Most Americans Oppose Soda, Candy Taxes

They say it's not government's role to try to influence what people eat, drink, Harris Interactive/HealthDay poll finds

By Amy Norton

HealthDay Reporter

THURSDAY, April 25 (HealthDay News) -- Most U.S. adults aren't sweet on the idea of soda and candy taxes, and many doubt the bigger price tags would trim the national waistline.

That's the finding of a new Harris Interactive/HealthDay poll released Thursday. In the online survey of more than 2,100 adults, respondents were opposed to government taxes on sugary drinks and candy by a more than 2-to-1 margin.

Between 56 percent and 58 percent said no to such taxes, while only 21 to 23 percent were in favor.

"This is a strong vote against the 'nanny state,'" said Humphrey Taylor, chairman of The Harris Poll.

"The idea of taxing calorie-rich candies and sodas may be popular with some public health advocates, who see them as major causes of the nation's obesity epidemic, but it is very unpopular with the public," Taylor said.

The poll results come at a time of rising debate over the potential health impact of taxing "junk food." Many U.S. states do have sales taxes on soda, but they are small -- and not aimed at driving down Americans' thirst for sugary drinks, said Kelly Brownell, a professor of psychology at Yale University and co-founder of the school's Rudd Center for Food Policy and Obesity.

"Sales taxes were intentionally kept small so they wouldn't affect consumption," said Brownell, a long-time advocate of a bigger tax that would make consumers think twice about that sugary drink.

For several years, Brownell and his colleagues have pushed for a penny-per-ounce excise tax on sweetened beverages (not just soda). That would ultimately boost the cost of sweet drinks by about 20 percent. And unlike sales taxes, which consumers do not see until they get to the cash register, excise taxes show up on the sticker price -- when people are making the decision to buy or not.

In a 2011 study, Brownell's team estimated that a national penny-per-ounce tax would cut Americans' sugary drink intake by one-quarter. The researchers also projected that the tax could generate $79 billion in revenue over five years.

A number of states and local governments have proposed such a tax, but they've gone nowhere.

The proposals have popped up in states like Vermont and Texas, big cities like New York and Philadelphia, and in smaller communities. Last year, voters in two California cities, Richmond and El Monte, rejected ballot initiatives that would have levied sugary-drink taxes.

The respondents in the Harris Interactive/HealthDay poll echoed those voters. Besides disliking the taxes, many doubted the potential health benefits -- 51 percent disagreed with the statement, "Sales taxes on candies and sodas would help to reduce obesity." Only 26 percent agreed.

A bigger percentage seemed to have a philosophical opposition to such taxes: Two-thirds agreed with the statement, "It should not be the role of government to influence what we eat and drink to make healthier choices."

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Many Americans Breathing Cleaner Air: Report

By Carina Storrs
HealthDay Reporter

WEDNESDAY, April 24 (HealthDay News) -- Although many Americans are now breathing cleaner air, others are living in cities that are more polluted than they were a decade ago, a new report shows.

"The long-term trend is positive and headed to much cleaner air," said report author Janice Nolen, assistant vice president of national policy and advocacy for the American Lung Association. "[However], there is an uptick in some areas that are a concern and some areas where the problem remains very, very serious."

The report, conducted by the American Lung Association, measured the levels of ozone and small particles in the air, known as soot, in almost 1,000 cities and counties in the United States between 2009 and 2011. About half of the 25 most polluted cities had improved since last year's report, and many of those cities were the cleanest they had been since the association began the research in 2000.

Unfortunately, the other half of the 25 most polluted cities was worse off. Even among the cities that improved, many were still near the top of the most-polluted list, including Los Angeles, which had the most ozone pollution, and Bakersfield, Calif., which had the highest level of particle pollution.

In total, there were 254 counties with unhealthy levels of ozone or particle pollution, and about 132 million people (42 percent of the U.S. population) live in these areas. The previous report had found that 127 million people (41 percent of the U.S. population) resided in areas with poor air quality.

In addition to the California cities, Houston, Dallas, Oklahoma City, Cincinnati, New York City and Washington, D.C., were among the metropolitan areas that had high levels of ozone. As for year-round levels of soot, many of the same cities in California topped the list, as well as Cincinnati and Canton in Ohio; Philadelphia and Allentown in Pennsylvania; Louisville, Ky.; St. Louis; and Fairbanks, Alaska.

One expert was not surprised by the findings.

"Being from California, I knew we had a few pretty bad areas, but this report really drives it home," said Irva Hertz-Picciotto, a professor of environmental and occupational health at the University of California, Davis.

The cleanest cities, which did not have a single day of unhealthy levels of ozone or particle pollution from 2009 to 2011, were Bismarck, N.D.; Rapid City, S.D.; and the Fort Meyers and Palm Beach areas of Florida.

A lot of it has to do with geography, Nolen said. Ozone, also known as smog, forms when gases from car exhaust, coal-fired power plants and other sources react with sunlight. In valley areas, like around Los Angeles, these gases get trapped, whereas they are dispersed quickly in elevated areas, she said.

The current report also listed more cities with unhealthy ozone levels than the last report, which is probably explained by hotter and sunnier weather, especially in the middle regions of the United States, Nolen said.

In addition to geography and climate, "a lot of transportation-related sources -- cars and trucks and shipping ports -- contribute to [the ozone] problem in the California area, and a lot of the most polluted cities in the eastern part of the country have coal-fired power plants," Nolen said.

To reduce the level of smog-causing vehicle emissions, the Environmental Protection Agency (EPA) proposed rules in March that would require less sulfur in gasoline and stricter vehicle emissions standards. Similar requirements went into effect in California in 2012.

Although health and environmental groups and the automobile industry support the proposal, oil companies oppose it, Nolen said. "We are encouraging people to support the EPA rule," she added.

Nolen recommended that people keep track of the air quality in their area through the AIRNow.gov website.

"If it is a high-alert day, drive less and don't burn wood or trash," she said.

Unfortunately, only about a third of counties in the United States have air-quality monitors, because they are expensive to install and collect, Nolen said. For the first time, however, this year's report has information on every county, using data from nearby cities and counties for areas that don't have their own monitors.

Both ozone and particle pollution can affect respiratory health, worsening breathing and increasing the risk of asthma attacks, respiratory infections and chronic obstructive pulmonary disease (COPD).

"People thought problems were limited to the lungs, but over the past 15 years quite a bit of work has shown things like cardiovascular effects," Hertz-Picciotto said. Studies have found links between high levels of ozone and soot and increased risk of heart attacks and stroke, as well as lower birth weights and increased risk of infant mortality.

Air quality can have the biggest effect on vulnerable groups of people, including young children, older adults and people with weak immune systems, Hertz-Picciotto said.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Janice Nolen, assistant vice president, national policy and advocacy, American Lung Association, Washington, D.C.; Irva Hertz-Picciotto, Ph.D., M.P.H., professor, chief, environmental and occupational health, department of public health sciences, University of California, Davis; American Lung Association report, State of the Air 2013

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Fewer Young Americans Lack Health Care Coverage

But 45 million Americans overall still don't have health insurance

By Dennis Thompson

HealthDay Reporter

TUESDAY, June 18 (HealthDay News) -- The number of young adults without health care coverage in the United States has declined significantly over the past few years, according to a new government report released Tuesday.

That's the good news.

Not-so-good are the findings that: 45.5 million people, 14.7 percent of the American population, still don't have health care coverage, and 4.9 million kids under the age of 18 also lack health insurance.

The U.S. Centers for Disease Control and Prevention's National Center for Health Statistics used data on 108,131 people contacted for the 2012 National Health Interview Survey to compile the latest profile on health insurance coverage.

Of immediate interest was the apparent impact of the Affordable Care Act, President Obama's landmark health reform law passed in 2010.

The new report found that 27 percent of young adults between the ages of 19 and 25 had no health care coverage in 2012, down from more than 35 percent in 2010, according to report co-author Robin Cohen, a CDC health statistician.

At the same time, the number of young adults covered by a private health plan increased, from 49 percent in 2010 to 58 percent in 2012.

Health policy experts said the increase is most likely due to a provision in the Affordable Care Act (ACA) that allows young adults to remain on their parents' health insurance plan up to age 26.

"You see a significant decline in uninsurance among young adults and a corresponding uptick in private health insurance coverage," said Kathleen Stoll, director of health policy at Families USA, a national nonprofit health reform organization. "That is clearly due to the provisions in the ACA that allowed young adults to stay on their parents' health coverage. That's a positive change you can directly tie to the ACA."

By comparison, the number of uninsured adults aged 26 to 35 remained the same at 27 percent between 2010 and 2012. There also was no big difference in private coverage for this age group, which was about 59 percent in both 2010 and 2012.

The effectiveness of this single provision of the Affordable Care Act should give hope to the 45.5 million Americans still without health insurance in 2012, said Sara Collins, vice president for affordable health insurance at the Commonwealth Fund, a health policy think tank.

That's because most of the major provisions of the ACA take effect in 2014, including the opening of the health insurance exchanges and a major expansion of Medicaid, she noted.

"Going forward, starting next year, we're probably going to start seeing the same thing across the age spectrum," Collins said. "Next year we're likely to see a new trajectory of uninsured rates across the whole population."

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Lots of Americans Want Health Care Via Their Smartphone

But all too often, the demand outpaces the technology to deliver it, Harris Interactive/HealthDay poll finds

By Amy Norton

HealthDay Reporter

TUESDAY, June 18 (HealthDay News) -- Plenty of Americans are eager to use their mobile phones and tablet computers to better manage their health care, a new poll finds -- though the nation has a way to go before we're all consulting Dr. Smartphone.

In a Harris Interactive/HealthDay survey released Tuesday, more than one-third of respondents who are online said they were "very" or "extremely" interested in using smartphones or tablets to ask their doctors questions, make appointments or get medical test results.

Similar numbers of respondents were eager to use mobile phones and tablets for actual health-care services -- such as monitoring blood pressure or blood sugar, or even getting a diagnosis. Such phone and tablet apps are, however, either just getting off the ground or not yet on the market.

The survey results show that the demand for digital assists to health care is "strong and likely to grow," said Humphrey Taylor, chairman of The Harris Poll.

But he added that big questions remain: What types of services will consumers be able to get with their mobile devices, and when?

"The devil will surely be in the details," Taylor said, "and these are very big details."

An expert in health-care information agreed. "Right now, we're looking at a patchwork system," said Titus Schleyer, who heads the Center for Biomedical Informatics at the Regenstrief Institute, based at Indiana University-Purdue University in Indianapolis.

Companies are developing a number of apps that, along with equipment attached to your phone or tablet, can help diagnose everything from ear infections and eye diseases to irregular heartbeats and malaria. One goal is to bring better health care to remote parts of the world.

But there are already apps out there designed for the masses -- including ones to manage your blood pressure or blood sugar readings, for example. You take the reading via a monitor that plugs into your smartphone, and the app records all the information, which can then be e-mailed to your doctor or sent to your electronic health record, Schleyer said.

Of course, your doctor has to have the systems in place to do something with that information. And, Schleyer added, depending on where you live, and what health system you're in, that may or may not be the reality.

Schleyer said he has first-hand experience with the obstacles. His wife found an app that let her record and organize her blood pressure readings, only to discover that her smartphone "couldn't talk" to their health-care system's portal.

She ended up just bringing her smartphone to her doctor's visit.

"This poll shows us that the public is interested in using these apps," Schleyer said. "But the health-care system has to make it easier for them to do it."

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Americans Still Making Unhealthy Choices: CDC

High rates of obesity, heavy drinking, smoking and inactivity reported, but most people getting enough sleep

By Dennis Thompson

HealthDay Reporter

TUESDAY, May 21 (HealthDay News) -- The overall health of Americans isn't improving much, with about six in 10 people either overweight or obese and large numbers engaging in unhealthy behaviors like smoking, heavy drinking or not exercising, a new government report shows.

Released Tuesday by the U.S. Centers for Disease Control and Prevention, the report found Americans continuing to make many of the lifestyle choices that have led to soaring rates of heart disease, diabetes and other chronic illnesses, including the following:

About six of 10 adults drink, including an increase in those who reported episodic heavy drinking of five or more drinks in one day during the previous year.Twenty percent of adults smoke, and less than one-half of smokers attempted to quit in the past year.Only one in five adults met federal guidelines for both aerobic activity and muscle-strengthening exercise. One in three was completely inactive when it came to any leisure-time aerobic activity.

The one bright spot in the report came in the area of sleep behavior. About seven in 10 adults meet the federal objective for sufficient sleep.

The findings have been gleaned from nearly 77,000 random interviews conducted between 2008 and 2010.

The numbers reflect persistent trends, said report author Charlotte Schoenborn, a health statistician at the CDC's National Center for Health Statistics.

"Changes have not been enormous," Schoenborn said. "It's been a very, very slow process of changing awareness of personal choices for healthier ways of life. All of the health-related federal agencies, and a lot of nonfederal groups, are putting a lot of resources to make people aware of the effect they can have on their own health. This report is just designed to say where we are."

The findings did not surprise Rich Hamburg, deputy director of Trust for America's Health, a nonprofit public health organization.

"I think we're in a situation now where we're at a crossroads," Hamburg said. "We have two paths to go. We're hopeful that if we continue to invest in community-based prevention, if we promote healthy eating and active living, these rates will begin to decrease."

Public health organizations use this report to determine which groups of Americans are susceptible to unhealthy behaviors, study author Schoenborn said.

For example, while overall people are getting enough sleep, it turns out that doesn't hold true for people with marital problems, she said. About 38 percent of divorced, separated, or widowed adults have trouble getting enough sleep, compared with 27 percent of married folks.

While this is not the federal government's official report on obesity, its findings jibe with both public and private research into the epidemic, said Hamburg at Trust for America's Health.

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Most Americans Should Eat Less Salt: Report

But too little salt may also cause health problems, report authors add

By Steven Reinberg

HealthDay Reporter

TUESDAY, May 14 (HealthDay News) -- Most Americans should consume less salt, but too little salt can also cause health problems for some, a new report says.

The problem is that there is scant evidence for determining exactly how much salt is too much and how little is too little, according to the Institute of Medicine (IOM) committee that penned the report, which was released Tuesday.

"Studies have looked at efforts to lower excessive salt intake, but raised questions about harm from too little salt," explained IOM committee chair Dr. Brian Strom, a professor of public health and preventive medicine at the University of Pennsylvania Perelman School of Medicine in Philadelphia.

So, although the report supports current U.S. dietary guidelines on salt consumption, it does not determine whether those suggested limits could or should be lower.

"Unfortunately, the message is a mixed message, which is deliberate on our part and reflects the mixed data," Strom said. "We clearly support that, in general, eating too much salt is harmful. [But] we are raising questions about the harm from too little salt."

The right balance of salt, however, isn't known. "As a committee, we did not provide a target range of what the right amount should be," Strom said.

Specifically, the committee looked at the amount of salt recommended by the U.S. Dietary Guidelines for Americans, which say most people aged 14 to 50 should limit their daily salt intake to 2,300 milligrams (mg).

However, for more than 50 percent of Americans -- those aged 51 or older, blacks and people with high blood pressure, diabetes or chronic kidney disease -- those same guidelines say that salt intake should be limited to 1,500 mg a day.

"Most Americans come nowhere near the low end of salt consumption," Strom noted.

Despite efforts by the public health community to get people to use less salt, most Americans still consume an average of 3,400 mg or more of salt a day. That is about 1.5 teaspoons of salt, according to the IOM committee.

Only about 11 percent of the salt people eat comes from the salt shaker, added IOM committee member Dr. Joachim Ix, an associate professor of medicine at the Veterans Affairs San Diego Healthcare System in California.

"The lion's share of salt that's consumed is in the food people are taking in already. A large part of that is in processed foods and foods eaten outside of the home," Ix noted.

Another expert agreed.

"We usually think of sodium as table salt," said Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City. "But many foods are unexpectedly high in sodium, including sweets, breads and cereals," she noted.

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More Americans using retail health clinics

Posted May 10, 2013, 9:35 am

As wait times to see a doctor for simple problems like sinusitis and urinary tract infection lengthen, more and more Americans are turning to retail health clinics—walk-in medical facilities located in pharmacies, grocery stores, and retailers such as Walmart and Target. The number of visits to such clinics quadrupled from 1.48 million in 2007 to 5.97 million in 2009, according to a study published in the journal Health Affairs, and topped 10 million last year.

What is driving this migration to retail health clinics? “For the majority of patients it is convenience,” says lead study author, Dr. Ateev Mehrotra, associate professor of medicine at the University of Pittsburgh and health policy researcher at the nonprofit RAND Corporation (he’ll be joining Harvard Medical School’s Department of Health Care Policy in June). You can walk into a retail health clinic without an appointment, and many clinics are open nights and weekends. In fact, nearly half of the visits in the study were on the weekends or other off-hours when doctors’ offices are typically closed.

The other attraction of retail health clinics is price, Dr. Mehrotra and his colleagues found. “Not the actual price, but the transparency of the cost,” he says. Clinics offer a menu of prices and services, which means there are fewer surprises when the bill arrives. And health insurance covers all—or a percentage of—the costs of services provided at these clinics, just as it does for care delivered at a doctor’s office.

As consumers increasingly turn to retail health clinics, the number of clinics has grown to meet demand—up to 1,423 this year and an estimated 3,200 by the end of 2014. And the types of services they offer has expanded beyond immunizations and common ailments such as strep throat and sinus infections. Last month, for example, Walgreens’ announced that its Take Care Clinics will now help manage chronic conditions such as high blood pressure, diabetes, high cholesterol, and asthma.

Retail health clinics are often staffed by nurse practitioners instead of doctors. That’s not an issue for people who are visiting for routine vaccinations or an antibiotic prescription for an ear infection—but are these clinics equipped to manage chronic conditions?

The research comparing nurse practitioners with doctors on several measures of care has been reassuring, Dr. Mehrotra says. “People who went to the nurse practitioner did just as well as those who went to a doctor.”

In some aspects of care, retail health clinics may actually outperform physician’s offices. “Whatever they do is guided by evidence-based protocols,” says Regina Herzlinger, Nancy R. McPherson Professor of Business Administration at Harvard Business School, and author of Who Killed Health Care? Not only are nurse practitioners required to follow specific care guidelines, but they must also keep meticulous records on the care they’ve provided, she says. “They have a record of what they’ve done that’s very detailed.”

A key outstanding question is whether visiting retail health clinics might interrupt continuity of care between doctors and their patients. Dr. Mehrotra found that individuals who received care at a retail clinic were less likely to follow up within the year with their primary care doctor, although that lack of follow-up didn’t seem to affect the quality of care they received overall.

In the retail health clinic setting, the burden of continuity in record keeping often falls on the patient. Although clinics can send health records to a patient’s primary care doctor, there’s a good chance the two offices use incompatible electronic medical record systems, rendering the clinic’s records unusable to the physician. “It’s really up to the patient to make sure that the excellent records these retail medical clinics keep is embedded in their personal health record with their primary health care provider,” Professor Herzlinger says. Getting a printed copy of your record from the retail health clinic and bringing it to your doctor can help prevent any discontinuity of care.

Today, retail health clinics are most appropriate for people with simple, acute health conditions such as a respiratory or urinary tract infection. “It’s generally people who don’t have a primary care doctor and who overall are healthier,” Dr. Mehrotra says.

That target group might change as more retail clinics expand their services to offer chronic disease care, and as the number of primary care doctors shrinks. “There is a tremendous shortage of primary care doctors,” says Professor Herzlinger. “Many of the people who use these clinics don’t have physicians, and can’t get physicians.”

What will happen to retail health clinics as the Affordable Care Act rolls out and the number of insured Americans rises? “We can only speculate,” Dr. Mehrotra says. “My own instinct is that as more people get insurance, they will increase the demand for primary care physicians. Given our fixed supply of doctors, wait times are likely to go up. This may drive demand to retail clinics.”

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Poll: Many Americans Don't See Their Kids as Overweight

Title: Poll: Many Americans Don't See Their Kids as Overweight
Category: Health News
Created: 2/25/2013 12:36:00 PM
Last Editorial Review: 2/26/2013 12:00:00 AM

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1 in 8 Americans Diagnosed With Type 2 Diabetes: Poll

By Amanda Gardner

HealthDay Reporter

WEDNESDAY, Feb. 20 (HealthDay News) -- A staggering one in eight Americans has been diagnosed with type 2 diabetes, a new Harris Interactive/HealthDay poll suggests.

And more than one third of those polled have been diagnosed with diabetes or have a parent, sibling, spouse or child with the condition.

"Type 2 diabetes has become one of the most common and fastest growing diseases. Fully one in eight adults -- approximately 29 million people -- now report that they have been diagnosed with this dangerous condition," said Harris Poll Chairman Humphrey Taylor.

Added Dr. Ronald Tamler, clinical director of the Mount Sinai Diabetes Center in New York City: "Diabetes is very insidious. You don't know you're in trouble until the complications hit or until it's so out of control you have uncontrolled urination and thirst" -- two of the common symptoms of diabetes.

While type 2 diabetes is occurring in epic proportions, the new poll also found that awareness of the disease is still surprisingly low, with only 21 percent of those surveyed considering themselves well-versed on the disease. That means the remaining 79 percent may not know they're at risk or may already have the disease, which is known as the "silent" killer.

But people already diagnosed with diabetes tend to be much more aware of the health risks, with slightly more than two-thirds considering themselves either "extremely" or "very" knowledgeable about the disease, the poll found.

Still, 35 percent of respondents with diabetes said their diabetes was only "somewhat" controlled and 5 percent said it was "not at all" well controlled.

"Because diabetes is a chronic condition, the treatment of which is critically dependent on patient behavior and self-care, this may be the most alarming finding," Taylor said.

On a more encouraging note, many people polled do understand that a number of factors can contribute to type 2 diabetes, including being overweight (79 percent of respondents realize this is a risk factor), diet (74 percent) and physical inactivity (62 percent).

These numbers were greater among people who had been diagnosed with diabetes.

Interestingly, 60 percent of respondents know that genetics can be a component of type 2 diabetes.

"We have a public perception that type 2 diabetes is entirely a disease of lifestyle and that is not true," said Dr. Robert Ratner, chief scientific and medical officer of the American Diabetes Association. "There is no question that lifestyle contributes to it, but the problem is one of biology . . . Environment really does play a role but the biology sets them up."

Indeed, certain ethnic groups, including many Native American tribes, bear a disproportionate diabetes burden, Ratner added.

Most adults, whether they actually have diabetes or not, seem fairly knowledgeable about the long-term consequences of the disease, which can include amputation of limbs, blindness, kidney disease and heart disease, the poll found.

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Millions of Americans Have an STD: Report

Title: Millions of Americans Have an STD: Report
Category: Health News
Created: 2/14/2013 4:36:00 PM
Last Editorial Review: 2/15/2013 12:00:00 AM

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More Americans Successfully Managing Diabetes

By Serena Gordon

HealthDay Reporter

FRIDAY, Feb. 15 (HealthDay News) -- A couple of decades ago, only 2 percent of people with any type of diabetes met or exceeded the three measures of good diabetes management. By 2010, that number had risen to 19 percent, according to new government research.

These measures of good diabetes management are average blood sugar, blood pressure and cholesterol levels. When researchers looked at each measure independently, more than half of people in the study met individual measures.

"Overall, there was a huge improvement between 1988 and 2010. These findings are very encouraging. However, only 19 percent of people were meeting all three goals," said senior study author Catherine Cowie, director of the Diabetes Epidemiology Program at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

One expert had mixed reactions to the study results.

"I see these findings as the glass is half full and half empty. With so much more awareness of diabetes and with newer medications, it's very disappointing to see only 19 percent with good management," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

"If you look at the LDL [bad] cholesterol, only half were on [cholesterol-lowering drugs called] statins, but 100 percent of people with diabetes should be on statins. Only half were well-treated for their blood pressure. That means half of the people with diabetes aren't being treated for blood pressure. I see this as a big problem," Zonszein said.

The study was published online Feb. 15 in Diabetes Care.

The three measures of diabetes management are sometimes called the ABC's of diabetes. "A" is hemoglobin A1C, an estimate of blood sugar levels over the past three months. A1C is expressed as a percentage, and specific A1C goals should be determined by an individual's doctor, but the American Diabetes Association generally recommends that people with diabetes aim for an A1C of less than 7 percent.

The "B" is blood pressure, and the association advises that people with diabetes should have blood pressure of 130/80 millimeters of mercury (mmHg) or less. And "C" is cholesterol, specifically LDL cholesterol. For people with diabetes, the association advises LDL levels be below 100 milligrams per deciliter (mg/dL).

It's important to keep these measures as close to the recommended goals as possible to avoid serious complications, such as heart disease, kidney failure and vision problems.

The researchers reviewed data from four U.S. National Health and Nutrition Examination Surveys, which were done from 1988 to 1994, from 1999 to 2002, 2003 to 2006, and 2007 to 2010. Nearly 5,000 study volunteers said they had diabetes but didn't specify what type they had. All were older than 20.

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With Benefits Unproven, Why Do Millions of Americans Take Multivitamins?

By Steven Reinberg

HealthDay Reporter

MONDAY, Feb. 4 (HealthDay News) -- Millions of Americans take multivitamins and other supplements, but convincing scientific evidence of any true health benefit is lacking, experts say. Now a new study explores why people continue to consume nutritional supplements.

"Most people were using supplements because they believe it will improve their health, but we really don't know whether that's true," said study lead author Regan Bailey, a nutritional epidemiologist in the Office of Dietary Supplements at the U.S. National Institutes of Health.

"Moreover, the vast majority of supplements used in the U.S. are based on personal choice, not because they are recommended by health care professionals," she added.

Nearly half of U.S. adults use dietary supplements, Bailey noted, and supplements are a $30-billion-a-year business.

"People have very strong beliefs about these products and I don't know where they are getting their information," Bailey said. "It's not from the doctors. The majority of scientific data available do not support the role of dietary supplements for improving health or preventing of disease."

Another expert said supplements can be expensive.

"A multivitamin might cost $20 a month. Why not spend that on more fresh produce?" said Marian Neuhouser, of the cancer prevention program at the Fred Hutchinson Cancer Research Center, in Seattle. "If someone is eating a healthy diet with plenty of fruits and vegetables and whole grains -- a wide variety of foods -- they should be getting all the nutrition they need."

The new report was published online Feb. 4 in the journal JAMA Internal Medicine.

To examine why Americans take multivitamins, Bailey's team collected data on nearly 12,000 adults who took part in the 2007 to 2010 U.S. National Health and Nutrition Examination Survey.

The researchers found that 45 percent of those taking a multivitamin did so because they believed it would improve their health, and 33 percent did so because they thought it would maintain their health.

Only 23 percent said their decision was based on advice from their doctor. When they recommend supplements, doctors are most likely to recommend calcium for bone health (24 percent) or to improve overall health (18 percent), or fish oil for heart health (12 percent) or to supplement diet (11 percent), Bailey said.

It's hard to tell whether vitamins actually improve health, because "adults who use dietary supplements tend to report more healthy lifestyles," Bailey said. "They report better overall health, more exercise, moderate alcohol consumption and are more likely to [have never smoked] or be former smokers."

A clear role exists for some dietary supplements -- such as folic acid to reduce the risk of birth defects. Calcium and vitamin D play an important role in bone health, Bailey said.

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Americans Sicker Compared to Other Wealthy Nations

Jan. 9, 2013 -- Americans die younger and have higher rates of many types of diseases and injuries than people in other high-income countries, a new report shows.

“The health of Americans is far worse than the health of people in other countries despite the fact that we spend more money on health care,” says report author Steven H. Woolf, MD, MPH, during a news conference. He is a professor of family medicine at Virginia Commonwealth University in Richmond. “This has been going on since 1980 and getting progressively worse. I am struck by the gravity of our findings.”

This health disadvantage exists at all ages from birth to age 75 and in all socioeconomic groups. “Even those who are insured and college educated and have high incomes seem to be in worse health than people in other nations,” he says.

The report, put out by the National Research Council and Institute of Medicine, looked at multiple diseases, injuries, and behaviors across the entire life-span among 17 nations, including the U.S., Australia, Canada, Japan, and Western European countries.

Overall, American men live four years less than men in certain other high-income countries, and women live five years less than women in certain other countries, the report shows.

According to the report, the U.S. is at or near the bottom in nine key health areas, including:

Infant death and low birth weightInjuries and murdersTeenage pregnancies and sexually transmitted infectionsPrevalence of HIV and AIDSDrug-related deathsObesity and diabetesHeart disease; chronic lung disease; and disability 

Specifically, children born in the U.S. are less likely to reach their fifth birthday than kids from certain other countries. The U.S. also has the highest infant death rate of any high-income country.

What’s more, U.S. teens have higher rates of death from traffic accidents and murders, the highest rates of teenage pregnancy, and are more likely to catch sexually transmitted infections. “I was stunned by how pervasive the disadvantage was across so many different topic areas,” Woolf says.

The playing field changes after age 75, the report shows. If an American lives to 75, they have a higher life expectancy than people in the other high-income countries.

So why are we faring so poorly up until 75? There are many possibilities, Woolf says.

Americans are more likely to take part in certain unhealthy behaviors, such as eating high-fat, high-caloric diets and not wearing seatbelts.

When looking for causes and solutions, we have to think outside of the box, says panel member Ana V. Diez-Roux, MD, PhD, MPH. She is a professor and chair of epidemiology, and director of the Center for Social Epidemiology and Population Health, at the University of Michigan in Ann Arbor. 

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