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Special 'Strategies' Can Help People With Parkinson's Walk, But Many Patients Unaware

THURSDAY, Sept. 16, 2021 (HealthDay News) -- Movement can be very difficult for people with Parkinson's disease, as shaking and stiffness play havoc with balance, coordination and gait.

There are many different tricks Parkinson's patients can use to improve their walking and avoid injury from a bad tumble — but a new study reveals that people often have to figure them out on their own, with no help from either a doctor or physical therapist.

Nearly one-quarter of Parkinson's patients have never tried well-known strategies proven to help improve movement, according to a report published online recently in Neurology.

"While compensation strategies are commonly used by persons with Parkinson's disease, their knowledge on the full spectrum of available strategies to improve walking are rather limited," said lead author Dr. Anouk Tosserams of the Radboud University Medical Center in the Netherlands.

Parkinson's is a disease of the nervous system that affects a person's ability to control their movement. It causes people to shake, have stiff muscles and limbs, move slowly, and struggle with walking, balance and coordination.

Symptoms worsen over time, and in advanced stages patients will require a wheelchair and full-time nursing care.

The disease stems from a lack of dopamine in the brain, and doctors often prescribe medications designed to combat this deficiency as "standard therapy," said Brett Benedetti, associate director of research programs at the Michael J. Fox Foundation for Parkinson's Research in New York City.

But Tosserams said patients are often left to their own devices to figure out strategies that will help them get around despite their Parkinson's.

"These strategies are typically spontaneously 'invented' by persons with Parkinson's disease," she said. "Until 2019, only anecdotal reports of these creative strategies were published."

That year, a team led by senior researcher Dr. Jorik Nonnekes at Radboud University reviewed hundreds of patient videos to collect 59 strategies, which they categorized into seven groups:

  • Internal cueing, like walking to a count in your head.
  • External cueing, like walking to the beat of a metronome.
  • Changing your balance requirements, such as turning in a wider circle.
  • Altering your mental state, maybe by employing a relaxation technique.
  • Observing other people walking, and visualizing their movement in your mind.
  • Adapting a new walking pattern, like jumping or going backward.
  • Finding other ways to use the legs, like bicycling or crawling.

It's hard to say which of these are better than the others, because it comes down to the individual patient, Benedetti said.

"What may work in one person with Parkinson's with a particular type of gait dysfunction may not work in another," he said. "The approach is going to be something that is going to be more tailored to each individual and what works best for them."

Now that Nonnekes had a list of strategies, he and Tosserams set out to see how many Parkinson's patients knew about them.

Surveying more than 4,300 patients, the investigators found that 35% suffered from walking difficulties bad enough to affect their day-to-day life. About 52% had one or more falls during the previous year.

But nearly one in five (17%) had never heard of these strategies, and 23% had never tried any of them, the researchers reported.

These tricks aren't well-known "because resources on the available strategies are lacking," Tosserams said, adding that researchers previously found that health care professionals also often lack specific knowledge and skills on this subject.

"Persons with Parkinson's disease often invent strategies themselves, but there is no platform via which these new strategies can be shared to inspire other persons with Parkinson's disease and health care professionals," she said.

The best-known strategy was external cueing (47%) followed by internal cueing (45%).

When Parkinson's patients knew about a strategy and tried it, a majority said it had a positive effect on their movement.

For example, 76% said changing their balance requirement helped, and 74% said altering their mental state helped.

But the strategies' effectiveness changed depending on the situation in which patients found themselves.

For example, internal cueing helped patients start walking (73% success rate), but it was less useful when trying to stop walking (47% success rate). Similarly, visualizing movement had an 83% success rate walking outdoors, but only a 55% success rate when trying to navigate a narrow space, the study authors said.

"The symptoms can be highly variable," Benedetti said. "They come and go. They are provoked by certain circumstances that a person finds themselves in, like trying to walk through a doorway or a particular corner or turning around."

Symptoms can also be aggravated by doing other things at the same time.

"Adding a cognitive load or a bunch of tasks while you're walking can make that symptom worse under certain circumstances," Benedetti said.

Patients and their loved ones should bring up their specific movement problems with their health care team, rather than try to figure things out on their own, said Dr. Shyamal Mehta. He is an associate professor of neurology and consultant with the Mayo Clinic's Division of Movement Disorders, in Phoenix, and was not involved with the study.

"It is very important to discuss gait and balance problems with the treating physician when they first begin and not wait until later," Mehta said. "Introduction of the appropriate techniques depending on the problem can go a long way in preventing falls. Many times, the caregiver can remind the patient to use those techniques when they see the patient having difficulties with ambulation."

Tosserams said researchers are working to address this unmet need by developing an online site with information on walking difficulties and compensation strategies for people with Parkinson's.

She said it would contain background information and video-illustrated compensation strategies.

"Persons with Parkinson's disease and health care professionals will also have the opportunity to send us their own videos of new strategies, to inspire others," Tosserams said.

The researchers aim to launch the new website by year's end.

More information

The U.S. National Institute on Aging has more about Parkinson's disease.

SOURCES: Anouk Tosserams, MD, Radboud University Medical Center, Nijmegen, the Netherlands; Brett Benedetti, PhD, associate director, research programs, Michael J. Fox Foundation for Parkinson's Research, New York City; Shyamal Mehta, MD, PhD, associate professor, neurology, and consultant, Mayo Clinic Division of Movement Disorders, Phoenix; Neurology, Sept. 8, 2021, online

White House Offers Nicki Minaj a Call After She Balks on COVID Vaccine

THURSDAY, Sept. 16, 2021 (HealthDay News) -- The White House has reached out to rapper Nicki Minaj over her concerns about the COVID-19 vaccine, which she said had caused swollen testicles in a friend of her cousin in Trinidad.

A White House official said Minaj was offered a call with a doctor to address her questions about the vaccine, after her message went viral on Twitter, various outlets report.

Minaj said on Twitter that she actually had been invited to the White House, but the Biden administration said she simply was offered a call.

"As we have with others, we offered a call with Nicki Minaj and one of our doctors to answer questions she has about the safety and effectiveness of the vaccine," a White House official told CBS News.

Minaj insists she was invited to visit in person. In an Instagram video posted Wednesday night, Minaj said: "Do y'all think that I would go on the internet and lie about being invited to the f****** White House?"

Minaj has faced global backlash after telling her more than 22 million Twitter followers that she would be skipping the Sept. 13 Met Gala in New York City because it required attendees to be vaccinated.

"If I get vaccinated it won't for the Met. It'll be once I feel I've done enough research," she tweeted on Monday. "I'm working on that now."

Minaj followed that up by tweeting that "my cousin in Trinidad won't get the vaccine cuz his friend got it & became impotent. His testicles became swollen. His friend was weeks away from getting married, now the girl called off the wedding."

No one in Trinidad has been able to confirm Minaj's story, Trinidad and Tobago Minister of Health Terrence Deyalsingh said in a news conference Wednesday.

"As we stand now, there is absolutely no reported such side effect or adverse event of testicular swelling in Trinidad, or I dare say … none that we know of anywhere else in the world," Deyalsingh said, according to CBS.

False rumors about the COVID vaccines causing infertility or reproductive problems have been working their way around social media for months, prompting vaccine hesitancy among young adults who want to start families.

U.S. National Institutes of Health Director Dr. Francis Collins said in February that he's "worried, frankly" about these unfounded infertility rumors.

"There are stories out there on the internet about how vaccination can lead to infertility," Collins told the Washington Post. "There's absolutely nothing to that. But when we look at people who are expressing hesitancy, in many instances those are women of childbearing age."

Minaj herself said Monday she'll likely get vaccinated, and even polled her Twitter followers on which vaccine they would recommend.

"A lot of countries won't let ppl work w/o the vaccine. I'd def recommend they get the vaccine. They have to feed their families," Minaj tweeted. "I'm sure I'll b vaccinated as well cuz I have to go on tour, etc."

More information

The U.S. Centers for Disease Control and Prevention has more about COVID vaccines.

SOURCES: CBS News; Washington Post

Robotics Bring the White Cane Into the 21st Century

THURSDAY, Sept. 16, 2021 (HealthDay News) -- The "white cane" that many blind people rely on for navigating the world hasn't been upgraded in a century, but researchers are reporting progress on a "robo-cane" they hope will modernize the assistive device.

The prototype cane is equipped with a color 3D camera, sensors and an "on-board" computer designed to guide the user to a desired location and avoid any obstacles along the way.

There are still issues to hammer out before the robotic cane is ready for the real world, according to lead researcher Cang Ye, a professor at Virginia Commonwealth University's College of Engineering, in Richmond.

The device needs to be made light enough, for example, to be user-friendly. And once the technical details are refined, the cane will face the ultimate test: acceptance among people with visual impairments.

"Is this a device people will really want to use?" Ye said.

The hope is to make it easier for visually impaired people to navigate large, unfamiliar indoor spaces, which can be challenging enough for sighted people, Ye noted.

Right now, people who use white canes can put technology to use in certain ways, according to Ye. There are phone-based apps that help with navigation outdoors, for example.

But big indoor locations are another matter.

In previous versions of the robo-cane, Ye's team tried to address the indoor navigation issue by incorporating building floor plans. Users could tell the cane where they wanted to go, and the cane via voice cues and a motorized roller tip could help guide them to their destination.

But, Ye said, it's difficult for a blind person to, for example, make a completely accurate turn. And over a long distance, little inaccuracies could build up and eventually leave the user in the wrong location.

The latest robo-cane — described recently in the journal IEEE/CAA Journal of Automatica Sinica — seeks to address some shortcomings. The researchers added a small color-depth camera that not only sees features like doorways, stairs and potentially dangerous obstacles like overhangs, but also determines how far away they are.

Using that information, along with data from a special sensor, the cane's on-board computer can guide the user precisely, and alert him or her to obstacles along the way.

"You can kind of view this as a combination of a robotic guide dog and a cane," Ye said.

Dr. Michael Chiang is director of the U.S. National Eye Institute, the federal agency that helped fund the research.

"We've never had so much technology available, and this research is an example of where we can match a human need with science and technology," he said.

It's important that studies not only aim to treat diseases, but also look at ways to "support the whole person," Chiang added.

"We live in a very visual world," he pointed out. "Driving, reading, navigation all rely on visual cues. If you can't see well, it's hard to use many of the devices that get us around in this world."

Chiang said research like the robo-cane project is about "expanding opportunities for people with low vision."

There is no way to predict when a robotic cane might be commercially available. "One of the challenges is turning a proof-of-concept into a real-world product," Chiang said.

Ultimately, he noted, any product will have to be approved by the U.S. Food and Drug Administration as a medical device.

According to Ye, the electronic components of the robotic cane should be durable. The roller tip will likely wear, but Ye said it could be replaced without the need for a whole new device.

Some issues now include refining the cane to work well in indoor places with lots of people walking around like airports and subway stations since all that movement could interfere with the system.

Once such a next-generation device is available, Ye said, "it will be ready to test for acceptance in the visually impaired community."

More information

The U.S. National Library of Medicine has more on vision impairment.

SOURCES: Cang Ye, PhD, professor, computer science, College of Engineering, Virginia Commonwealth University, Richmond; Michael Chiang, MD, director, National Eye Institute, Bethesda, Md.; IEEE/CAA Journal of Automatica Sinica, August 2021

AHA News: Physical Activity Is Helpful After a Stroke, But How Much Is Healthy?

THURSDAY, Sept. 16, 2021 (American Heart Association News) -- Jeff Vallance jump-started every day with a 4-mile run. It woke him up and kept him feeling fit. As an expert in chronic disease management, he knew the importance of staying active.

He also knew the signs of a stroke. When his right foot started to go numb, scuffing the sidewalk and making him stumble on his daily jog, he grew concerned. Then his right arm started to tingle, followed by the right side of his face.

"I started talking to myself, and I could hear my speech changing," he said. "The right side of my mouth did not want to work like the left side."

Vallance knew what it meant because he remembered the lifesaving acronym FAST: Face drooping, Arm weakness and Speech difficulties meant it was Time to call 911. He was having a stroke.

What he didn't know was how difficult it was going to be to recover, or that it would be well over a year before he felt safe enough to return to his daily runs.

"For years, I have told all of our research participants with chronic disease to get out there and be active," said Vallance, a professor and Canada Research Chair in Health Promotion and Chronic Disease Management at Athabasca University in Alberta, Canada. "I never realized the incredible amount of fear and apprehension the individuals must have felt."

Research supports staying physically active during stroke recovery. In a 2014 scientific statement, the American Heart Association recommended doctors prescribe low- to moderate-intensity aerobic activity, muscle-strengthening activity, reduction of sedentary behavior and risk management to prevent a second stroke.

Guidelines from the AHA published in May offer more specifics. For patients who are capable, it calls for moderately intense aerobic activity for at least 10 minutes four times a week, or vigorous activity for a minimum of 20 minutes, twice a week.

For those with mobility problems, the guidelines recommend seeking a supervised exercise program with a health care professional, such as a physical therapist or cardiac rehabilitation specialist.

But the guidelines apply generally. And Vallance quickly learned little was known about how exercise might affect his particular situation.

"I was stunned when my neurologist and cardiologist advised me to refrain from vigorous exercise and heavy lifting," Vallance said.

Vallance had an ischemic stroke, most likely caused by a patent foramen ovale, or PFO, an opening between the two upper chambers of the heart. It allowed blood, and a clot, to leak from the right side of the heart to the left during exertion. His doctors cautioned that continued exertion could send blood clots straight to the brain and trigger a second stroke. Until that hole could be closed, they said, he shouldn't exert himself too much.

An avid distance runner, Vallance had been running for 25 years. The thought that doing one of the things he loved most could potentially harm him was terrifying. He looked for guidance on what he could do while he waited for the procedure to close the hole in his heart.

But he found little in the scientific literature. Researchers only recently confirmed that closing the hole following a stroke was even necessary since PFOs, estimated to occur in about 1 in 5 adults, typically don't cause serious problems.

Investigators still have a lot to learn about exercise and stroke recovery, said Sandra Billinger, director of the Research in Exercise and Cardiovascular Health laboratory at the University of Kansas.

"It wasn't that long ago that exercise was thought not to be good for people after stroke. The research is still in its infancy," said Billinger, lead author of the AHA's 2014 scientific statement.

A study from May in the journal Stroke found exercising for at least 150 minutes per week for at least 12 weeks after a stroke helped improve health-related quality of life measures, such as mental health. Other studies over the past two decades show exercise during stroke recovery can help with physical fitness, walking and balance.

"But here we are 20 years later, and we're still looking for the exact prescription," Billinger said.

Overall, maintaining some type of physical activity during recovery is what's important, she said. "People think of exercise as running a marathon, or running for an hour, and that's not really necessary. It's about reducing sedentary time."

Billinger recommends patients try "brisk walking or going up and down stairs. If people can't walk long distances or go up and down stairs, we recommend walking at the pace they can, or going to a health center or gym where maybe they can use a recumbent bike or stepper and just get their heart rate up."

Stroke survivors should speak with health care professionals about how much exercise is appropriate, she said. If they have mobility issues, they should consult with a physical therapist about how to be active without increasing the risk for a fall.

In neighborhoods where safety may be an issue, group activities at community recreation centers or churches can help, Billinger said.

She'd like to see supervised rehabilitation programs for people recovering from strokes that are similar to those for people recovering from heart problems. Research shows cardiac rehabilitation, which includes physical activity, education and counseling, can help prevent second heart attacks and aid recovery.

Such programs also could provide education on blood pressure management, which is a significant factor in preventing second strokes, and advice on eating and sleeping well. "All of those things contribute to the prevention of second strokes," Billinger said. "But we don't do this for people who have had strokes."

With the help of his physiotherapist, Vallance individualized his own exercise program to balance his need for physical fitness with the risk of too much exertion. Because of the pandemic, Vallance had to wait more than a year to get the procedure to close the hole in his heart.

"It wasn't until I had the procedure that I was able to start slowly exercising again and build my body and fitness level back up," he said.

And he did, gradually extending his runs to 5, then 10 miles. This summer, he pushed himself to complete an ultramarathon in his hometown in the Rocky Mountains of British Columbia. It covered about 35 miles of rugged mountain terrain.

"I feel like I'm back now," he said. "My body's back to where I can feel safe. That was my goal – to push myself again without having to worry about the possibility of having another stroke."

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Laura Williamson

Statin Cholesterol Drugs May Help Fight Ulcerative Colitis

THURSDAY, Sept. 16, 2021 (HealthDay News) -- Millions of people take statins to lower their cholesterol, and new research suggests these drugs may also ease ulcerative colitis.

An inflammatory bowel disease with no real cure, ulcerative colitis causes sore spots on the lining of the colon that can lead to rectal bleeding, diarrhea and cramping. Treatment typically involves anti-inflammatory drugs and/or removal of part or all of the colon (colectomy). Ulcerative colitis affects nearly 1 million Americans.

"Statins have been known to have an anti-inflammatory effect for quite some time," said lead researcher Purvesh Khatri, an associate professor of medicine and biomedical data science at Stanford University. "Our study provides strong evidence in support of further investigations to identify the mechanism of action."

It found that patients with ulcerative colitis who were also taking atorvastatin (Lipitor) were less likely to be hospitalized and had about a 50% decrease in colectomy rates.

Khatri said the finding is significant as fully 30% of people with ulcerative colitis eventually undergo the procedure.

Exactly how, or even if, statins affect ulcerative colitis is not fully understood yet, researchers emphasized.

For the study, they analyzed genetic data from hundreds of patients who had undergone a colon biopsy. Then they used data from lab studies to investigate how certain approved drugs reversed the genetic signature of ulcerative colitis.

Three drugs seemed to do the trick: two were chemotherapy drugs and the other was atorvastatin. Researchers said chemotherapy drugs have too many side effects to be considered for this purpose.

A review of electronic health records of people revealed that long-term use of atorvastatin provided more protection than short-term use.

"Our results support additional investigation into the use of atorvastatin for treating patients with ulcerative colitis," Khatri said. "Trials are needed to confirm whether and how much atorvastatin treatment would benefit patients with ulcerative colitis."

Researchers said they plan to see if the benefits hold with other available statins.

The findings will appear Sept. 16 in the Journal of the American Medical Informatics Association.

Outside experts who weighed in after reviewing the findings caution that it's too soon to draw any conclusions about what role statins may play in treating ulcerative colitis.

But given the scarcity of treatment options, the study is a "welcome experiment to see if a commonly used medication, the cholesterol drug atorvastatin, could be used for ulcerative colitis," said Dr. Elena Ivanina, director of neurogastroenterology and motility at Lenox Hill Hospital in New York City.

"Atorvastatin has been shown to have anti-inflammatory effects including the reduction of colitis in animal models of inflammatory bowel diseases, therefore, reinforcing that this medication could be a potential treatment," she said.

But Ivanina added that large clinical trials will be required to understand if atorvastatin does have an impact on ulcerative colitis and colectomy rates.

Dr. Hamed Khalili, associate director of the clinical and translational epidemiology unit at Massachusetts General Hospital in Boston, agreed.

"I think this kind of innovation is helpful because it explores the potential therapeutic role of established and already approved medications for ulcerative colitis," he said. "The data is too preliminary to recommend statin as a treatment and more studies are needed."

More information

The American College of Gastroenterology offers more on ulcerative colitis and its treatments.

SOURCES: Purvesh Khatri, PhD, associate professor, medicine and biomedical data science, Stanford University, California; Elena Ivanina, DO, MPH, director, neurogastroenterology and motility, Lenox Hill Hospital, New York City; Hamed Khalili, MD, MPH, gasterenterologist and associate director, clinical and translational epidemiology unit, Massachusetts General Hospital, Boston; Journal of the American Medical Informatics Association, Sept. 16, 2021

Do Your Genes Up Your Odds for Alcoholism? One Factor Cuts the Risk

THURSDAY, Sept. 16, 2021 (HealthDay News) -- Even when genetics and personality are working against you, having a strong network of supportive friends and family may help lower alcoholism risk, researchers say.

"Genes play an important role in alcohol use," stressed Jinni Su, an assistant professor of psychology at Arizona State University in Tempe, and lead author of a new study.

But "genes are not our destiny," she added.

For the study, her team analyzed links between genetic makeup, personality traits, social support and alcoholism risk among more than 2,800 men and women aged 18 to 65.

The researchers found that adults with an elevated genetic risk for problem drinking were likely to have thrill-seeking personalities, Su said.

But they also found that strong social support from friends and family was protective against drinking.

"Family and friends can play an important role in helping their loved ones who might struggle with alcohol problems by, for example, providing emotional support or helping to identify and engage in activities that channel their genetic predispositions in healthy ways," Su explained.

In day-to-day life, she said, that can simply mean egging on high-risk, sensation-seeking friends to get their thrills from rock-climbing, rather than drinking.

Still, the study team underscored prior research indicating that about half of the risk for developing a drinking problem sources back to genetic predisposition.

All of the study participants were European Americans enrolled in a study on the genetics of alcoholism, launched in 1991.

All underwent initial assessments and follow-up testing that stacked DNA analyses up against drinking behavior. Participants also completed personality questionnaires designed to establish how much they were drawn to sensation-seeking situations.

One sample question: Do you prefer wild, uninhibited parties or quiet parties with good conversation?

Lastly, participants were asked to discuss how much moral, emotional and social support they perceived having received from friends and family.

The result? Those who inherited a high risk for alcohol abuse were also more likely to be sensation-seekers and more likely to drink excessively.

At the same time, "we found that people with higher genetic risk for alcohol misuse are more susceptible to having poor social relationships," said Su. Investigators specifically cited lower levels of family support among heavy drinkers.

But the inverse, she noted, was also true: Perceiving "strong social support from friends and family was protective against drinking, particularly among people who had elevated genetic risk and sensation-seeking tendencies."

More broadly, Su said that the study's highlighting of the strong and complex interaction between social support, genetics and personality can be extremely helpful to efforts to help rein in excessive drinking.

"This finding gives us a possible pathway to help individuals with genetic risk channel their predisposition in healthy ways," she said.

Michael Pollard, a senior sociologist with the RAND Corporation, echoed similar thoughts.

"We already know that social support is protective against all kinds of negative outcomes, including alcohol use disorder," said Pollard, who is also a professor at the Pardee RAND Graduate School in Santa Monica, Calif.

"But this study," he said, "helps put a link between social support and genetic predisposition by identifying its role in reducing sensation-seeking," in an effort to help curb problematic drinking habits.

Pollard cautioned that the study "measured perceptions of support, not necessarily whether the support is actually available." This means people with alcohol use disorder may be less aware of the real level of help they might be able to get from family members, he explained.

Still, he acknowledged that perceived problems often become real problems, particularly among older adults "who often have fewer friends to rely on than younger adults."

Research funding came from the U.S. National Institute on Alcohol Abuse and Alcoholism and the U.S. National Institute on Drug Abuse. The findings were published recently in the Journal of Abnormal Psychology.

More information

See how families can address alcoholism risk at the U.S. Substance Abuse and Mental Health Services Administration.

SOURCES: Jinni Su, PhD, assistant professor, psychology, Arizona State University, Tempe; Michael S. Pollard, PhD, senior sociologist, RAND Corporation, and professor, Pardee RAND Graduate School, Santa Monica, Calif.; Journal of Abnormal Psychology, July 1, 2021

In 16 States, 35% or More Residents Now Obese: CDC

THURSDAY, Sept. 16, 2021 (HealthDay News) -- America's waistline keeps widening.

On Wednesday, the U.S. Centers for Disease Control and Prevention announced that 16 states now have at least 35% of their residents who are obese, a number that's nearly doubled since 2018.

The CDC's 2020 Adult Obesity Prevalence Maps now show that Delaware, Iowa, Ohio and Texas have joined Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia with high rates of obesity.

One expert said the unhealthy move towards more obese Americans isn't surprising.

"While COVID may be an accelerator, the trends have been going on for a long time," said Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City. "This is the consequence of changes in our food supply and increased consumption of processed foods."

He believes the ease of access to unhealthy, processed foods — often cheaper and easier to prepare than fresh, unprocessed foods — means that Americans increasingly eat high-calorie, low-nutrient fare.

So, said Roslin, "if you go with the flow and are not proactive, obesity and insulin resistance have become the norm." Insulin resistance is a precursor to diabetes.

The CDC pointed to notable racial and ethnic disparities around obesity, as well. Some states and territories did not have sufficient data to break down the issue by race and ethnicity, but among those that did, 35 states and Washington, D.C., had an obesity prevalence at or above 35% among Black residents, 22 states had reached that level for their Hispanic residents, and seven states had that prevalence among white residents.

"The ethnic disparities to some extent can be explained by socioeconomic factors," Roslin said. "Real food that is not processed costs more money. Fresh fruit and vegetables are expensive. So are animal products and fish that are only given natural foods."

No states had an obesity prevalence at or above 35% among Asian residents. However, some studies have suggested that health risks associated with obesity may occur at a lower body mass index for people who are Asian.

Obesity remains a huge health concern in the United States because obesity brings increased risks for heart disease, stroke, type 2 diabetes, certain cancers and even poorer mental health, the researchers said in a CDC news release.

Sharon Zarabi is a registered dietitian and program director at Northwell Health's Katz Institute for Women's Health, in New York City and Westchester. She believe it's getting tougher for Americans to resist the lure of cheap, high-calorie foods.

"Look around — there is no surprise that obesity rates have been proliferating over the past decade," Zarabi said. "We live in a world where food is ubiquitous, highly processed, and just tastes really good. Oreo cookies have almost 20 varieties of flavors — how can you pass that up?"

Being "cooped up" at home during the pandemic hasn't helped trim waistlines, she added. But there are simple lifestyle changes that can help.

"If we start the day with a high-protein, high-fiber breakfast, and continue listening to our hunger and satiety cues throughout the day with whole foods, we will feel more energized, walk around with less inflammation and be better able to function at our best," Zarabi said.

As for the nation as a whole, solutions to the obesity epidemic include a "sustained, comprehensive effort from all parts of society," according to the CDC. This includes addressing poverty, a lack of health care access and other equity issues that can be contributors to health disparities.

On an individual level, people should also talk regularly to their health care provider about their body mass index, family history, lifestyle and health risks, the CDC team advised.

More information

The Commonwealth Fund has more on the obesity crisis in the United States.

SOURCES: Sharon Zarabi, RD, program director, Northwell Health's Katz Institute for Women's Health, New York City and Westchester; Mitchell Roslin, MD, chief, obesity surgery, Lenox Hill Hospital, New York City; U.S. Centers for Disease Control and Prevention, news release, Sept. 15, 2021

Hospitalizing the Unvaccinated Has Cost U.S. Nearly $6 Billion

THURSDAY, Sept. 16, 2021 (HealthDay News) -- The cost of providing hospital care for unvaccinated Americans has reached $5.7 billion in just three months, CBS News reported.

Between June and August, about 287,000 people who were not vaccinated were hospitalized for COVID-19 in the United States, according to data from the Kaiser Family Foundation (KFF) and the Peterson Center on Healthcare, which collaborated to track health care costs and quality.

Most adults in the United States have had access to vaccines since the spring, so these hospital stays could likely have been avoided, the study authors noted.

In the new report, the KFF-Peterson team used data from the U.S. Centers for Medicare and Medicaid Services to estimate the average cost of hospitalization with COVID-19 at $20,000 per person. They then calculated the overall expense at $5.7 billion.

"This ballpark figure is likely an understatement of the cost burden from preventable treatment of COVID-19 among unvaccinated adults," the authors wrote, noting that the study doesn't account for outpatient costs.

According to the U.S. Centers for Disease Control and Prevention, compared to fully vaccinated people, those who are unvaccinated are 11 times more likely to die from COVID-19.

This study factored in that vaccines are effective in preventing severe illness and hospitalization, and the occurrence of breakthrough infections in fully vaccinated people.

The expense of health care for people with COVID-19 is "borne not only by patients but also by society more broadly, including taxpayer-funded public programs and private insurance premiums paid by workers, businesses and individual purchasers," according to the authors of the report.

These shared costs – for copays, coinsurance or payments toward a deductible – have not always been passed on to the patient, but they soon could be.

As of November 2020, nearly 90% of insured individuals would have had their out-of-pocket costs waived if they were hospitalized for COVID-19, according to the report. Now, more than 70% of the largest insurers are not waiving treatment costs. Another 10% will phase out cost-sharing by the end of next month, CBS News reported.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

SOURCE: CBS News

Health Highlights: Sept. 16, 2021

Here are some of HealthDay's top stories for Thursday, Sept. 16:

NIH spending nearly $470 million on long-haul COVID study. "Some people have had their lives completely upended by the major long-term effects of COVID-19," said Dr. Francis Collins, director of the National Institutes of Health. A major research initiative involving 30 institutions is being launched to better understand long-haul symptoms. Read more

Why are more American babies being born with syphilis? According to new CDC data, the number of infants born with congenital syphilis has now reached levels not seen for 25 years. Rising rates of drug abuse and a lack of access to prenatal care may be partly to blame, researchers say. Read more

Hospitalizing the unvaccinated cost U.S. more than $5.7 billion. At roughly $20,000 per case, and with more than 287,000 such cases occurring between June and August, the financial burden of hospital care for Americans who haven't gotten vaccinated is soaring. It's all so unnecessary, experts say. Read more


Why Are More U.S. Babies Being Born With Syphilis?

THURSDAY, Sept. 16, 2021 (HealthDay News) -- The number of U.S. infants born with syphilis is climbing at an alarming pace, reaching a high not seen since the 1990s, according to new government figures.

Newborn syphilis, a potentially fatal condition, was at one time nearly eliminated in the United States. But the disease has seen a resurgence in recent years — and 2020 was no exception, say researchers with the U.S. Centers for Disease Control and Prevention.

So far, there have been more than 2,000 known cases of newborn syphilis among U.S. infants born in 2020. That's up from 2019, and it continues a steep upward trend that began several years ago.

"It's the highest number we've seen in 25 years," said Virginia Bowen, lead author of a CDC report published Sept. 16 in the New England Journal of Medicine.

Syphilis is a sexually transmitted bacterial infection that, left untreated, can cause serious health problems. One consequence is congenital syphilis, which is passed from mother to baby during pregnancy.

Congenital syphilis can have "devastating" effects, Bowen said — including miscarriage, stillbirth, newborn death and, in infants, complications such as deformed bones, blindness and hearing loss.

Congenital syphilis is on the rise because of a broader problem: More Americans than ever have sexually transmitted infections, including gonorrhea, chlamydia and syphilis.

"This is really a direct reflection of what we're seeing among women and their male partners," Bowen said.

Less than 20 years ago, syphilis was virtually non-existent in the United States. In the intervening years, however, the disease has come roaring back. In 2019, almost 130,000 syphilis cases were reported nationwide, according to the CDC — a 74% increase from 2015.

Why? There are certain factors that put people at increased risk of syphilis, Bowen said.

Drug abuse is one such factor, and the nation's opioid epidemic has been cited as a reason for the syphilis surge. A 2019 CDC study found that in recent years, a growing percentage of women and heterosexual men with syphilis reported using methamphetamine, heroin or other injection drugs.

At the same time, public health resources aimed at STD prevention, screening and treatment have dwindled, according to David Harvey, executive director of the National Coalition of STD Directors.

The organization, which represents public health department STD directors, said that since 2003, the CDC's division on STD prevention has been funded at a 40% reduction.

"The one federal agency focused on STD prevention has been starved of funding for the past 20 years," Harvey said.

The fortunate thing about syphilis is that it's easily cured with antibiotic injections, even as little as one. That's why it once was virtually vanquished.

However, that also means most Americans see syphilis as a disease of the past. Even among health care providers, many may not have it on their radar, Harvey and Bowen said.

To help prevent congenital syphilis, the CDC says all pregnant women should be screened for the disease at their first prenatal visit. Women at increased risk — because of high syphilis rates in their local area, for instance — should be screened again in the third trimester and at delivery.

Even when a pregnant woman has the infection, antibiotic treatment can prevent her from passing it on to her baby.

Yet, other CDC research has found, congenital syphilis still occurs, in part, because some women lack timely prenatal care. In other cases, they are in prenatal care, but screening or treatment are not done on time.

"That's a failure of the system," Harvey said.

Bowen agreed. "We don't need to have any congenital syphilis cases in the U.S.," she said.

Yet as of July 29, the CDC had received 2,022 reports of congenital syphilis among U.S. infants born in 2020. That number already surpasses the 1,870 cases reported for 2019, and will likely be higher once the reporting period ends in October, the agency reported.

While prenatal care is vital to battling newborn syphilis, Bowen said, the first line of defense is syphilis prevention in adults.

She encouraged people to talk with their health care provider about prevention and testing. "Don't be afraid to ask frank questions," Bowen said. "This is preventable and treatable."

Harvey made similar points. "Know your risk factors for sexually transmitted infections," he said. "Get tested regularly at a local clinic or your doctor's office, and use barrier protection, including condoms."


More information

The U.S. Centers for Disease Control and Prevention has more on congenital syphilis.

SOURCES: Virginia B. Bowen, PhD, MHS, Division of STD Prevention, U.S. Centers for Disease Control and Prevention, Atlanta; David C. Harvey, MSW, executive director, National Coalition of STD Directors, Washington, D.C.; New England Journal of Medicine, Sept. 16, 2021

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