In U.S., Fish Widely Eaten is Largely Safe

Consumption of the many varieties of fish deemed safest is indeed very safe, even for higher-risk demographics.
(go to article)


Biking Through Class for Better Behavioral Outcomes

On days when children participated in cybercycling during class, odds of disruptive levels of behavioral dysregulation declined between 71% and 76%.
(go to article)


Warning Your Teen Athlete Not to Heed Supplement Sellers’ “Advice”

A research assistant posing as a 15-year-old high school football player called a national sample of 244 health food stores and told the sales attendant he was involved in strength training.
(go to article)


Heartburn: When to See a Doctor

When symptoms don't improve and start to interfere with sleep or daily life, it is time to get your doctor's help.
(go to article)


Red Meat Tied to Significant Diverticulitis Risk Increase

The present study offers at least one clear cut aspect of high levels of red meat consumption that virtually all of us would consider undesirable.
(go to article)


Are You D Deficient?

When physicians check blood levels for vitamin D, precisely how to act on the result is still the subject of great controversy.
(go to article)


The Clinic

30 Weekly Miles is Not Likely to Affect Fertility
(go to article)

Evaluate Blood Pressure if Cramping Persists
(go to article)

Hamstring Rehab
(go to article)

Post-Marathon Pain One Month Out
(go to article)


The Back Page

The Longest Run

Seen and Heard…while coaching
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Good News for Weekend Warriors

In a recent U.K. study of 63,591 middle-aged survey respondents self-reporting their leisure time physical activity several times over a decade and a half, the take-home message appears to be: To reduce mortality risk, get some exercise no matter what.

Survey respondents who reported even the lowest levels of exercise short of zero—a group categorized in the study as “insufficiently active”—still saw over a 30% reduction in mortality risk compared to sedentary controls.

It is not surprising that those at greatest risk are inactive adults, but once some level of physical activity was undertaken, it is striking how similar the health outcomes were across all activity levels for the three causes of mortality studied. Those three causes were: all-cause, cardiovascular disease (CVD), and cancer mortality.

In the observational study, which was published in JAMA Internal Medicine, activity levels were defined as follows:

  1. Inactive: No moderate or vigorous activity
  1. Insufficiently active: Less than 150 minutes/week of moderate and less than 75 minutes/week of vigorous activity
  1. Weekend warrior: Equal to or above 150 minutes/week of moderate or 75 minutes/week of vigorous activity, but from only 1 to 2 sessions
  1. Regularly active: Equal to or above 150 minutes/week of moderate or 75 minutes/week of vigorous activity from 3 or more sessions

Household survey respondents 40 years and older from 11 cohorts in England and Scotland were included in the analysis. Data were collected from 1994 to 2012 and analyzed in 2016.

During the nine years of follow-up, 8,802 participants died. The results across activity groups are shown in the table below. (continued)

Physicians Panel to Healthy Women: Skip These Tests

Health fairs and clinics often promote screening tests for women you might not have heard of or ever had. Some of these tests, though widely offered for screening, aren't advised for generally healthy people and may lead to unnecessary procedures.

To resolve potential confusion, the United States Preventive Services Task Force (USPSTF) has compiled a list of tests they deem avoidable. The USPSTF is a panel of primary care physicians and epidemiologists funded by the U.S. Department of Health and Human Services. They develop clinical practice recommendations about various aspects of patient care. The guidelines are based upon the best available research evidence and practice experience and are meant to reduce undesirable variations in medical practice across different parts of the country by giving guidance to doctors for best practices.

To determine whether specific screening tests ought to be recommended, USPSTF panelists weigh the evidence of the potential benefits and risks of administering the tests to millions of people who have no signs of disease.

Their analysis considers whether the evidence is from "gold standard" randomized controlled trials, observational investigations or case studies. The issued guidelines then present who may and may not benefit from the tests.The USPSTF regularly examines new evidence to reassess the guidelines and issue new ones if necessary.

Tests currently not recommended
For low-risk women with no cardiovascular symptoms, these tests can generally be avoided:

Electrocardiogram (ECG). This test reveals abnormalities in the heart's electrical activity. The USPSTF recommends against using an ECG to predict the likelihood of heart attacks or related problems in people at low risk for heart disease and even says that there isn't enough evidence to determine whether it is useful for people at higher risk.

Carotid artery screening. The two carotid arteries pass through the neck, supplying blood to the neck, face and brain. Ultrasound imaging is used in carotid artery screening to detect narrowing of these major blood vessels, which is sometimes thought to predict an increased risk of stroke. However, the USPSTF says that there is little evidence to indicate that narrowed carotids increase stroke risk in asymptomatic people. This test may also lead to additional procedures, such as a surgical procedure to widen the arteries (carotid angioplasty), which carries a modest but real risk of complications. (continued)

editorial board

Kenneth Cooper, MD
Kevin Beck
Jack Daniels, PhD
Randy Eichner, MD
Mary Jo Feeney, MS, RD
Mitchell Goldflies, MD
Paul Kiell, MD
Sarah Harding Laidlaw, MS, RD
Paul Langer, DPM
Douglas Lentz, CSCS
Todd Miller, MD
Gabe Mirkin, MD
Col Francis O’Connor, MD
Stephen Perle, DC, CCSP
Pete Pfitzinger, MS
Charles L. Schulman, MD
Bruce Wilk, PT, OCS
Michael Yessis, PhD
Jeff Venables, Editor

board of directors

Jeff Harbison, President
Bill Young, Secretary-Treasurer
Immediate Past-President
(Vacant) Vice President
Robert Corliss
Charles L. Schulman, MD, AMAA Pres.
AMAA President
Terry Adirim, MD, MPH
Gayle Barron
Sue Golden
Senator Bill Frist, MD
Jeff Galloway
Jeff Harbison
Ronald M. Lawrence, MD, PhD
Jeff Moore
Noel D. Nequin, MD
David Pattillo

Association Staff

Executive Director: Dave Watt
Project Consultant: Barbara Baldwin, MPH

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