Study of One Million Americans Shows Obesity and Pain Linked

Newswise — STONY BROOK, N.Y., January 26, 2012 – A clear association between obesity and pain – with higher rates of pain identified in the heaviest individuals – was found in a study of more than one million Americans published January 19 in the online edition of Obesity. In “Obesity and Pain Are Associated in the United States,” Stony Brook University researchers Arthur A. Stone, PhD., and Joan E. Broderick, Ph.D. report this finding based on their analysis of 1,010,762 respondents surveyed via telephone interview by the Gallop Organization between 2008 and 2010.

Previous small-scale studies have shown links between obesity and pain. The Stony Brook study took a very large sample of American men and women who answered health survey questions. The researchers calculated respondents’ body mass index (BMI) based on questions regarding height and weight. Respondents answered questions about pain, including if they “experienced pain yesterday.”

“Our findings confirm and extend earlier studies about the link between obesity and pain. These findings hold true after we accounted for several common pain conditions and across gender and age,” says Dr. Stone, Distinguished Professor and Vice Chair, Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, and an expert on patient reported measures of health, pain, and well-being.

Sixty three percent of the 1,010,762 people who responded to the survey were classified as overweight (38 percent) or obese (25 percent). Obese respondents were further classified into one of three obesity levels as defined by the World Health Organization. In comparison to individuals with low to normal weight, the overweight group reported 20 percent higher rates of pain. The percent increase of reported pain in comparison to the normal weight group grew rapidly in the obese groups: 68 percent higher for Obese 1 group, 136 percent higher for Obese 2 group, and 254 percent higher for Obese 3 group.

“We wanted to explore this relationship further by checking to see if it was due to painful diseases that cause reduced activity, which in turn causes increased weight,” says Joan E. Broderick, Ph.D., Associate Professor in the Department of Psychiatry and Behavioral Science and School of Public Health at Stony Brook University, and lead investigator of a National Institutes of Health-funded study on how arthritis patients manage their own pain.

“We found that ‘pain yesterday’ was definitely more common among people with diseases that cause bodily pain. Even so, when we controlled for these specific diseases, the weight-pain relationship held up. This finding suggests that obesity alone may cause pain, aside from the presence of painful diseases,” Dr. Broderick explains.

Interestingly, the pain that obese individuals reported was not driven exclusively by musculoskeletal pain, a type of pain that individuals carrying excess weight might typically experience.

Drs. Broderick and Stone also suggest that there could be several plausible explanations for the close obesity/pain relationship. These include the possibility that having excess fat in the body triggers complex physiological processes that result in inflammation and pain; depression, often experienced by obese individuals, is also linked to pain; and medical conditions that cause pain, such as arthritis, might result in reduced levels of exercise thereby resulting in weight gain. The researchers also indicated that the study showed as people get older, excess weight is associated with even more pain, which suggests a developmental process.

Drs. Broderick and Stone believe that the study findings support the importance of metabolic investigations into the causes of pain, as well as the need for further investigation of the obesity—pain link in U.S. populations.

Released: 1/26/2012

Source:  Stony Brook University Medical Center

Related Link:

http://www.newswise.com/articles/study-of-one-million-americans-shows-obesity-and-pain-linked

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New Year’s Resolutions: Reality Check for Would-Be Runners

Newswise — ST.LOUIS – You’ve likely noticed friends, family and coworkers joining running groups, using Facebook apps to share their training times, participating in 5Ks for charity and training for marathons. If you feel motivated to lace up your sneakers in 2012, take some advice from assistant professor of physical therapy at Saint Louis University, Chris Sebelski, to hit the ground running and have realistic expectations about the work ahead.

Sebelski encourages those who want to join the sport’s growing numbers, saying “Running is very accepting of beginners. It’s a great way to stay active at all ages, and it’s a healthy choice for those who have set a New Year’s resolution to get in shape.

“Running really has become the everyman and everywoman sport. It’s also something that more and more people do in their later years. We used to believe it would ruin your joints. There have been several studies in recent years about running, aging and arthritis that have disproved this idea.”

However, while getting in shape is a terrific aim, there can be rocky terrain between your good intentions and the finish line without thorough preparation and a realistic plan.

If you’re ready to join the race, consider these words of wisdom from Sebelski, an avid runner herself:

Overall Body Checkup
Before you begin, visit your primary care doctor for a complete overall body check-up, Sebelski says, and talk about your exercise plans. Depending on your goals and current state of fitness, you may also consult a physical therapist or nutritionist so that they can help you create a holistic plan.

“Remember, it’s so much better to prevent injuries than to try to recover from them,” Sebelski says.

Realistic Goals
It’s easy to go overboard during the enthusiasm of planning, but be sure you accurately acknowledge your current level of fitness. If you haven’t been exercising at all, you’ll want to start with a walking/jogging mix, Sebelski says. Some people feel very tired for the first few weeks after they begin to exercise, so set a reasonable goal that you’ll be able to stick with as your body gets used to the new activity. You might consider journaling to keep track of your progress and how you feel.

“Make your goals personal,” Sebelski says. “On an everyday level, the key is to think about small steps and celebrate the little victories.”

Setbacks
When it comes to setbacks, it’s not if, but when, Sebelski says. “Running doesn’t happen in a vacuum. Everyday things are going on. You’re fighting off a cold. Your children needed extra help with their homework. You may have an injury. Expect that there will be off days when you can’t fit in a workout or your time isn’t your best.”

By anticipating the obstacles to your training, you’ll be able to adjust your workout rather than throw it out the window entirely. And, when it comes to exercising, your efforts are cumulative.

“On a day when you realize you’re not going to be able to complete your normal routine, evaluate the situation and set a good goal for that day,” Sebelski says. “Always do something. Eight minutes is better than nothing.

“It’s never all or nothing. Go for a walk, take the stairs, do squats or do something else that elevates your heart rate. You’ll keep yourself from losing ground and you won’t have the emotional setback of feeling like you gave up.”

Hear more from Chris Sebelski about dealing with setbacks: http://www.youtube.com/watch?v=OcdqMZJIuow&feature=youtu.be

Food and Water
When you start burning more calories, you may find yourself very hungry. But, proceed with caution. You can’t simply consume unlimited calories, even if you are burning more during your workouts. Look at what you’re eating and be smarter about what types of calories by including plenty of lean proteins and whole grains. And, don’t forget about hydration, Sebelski says. “Remember: Water. Water.Water.”

Cross-training
Including other forms of exercise in your training regimen will help you reach your running goals. Yoga, for example, offers stretches that will help to change and improve posture and the alignment of the body. Exercises like Pilates can build core strength, which in turn, will help you breathe as you run.

“There’s a big link between core strength and breathing,” Sebelski says. “Core strength assists with posture which in turn will make breathing easier.

“Running itself is an all-over body sport. People think it’s concentrated in the legs, but that’s not true. It affects your arms, back, trunk, and almost every muscle in your body. Cross-training is helpful because you’ll strengthen these other muscles and avoid the injury risk posed by the repetitive motion of running every day.

Staying on Track
Running is hard work, and after the first month or two of diligent training, you may find your enthusiasm waning if you don’t plan for ways to stay engaged. Consider joining friends in the park or a running group to train for a 5K. The social aspect can help keep you on track.

Technology offers helpful ways to stay engaged, as well. Share your training time with friends on Facebook, and you’ll be amazed by the support you receive. There are apps that make it easy to report back to your support group regularly. Or, tell your social circle about your training sessions on your blog so that they can follow your story and cheer you on.

Finally, a reality check shouldn’t dampen your enthusiasm. Though training can be tough, the obstacles are no reason to be daunted. The rewards from running are well worth the effort, and knowing what the terrain looks like makes it more likely you’ll reach your goal.

Released: 12/20/2011

Source: Saint Louis University Medical Center

Related Link:

http://www.newswise.com/articles/new-year-s-resolutions-reality-check-for-would-be-runners

Top 5 Winter Activities that Land You In The Emergency Room

Newswise — The first day of winter is Wednesday, December 21, and many states are bracing for a season of snow and ice. Broken bones from snowboarding and sledding top the list of common visits to the Emergency Department (ED) during the winter months. According to the Centers for Disease Control and Prevention, one-quarter of all emergency hospital visits are attributed to snowboarding accidents, and half of all cases were for broken bones and sprains.

“Chicagoans embrace winter with gusto largely because of the great love for hockey, sledding and ice skating,” said Gottlieb Memorial Hospital orthopaedic surgeon Daryl O’Connor, who formerly cared for U.S. Olympic ski and winter sports athletes in Salt Lake City, Utah. Dr. O’Connor is board certified in orthopaedic surgery and now specializes in sports medicine in the Orthopaedic Department at Gottlieb Memorial Hospital, part of Loyola University Health System.

Here are Dr. O’Connor’s evaluations of the top five winter sports:

1. Sledding – “More than 700,000 injuries are reported each year in the United States due to sledding. More than 30 percent are head injuries, caused by collisions,” O’Connor said.

2. Hockey – “Lacerations, as well as neck, shoulder and knee injuries are common in hockey. Many injuries are caused through contact with another player, the ice, a puck or actual skate blade,” he said.

3. Ice skating – “Injuries to the wrist as well as head and neck are most common and most injuries are caused by falls,” he said.

4. Snowboarding – “Wrist and elbow injuries are caused by falls on outstretched hands,” he said.

5. Skiing – “Knees really take a pounding and injury is often caused by extreme twisting force-propelled by the skis,” he said.

Snitching on Skitching

“This is not even a sport; it’s just being foolish,” said Dr. O’Connor of the practice in neighborhoods of daredevil teens grabbing a car’s rear bumper and sliding on their feet, or being pulled by ropes on inner tubes or sleds through icy streets. “In addition to broken bones, neck and shoulder injuries, young people can suffer fatal head trauma. Please, resist the skitch at all costs.”

Released: 12/21/2011

Source: Loyola University Health System

Related Link:

http://www.newswise.com/articles/top-5-winter-activities-that-land-you-in-the-er

Researchers Find That Young Adults Drop Exercise with Move to College Or University

Regular exercise tends to steeply decline among youth as they move to university or college, and does not appear to revert itself, but continues on a downward trajectory into adulthood.

Newswise — Hamilton, ON (Dec. 15, 2011) – Regular exercise tends to steeply decline among youth as they move to university or college, according to a study by researchers at McMaster University.

Researchers found a 24 per cent decrease in physical activity over the 12 years from adolescence to early adulthood. The steepest declines were among young men entering university or college.

The research appears today in the American Journal of Preventive Medicine. The study, based on Statistics Canada’s National Population Health Survey, followed 683 Canadian adolescents 12 to 15 years old, who were interviewed twice a year until they were 24 to 27 years of age.

While the children were most active, the research suggests that this advantage quickly disappears.

“This is a critical period, as the changes in physical activity during the transition from late adolescence to early adulthood represents the most dramatic declines in physical activity across a person’s life,” said Matthew Kwan, the principal investigator for the study and a postdoctoral fellow of the Department of Family Medicine of the Michael G. DeGroote School of Medicine.

“In particular, the transition into post-secondary is a one-time period when individuals become much less active.”

Risk estimates suggest 20 per cent of premature deaths could be prevented with regular physical activity. Yet, recent data show 85 per cent of Canadian adults are not active enough to meet the recommended 150 minutes of moderate-to-vigorous physical activity a week.

Public health campaigns encourage Canadians to be more active but the McMaster researchers say little work has been done to prevent the decline in physical activity and they suggest this issue should be made a priority.

For the study, physical activity was measured by estimating the amount of total energy used during leisure activities over a three-month period during the transition from adolescence into early adulthood, including the move to college or university.

The researchers found the rate of decline in physical activity was greater for men than for women, who showed only a modest 1.7 per cent decrease in their overall activity levels; however, the women were less active in high school.

“It may be that girls experience the greatest declines in physical activity earlier in their adolescence,” said Kwan.

For comparative purposes, the researchers also examined other health-risk behaviours of smoking and binge drinking. While both increased through adolescence, the researchers found the behaviours began to plateau or decrease in early adulthood; suggesting that individuals may be maturing out of these health-risk behaviours.

Conversely, Kwan added, physical activity decline does not appear to revert itself, but continues on a downward trajectory into adulthood.

Released: 12/15/2011

Source: McMaster University

Related Link:

http://www.newswise.com/articles/young-adults-drop-exercise-with-move-to-college-or-university-mcmaster-researchers

Increased Use of Bikes for Commuting Offers Economic, Health Benefits

Newswise — MADISON – Cutting out short auto trips and replacing them with mass transit and active transport would yield major health benefits, according to a study just published in the scientific journal Environmental Health Perspectives.

The biggest health benefit was due to replacing half of the short trips with bicycle trips during the warmest six months of the year, saving about $3.8 billion per year from avoided mortality and reduced health care costs for conditions like obesity and heart disease.

The report calculated that these measures would save an estimated $7 billion, including 1,100 lives each year from improved air quality and increased physical fitness.

Moving five-mile round trips from cars to bikes is a win-win situation that is often ignored in discussions of transportation alternatives, says Jonathan Patz, director of the Global Health Institute at the University of Wisconsin-Madison. “We talk about the cost of changing energy systems, the cost of alternative fuels, but we seldom talk about this kind of benefit,” he says.

The study of the largest 11 metropolitan statistical areas in the upper Midwest began by identifying the air pollution reductions that would result from eliminating the short auto trips.

A small average reduction in very fine particles, which lodge deep in the lung and have repeatedly been tied to asthma, which affects 8.2 percent of U.S. citizens, and deaths due to cardiovascular and pulmonary diseases, was a major source of health benefits, says co-author Scott Spak, who worked on the study at UW-Madison and is now at the University of Iowa.

“The reductions tend to be much larger during high pollution episodes, and even small changes reduce a chronic exposure that affects the 31.3 million people living throughout the region — not just in these metropolitan areas, but even hundreds of miles downwind,” Spak says.

The study projected that 433 lives would be saved due to the reduction in fine particles.

The second step was to look at the health benefits of using a bicycle on those short trips during the six months with optimum weather, when cycling is quite feasible in the region.

“Obesity has become a national epidemic, and not getting exercise has lot to do with that,” says first author Maggie Grabow, a Ph.D. candidate at UW-Madison’s Nelson Institute, who will present the study today (Wednesday, Nov. 2) to the American Public Health Association in Washington, D.C.

“The majority of Americans do not get the recommended minimum level of exercise,” says Grabow. “In a busy daily schedule, if that exercise can automatically occur while commuting to work, we anticipate a major benefit in stemming the obesity epidemic, and consequently a significant reduction in type II diabetes, which is a deadly epidemic in its own right.”

Overall, the study may underestimate the benefits of eliminating short auto trips, says Patz, an environmental health specialist in the Department of Population Health Sciences, because it did not measure the financial savings due to reduced auto usage. Furthermore, the study did not try to account for the health benefits of the foregone auto trips, which would be performed on foot or via mass transit, both of which provide an additional amount of exercise.

Patz acknowledges that it’s unrealistic to expect to eliminate all short auto trips, but notes that biking as transportation is gaining popularity in the United States, and that in some cities in Northern Europe, approximately 50 percent of short trips are done by bike. “If they have achieved this, why should we not think we can achieve it too?” he asks.

Chicago and New York, among other cities, have devoted significant resources to bike infrastructure in recent years, Patz notes.

The new study, he says, should provide another motivation for making cities more bike friendly, with better parking, bike racks on buses and trains, and more bike lanes and especially separate bike paths.

“Part of this is a call for making our biking infrastructure safer. If there are so many health benefits out there, we ought to try to redesign our cities to achieve them without putting new riders at risk,” Patz says.

By lessening the use of fossil fuels, a reduction in auto usage also benefits the climate, Patz adds. “Transportation accounts for one-third of greenhouse gas emissions, so if we can swap bikes for cars, we gain in fitness, local air quality, a reduction in greenhouse gases, and the personal economic benefits of biking rather than driving. It’s a four-way win,” he adds.

Released: 10/28/2011

Source: University of Wisconsin-Madison

Related Link:

http://newswise.com/articles/increased-use-of-bikes-for-commuting-offers-economic-health-benefits

Sports Medicine Experts Offer Tips to Help Post-Marathon Recovery

Newswise — More than 40,000 runners have spent the past several months training for the ING New York City Marathon. Once they have completed the race and achieved their goals, there are measures they can take to facilitate recovery, decrease post-race discomfort and return to running without injury.

Eating immediately after the marathon, icing sore muscles, and having a gentle massage are only a few of the tips that Michael Silverman, PT, MSPT, physical therapist from the Rehabilitation Department at Hospital for Special Surgery in New York, offers runners who cross the finish line.

“In recovery, marathon runners need to listen carefully to their bodies so they don’t injure themselves,” says Silverman. “Extensive training should have provided runners with a good idea of how their body works. Runners should take everything they’ve learned while training and apply it to taking proper care of their body after the marathon—they will feel better, faster.”

The following are marathon recovery tips from Silverman on ways to bounce back from a marathon:

• Eating the day after is just as important. Try to stay away from enormous meals. Eat small amounts of nutrient-rich foods every two hours. Good meals could be steak, sweet potatoes and broccoli. Berries, chocolate or yogurt parfaits are good desserts. Chicken stir fry with loads of vegetables is an excellent lunch;

• Ice your muscles often. If you are having severe muscle pain during the race, immediately go to the medical tent to ice your muscles. After returning home from the race, ice your muscles with ice packs or (preferably) an ice bath. Ice baths soothe microscopic muscle damage and inflammation. Sit in a 54 to 60-degree (Fahrenheit) ice bath for 6 to 12 minutes. Thirty to 60 minutes afterward, take a warm shower;

• Stretch correctly after the race. After finishing the race, walk for 10 to15 minutes and perform very light stretching. During the next day, perform light stretching and a light warm-up (biking or a warm shower).

• Get a massage a few days after the race. Use caution during the first 48 hours after the race, as your muscles are very sensitive. If you get a massage, schedule it for a few days after the race. Make sure it is a flushing (light) massage and be sure the therapist knows that you just ran a marathon.

• Perform low-impact, low-intensity exercise after the race. Only start exercising when you are feeling ready. This can take up to a month. Cycling, the elliptical, and exercises in the pool (swimming, underwater running) are ideal;

• Wait five to seven days after the race before running again. Begin with decreased intensity on soft surfaces and don’t run more than 25 percent of your peak weekly mileage. A good rule of thumb is: perform one week of reduced intensity training for every hour run.
.
“Feeling sore after a marathon is normal; but pain and swelling are the body’s ways of indicating that something is wrong,” says Brian Halpern, M.D., a primary care sports medicine physician at Hospital for Special Surgery and author of Men’s Health Best Sports Medicine Handbook. “The best way to handle almost every sports injury is the RICE method, which stands for Rest, Ice, Compression and Elevation.”

Experts from Hospital for Special Surgery will also lead the ING New York City Marathon Monday Recovery event at Tavern on the Green. They will discuss different post-race recovery approaches, stretching and provide consultations. For more information on this event, log on to http://www.ingnycmarathon.org/schedule.htm.

Hospital for Special Surgery is an Orthopedic Consultant to the New York Road Runners for the ING NYC Marathon.

Released: 11/1/2011

Source: Hospital for Special Surgery

Related Link:

http://www.newswise.com/articles/sports-medicine-experts-offer-tips-to-help-post-marathon-recovery

New Findings….Obesity Limits Effectiveness of Flu Vaccines

Newswise — People carrying extra pounds may need extra protection from influenza.

New research from the University of North Carolina at Chapel Hill shows that obesity may make annual flu shots less effective.

The findings, published online Oct. 25, 2011, in he International Journal of Obesity, provide evidence explaining a phenomenon that was noticed for the first time during the 2009 H1N1 flu outbreak: that obesity is associated with an impaired immune response to the influenza vaccination in humans.

“These results suggest that overweight and obese people would be more likely than healthy weight people to experience flu illness following exposure to the flu virus,” said Melinda Beck, Ph.D., professor and associate chair of nutrition at the UNC Gillings School of Global Public Health and senior author of the study.

“Previous studies have indicated the possibility that obesity might impair the human body’s ability to fight flu viruses. These new findings seem to give us a reason why obese people were more susceptible to influenza illness during the H1N1 pandemic compared to healthy weight people.”

The study reports for the first time that influenza vaccine antibody levels decline significantly in obese people compared to healthy weight individuals. What’s more, responses of CD8+ T cells (a type of white blood cell that plays a key role in the body’s immune system) are defective in heavier people.

Researchers studied people at a UNC clinic who had been vaccinated in late 2009 with inactivated trivalent influenza vaccine, the common flu vaccine for that fall and winter season. Although obese, overweight and healthy weight individuals all developed antibodies to flu viruses within the first month after vaccination, the antibody levels in the blood declined more rapidly in obese and overweight individuals over time.

About 50 percent of obese participants had a four-fold decrease in antibody levels at 12 months compared to one month post vaccination. However, less than 25 percent of healthy weight participants had a four-fold decrease in antibody levels.

Also, when study participants’ blood samples were tested in the lab and exposed to a flu virus 12 months after vaccination, about 75 percent of healthy weight people’s CD8+ T cells still expressed interferon-γ, an infection-fighting protein. However, only about 25 percent of obese patients’ cells responded by producing the protein.

When vaccination fails to prevent flu infection, people must rely in part on their CD8+ T cells to limit the spread and severity of infection, said Patricia Sheridan, Ph.D., research assistant professor of nutrition and an author on the paper.

“If antibody titers are not maintained over time in the obese individuals and memory CD+ T cell function is impaired, they may be greater risk of becoming ill from influenza,” Sheridan said.

Heather Paich, a doctoral student in Beck’s lab, added: “The findings also suggest overweight and obese people are more likely to become sicker and have more complications. That’s because influenza-specific CD8+ T cells do not protect against infection, but instead act to limit the disease’s progression and severity of disease.”

In 2005, Beck and her colleagues reported that obesity in mice impaired the animals’ ability to fight influenza infections and increased the percent dying from influenza, compared to lean mice with the same infections. In 2010, her team showed that obesity seemed to limit the mice’s ability to develop immunity to influenza, suggesting vaccines may not be as effective in obese and overweight as in healthy weight humans. Also, the fatality rate was higher in obese mice – none of the lean mice died, but 25 percent of the obese mice died.

“This latest study shows that obese people may have a similar impaired response to influenza vaccines as our mouse models did to influenza virus,” Beck said. “We need to continue to study the effect of obesity on the ability to fight virus infections. Influenza is a serious public health threat, killing up to half a million people a year worldwide. As rates of obesity continue to rise, the number of deaths from the flu could rise too. We need to better understand this problem and to look for solutions.”

Along with Beck, Sheridan and Paich, other UNC nutrition department study authors were Erik A. Karlsson, now a postdoctoral research associate, at St. Jude Children’s Research Hospital, and Aileen B. Sammon and Lara Holland, who were undergraduates at the time. Other authors were Michael G. Hudgens, Ph.D., research associate professor of biostatistics in the public health school; and Jean Handy, Ph.D., associate professor of microbiology and immunology, Samuel Weir, M.D., clinical associate professor of family medicine, and Terry L. Noah, M.D., professor of pediatrics, all from the UNC School of Medicine.

For more information or a copy of the study, see: http://www.nature.com/ijo/index.html

Released: 10/20/2011

Source: University of North Carolina at Chapel Hill School of Medicine

Via Newswise

Related Link:

http://www.newswise.com/articles/obesity-limits-effectiveness-of-flu-vaccines

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