Lincoln University, a historically black college located west of Philadelphia, requires that overweight students take a fitness course if they want to graduate, and that’s not sitting well with a number of students.

The rule was enacted 4 years ago. It requires that students get their body mass index checked, and those found to be obese—a BMI of 30 or higher—must take a class called “Fitness for Life,” which meets three hours per week.

The course involves physical activities including walking and weight training as well as information on nutrition and stress management.

James DeBoy, chairman of the Lincoln’s department of health said the school had become concerned about high rates of obesity and diabetes in the African-American community.

“We’re in the midst of an obesity epidemic,” he told MSNBC. “We have an obligation to address this head on.”

Protests bean last week when seniors—who are the first class affected by the new rule—began realizing they were running out of chances to meet the requirement.

Senior Tiana Lawson wrote in the student newspaper that she “didn’t come to Lincoln to be told that my weight is not in an acceptable range. I came here to get an education.” Lawson added that she has no problem with the general concept so long everyone must take the class.

As of this fall, about 80 seniors — 16% of the class — had neither had their BMI tested nor taken the class. At least some of them are expected to be cleared because they are not obese, officials said.

————–

UPDATE: After this post was written and scheduled for publication on Pizaazz, faculty at Lincoln decided to nix the idea of a required “fat course.” So obese students at Lincoln can now graduate without taking the class. 

In lieu of the requirement, the school will “suggest” to certain students that they enroll in a “Fitness for Life” class.

In the last decade, ultra endurance sports like triathlons and cycling marathons have grown in popularity. The granddaddy of these extreme sports is the Western States 100-Mile Endurance Run, which courses through the Western States Trail in Northern California. The first running was held way back in 1976.

Recently, scientists from the Virginia Commonwealth University and the Department of Veterans Affairs Northern California decided to have a look at the 3,500 people who have entered this event over the years.

They found dramatic trends in the demographics and results of the participants.

For example, the average age of race starters was 41 back in 1986, but between 2000 and 2007 the average age had risen to 45-47.

In addition, many more women now compete in the race. From 1986 to 1988, between 10-12% of the competitors were female. Since 2001 however, that percentage has nearly doubled to 20-22% of the competitors.

The scientists attribute this to the fact that more women in their 40s and up, and more men in their 50s and up have signed up for the race, while fewer men who were less than 50 have entered.

And these older runners have delivered. Every year since the inception of the event, the average age of the top 5 finishers has gone up. Initially this number was in the early 30s, but now it is in the late 30s. This phenomenon is mostly attributable to changes in finish times for women, which the scientists say have improved by 37 minutes per decade since 1980.

This means that the finish time difference between the top men and women has been cut by 4% per decade, to a margin of 14% in 2007.

The study appears in Medicine & Science in Sports & Exercise.

Until Friday, the UN-sponsored climate conference in Copenhagen had been a rather dull affair, characterized as it was by the bickering of mid-level dignitaries and the usual menagerie of activists and hangers-on outside the convention center.

But on Friday, there was significant news.

An ad-hoc UN working group released a document that will likely serve as a starting point for negotiations when the big boys roll into town later this week.

The document proposes a deal in which industrial nations cut carbon-based emissions between 25 and 45% compared with 1990 levels by 2020, and major developing countries like China and India cut theirs over the same period by 15 to 30%.

In addition, all countries would reduce emissions by 50 to 95% by 2050.

The document skated over details like how much money rich countries would fork over to poor ones to help them cope with global warming, or what levels of global temperature increases would be deemed “tolerable.”

Still, it was a start.

Aside from survival of the planet as we know it, the economies of every nation on Earth could depend on the outcome of this agreement. Rifts have developed between developed and emerging economies and between the world’s 2 major carbon emitters, China and the US.

The 2 superpowers disagree about their obligations to fix the mess, and warily eye each other in advance of the battle for supremacy in Green technology, which seems certain to drive national economic success for the rest of the century, much as information technology has driven US economic success since the 1970s.

Costa Rican delegate Ricardo Ulate, described the skirmishes for the Washington Post  as “a game where a new economic hegemony is being developed.”

That may be, but what he’s seen so far is just the undercard.

The main event begins later this week, at which point heads of government from 60 countries will have arrived in Copenhagen.

“We’re getting into the big leagues,” said Carlos Manuel Rodriguez, vice president for global policy at Conservation International. “The heavyweights are coming.”

Drugs used to reverse anemia in cancer and kidney failure patients are largely ineffective and markedly increase the risk of blood clots, according to a study by scientists at Columbia University Medical Center.

To reach this conclusion, Dawn Hershman and colleagues studied use of the so-called erythropoiesis stimulating agents (ESAs) in more than 50,000 patients that had been diagnosed with cancer.

In these patients, ESAs did not reduce blood transfusion requirements caused by chemotherapy, but they did jack up the risk of deep venous thrombosis and pulmonary embolism.

Hershman’s study population included patients that were at least 65 years of age and had been diagnosed with cancers of the breast, colon and lung. ESAs are used frequently in such patients as adjuncts to chemotherapy.

Survival was not impacted by the ESAs.

The number of patients receiving ESAs jumped 10-fold from 1991 through 2002. By that time, nearly half of all cancer patients were receiving them.

“This analysis confirms the association between ESAs and venous thromboembolism, which was observed in previous meta-analysis,” Hershman told BurillReport. “This data is from community practice – real-life clinical settings – where you see things that wouldn’t necessarily show-up in a short-term, 12-week study.”

Leading ESAs include Amgen’s Aranesp and Epogen, and Johnson & Johnson’s Procrit. Sales of these drugs topped $10 billion in 2006 in the US alone.

The meta-analysis mentioned above prompted the FDA to issue a black-box warning regarding the potential for tumor promotion, venous thromboembolism and decreased survival with ESAs. The warning suggested that ESAs should be used only for specific tumors and only when hemoglobin levels dropped below certain levels.

The write-up appears in the Journal of the National Cancer Institute.

For the second time this year, a clinical trial has shown that the cholesterol-lowering drug Zetia does not prevent heart disease.  

The first trial appeared last January. That trial compared Vytorin—a blockbuster drug that combines  the active ingredient in Zetia with a generic cholesterol-buster known as simvastatin—against simvastatin alone in patients with a genetic condition causing them to have very high levels of LDL (bad) cholesterol and premature cardiovascular disease.

In that trial, Vytorin reduced LDL cholesterol levels much more than simvastatin alone but surprisingly, atherosclerotic plaques actually grew faster in the coronary arteries of the patients taking Vytorin.

The news was greeted with a precipitous fall in prescription volume for both Zetia and Vytorin.

The second study was published last week in the New England Journal of Medicine. This study compared Zetia to Niaspan, a drug that raises blood levels of HDL (good) cholesterol.

In the second study, Allen Taylor of the Walter Reed Army Medical Center and colleagues enrolled 363 people with coronary artery disease that had been taking statins for many years. 

Taylor’s group found that Niaspan shrank carotid artery plaques by 2%, but Zetia had no such effect, even though it effectively reduced cholesterol levels (as it did in the first trial). In addition, patients who received Niaspan sustained 2 heart attacks or heart-related deaths during the study, while 9 patients receiving Zetia suffered that outcome, a significant difference.

Zetia “should be better for the arteries and it wasn’t,” Taylor told reporters covering last month’s American Heart Association meetings. “The drug wasn’t operating as you would expect.”

Officials at Merck, which co-markets Vytorin, said the study wasn’t large enough to draw firm conclusions and that larger trials of a similar nature are underway. Stay tuned.

This week, the Senate will bicker over health reform, EHR vendors will continue their anxious wait for government agencies to release Meaningful Use criteria on which their financial viability depends, people  will continue arguing whether middle-aged women should get mammograms, and world leaders from 100 countries will convene in Copenhagen to hammer out a new agreement that prevents or at least slows down global warming.

There’s not much doubt which issue will have the most impact on the health of US citizens, at least those who are around 50-100 years from now.

In 1997, the global family of nations released a document known as the Kyoto protocol. Its goal was to reduce worldwide greenhouse gas emissions to levels 5.2% below those produced in 1990 by year-end, 2012.

Since then, 187 countries have signed the document, including China, Russia, India and every country in Europe. But Uncle Sam, the source of nearly one-third of the world’s carbon emissions, never did. 

In the absence of leadership from the world’s biggest offender, global carbon-dioxide emissions rose 33% since the treaty was signed.

That’s despite the ready availability of cheap, low-carbon technologies which can be deployed in both developed and developing nations. Electricity can be produced by wind and solar plants, hydropower and nuclear fission, and cars and trucks can run on electricity and biofuels.

Views on the matter of climate change are as divergent as can be. Some are convinced that life on the planet hangs in the balance: we must reach an accord in Copenhagen and make it stick in major offending countries like the US…or else. Others think the global warming is unrelated to human activity and is likely to self-correct in a century or two.

Nobody really knows whether global warming is man-made or how bad it will get, so it’s no wonder that it’s been hard to persuade people to spend money on a fix. It’s the mother of all externalities.

Yet as The Economist points out, this uncertainty is precisely why man needs to tackle global warming, now. If we knew that temperatures would rise by just a few degrees in the next century, then the argument to let things go would seem somewhat reasonable.

But the Intergovernmental Panel on Climate Change (IPCC), which was organized by the UN to develop evidence-based consensus on the matter, and which used every shred of evidence it could find, could do no better than give a range. It concluded that if things are left as they are, by the end of this century the average temperature on planet Earth will rise somewhere between 2-11ºF.

No sane person can argue that temperature elevations near the top end of this estimate would be anything less than catastrophic. More than a billion people would be displaced by coastal flooding, and at least that many would be severely affected by associated climate change.

But there’s some good news. Assuming humans approach the problem smartly (as discussed for example, here), the costs of averting that kind of catastrophe are not nearly as great as many think…about 1% of the world’s global economic output for the next several years.

On average, US homeowners spend about that percentage of their income insuring their homes. Heck, just last year, the world spent 5% of total global output bailing out the banking system.

The technology to control global warming is here. Global warming is a problem with unknown but potentially catastrophic consequences that can be averted with no worse than mild economic consequences. How could we not do this?

Occupational exposure to bisphenol A (BPA) is associated with erectile dysfunction, loss of sexual desire and ejaculation difficulties, according to US and Chinese scientists. Their report is one of the first to show this negative association in humans. Numerous earlier studies had done so in animals.

BPA is chemically similar to estrogen. It is used to produce polycarbonate plastics, and can be found in baby bottles, water bottles and cans used to package food and beverages.

The chemical leaches from these products into food, and can be detected in the urine of nearly every American.

In animal studies, BPA had been associated with infertility, early onset of puberty, weight gain, cancer and diabetes.

Last summer, the FDA issued a provisional ruling that BPA is safe at levels found in the US population. That ruling was disputed by its own advisory panel. Many places including Canada have banned BPA from baby bottles.

De-Kun Li and colleagues studied 634 Chinese factory workers. Of these, 230 were exposed to high levels of BPA on the job, and 404 had no such occupational exposure.

The scientists measured BPA levels in the air and the worker’s food and in their urine as well. At the same time, they surveyed workers about sexual experiences.

Workers with occupational exposure to BPA had more than 4 times the risk of erectile dysfunction, were 4 times more likely to report low sexual desire, and were 7 times more likely to experience ejaculation difficulties. The risk of these problems increased with urinary BPA concentrations.

The factory workers’ urinary BPA levels were about 50 times higher than that found in US males.

“Critics dismissed the animal studies, saying, ‘Show us the human studies,’” Li told the Los Angeles Times. “Now we have a human study and this can’t be dismissed,” he added.

The study appears in Human Reproduction.

This post first appeared on HCPLive.com/Psychiatry.

The Food and Drug Administration has sent a letter to 30 companies warning that it hasn’t approved beverages containing both caffeine and alcohol, and that it intends to begin removing such products from store shelves in 30 days if the companies can’t explain why such products are safe and legal.

The letter cited research showing that the combo drinks increase the risk of motor vehicle accidents and sexual assaults.

In one such study, Mary Claire O’Brien of Wake Forest University found that nearly one quarter of all college students claimed to have consumed such beverages in the last month alone.

O’Brien found that students who consumed alcohol-laced energy drinks were 70% more likely to be taken advantage of sexually (6.4% vs. 3.7%) and more than twice as likely (3.7% vs. 1.7%) to have taken sexual advantage of someone than students who drank alcohol alone.

O’Brien reported similarly appalling statistics for riding with a driver that had been drinking (38.9% vs. 22.5%), being hurt or injured (12.3% vs. 5.9%), and requiring medical treatment (2.6% vs. 1.2%). 
 
Last year, state authorities persuaded Anheuser-Busch and MillerCoors to remove their combo drinks, known as Bud Extra, Tilt, and Sparks from the market.

But at least 30 smaller companies still market the drinks, which contain roughly the same dose of caffeine as a large cup of Joe and nearly 10% alcohol. The provocatively-named beverages include Max Vibe, Moon Shot and Slingshot Party Gel.

In its press release on the matter, the FDA cited regulations that deem as unsafe all substances added to food or alcoholic beverages unless their “particular use has been approved by the FDA, or (they are) ‘Generally Recognized As Safe.’”

In a press conference explaining the FDA’s move, Joshua Sharfstein, the agency’s principal deputy commissioner explained that the “FDA is not aware of the basis on which these manufacturers have concluded that caffeine added to alcoholic beverages is, quote, ‘Generally Recognized As Safe.’” (more…)

One day during last year’s presidential campaign, FBI agents notified Barack Obama’s campaign that its computers had been hacked. Later, they told McCain’s campaign the same thing. 

Both attacks almost certainly originated in China.

These were not isolated incidents. China, or free-agent hackers on their payrolls, has penetrated computer systems of the State Department, US nuclear weapons labs and defense contractors.

It has stolen files on political dissidents from members of Congress, disrupted e-mail servers used by the Secretary of Defense and launched a spyware attack on electronic devices used by the Commerce Secretary during a visit to Beijing.

Last April, then-National Counterintelligence Executive Joel Brenner famously reported that the Chinese had penetrated “certain of our electricity grids” with malicious code that could be activated at a later date, perhaps bringing it down altogether. 

Officials can’t know exactly what has been stolen or how badly US systems have been exposed, but they do know why China has become an aggressive cyber threat.

“This is the way they plan to thwart US (military) supremacy in a potential conflict,” Robert Knake, a Council on Foreign Relations fellow told the Washington Post. “They believe they can deter us through cyber warfare.”

Chinese officials scoff at the accusations. “Allegations that China is behind cyber attacks against the US are irresponsible,” said Wang Baodong, a Chinese Embassy spokesperson.

“Since the US serves as the hub of the international information highway, attacking the US in cyberspace equals attacking one’s own cyberspace assets. . . . What’s the logic?” Wang added.

Amid the furor, US cyber policy expert James Lewis said it best, “I’m not going to get upset about China spying on us, because we spy on them. The only thing I’m going to get upset about is if we don’t do better.”

Only 72% of Americans believe global warming is happening, down from 80% just a year ago, according to a new Washington Post-ABC News poll. 

The increased skepticism is derived mainly by people describing themselves as Republicans and independents.

Three years ago, 76% of Republican voters believed the phenomenon was real, but that has dropped to just 54% now.

The tail-off among independents was from 86% to 71%. Among democrats, the dip was from 92% to 86%.

Despite these evolving trends, a slight majority, 53% of respondents still support legislation that would cap emissions and institute trade pollution allowances. A similar number, 55% believe the US should cut carbon emissions regardless of whether developing countries like China and India choose to do so.

The increasing political divide on the issue is surfacing just as President Obama and congressional Democrats have stepped up efforts to enact new climate legislation and at least make a credible presence at next week’s global summit on the matter in Copenhagen. 

“It’s a sad state of affairs when science becomes subject to partisan politics,” Democratic pollster Mark Mellman told the Washington Post. “It can only be attributed to the sense that this issue has become part of a political battle.”

Amanda Feinberg, a retired secretary who lives in South Williamsport, Pa., told the Post she began changing her views on global warming shortly after Al Gore released his movie documentary on the subject, “An Inconvenient Truth.”

“He just seemed a little radical in his views,” said Feinberg, a Republican. “I don’t deny it’s happening, I just think it’s just an evolution of nature.”

Another Republican respondent, Lisa Woolcott doubted whether Americans would support policies that raised energy prices amid the current recession.

“I don’t think the public’s going to back it,” she said. “It’s all they can do to pay their electric bill and put gas in their cars. It’s like, let’s get through Thanksgiving and Christmas.”