
* An estimated 5 million older adults have mild depression, which is often undiagnosed.

Symptoms of depression may include:

* feelings of sadness or hopelessness;
* loss of interest in activities that were once enjoyed;
* change in appetite or sleep patterns;
* difficulty thinking and remembering; or
* frequent thoughts of death or dying.

"Despite the reported satisfactory outcomes of knee replacement surgery a percentage of patients still experience knee pain and impaired movement," said Dr. Kim said. "Sometimes pain and disability after surgery is medically unexplained, so in these patients screening for depression might be a very good option."

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Pfizer Global Pharmaceuticals (Grant No. 06-05-039) and Seongnam City Government in Korea (Grant No. 800-20050211). Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.


More information on osteoarthritis of the knee and other orthopaedic conditions can be found at www.orthoinfo.org.

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U.S. Death Rate Falls for 10th Straight Year

The age-adjusted death rate for the U.S. population fell to an all-time low of 741 deaths per 100,000 people in 2009 -- 2.3 percent lower than the 2008 rate, according to preliminary 2009 death statistics released today by CDC's National Center for Health Statistics. This marks the 10th year in a row that U.S. death rates have declined.

Life expectancy at birth increased to 78.2 years in 2009, up slightly from 78.0 years in 2008. Life expectancy was up two-tenths of a year for males (75.7 years) and up one-tenth of a year for females (80.6 years). Life expectancy for the U.S. white population increased by two-tenths of a year. Life expectancy for black males (70.9 years) and females (77.4 years) was unchanged in 2009. The gap in life expectancy between the white and black populations was 4.3 years in 2009, two-tenths of a year increase from the gap in 2008 of 4.1 years.

The findings come from "Deaths: Preliminary Data for 2009," which is based on death certificates provided to NCHS through the National Vital Statistics Reporting System from all 50 states, the District of Columbia and U.S. territories.

Other findings:

* Age-adjusted death rates declined significantly for 10 of the 15 leading causes of death in 2009: heart disease (declined by 3.7 percent), cancer (1.1 percent), chronic lower respiratory diseases (4.1 percent), stroke (4.2 percent), accidents/unintentional injuries (4.1 percent), Alzheimer's disease (4.1 percent), diabetes (4.1 percent), influenza and pneumonia (4.7 percent), septicemia (1.8 percent), and homicide (6.8 percent).
* In 2009, suicide passed septicemia (blood poisoning) to become the 10th leading cause of death. Although the U.S. suicide rate did not change significantly between 2008 and 2009, the number of suicides increased from 35,933 in 2008 to 36,547 in 2009 (1.7 percent increase). Deaths from septicemia declined 1 percent from 35,961 in 2008 to 35,587 in 2009. Otherwise, the rankings for the 15 leading causes of death did not change between 2008 and 2009.
* Overall, there were 2,436,682 deaths in the United States in 2009 – 36,336 fewer than in 2008 (1.5 percent decrease).

SOURCE Centers for Disease Control and Prevention (CDC)

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Every Five Minutes Someone Dies from a Blood Clot

/PRNewswire/ -- Each year between 100,000-180,000 Americans die as the result of pulmonary embolism, a complication from blood clots in the lungs. The Vascular Disease Foundation urges Americans, especially women, to learn about the risks of venous blood clots to help prevent these deaths. While men and women are at equal risk, the risk for deep vein thrombosis, or blood clots, varies depending on where a woman is in her lifecycle, her hormone levels, and if she has a family history of clotting disorders.

DVT occurs when a blood clot forms in the deep veins, usually of the pelvis or leg. DVT can be dangerous in two ways. First, DVT can be fatal if a blood clot breaks free from the leg veins and travels through the heart and lodges in the lung arteries. This complication, called pulmonary embolism (PE), causes between 100,000 and 180,000 deaths per year in the United States. Second, because blood clots can permanently damage the veins, as many as half of DVT survivors can experience long-term leg pain, heaviness and swelling that can progress to difficulty in walking, changes in skin color and open leg sores (known as ulcers). This condition, called post-thrombotic syndrome (PTS) or "chronic venous insufficiency," can significantly impair quality of life.

Certain individuals may be at greater risk for developing DVT, but it can occur in almost anyone. Risk factors or triggering events that are more likely to affect women include pregnancy and the six to eight weeks after giving birth, the use of birth control pills or postmenopausal hormone replacement therapy, cancer and its treatment, and major surgery.

Anyone may be at risk for DVT but the more risk factors you have, the greater your chances are of developing it. Knowing your risk factors gives you the chance to do something about it:

* Hospitalization for a medical illness or any illness
* Recent major surgery (especially orthopedic surgery) or injury or trauma
* Personal history of a clotting disorder or previous DVT
* Increasing age
* Cancer and their treatments
* Family history of DVT
* Extended bed rest
* Obesity
* Smoking
* Prolonged sitting when traveling (longer than 6 to 8 hours)


DVT and PE should be considered emergencies that require immediate care if any of the following symptoms are present:

Symptoms of Possible DVT:

Recent swelling of one leg
Unexplained pain or tenderness of one leg
Change in skin color or skin is hot to the touch

Symptoms of Possible PE:

Recent or sudden shortness of breath
Sharp chest pain, especially when breathing in
Coughing up blood or sudden collapse

"Every year, more people die from preventable blood clots than from breast cancer, AIDS and traffic accidents combined," said Dr. Samuel Goldhaber, Chairman of the Venous Disease Coalition. "It is so important to raise awareness about DVT and PE because although blood clots are common, few Americans have sufficient knowledge about blood clots and how to prevent them."

For more information about DVT, its risk factors, signs and symptoms or to take a free risk assessment quiz, visit www.vdf.org

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Leading Health Groups Launch National Campaign for Tobacco-Free Baseball

/PRNewswire/ -- With spring training for the 2011 baseball season underway, 10 major medical and public health groups have joined together in the launch of a coordinated campaign urging Major League Baseball and the Major League Baseball Players Association to ban tobacco use by players, managers, coaches and other staff at major league ballparks.

Today, the groups have teamed up to kick off the online campaign featuring a new website, www.tobaccofreebaseball.org, with social media tools that allow fans and other members of the public to tell their hometown teams, players and Major League Baseball that continued use of smokeless tobacco at baseball games is unacceptable. The campaign is called Knock Tobacco Out of the Park.

The groups involved are: American Academy of Pediatrics, American Cancer Society, American Dental Association, American Heart Association, American Lung Association, American Medical Association, Campaign for Tobacco-Free Kids, Legacy, Oral Health America and Robert Wood Johnson Foundation.

In Florida last weekend, youth activists rallied and circulated petitions at games between the New York Mets and Atlanta Braves in Port St. Lucie and between the Detroit Tigers and Toronto Blue Jays in Dunedin.

Earlier this month, U.S. Senators Richard Durbin (D-IL) and Frank Lautenberg (D-NJ) called for Major League Baseball and the players association to ban the use of tobacco products at MLB venues. The senators cited Washington Nationals' pitching ace Stephen Strasburg's struggle to overcome his addiction to smokeless tobacco.

In November, the chief executives of the 10 health groups wrote to Major League Baseball Commissioner Bud Selig and Michael Weiner, executive director of the players association, urging that they agree to the tobacco ban in the contract that takes effect in 2012. The new collective bargaining agreement is being negotiated this year.

"Use of smokeless tobacco endangers the health of Major League ballplayers. It also sets a terrible example for the millions of young people who watch baseball at the ballparks and on TV and often see Major League players and managers using smokeless tobacco," the groups wrote.

The use of smokeless tobacco in Major League Baseball has drawn scrutiny from Congress and the media for months. In April 2010, the House Energy and Commerce Subcommittee on Health, chaired by Rep. Frank Pallone (D-N.J.), held a hearing on the issue.

Several news stories have examined the difficulty players and coaches have in breaking their addiction. Among those who have spoken about the challenge of quitting are Strasburg, American League Most Valuable Player Josh Hamilton and Bruce Bochy, manager of the World Champion San Francisco Giants. Hall of Famer Tony Gwynn's recent cancer diagnosis and his public comments attributing his disease to years of chewing tobacco have underscored the health threat from smokeless tobacco.

Tobacco use was banned in baseball's minor leagues in 1993. The NCAA and the National Hockey League have instituted prohibitions on tobacco use. Major League Baseball is lagging behind.

Meanwhile, smokeless tobacco use among high school boys is spiking – there has been a 36 percent increase since 2003 and 15 percent of high school boys currently use smokeless tobacco, according to the Centers for Disease Control and Prevention.

Smokeless tobacco contains at least 28 known carcinogens and has been found to cause oral cancer, pancreatic cancer, cardiovascular disease, gum disease, tooth decay and mouth lesions. It has also been linked to other forms of cancer.

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Joint Pain in Children: Is it Just a Sore Knee, or...?

/PRNewswire/ -- While lab tests and imaging can sometimes help diagnose juvenile idiopathic arthritis (JIA), a physical examination and thorough patient history are the most valuable tools in identifying this disease. According to a new literature review from the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), the rate of false positives in laboratory evaluations and imaging studies meant to screen for juvenile arthritis makes their value limited.

Juvenile idiopathic arthritis (formerly known as juvenile rheumatoid arthritis) is an autoimmune disease that affects nearly 300,000 children in the United States under the age of 18. The cause is not known, and it does not appear to be genetic, although some family members may suffer from other autoimmune disorders. Symptoms may include:

* joint stiffness in the morning that improves later in the day;
* pain, swelling, and tenderness in the joints;
* limping or limits in range of motion;
* high fever and light rash;
* weight loss;
* fatigue or irritability; and/or
* red eyes or blurred vision.


Depending on the type of JIA, these symptoms can vary quite a bit. In fact, some young patients may not suffer any of these symptoms, but have a swollen joint that is discovered after another incident such as an injury.

"To establish a diagnosis of juvenile idiopathic arthritis is a matter of pattern recognition," says Marilynn Punaro, MD, a pediatric rheumatologist at Texas Scottish Rite Hospital for Children and University of Texas Southwestern Medical Center, Dallas, TX, and the author of this review. "Also, there is no lab test that can conclusively diagnose rheumatic disease—you have to rule out other common diagnoses. That is why a full physical exam is important, as well as a detailed patient history that will reveal other symptoms. If the patient has one swollen joint, the other joints should be examined because the diagnoses could be very different based on what is found in that exam."

Review details and findings:

* If JIA is suspected, the orthopaedic surgeon should conduct an assessment of all peripheral joints, not just the joint or joints about which the patient is complaining.
* Exquisitely painful, tender, or red joints are not typically diagnostic for JIA.
* Oligoarticular JIA (where just a few joints are affected) is the most common type of JIA, affecting 60 percent of children with this disorder. The onset of this type of arthritis is usually between the ages of 1 and 3.
* Treatment of juvenile arthritis is designed to reduce swelling, maintain full movement of affected joints, and relieve pain, and includes medications and physical therapy. Surgery may be indicated in rare cases. Some JIA patients' disease can go into remission.
* Recent clinical trials are showing that with new drug treatments, remission will soon be a realistic goal for most patients.


"It is important to try and diagnose JIA early so treatment can begin," Punaro says. "If left untreated for months or years, there is a likelihood of long-term disability, growth problems or deformity. The disease can cause joint damage that is irreversible. The good news, though, is that when we do diagnose JIA, we have many excellent treatments available."

Disclosure: Dr. Punaro has nothing related to this study to disclose. 

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Arthritis Foundation and National Psoriasis Foundation Launch Effort to Encourage Early Diagnosis and Treatment of Psoriatic Arthritis

/PRNewswire/ -- Two leading patient advocacy organizations have joined forces to educate people about psoriatic arthritis, an inflammatory disease that can lead to joint damage, especially if not diagnosed and treated early. The Joint Smart Coalition, launched today by the Arthritis Foundation and the National Psoriasis Foundation in collaboration with Amgen and Pfizer, aims to provide empowering and educational resources for people with psoriatic arthritis and other related inflammatory conditions like rheumatoid arthritis and plaque psoriasis.

A key component of the effort is BeJointSmart.org, a website that provides resources and information for people to learn more about these diseases. The central message of the site is that people who have certain chronic inflammatory diseases should carefully monitor their joint health, and see a doctor if they experience pain, tenderness or swelling in their joints lasting more than three days, or similar symptoms that come and go several times in a month.

"About 7.5 million adult Americans have psoriasis, a serious chronic disease that appears on the skin," said Randy Beranek, president and CEO of the National Psoriasis Foundation. Psoriasis occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Up to 30% of patients diagnosed with psoriasis may actually have psoriatic arthritis. "Many of them are not aware that they may actually have this potentially disabling form of arthritis."

"Early diagnosis and treatment of psoriatic arthritis can help to stop or slow the progression of permanent damage to the joints," says Dr. Patience White, Arthritis Foundation vice president of public health. "Through the 'Be Joint Smart' effort we aim to educate people with chronic inflammatory forms of arthritis, like psoriatic arthritis, to seek early diagnosis and treatment to reduce the potential for progression of joint damage."

While 70 percent of people who develop the disease already have skin lesions, others develop the arthritis first, or develop both skin and joint symptoms at about the same time. People with a family history of either psoriasis or psoriatic arthritis are also at risk.

If you or someone in your family has psoriasis and/or you are experiencing persistent or recurring joint pain, stiffness or swelling, the Joint Smart Coalition urges you to see a doctor. Learn more at BeJointSmart.org.

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