by Gary Varvel, originally uploaded by the Health Advocate.

The World Health Organization has now increased it’s pandemic alert to phase 5 which means there has been human-to-human spread of the H1N1 virus (swine flu) into two or more countries.  Most of the cartoonist commenting on the recent events surrounding swine influenza took the ‘just when you thought it couldn’t get any worse approach’ but this piece by Varvel was just a little bit different. In underscoring some of the basics for avoiding the spread of contagious disease, it actually made me chuckle. What about you?

by Steve Kelley, originally uploaded by the Health Advocate.

It is simply undeniable, our diets really do affect our health and overall risk for disease. This week, cartoonist Steve Kelley reminds us.

The prevalence for different types of cancer varies greatly according to the race and ethnicity of the population in question.  For example:

• While the gap (as compared to non-Hispanic whites has narrowed since 1991) black Americans are more likely to develop and die from cancer than any other racial or ethnic group. The most common cancers among men in 2009 are projected to be prostate (34%), lung (16%), and colorectal (10%) cancer, and among women, breast (25%), lung (12%), and colorectal (11%) cancer. For all cancer types, blacks are far more likely to be diagnosed in advanced stages of disease, when the cancer is less treatable.  Blacks are also less likely than whites to survive 5 years after a diagnosis, regardless of cancer type and stage of diagnosis.
• Cancers associated with viral infection are the most common caners in Hispanics/Latinos. Women have the second highest number of cases of cervical cancer (which is often caused by human papillomavirus) while cases of liver cancer (which is often caused by the hepatitis virus) are twice as high in Hispanic men and women as in non-Hispanic whites.
• Asian Americans/Pacific Islanders are more likely to develop and die from both liver and stomach cancers than all other racial or ethnic groups (except in the case of stomach cancer where their prevalence and death rates are second to those of blacks).

Racial and ethnic minorities have less access to cancer screening

Medical researchers focusing on areas of health care disparities continue investigations to elucidate these figures. The interrelationship between multiple factors continues to yield reasons that are complex.

“Rates are driven by social and economic factors,” says Ahmedin Jemal, PhD, ACS Department of Epidemiology and Surveillance Research. “In the African American population, there’s far less utilization of screening. For example, in 2005, 44% of African Americans were screened for colorectal cancer, compared to 51% of whites.”

Other research reveals this failure to access care through regular recommended screening is true across all racial/ethnic minority groups. Surveys show that about a third of Hispanic/Latinos and 20% of blacks have no coverage at all. The consequences are significant as people who don’t get mammograms, colon exams, and Pap tests on schedule are more likely to be diagnosed with a cancer at a later stage in the disease, when survival rates are lower.

“Having health insurance coverage is the single greatest determinant of access to health care services,” explained Eve Nagler, ACS Director of Special Populations.

Access Resources:

Use this CDC interactive map to locate National Breast and Cervical Cancer Early Detection Program low-cost and free screening resources near you.

Sources:

Cancer’s Racial Gap Narrowing yet Challenges Persist. In ACS News Center. American Cancer Society.  Cited April 22, 2009. Available at <http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Cancers_Racial_Gap_Narrowing_Yet_Challenges_Persist.asp>

Cancer Is A Burden, Finding Help Should Be. In In the Spotlight.  American Cancer Society. Cited April 22, 2009.  Available at <http://www.cancer.org/docroot/SPC/content/SPC_1_Cancer_Is_a_Burden_Finding_Help_Shouldnt_Be.asp>

Bridging the Disparity Gap.  In In the Spotlight.  American Cancer Society. Cited April 22, 2009.  Available at <http://www.cancer.org/docroot/SPC/SPC_0.0.asp>

Racial and ethnic minority populations continue to grow such that by mid-century, Latino, black and Asian populations are expected to represent the majority of people living in the US, according to the Census Bureau.  This is already the case for the nation’s largest metropolitan areas and it is increasingly becoming the case in smaller communities fueled by the growing Latino population.  In light of this fact, minority health and health disparities among racial and ethnic minorities is not a issue for special populations but rather an issue that concerns us all especially as we examine the health status of the population as a whole.  Nevertheless, the third week in April (19-25) is set aside as National Cancer Minority Awareness Week.

Do race and ethnicity affect cancer risk?

Each year, cancer statistics continue to show that minority groups are more likely than the general population to develop and/or die from certain types of cancer.  As researchers continue to unravel the multiple contributing factors to this issue there are things that individuals can do for themselves.

About fifty percent of cancer deaths can be prevented through regularly scheduled screenings, healthy eating, regular physical activity and quitting tobacco use. However, minorities continue to have lower screening rates than whites; report less leisure-time activity than recommended – less than the recommended 30 minutes of moderate-to-vigorous physical activity above usual activities on five or more days per week; and consume less fruits, vegetables and whole grains. The American Cancer Society recommends eating five or more servings of fruits and vegetables each day, choosing whole grains in preference to processed grains and limiting consumption of processed and red meats.

(click through the image link)

Despite  health disparities, race and ethnicity are only two among several factors that contribute to cancer risk.  This personal cancer risk profile tool (developed by the University of Texas MD Andersen Cancer Center) can help you begin to assess your own risk for cancer. This questionnaire will determine specific actions you can take to reduce your risks for developing cancer and/or to make sure that you identify the disease in the earliest, most treatable phase.

Learn More at The American Cancer Society website and MD Andersen Cancer Center website

Fitness Friday. If a journey of a thousand miles begins with just one step, this might be the next step (at least for walkers).  Last month, I discussed walking as one of the easiest and most reliable forms of physical activity to incorporate into a fitness lifestyle.  Another key to staying active is setting goals and staying motivated.  Pedometers (digital devices that count steps) are excellent devices for reaching fitness goals in aerobic (or cardio) activity*. Yet, it wasn’t until recently (November 2007) that scientist conducted the research that proves this.  The physician Dena Bravata led a group of Stanford University scientists in a systemic review of studies that used pedometers to increase physical activity and ultimately improve health.  In their research, which was published in the Journal of the American Medical Association, they concluded that pedometer usage combined with specific goal setting and exercise logs resulted in significant increases in physical activity.  Previously sedentary patients increased their physical activity by nearly an additional mile of walking per day.  More importantly, they found a significant reduction in blood pressure.  A reduction associated with decreasing the risk of stroke in middle-aged patients in previous studies.

The best way to add a pedometer to your walking program is to first count, then assess, your daily steps after one full week of use to establish your baseline.  You then increase that number incrementally. For many of us,10,000 steps a day (roughly the equivalent of 5 miles) is a lofty goal.  You might enjoy The 20% Boost Program at pbs.org because it helps you gradually build up from your baseline.  A pedometer when combined with goal-setting is an easy way to track your progress and also motivate you to stay active on a given day until you’ve met your goal.  Dr. Bravata and her colleges concluded:

“Despite the abundance of lay literature on the use of pedometers, our study is the first published synthesis of the evidence. Our results suggest that the use of these small, relatively inexpensive devices is associated with significant increases in physical activity and improvements in some key health outcomes, at least in the short term. The extent to which these results are durable over the long term is unknown.”

Who among you uses exercise logs or diaries?  How do logs and goal-setting help you get the most out of your walking workout?  Leave me a comment sharing the ways you’ve discovered to get an urban (or suburban) aerobics workout.  The best comment will win a pedometer. (Comments will close on Friday, April 3.)

*Note:  The American College of Sports Medicine and the 2008 Physical Activity Guidelines for Americans each advise adults to get at least 30 minutes of moderate-intensity activity no less than 5 days of the week

Sources:

Bravata, D.M., Smith-Spangler, C. et al. Pedometers to Increase Physical Activity and Improve Health:  A Systematic Review [Electronic Version]. JAMA. 2007;298(19):2296-2304. Available at <http://jama.ama-assn.org/cgi/content/full/298/19/2296#AUTHINFO>

The 20% Boost Program: Fit Walking into Your Life.  In America’s Walking: Personal Health & Fitness.  Cited March 27, 2009.  Available at <http://www.pbs.org/americaswalking/health/health20percentboost.html>

Chapter 4:  Active Adults. In Physical Activity Guidelines for Americans [Electronic Version]. Cited March 27, 2009.  Available at  <http://www.health.gov/PAGuidelines/guidelines/chapter4.aspx>

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Why is Diabetes Alert Day important?

• 23.6 million children and adults in the U.S. have diabetes
• Nearly one-quarter of those do not know they have diabetes
• One in five Americans is at risk for developing type II diabetes

For many, diagnosis may come seven to ten years after the onset of the disease. Therefore, early diagnosis is critical to successful treatment and delaying or preventing some of its complications such as heart disease, blindness, kidney disease, stroke, amputation and death.

Everyone should be aware of the risk factors for type 2 diabetes. People who are overweight, under active (living a sedentary lifestyle), and over the age of 45 should consider themselves at risk for the disease. African Americans, Latinos, Native Americans, and people who have a family history of the disease are at an increased risk for type II diabetes.

Watch this video to learn more.

Source: This post was a excerpt from: 21st Annual Diabetes Alert Day. In Community Programs and Local Events. Alexandria, VA: American Diabetes Association. [cited March 22, 2009] Available at <http://www.diabetes.org/communityprograms-and-localevents/ american-diabetes-alert.jsp?WTLPromo=FNLP_alert>

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"At Honest Tea, we are alarmed by the obesity epidemic gripping our nation. Super-sweet beverages loaded with high-fructose corn syrup are often blamed for America’s growing waistlines." from the Honest Beverages website

A common question to tea drinkers has been sugar or honey? But if your tea is already sweetened and comes in a can or a bottle it is most likely sweetened with high-fructose corn syrup (HFCS). Competition from companies like Honest Beverages forced Snapple to re-evaluate its own ingredients list recently. High-fructose corn syrup is an artificial sweetener and preservative that is created when one of the sugars contained in cornstarch is converted from glucose to fructose. The result is a sweetener that is made up of both glucose and fructose. This extremely sweet substance extends the shelf life of processed foods. And it is these two characteristics that have helped high-fructose corn syrup become such a widespread food ingredient since the late 1970s. In fact,

“HFCS now represents more than 40 percent of caloric sweeteners added to foods and beverages and is the sole caloric sweetener in soft drinks in the United States,” according to George A. Bray, Samara Joy Nielsen and Barry M. Popkin, the authors of a commentary in the April 2004 issue of the American Journal of Clinical Nutrition.

Unfortunately, research has yielded conflicting results to date regarding the impact of high-fructose corn syrup on the body and health. It is believed to be a hidden culprit in the rise of obesity and type II diabetes in Americans. This is because some studies have shown that fructose unlike glucose is metabolized (or used) by the body in a different manner, so that it is converted to fat more readily than is glucose. At the same time, it bypasses the release of leptin, a hormone (or chemical messenger) that tells your brain you’re satiated (or full). The results of other studies (some of which have been privately funded by the beverage industry) suggest that HFCS does not behave any differently in the body than other sweeteners. Obviously, strict moderation is the key if your goal is to eat right. Be aware of high-fructose corn syrup on the labels of foods you purchase and eat. If it’s one of the first ingredients listed, then that item contains a large amount of HFCS and is probably not the best choice if you also want to get some nutritional value from the calories you consume. In general, limiting the processed foods you eat and choosing fresh, whole food alternatives (as I discussed in a previous post on veganism) will help a great deal. The announcement of changes to the Snapple line of beverages is just one of several examples of the need to read food labels closely and critically. Other foods that you might not expect to contain HFCS include: fruit flavored yogurt, frozen yogurts, fruit juices with added sweeteners, juice cocktail beverages, and fruits canned in heavy syrup.

What types of foods have you been surprised to learn contained high-fructose corn syrup? Leave a comment and let me know.

Sources:

Mohr, C.R. (2005, May). Is This Disguised Sugar Affecting Your Diabetes [Electronic Version]. Diabetes Health.

High-fructose corn syrup: What are the concerns? In Nutrition and Healthy Eating: Expert Answers. October 24, 2008. http://www.mayoclinic.com/ health/high-fructose-corn-syrup/AN01588
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Tomorrow, March 12 is World Kidney Day. Last month we discussed how heart disease is the leading cause of death for American women. Unfortunately, too few Americans realize that chronic kidney disease is another life-threatening illness that often goes undetected until it reaches very advanced stages. Two common conditions that can lead to or exacerbate chronic kidney disease are high blood pressure and diabetes. Take some time on World Kidney Day to learn more about what your kidneys do for you and what you can do for your kidneys (to keep them healthy). Also, don’t forget as we focus on nutrition this month that both high blood pressure and type II diabetes can be significantly controlled, if not alleviated with the right type of diet and regular moderate to intense physical activity (consult your doctor for specific recommendations).

Learn More:

Take these 6 Steps for protecting your kidneys and your health.

10 Facts about Diabetes and Kidney Disease

10 Facts about High Blood Pressure and Kidney Disease

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Featured Health Observance. National Nutrition Month® is an education and information campaign created by the American Dietetic Association. This makes the month of March a good time to focus our attention on the importance of making informed food choices and developing sound eating habits. Diet and exercise create a solid foundation for our health and wellness. You may not be fully aware, however just how much diet and exercise also contribute to the presentation and progression of chronic conditions like obesity, diabetes, hypertension and heart disease. Here at enBloom, we will follow the lead of the American Dietetic Association and focus on how to eat right because healthy choices can help us all live longer and richer lives.

In keeping with the broader concept of the relationship between diet and disease, we will also feature the following health observances this month so keep an eye out for ways to take part and educate yourself around these issues.

March 12. World Kidney Day

March 24. American Diabetes Alert Day

Just how much do you already know about how to eat right? Take the quiz here.

Peruse the nutrition bookshelf for additional materials on healthy snacks for kids, smart food shopping, and healthy recipes.

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Fitness Friday. Last month in the debut post of this series, I emphasized the importance of integrating fitness routines into your lifestyle for lasting success. Walking is an ideal fitness choice for several reasons. Walking

• Can be done almost anywhere
• Has a low-impact on the body
• Requires no practice
• Requires no equipment (save a good comfortable pair of shoes)
• and it’s FREE

There are also several essential health benefits from lowering your blood pressure to strengthening back muscles and bones. This is great because it extends your mobility and independence as you age. In fact, the original Report of the Surgeon General on Physical Activity and Health (1996) found that the most popular leisure-time physical activities among adults were walking and gardening/yard work. I personally enjoy walking because it fits easily into what I’ve come to call urban aerobics. Fooling myself into getting that heart rate up works better for me than a dedicated work out where I have nothing to do but think, “ok I’m working out now…breath rate…increasing…heart rate…quickening”. With urban aerobics, I walk to the Metro station. Often I’ll choose the next closest metro (rather than the closest). It also includes taking the stairs or walking while on the escalator. Walking to the corner market and the local grocery store are also frequent activities. The key is to keep moving briskly for no less than a 10-minute duration. What I’m describing is consistent with the Surgeon General’s recommendation to accumulate 30 minutes of moderate-intensity activity most days of the week. Enough, that is to reduce your risk for disease and help you lead a longer, healthier life. You may have even heard that walking 10,000 steps in a day (roughly the equivalent of 5 miles) is one such way to achieve this goal.

from MayoClinic.com

Getting started

As an old proverb states, the journey of a thousand miles begins with just one step. Taking that step now to initiate and maintain a walking fitness routine can set you on the path toward many of the health benefits discussed earlier. The professionals at the Mayo Clinic have a few recommendations to get your walking routine started.

• Begin gradually by walking only as far or as fast as you find comfortable. Then, over several weeks’ time, you can gradually work your way up to 30 to 60 minutes of walking most days each week.
• Use proper technique by using the correct posture and movements is essential. (Take a minute to study the photo above.)
• Measure the intensity of your workout. As you walk, measure the intensity of your workout by checking your heart rate. Knowing your heart rate allows you to increase the intensity to maximize your workout or slow down to avoid overdoing it.

For even more on fitness and walking, check out The Complete Guide to Walking for Health, Weight Loss, and Fitness on the bookshelf (widget) to the right. As you work walking into your fitness routine, please share with me the ways you’ve discovered to get an urban (or suburban) aerobics workout.

Sources:

1996 Report of the Surgeon General on Physical Activity and Health at www.cdc.gov 2008 Physical Activity Guidelines for Americans at www.health.gov and Walking for fitness: How to trim your waistline, improve your health at MayoClinic.com

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