TUESDAY, Aug. 19 (HealthDay News) -- The obesity epidemic in America has gotten worse -- not better -- in the last year, despite public service campaigns warning about the health risks posed by carrying too much weight, a new report found.

Adult obesity rates increased in 37 states, while there were no decreases in any states, according to the annual report released Tuesday by the nonprofit Trust for America's Health and the Robert Wood Johnson Foundation.

The obesity rates rose for a second consecutive year in 24 states and for a third consecutive year in 19 states, according to the report, F as in Fat: How Obesity Policies Are Failing in America, 2008".

More than 25 percent of adults are obese in 28 states, up from 19 states last year. And more than 20 percent of adults are obese in every state except Colorado. In 1991, no state had an obesity rate greater than 20 percent.

Eleven of the 15 states with the highest obesity rates are in the South. Northeastern and Western states have the lowest obesity rates.

"Despite widespread acknowledgement that obesity is endangering the health of millions of Americans, the country is still failing to respond clearly or comprehensively," Dr. Risa Lavizzo-Mourey, president and chief executive officer of the Robert Wood Johnson Foundation, said in the news release. "We must work together, governments, schools and communities, to improve nutrition and increase physical activity for all ages. We must ensure that strong policies are implemented and enforced in every state, not only to help reverse existing obesity rates, but to prevent obesity among our nation's children and generations to come."

The five fattest states and their obesity rates are Mississippi (31.7 percent), West Virginia (30.6 percent), Alabama (30.1 percent), Louisiana (29.5 percent) and South Carolina (29.2 percent). The five slimmest states are Colorado (18.4 percent), Hawaii (20.7 percent), Connecticut (20.8 percent), Massachusetts (20.9 percent), and Vermont (21.1 percent), according to the report.

An estimated two-thirds of Americans are now overweight or obese. That compares to 1980, when the national average of obese adults was 15 percent.

Obesity is defined as a body mass index -- BMI, a ratio of weight to height -- of 30 or more. A person who is 5-feet, 8-inches tall and weighs 197 pounds has a BMI of 30.

The report said that rates of type 2 diabetes -- a disease typically associated with obesity -- increased in 26 states last year. Four states now have diabetes rates above 10 percent. And all 10 states with the highest rates of diabetes and high blood pressure are in the South.

Besides type 2 diabetes, obesity has been linked to coronary heart disease and stroke, cancer, osteoarthritis, gall bladder disease, liver disease and pregnancy complications, according to the U.S. National Institutes of Health.

The report also noted a relationship between poverty and obesity rates. It found that seven of the 10 states with the highest obesity rates are also among the 10 states with the highest poverty rates.

While a number of promising policies designed to promote physical activity and good nutrition have been introduced in communities, the report's findings suggest that these policies aren't being adopted or implemented at levels sufficient to reverse the obesity epidemic.

"America's future depends on the health of our country. The obesity epidemic is lowering our productivity and dramatically increasing our health care costs. Our analysis shows that we are not treating the obesity epidemic with the urgency it deserves," Jeffrey Levi, executive director of Trust for America's Health, said in a news release. "Even though communities have started taking action, considering the scope of the problem, the country's response has been severely limited. For significant change to happen, combating obesity must become a national priority."

Among the report's other findings:

• While all 50 states and the District of Columbia have passed laws related to physical education and/or physical activity in schools, only 13 states include language to enforce the laws. Of these states, only four have sanctions or penalties if the laws are not implemented.
• While the Dietary Guidelines for Americans were updated in 2005, the U.S. Department of Agriculture school meal program has yet to adopt the recommendations.
• Eighteen states have enacted laws requiring school meals to exceed USDA nutrition standards. But, only seven of these laws have specific enforcement provisions, and only two state laws include sanctions if its requirements aren't met.
• Ten states do not include specific coverage for nutrition assessment and counseling for obese or overweight children in their Medicaid programs.
• Twenty states explicitly do not cover nutritional assessment and consultation for obese adults under Medicaid.

The report offered a series of recommendations to combat the obesity epidemic, including investing in community-based disease-prevention programs that promote physical activity and good nutrition; improving the nutritional quality of foods available in schools and child-care programs; increasing the amount and quality of physical education and activity in schools and child-care programs; encouraging employers to provide workplace wellness programs; and requiring public and private insurers to provide preventive services, including nutrition counseling for children and adults.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about obesity.

MONDAY, Aug. 11 (HealthDay News) -- It may, in fact, be possible to outrun death -- and even the creeping ravages of time -- at least for a while.

Research spanning two decades has found that older runners live longer and suffer fewer disabilities than healthy non-runners.

And the findings probably apply to a variety of aerobic exercises, including walking, said the study authors, from Stanford University School of Medicine, whose findings are published in the Aug. 11 issue of the Archives of Internal Medicine.

"This is telling you that being a runner, being active is going to reduce your disability, and it's going to increase your survival," said Marcia Ory, professor of social and behavioral health at the Texas A&M Health Science Center School of Rural Public Health in College Station. "Late in life, you still see the benefit of vigorous activity."

In 1980, the study's lead author, Dr. James Fries, emeritus professor of medicine at Stanford, wrote a landmark paper outlining his "compression of morbidity" hypothesis. The theory held that regular exercise would compress, or reduce, the amount of time near the end of life when a person was disabled or unable to carry out the activities of daily living, such as walking, dressing and getting out of a chair.

"Illness would be compressed between later age of onset and age of death, and that paradigm was controversial, because it went against conventional wisdom and had no proof," Fries explained.

At the time, many experts believed that vigorous exercise would actually harm older individuals. And running, in particular, would result in an epidemic of joint and bone injuries.

But this new study proves otherwise.

Two hundred and eighty-four runners and 156 healthy "controls," or non-runners, in California completed annual questionnaires over a 21-year period. The participants were 50 years old or over at the beginning of the study and ran an average of about four hours a week. By the end of the study period, the participants were in their 70s or 80s or older and ran about 76 minutes a week.

At 19 years, just 15 percent of the runners had died, compared with 34 percent of the non-runners.

Also, said Fries, who is almost 70, runs 20 miles a week and plays tennis, "Running delayed the onset of disability by an average of 16 years, and that is largely a conservative number, because the control group was pretty darn healthy."

And the slew of predicted orthopedic injuries never materialized.

Surprisingly, the health gap between runners and non-runners only increased with time. "I always thought that the two curves would start to parallel each other and that eventually aging would overpower exercise," Fries said. "I think that will happen, but we can't find even a little twitch toward that gap narrowing in the present time."

Which is not to say that running is the only activity that's good for you.

"Vigorous activity has a really dramatic impact, but we can't ignore that there are also helpful benefits to people who are active at all levels, meaning those people who are just out walking" said Ory. "It's so important to be physically active your whole life, not just in your 20s or 40s, but forever."

Added Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City: "Exercise is like the most potent drug. Exercise is by far the best thing you can do."

More information

Visit the U.S. National Institute on Aging for more on healthy aging.

TUESDAY, July 29 (HealthDay News) -- Despite high levels of smoking, Japanese men are far less likely to have dangerous plaque build-up in their blood vessels than white or Japanese-American men, a difference that researchers believe stems from a lifelong, near-daily consumption of fish.

"Japanese living in Japan eat fish every day, about 100 grams every day," said study author Dr. Akira Sekikawa, an assistant professor of epidemiology at the Graduate School of Public Health at the University of Pittsburgh in Pennsylvania. "They also have very low rates of coronary heart disease, even with a high rate of smoking and other risk factors."

Results of the study are in the Aug. 5 issue of the Journal of the American College of Cardiology.

Current American Heart Association (AHA) guidelines recommend eating oily fish, such as salmon or albacore tuna, at least twice a week if you don't have heart disease. If you already have heart disease, the AHA suggests getting at least one gram of omega-3 fatty acids daily, preferably from fatty fish. However, the AHA cautions that you shouldn't consume more than two grams of fish oil daily without first consulting your doctor, because of a risk of excessive bleeding.

Sekikawa's study included 281 Japanese men, 306 white American men, and 281 Japanese-American men. Along with giving blood samples, all of the men underwent electron beam computed tomography (EBCT) to measure coronary artery calcification (plaque deposits on the heart's arteries) and ultrasound examinations of the carotid artery in the neck.

Overall, the researchers found that Japanese-American men had the highest number of heart disease risk factors of all three groups. They had the highest average body-mass index, blood pressure, triglycerides and the highest levels of diabetes.

The Japanese men living in Japan had far higher rates of smoking -- 47 percent -- and smoking is one of the most significant heart disease risk factors.

But they had significantly less coronary artery calcifications and less build-up in their carotid arteries.

The levels of omega-3 fatty acids in the blood were 9.2 percent for men living in Japan, 3.9 percent for white men, and 4.8 percent for Japanese-American men. Yet, Japanese-American men had more coronary artery calcifications and more build-up in their carotid arteries than the white men and the men in Japan.

"Fish is an important factor in keeping the Japanese healthy," said the author of an accompanying editorial, William Harris, director of the Metabolism and Nutrition Research Center, Sanford Research/USD, in Sioux Falls, S.D.

"The combination of increased fish oil and a low saturated fat diet is probably the best way to lower heart disease risk. Eskimos have a diet high in omega-3s, but also high in saturated fat, and they don't have the same low levels of heart disease," he added.

Harris said what's important is to consume fish or fish oil on an ongoing basis. "A month of supplements won't get you there," he said. But, if you don't like fish, he said that fish oil supplements can also improve your health, but he suggested that you read the supplement label and make sure that each capsule contains one gram of omega-3s. And, he said, they don't have to be expensive to be effective.

If you don't have heart disease, he said, two grams a day "is more than adequate." And, if you like fish, that's even better.

"Choose oily fish, not fried fish, but fish that naturally contain omega-3s, like salmon, sardines, albacore tuna, herring and mackerel, and you need to eat about two 4-ounce servings a week," Harris added.

More information

To learn more about fish, omega-3s and heart health, visit the American Heart Association  .

THURSDAY, July 10 (HealthDay News) -- For years, scientists have known that flavonoids, antioxidants found in foods as diverse as fruit, vegetables, herbs, grains and chocolate, are heart-healthy.

Now, researchers who looked at the effects of flavonoid-rich foods on cardiovascular disease risk factors such as high blood pressure have linked certain foods with specific benefits.

Health benefits associated with flavonoids have been reported for decades, but it's still difficult for experts to make specific recommendations about which flavonoids to eat for specific health effects because of a lack of data. Antioxidants slow or prevent the oxidative process caused by substances called free radicals, which can cause cell dysfunction and the onset of heart disease and other health problems.

In the new study, Dr. Lee Hooper, a lecturer at the University of East Anglia in Norwich, U.K., and colleagues sifted through the 133 studies to look at the links between different flavonoid subclasses and flavonoid-rich foods on different risk factors for cardiovascular disease, such as unhealthy cholesterol, high blood pressure and blood flow.

Among the findings:

• Eating chocolate or cocoa increased a measure called flow-mediated dilation, which is a good indication of blood flow in the veins. It also reduced blood pressure, both systolic (the upper number, reflecting the maximum pressure exerted when the heart contracts) by about 6 points, and diastolic (the bottom number, reflecting the maximum pressure when the heart is at rest), by about 3.3 points. But it didn't seem to have an effect on so-called "bad" LDL cholesterol.
• Soy protein reduced diastolic blood pressure by almost 2 points of mercury and improved bad cholesterol but didn't improve so-called good HDL cholesterol. But those effects were found just for isolated soy protein, not for other soy products.
• A habit of green tea drinking reduced bad cholesterol levels, but drinking black tea boosted both systolic and diastolic pressure -- by 5.6 points for systolic and 2.5 for diastolic.

As more research on flavonoids becomes available, it is likely that no single one will emerge as a "miracle food, but that many will contribute to our cardiovascular health," said Hooper, whose review was published in the July issue of The American Journal of Clinical Nutrition.

The new review helps define the role of foods rich in antioxidants, said Dr. Johanna Geleijnse, a nutritional epidemiologist at Wageningen University, the Netherlands, who co-authored an editorial to accompany the report.

"Evidence is accumulating that these substances are more important to cardiovascular health than vitamin C and vitamin E," and this most recent analysis strongly suggests good effects on blood pressure and blood vessel function, she said.

But much remains to be found out, she added.

Meanwhile, what to do? Eat a good mixture of the flavonoid-rich foods you like best, said Hooper. "For me, this would include lots of fruit, small amounts of a good dark chocolate (at least 70 percent cocoa), plus the basics like onions and green tea and an occasional glass of red wine."

More information

To learn more about flavonoids, visit the American Dietetic Association  .