First major study of diet and strokes links fried, sugary Southern diet, low on fruits and vegetables, to increased risk

Genuine Kentucky fried platter:
Cornbread, fried catfish, fried green
tomatoes, fried apples and fried okra
(Photo from Ramsey's, Lexington)

By Molly Burchett
Kentucky Health News

People with a Southern diet, or one heavy on fried food and sugary drinks like sweet tea and soft drinks, are more likely to suffer a stroke, a new study finds.

It's the first big look at diet and strokes, and researchers say it might help explain people in the nation's "stroke belt" or southern states suffer more of them, reports Marilynn Marchione of The Associated Press.

These findings have important implications for Kentuckians because stroke accounts for 5.5 percent of Kentucky deaths each year and more than 81 percent of Kentucky adults eat fruit and vegetables fewer than 5 times a day, which is a indicator of risk for stroke:

Heart Disease and Stroke Risk Factors from federal Behavioral Risk Factor Surveillance System national survey	Ky.	U.S.
Eat fruits and vegetables less than 5 times/day	81.6	75.6
Overweight or obese	69.1	62.9
No moderate or vigorous physical activity	55.8	50.5
High total blood cholesterol	38.5	37.6
High blood pressure	30.0	27.8
Cigarette smoking	28.2	19.8
Diabetes	9.9	8.0

"We're talking about fried foods, french fries, hamburgers, processed meats, hot dogs," bacon, ham, liver, gizzards and sugary drinks, said the study's leader, Suzanne Judd of the University of Alabama in Birmingham.  For the study, a southern diet also included jerky, red meat, eggs, and whole milk.


Fried foods tend to be eaten with lots of salt, which raises blood pressure and sweet drinks increases risk for diabetes- both are known stroke risk factors, Judd said.

People who ate about six meals a week featuring these sorts of "Southern" foods had a 41 percent higher stroke risk than people who ate that way about once a month, researchers found.

In contrast, people whose diets were high in fruits, vegetables, whole grains and fish had a 29 percent lower stroke risk, reports Marchione.

"It's a very big difference," Judd said. "The message for people in the middle is there's a graded risk" — the likelihood of suffering a stroke rises in proportion to each Southern meal in a week. 

These findings were reported last week at the American Stroke Association conference. The study was launched in 2002 to explore regional variations in stroke risks and reasons for them.

Stroke death rates in Kentucky vary widely among counties. Here's a county map of the rates, from KentuckyHealthFacts.org, which has a county-by county list:

The map shows stroke rates in ranges per 100,000 population from 2003 through 2007. Purple counties had rates above 69; blue counties ranged from 52 to 69; turquoise were 44 to 52; light blue were 31 to 44 (the number that is about the national average), and tan were 18 to 31.

Five Facts about Stroke for the Caregiver

If your loved one has suffered a stroke, there's no doubt that you're going through a very difficult and frightening time. The National Stroke Association tells us that over 750,000 people in America each year suffer a first or recurrent stroke, and one in 55 Americans are living with the effects of a stroke. If you are caring for someone who has recently had a stroke, here are five facts that you need to know:

1.It's All in the Head

Many people are confused when it comes to exactly what a stroke is. To understand stroke, think of it as a sort of "brain attack." When a blood clot interrupts the blood flow to an area of the brain, a stroke results. During a stroke, brain cells can die due to a lack of oxygen. As brain cells die, the abilities that are controlled by that particular area of the brain become impaired. Typically, these abilities include memory, speech and movement.

2.Effects on the Survivor

Because not every person is the same, every stroke is different. Each person is affected by stroke in different ways. On average, a stroke survivor can expect to have impaired mobility, memory loss, depressions, communication problems, muscle spasticity, and difficulty in performing daily tasks that require manual dexterity. A stroke survivor can incur one of these results or a combination of them. The resultant issues of a stroke can last for weeks, months or for the rest of the survivor's life.

3.Rehabilitation

If your loved one has had a stroke, his or her needs for rehabilitation therapy may vary. Each stroke patient will need to undergo some form of rehabilitation immediately after leaving the hospital. Your loved one may receive rehabilitation services directly from the hospital, from a specialized rehab hospital or even in a nursing home. If your loved one's stroke was mild, he or she may be able to undergo a course of rehabilitation at home. It's also important to note that rehabilitation may take as little as a few weeks and as long as several years.

4.Recovery Rates

As a caregiver, you should know that recovery rates among stroke victims vary widely. Of stroke victims, only ten percent recover completely. Twenty-five percent will recover with only minor physical impairments, 40 percent will require special care due to moderate to severe impairments, ten percent will requpire long-term care, and 15 percent die within days, weeks or months of suffering their stroke.

5.As a Caregiver

Caring for a loved one who has suffered a stroke can be a tiring, overwhelming process. It's not unusual caregivers to encounter feelings of guilt and depression. As the caregiver of someone who has suffered a stroke, it's important to remember that you can't do it all. Find help when you need it from friends and family members. You may also want to consider hiring a part-time nurse who can relieve you of your duties, even if it's only one day a week. Don't forget to take time for yourself; it doesn't make you a bad person. Keep in mind that the healthier you are both physically and mentally, the better equipped you will be to care for your loved one.

If your loved one has suffered a stroke, arming yourself with the facts will make the process that follows a stroke less overwhelming. If you are directly related to the person who has suffered a stroke, don't neglect to have your own risk assessed. A simple blood test, conducted as part of an annual physical, can tell you if you are at high risk for stroke.

John Martin writes articles for health blogs and suggests having blood work done one of the Tennessee lab testing locations.

One S.C. county serves as incubator for state's efforts to battle weight problems, with some good results

PE teacher Sharon Williams, right,
leads morning exercises before
classes start at Bells Elementary.
(The State photo by Tim Dominick)

With nearly two-thirds of South Carolina deemed overweight or worse, lucky Colleton County got picked to be a test case for doing better. That is, for improving its chances to beat the state's already overwhelming rates of diabetes, heart disease and stroke and for helping to lower the state's $1.2 billion dollar medical bill. Lucky, because in 2010, the county was awarded almost a half million Eat Smart Move More grant by the BlueCross BlueShield of South Carolina Foundation to see if it could promote health eating and more physical exercise countywide. Joey Hollerman of The State newspaper in Columbia, S.C., reports that "the results have been striking," though he notes that changing obesity numbers is "like turning an aircraft carrier, it's a slow process." Mostly, he's talking about attitude and perseverance.

How does the county-wide program work on a daily basis? First, of course, you have to have buy-in, which this county did. Hollerman explains that now when children arrive at Bells Elementary School in the county seat of Walterboro, "they go straight to the gym and walk laps before heading to classrooms. Worshipers at Power of Faith Delivery Ministry harvest collards as well as souls, and fried chicken is discouraged at church dinners. The local farmers market has a sparkling new home and a system set up to accept cards from the Supplemental Nutrition Assistance Program." The Let’s Go, Eat Smart program and exercise programs are posted in schools, workplaces, grocery stores and churches.

So how, if the numbers aren't clear yet, how to measure if it's working? Well, only one fried chicken basket showed up at a recent church supper and the member who brought it ended up apologizing for her breach. On the day the reporter visited only the elementary school only one child in the entire first grade tried to slip through without selecting a fruit or vegetable. He was sent back and grabbed a plastic container of grapes from the Go (instead of the Slow or Whoa) food options, Hollerman reports. There are also anecdotes galore, including those of children, once on insulin, who are now fine without it.

South Carolin's BlueCross BlueShield recently awarded another grant to Eat Smart Move More, in part to continue the work in Colleton County but also to for expand it to other communities. (Read more)

Women who smoke triple their risk of dying early, but quitting early enough might just wipe out that risk

A new study of more than a million women found that smokers have more than triple the risk of early death than nonsmokers, and that quitting can virtually eliminate the increased risk. Smoking is still the most preventable cause of death in the United States and the United Kingdom.

The University of Oxford study, published this week in the British medical journal The Lancet, included 1.3 million women between the ages of 50 and 65, making it one of the largest ever conducted on smoking. At the start of the study, in 1996, 20 percent of the women were smokers, 28 percent were former smokers and 52 percent had never smoked. "Each of the women was registered in the U.K.’s national health system, so their deaths and cause of death were recorded," explains Alexandra Sifferlin of Time magazine. "By 2011, 66,000 had passed away." Researchers found that even smokers who smoked as few as nine cigarettes a day had twice the mortality rate of nonsmokers.

"More encouraging, however," writes Sifferlin, "was the positive effect that quitting seemed to have on the women’s life span. Those who quit smoking before they reached 40 avoided more than 90 percent of the increased risk of premature death from cigarettes, while women who stopped even earlier -- before age 30 -- avoided 97 percent of the added risk." (Read more)

Study: Stroke victims getting younger and, yes, risk factors include obesity, diabetes and high cholesterol

A study conducted on first-ever stroke patients in the Greater Cincinnati and northern Kentucky area may have some devastating repercussions for the nation. The results of the University of Cincinnati research, published this week in the online issue of Neurology, found that the average age of stroke victims has dropped and that this has great implications for lifetime disability. Study author Brett Kissela, MD, with the UC's College of Medicine explained that the rise in risk factors like diabetes, obesity and high cholesterol are the cause. Newswise reports that the study found that strokes among people under 55 made up a greater percentage of all strokes over time, growing from about 13 percent in 1993-94 to 19 percent in 2005. The study was funded by the National Institutes of Health.

"What [the study] means is that even though young people typically feel like they're healthy and that a stroke can't happen to them, the fact is that our study is evidence that that is not true," said Kissela.“The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise. However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease.” (Read more)

18 Kentucky hospitals cited as 'top performers' on accreditation board's annual list

Eighteen Kentucky hospitals have been included on the annual list of hospitals that have excelled at adhering to basic procedures for surgery and other treatment of common illnesses such as heart attacks, heart failure and pneumonia. The Joint Commission, the nation’s major hospital accreditation board, has released this year's list of 620 hospitals considered to be “top performers” for following recommended protocols at least 95 percent of the time. The top 18 percent of accredited hospitals make the list.

Among the Kentucky hospitals that qualified on all four measurements were Greenview Hospital in Bowling Green, Ephraim McDowell Regional Medical Center in Danville, St. Elizabeth Medical Center in both Florence and Fort Thomas, Central Baptist Hospital in Lexington.

Those qualifying in three categories were the Robley Rex Veterans Affairs Medical Center in Louisville (not in surgery) and the Appalachian Regional Hospitals in Harlan and Middlesboro (not in heart attack).

Qualifying in two categories were Twin Lakes Regional Medical Center in Leitchfield, Frankfort Regional Medical Center, the Hospital of Louisa and Jackson Hospital Corp., all for pneumonia and surgical care.

Recognized for pneumonia care were Parkway Regional Hospital in Fulton, Paul B. Hall Regional Medical Center in Paintsville, Logan Memorial Hospital in Russellville and the KentuckyOne Health Hospital in Martin.

Among behavioral-health hospitals, ranked on their in-patient psychiatric care, the Kentucky facilities on the list were the Universal Health Services facility in Bowling Green, the new Cumberland Hall Hospital in Hopkinsville.

According to Kaiser Health News, the Leapfrog Group, a nonprofit organization devoted to patient safety, aided in the rankings process, as did Consumer Reports. The Commission has its own metrics. It's worth noting that next month, Medicare will start using hospital quality rankings on its Hospital Compare website to set reimbursements. (Read more)

Report: Two-thirds of Kentuckians obese by 2030 if trends continue; cost to nation's future unquestionably high

Nearly two-thirds of adults in Kentucky will be obese by 2030 if rates continue to climb as they are now, an analysis reported Tuesday. The level of obesity, defined as being roughly 30 or more pounds overweight, is projected to reach 60.1 percent in Kentucky in 2030, up from 30.4 percent in 2011, according to an analysis commissioned by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation. Nancy Hellmich and Laura Ungar of The Courier-Journal in Louisville report that if states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020, and double again by 2030. Medical costs associated with treating preventable obesity-related diseases could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually. (Read more)

The joint report also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index (BMI) of their residents by just 5 percent by 2030. Doing so would spare millions of Americans serious health problems, and the country could save billions of dollars in health spending. See the interactive map showing how much improvement could be made if that small change were made here.

The report also features a series of joint policy recommendations from TFAH and RWJF, including full implementation of the Healthy, Hunger-Free Kids Act, protection of the federal health reform law's Prevention and Public Health Fund, and inclusion of additional physical education and activity components in the Elementary and Secondary Education Act. To download the full report, go here. 

5 Reasons You Need Your Sleep, and 5 Reasons You May Not Be Getting It

Fall bustles with the start of school and the continual grind at work. It's easy to skimp on your rest. We've got five reasons for you to make sleep a priority, and five health issues that could be ruining your rest.

1. Plenty of R&R (rest and relaxation) can boost your mood, focus and energy. Conversely, people with poor sleep habits experience higher levels of stress, depression and anxiety.
2. Want your kids to get A's and B's? Make sure they catch their Z's. Well-rested equals alert in the classroom, and a regular sleep routine may boost math and literacy scores. Some schools are even starting later in an effort to help kids improve learning.
3. Reap the benefits of beauty sleep. When the body is sleep-deprived it produces more of the stress hormone cortisol. Cortisol can cause weight gain and oily skin.
4. Getting your eight hours in could cut your risk for chest pain, heart attack and stroke. A recent study by West Virginia University indicates that people who sleep five hours daily are more than twice as likely to experience these problems.
5. Rest is a responsibility, and apparently so is justice. In a study that appears in SLEEP, Swedish naval officers were more likely to act morally and make moral judgments when fully rested.

Maybe you want to get your shut-eye but can't quite get your eyes to shut? Sleeplessness plagues 60 million Americans. These are just a few health problems that could be keeping you up at night:

1. Your thyroid helps regulate your sleep patterns. An overactive thyroid (hyperthyroidism) can cause difficulty sleeping, fatigue and irritability.
2. Believe it or not, menstruation can affect your sleep patterns. Two in three women experience menstrual insomnia disturbed sleep due to tossing and turning and general menstrual discomfort.
3. Maybe you do sleep, but continue to experience tiredness regardless of how much sleep you get? If you snore, have a dry throat on waking or regularly become irritable, you may want to talk to your doctor. This could be a symptom of sleep apnea.
4. Your sweetie slumbers soundly while you lay awake at night, so you decide to wake him up. Sound familiar? Ladies, you may have a case of sleep envy. You're not alone, either. Up to 40 percent of women envy the ease with which their darlings doze. Jealous much?
5. Some people toss and turn through the night before finding sleep. If this is caused by painful or irritating tingling or tugging in your lower limbs, you may have a condition known as restless leg syndrome (RLS).

Want to keep up with the latest sleep science? Visit the National Sleep Foundation site or check out the journal SLEEP.

Eating more Fruits and Vegetables

It's almost June, which means you have a little more than six months to finally complete that New Year's weight loss resolution. Now a study offers two simple changes that may help you reach your goal: Stop sitting in front of the television and start eating more fruits and vegetables.

While these health tips might seem obvious, it's their long-term sustainability that has scientists praising their virtues. According to the Northwestern University Feinberg School of Medicine study published in the May 28 issue of Archives of Internal Medicine, by making these adjustments you'll be more likely to maintain these habits to lead a healthier lifestyle.

Sedentary lifestyle tied to diabetes, heart disease, premature death: Is TV to blame?
Sitting too much may double your risk of dying, study shows

"Just making two lifestyle changes has a big overall effect and people don't get overwhelmed," Dr. Bonnie Spring, a professor of preventive medicine at Northwestern University Feinberg School of Medicine, said in a press release. "Americans have all these unhealthy behaviors that put them at high risk for heart disease and cancer, but it is hard for them and their doctors to know where to begin to change those unhealthy habits," Spring said. "This approach simplifies it."

In the study, 204 adult patients between the ages of 21 to 60 with elevated saturated fat and low fruit and vegetable intake, high sedentary leisure time and low physical activity were placed in one of four treatment categories. One group had to increase fruit and vegetable intake, another had to decrease fat and sedentary leisure, yet another decrease fat and increase physical activity (otherwise known as traditional dieting) and the last group had to increase fruit/vegetable intake and decrease sedentary leisure. Patients had to record their daily results for three weeks and were coached remotely through mobile technology. If the patients met their goals and displayed healthy lifestyle changes, they would receive $175.

On average, daily fruit and vegetable intake increased from 1.2 servings to 5.5 servings, sedentary leisure time decreased from 219.2 minutes per day to 89.3 minutes, and daily saturated fat decreased from 12.0 percent to 9.5 percent of calories consumed. The group that participated in traditional dieting reported fewer improvements than the other groups.

Then, the participants were given the option of continuing to report their lifestyle. They did not have to keep up with the dietary or exercise recommendations and would receive monthly payments just for turning in their data three times each month for six months.

Ninety-eight percent of the test subjects opted to continue with the second 20-week phase of the study. Out of the 185 people who continued on, 86.5 percent said they tried to "definitely" or "somewhat" maintain what they did in the three-week treatment period even without the financial or mobile encouragement.

What's even more surprising is they seemed to maintain the healthy habits of eating more fruits and vegetables and decreasing sedentary activity without receiving any financial incentive to do so. Though the patients did not increase their healthy behaviors in the six month follow-up, they made "substantial" improvements in watching less television and eating more vegetables compared with their rates when the study started. It is worth noting, however, that those who traditionally dieted for the most part did not carry healthy habits through the second part of the experiment, especially when it came to increasing physical activity.

"We said we hope you'll continue to keep up these healthy changes, but you no longer have to keep them up to be compensated," Spring said. "We thought they'd do it while we were paying them, but the minute we stopped they'd go back to their bad habits," she said. "But they continued to maintain a large improvement in their health behaviors."

The results suggest that even a short period of encouraging healthy lifestyles through coaching and incentives may have a lasting effect. Considering that according to the Centers for Disease Control and Prevention, more than one-third of U.S. adults - 35.7 percent - are obese, and obesity has been linked to heart disease, stroke, type 2 diabetes and certain types of cancer, taking these simple steps could make a big difference.

By: Michelle Castillo

Penny-per-ounce tax on sugar drinks could save $17 billion, cut consumption and prevent disease and death, academics say

More than $17 billion in medical costs over 10 years could be saved if sugared drinks were taxed at 1 cent per ounce, and it would prevent 95,000 cases of coronary heart disease, 8,000 strokes and 26,000 premature deaths, say researchers at Columbia University and the University of California.

The tax would mean an extra 12 cents per can or 20 cents per bottle, and would generate about $13 billion in annual tax revenue. The study, published in this month's HealthAffairs, found the consumption of sugary drinks, including soda, sports drinks like Gatorade and energy drinks like Red Bull, would be cut by 15 percent among adults ages 25 to 64.

"Even our conservative estimates show that a penny-per-ounce tax on sugar-sweetened beverages could substantially reduce the negative health and financial impacts of obesity, diabetes and cardiovascular disease," said Dr. Y. Claire Wang, assistant professor at the Mailman School of Public Health at Columbia  and lead author of the study. "Putting the money raised by the tax into efforts to prevent obesity and other health problems could potentially increase the impact of such a policy."

In 2009, Americans consumed 13.8 billion gallons of sugar-sweetened beverages, which translates to about 45 gallons per person. The average 20-ounce bottle of a sugar drink contains almost 17 teaspoons of sugar. (Read more)