Fitness Mantra : A Health and Fitness Blog

The first post of this year was (naturally) a resolutions-centric one (I think it’s endearing to be predictable!). The list of to-dos for 2007 in 5 Simple New Year Resolutions For A Fitter, Healthier You! began with the expected items: non-processed foods, fruits, veggies, exercise… you know, the good stuff.

doctor However, for #5 I chose to include “Annual Physical Exam” and while some may question whether this is really a “top 5″ item, a recent study published in the Annals of Internal Medicine might just vindicate my choice.

Systematic Review: The Value of the Periodic Health Evaluation is a detailed analysis of PHE (Periodic Health Evaluation is another term for Annual/Regular Physicals) and its benefits and harms, if any. As the study states in the very beginning, PHEs have been a fundamental part of medical practice for decades, despite a lack of consensus regarding its value in health promotion and disease prevention.

For example, opponents of regular checkups cite unnecessary use of medical resources, additional expenses and the use of unrecommended services as some of the reasons to reduce the number of PHEs performed every year.

Defining Periodic Health Evaluation:

The review, however, sought a broader definition of PHEs that could be applied to most clinical practice environments, regardless of patient populations, health care delivery settings, or resource constraints.

We defined the PHE as one or more visits with a health care provider for the primary purpose of assessing patients’ overall health and risk factors for disease that may be prevented by early intervention. […] According to our definition, the PHE did not include the delivery of clinical preventive services that patients could receive during or after their visit for the PHE and that we considered an outcome of the PHE. […] Under our definition, the delivery of clinical preventive services provided both during that visit (such as counseling to stop smoking and a Papanicolaou [Pap] smear) and outside of the visit (such as mammography or colonoscopy) were considered to be a result of the PHE (history, risk assessment, and physical examination) and not part of the PHE.

Sources for the review:

Using these definitios in place, the authors of the review went through previous studies in journals like MEDLINE, Health Tecnology Assessment Database and other National Health System databases published through September 2006, searching for such terms as “annual physical examination” and “periodic health evaluation”. More than 7000 articles were finally narrowed down to 33 studies that were reviewed in detail to obtain the results. To ensure a broad range, these studies were chosen over a period of 3 decades and while two-thirds were performed in the United States, the rest are from countries like Untied Kingdom, Canada and Japan.

Results of the review:

As with any study the results themselves are graded differently based on the type of screening performed at the PHE. Three main groups of results were published:

Clinical preventive services:
High Rating: gynecologic examination, Pap smear and fecal occult blood screening
Medium Rating: evidence on immunizations and cholesterol screening
Low Rating: evidence on counseling and mammography.

Proximal Clinical Outcomes(disease detection, change in patient health-habits):
High Rating: evidence on blood pressure
Medium Rating: evidence on disease detection, health habits, patient attitudes, health status, and body mass index
Low Rating: Evidence on serum cholesterol
The PHE also had a beneficial effect on patient worry (less increase in patient worry over time among persons undergoing the PHE than in those not undergoing the PHE)

Distal Economic and Clinical Outcomes (costs, hospitalization factors):
High Rating: evidence on hospitalization received a high rating.
Medium Rating: Evidence on costs, disability, and mortality

Conclusions:

As can be clearly seen from the results described in the section above, PHEs have great benefits in several areas, particularly:

Blood pressure - probably the most easily preventable disease if detected and treated prompty.
Gynecologic, pap smears and breast exams - probably the most important of regular exams for women that can lead to early detection of various forms of cancer of other diseases.
Cholesterol screenings to ensure supplements or prescription medicine can be recommended in time to prevent the serious effects of high cholesterol like stroke or heart disease.
Health habits and patient attitudes to fitness and nutrition, though moderate are still good enough reasons for a PHE.
Reduction of patient worry - a significant stress-buster. Knowing you are healthy is a great feeling, but knowing your PHE helped you catch something on time and begin treatment that can lead to a full recovery is an even better feeling!

So pay your good doctor a visit at least once a year even if you are feeling perfectly healthy - he/she can help make sure you stay that way.

When do you plan to get your annual physical examination this year?

Technorati Tags: health, fitness, annual physical examinations, periodic health evaluations, annual physical checkups

Fitness Mantra del.icio.us page Welcome to “FitnessMantra Weekend”, your once-a-week health news update. As always you can also stay updated with the latest in fitness news by subscribing separately to the Fitness Mantra del.icio.us feed.

One of my biggest gripes with Girl Scout Cookies was that they were always made with heart-stopping trans fats (although as usual the labels would declare them to be free of trans fat because a single serving had less than 0.5 g of partially-hydrogenated oils). For example consider the nutrition label and ingredients of the most popular of them all - “The Thin Mints” (taken from the Girl Scout Cookies ABCs page for Thin Mints):

Ingredients: Enriched flour (wheat flour, niacin, reduced iron, thiamine mononitrate, riboflavin, folic acid), sugar, vegetable shortening (palm, partially hydrogenated palm kernel and/or soybean oil), cocoa (processed with alkali), caramel color, contains less than 2% of: high fructose corn syrup, corn starch, whey, salt, leavening (sodium bicarbonate), soy lecithin, natural and artificial flavor, peppermint oil.

Enriched flour, partially hydrogenated oils and high fructose corn syrup - the unhealthy trifecta for your eating pleasure, folks! It used to give me a good excuse when I refused to buy these artery cloggers from coworkers, though! I would point to my heart and they had to back down. But after reading this MSNBC article it looks like I might have finally run out of excuses now:

For much of the country, it’s Girl Scout cookie time again. And this year, all those cookies, not just the Thin Mints and a few others, will come nearly free of harmful trans fats. […] The change reflects a movement by the scouts in recent years to add an element of health consciousness to their annual bake sale.

- Girl Scout cookies toss out trans fats

As always a healthful change in recipe is always welcome but in this case, all the more so since it involves children (although if you see some of my coworkers buying these cookies, you might disagree that it is all about the children!).

Anyway, here are the week’s top health and fitness stories:

Washington youth at high risk for obesity: Almost one in four of eighth, 10th and 12th graders in Washington state is overweight or obese, and most of the kids who are heaviest now will have weight problems as adults.
UK women are now officially the fattest in Europe: The scale of the obesity crisis was laid bare last night when an alarming report revealed Britons are the fattest people in Europe.
Job burn-out ‘ups diabetes risk’: People who suffer from job burn-out may be prone to developing type 2 diabetes, research suggests.
Why Weight-Loss Efforts Fail: About one in three American adults is trying to lose weight at any given time, and while their track record for trying is good, their track record for succeeding is not.
Girl Scout cookies toss out trans fats: For much of the country, itâ€™s Girl Scout cookie time again. And this year, all those cookies, not just the Thin Mints and a few others, will come nearly free of harmful trans fats.
Caffeine may prevent heart disease death in elderly: Drinking caffeinated beverages often may provide protection against heart disease mortality in the elderly people aged 65 or older, according to researchers at SUNY Downstate Medical Center and Brooklyn College.
Vitamin D May Cut Elders’ Falls: Vitamin D, taken in a high dose, may help prevent falls in the elderly.
Kids Living Near ‘Green Spaces’ Less Likely to Be Overweight: Children who live in densely populated urban areas may be less likely to be overweight if they have parks and lawns in their neighborhoods, a U.S. study suggests.
Coffee May Pack Dietary Fiber: Your coffee may come with a little something extra — and not just cream and sugar. Some of the dietary fiber in coffee beans may make it into your mug, Spanish researchers report.
Trans fats are not the only villain in American diets: Artery-clogging trans fats are the villain of the moment in the enduring story of America’s love affair with food. Now, some nutrition and health analysts say the preoccupation with trans fats has gone too far.
Eat Your Favorite Foods and Still Lose Weight: The best way to peel away pounds and get the body you want is to eat what you want in moderation.
Junk food ad ban plans laid out: The broadcasting regulator is sticking to its plans to ban junk food ads during TV shows watched by under-16s.
Health care costs will keep climbing: Health care is expected to account for $1 of every $5 spent in the United States in another decade.
Boost your brain power with exercise: Can exercise make you smarter?
Location is key to seniors walking: The benefits of walking and being active are well known, especially for older people, but what kind of neighborhood gets seniors going?
Researcher Says Anorexia May Be Genetic: A researcher at a Tulsa clinic says a decade-long study into anorexia nervosa is beginning to reveal that those who suffer from the disease might have a genetic predisposition toward it.
The Hindu News Update Service: The â€œdiabetes clockâ€ may start ticking in women years in advance of a medical diagnosis of the disease, new research has shown.
Young ‘hung up on their bodies’: Some 51% of young women would have surgery to improve their looks and a third of those who are a size 12 think they are overweight, a survey suggests.
A Silent Epidemic: During a routine postoperative checkup several weeks later, Cordell vividly remembers, she was stunned when the nurse asked, “How are you since your hysterectomy?”
Negative Reinforcement: If you’re just getting into regular weight training, or have hit a plateau in your progress, here’s an offbeat suggestion: Accentuate the negative.
Sir, Yes, Sir!: There’s a reason new military recruits are put through boot camp: to make them strong and fit and all that they can be. But could I really be all that I never was?
New guidelines issued for women’s heart health: Nearly all American women are in danger of heart disease or stroke and should be more aggressive about lowering their risk â€” including asking their doctors about daily aspirin use, the American Heart Association said today in new guidelines.
$5M to bring back ParticipACTION exercise program: The federal government pledged $5 million over two years Monday to renew ParticipACTION, the federal fitness-awareness campaign.
Computer games ‘burn up calories’: Playing new style computer games can help people burn up a significant number of calories, research has found.
Waistlines keep expanding around the globe: No matter how you tip the scales, Americans are getting wider every year. What’s worse is that many nations are following suit.
5 Simple Steps to Keep Off Rebound Pounds: Want to keep lost pounds from finding their way home again? Try these five simple rules
Study: Cholesterol may help cause diabetes: Cholesterol may not just be bad for your heart. A study suggests problems with cholesterol regulation in the insulin-producing cells of the pancreas may be responsible for the development of Type 2 (formerly known as late onset) diabetes.
Some cocoa may improve brain blood flow: A nice cup of the right kind of cocoa could hold the promise of promoting brain function as people age.
Chemicals ‘could be the cause of obesity’: Exposing babies to plastics and pesticides before they are born could make them more prone to obesity and disease, a scientist said yesterday.
Exercise May Help Prevent Breast Cancer: Exercise may help prevent breast cancer, and help those who do get it cope, two new studies show.
Diabetes in pregnancy can hamper infant memory: Babies whose mothers had diabetes during pregnancy may be less able to form early memories than children whose mothers had normal pregnancies, a U.S. researcher said on Friday.
Cooking Garlic? Crush It First: Got a recipe that involves cooking garlic? You might want to crush the garlic first.
Get the diet scoop: 6 promising supplements, 6 to avoid: The sales pitches are irresistible: “Lose 2 Pounds a Day!” “Burn Fat Round the Clock!”
Your drinks may be making you fat: New findings are adding to the research suggesting that more than ever before, what and how much we drink may increase calorie intake and weight without our noticing.