Saint Joseph hospitals in Lexington, London and Mount Sterling seek applications for grants to improve well-being, health equity

By Melissa Patrick

Kentucky Health News

The CHI Saint Joseph Health hospitals in Kentucky are accepting applications for local nonprofit organizations to apply for grants aimed at supporting services to improve well-being and health equity in their service areas. 

The grants are part of the Community Health Improvement Grants program, which was created in 2019 when Catholic Health Initiatives and Dignity Health came together to create the national health system CommonSpirit Health.

Grants through Saint Joseph Hospital and Saint Joseph East in Lexington, and Saint Joseph London, can be as small as $20,000 and as large as $100,000. Grant opportunities are also available at Saint Joseph Mount Sterling to serve that area, ranging from $10,000 to $19,500.  Click here for the link to the application website. 

"Grant applications must include collaborating partner organizations helping to deliver services and not be solely about one agency’s work,” Michael Bilton, CommonSpirit Health's senior director for community health and benefit, said in a news release. 

The application period is open through Aug. 16. Grants are available to nonprofit organizations that address substance-use disorders, mental health, and issues involving weight, physical activity and nutrition. All projects must be planned for calendar year 2025. 

The priorities were identified in the hospitals' most recent community health needs assessment, which is conducted every three years. 

“We are deeply committed to the well-being of our community," Christy Spitser, interim market president of CHI Saint Joseph Health, said in the release. "Providing grants to local nonprofits is a vital part of our mission to give back and make a tangible difference in the lives of those we serve.” 

Interested organizations can learn more about the grant program, including eligibility criteria, how to apply, and a local contact for questions, by visiting https://www.commonspirit.org/communitygrants.

It's Heart Month, which confronts the leading killer in the U.S.; here are five ways to keep your heart healthy or make it healthier.

University of Florida illustration

Kentucky Health News

February is American Heart Month, which focuses on the fact that heart disease is the leading cause of death in the U.S., and ways to lower your risk for heart disease. Here are five ways to boost your heart health, from the Centers for Disease Control and Prevention:

Exercise regularly. Maintaining a healthy weight is an important part of heart disease prevention, and regular exercise is one way to achieve this. The surgeon general recommends that adults get two and a half hours of moderate physical activity like walking or biking weekly. Children and adolescents should aim for an hour of physical activity every day.

Eat healthy. Establishing healthy eating habits is another way to maintain a healthy weight. Avoid foods that are high in saturated fat and trans fat. Opt for foods that are high in fiber and low in saturated fat, trans fat and cholesterol to help prevent high cholesterol. Foods with lower sodium can help lower your blood pressure, and consuming foods with less sugar can help keep your blood sugar under control.

Set limits. Limiting your alcohol intake and avoiding smoking can also help you prevent heart disease. Knowing your limits and setting boundaries can help you stay disciplined, which is another vital part of lowering your risk for heart disease.

Monitor health conditions. If you struggle with high blood pressure or high cholesterol or have diabetes, managing these conditions is a key part of preventing and lowering your risk for heart disease. Consult with doctors and other members of your health team to see what their recommendations are for managing existing medical conditions. They may prescribe medicines to help manage your blood pressure, cholesterol or blood sugar, along with lifestyle changes to help.

Work with a team. It's important to work with your health care team if any of your conditions change, if your family has a history of any of these medical conditions or if you suspect you might be at risk for them. Consult your doctor if you’ve already had a heart attack or if you struggle with mental-health issues. Create a treatment plan that works for you and discuss it regularly, making adjustments when necessary. Don’t stop taking any prescribed medicines before talking to your doctor.

Prioritizing heart health is critical for preventing and lowering your risk for heart disease. For more tips to boost heart health, visit cdc.gov/heartdisease/prevention.htm.

'SMART' ways to make those New Year’s resolutions stick

SMART goals concept
(Wikipedia graphic)

By Shorus Minella

University of Kentucky

If you’re looking for ways to make those New Year’s resolutions stick, try finding something you are really motivated to do. You are more likely to want to work toward a goal if you enjoy the activity. 

For example, if you want to start exercising but hate exercise equipment at the gym, find a dance or aerobic class instead.

After you’ve identified something you want to work towards, be realistic and set a specific goal. 

Instead of a broad goal like “I want to eat healthy,” instead, try “I want to eat two cups of vegetables every day.” You’re more likely to accomplish and stick to a specific goal.

Following the SMART goals concept is a great guide to setting and sticking to goals. Here’s what to keep in mind when making your goals:

 

Specific – Giving yourself a very specific goal makes it easier to achieve. For example, instead of setting a goal to lose weight, aim for a specific number, such as five pounds. When you reach that goal, aim for another five pounds.
Measurable – Set yourself up for success by tracking your progress. Seeing how far you’ve come is an excellent motivator!
Achievable – If you’ve never run a step in your life, vowing to run a marathon might be a difficult goal to stick to. Start small by running around the block, then a mile, then try signing up for a community 5K.
Relevant – Your goals should be in line with your values and passions. You’re more likely to achieve your goal if you are enjoying it!
Time-Based – Give yourself a realistic time frame to complete your goal.

Most importantly, give yourself grace during your journey. Celebrate your successes but don’t get discouraged by any setbacks. Talk to your doctor or check in with the local health department for resources and programs to help you meet your goals.

Shorus Minella is a dietitian and patient education coordinator at UK HealthCare’s Gill Heart & Vascular Institute.

Ga. professor develops model to show how much you need to walk each day to achieve a specific reduction in your weight

Step counts and weight loss have an inconsistent relationship.
(Photo by Jose Carlos Cedeno Martinez, Getty Images)

By Bob Buresh
The Conversation

Over the last decade, smartphones have become ubiquitous not just for sending texts and staying abreast of news, but also for monitoring daily activity levels.

Among the most common, and arguably the most meaningful, tracking method for daily physical activity is step counting.

Counting steps is far more than a fad. The U.S. Department of Health and Human Services dedicated a sizable portion of its most recent physical activity guidelines to documenting the relationship between daily step counts and several chronic diseases.

Unfortunately, the guidelines have little to say about how step counts might be used to aid in weight management, an outcome of critical importance given the high rates of overweight and obesity in the U.S.

In the early 1980s, fewer than 14% of adults in the U.S. were classified as having obesity. Today, just over 40 years later, the prevalence of obesity is greater than 40% in the adult population, and current trends suggest that almost half of adults in the U.S. will be obese by 2030.   

I am a professor of exercise science at Georgia's Kennesaw State University, and our lab has been conducting studies examining relationships among step counts and a number of health outcomes.

While the evidence is clear that increasing numbers of adults are living in a chronic energy surplus that leads to weight gain, a key question is – why? What has changed so dramatically since 1980 that could explain why obesity rates have tripled?

Although the American diet is likely a key contributor, a wealth of research points to a reduction in physical activity as a major culprit behind the expanding waist lines – and step counts are an excellent indicator of physical activity.

 
Step counts may – or may not – lead to weight loss

A number of recent studies have looked at whether increasing step counts can lead to weight loss over a certain period of time. One large-scale study called a meta-analysis concluded that increasing physical activity by way of step counts was effective for attaining modest weight loss. However, many if not most studies examining the effect of exercise on weight loss report modest outcomes, with results that are variable and often disappointing.

That may be in part because the step count targets used in many weight management studies are most often set in an arbitrary manner, such as targeting 10,000 steps per day. Or, if they’re individualized at all, they’re based on initial behavioral characteristics, like adding a given number of steps to what a person is already accumulating in a typical day. Rarely, if ever, are the step targets in research studies based on any physical attributes of the participants.

My team’s research has compiled weight, body-fat percentages and average step counts for large numbers of adults between 19 and 40 years of age. From that data, we have identified a way to determine specific step count goals based on key physical attributes – namely, baseline body weight and composition, and the desired body composition.

When it comes to health, it is important to remember that body weight does not tell the whole story. In fact, body composition is much more predictive of health status than body weight. Someone who weighs more than another person may be in better health if they have more muscle mass and a lower percentage of body fat than the other person who weighs less but has a higher proportion of body fat.

Parsing the numbers

We have used our data to develop a model that predicts average daily step counts per unit of fat mass from body-fat percentage. We believe that this model can be used to determine how much people would need to walk to achieve a specific amount of weight and body fat reduction.

Take, for instance, a man who weighs 175 pounds (80 kilograms), of which 25% is fat. Our model suggests that he walks an average of 10,900 steps a day. Then consider another man who weighs 220 pounds (100 kilograms), of which 20% is fat. Although they have different amounts of lean mass, both men have about 44 pounds (20 kilograms) of fat. So our model predicts that the heavier man walks an average of 15,300 steps a day. In other words, the heavier person has a lower percentage of body fat and walks more to maintain that leaner body composition.

A person’s body fat percentage is every bit as important as their weight. That’s because how much muscle you have affects how hungry you get, as well as how many calories you burn. Muscle mass requires energy to maintain, and this requirement leads to increased appetite, which means taking in more calories. In this example, the heavier man probably eats more than the lighter man in order to maintain his lean muscle mass, and he must walk more to maintain his lower body fat percentage.

If you want to lose body fat, and therefore weight, you basically have two choices: You can eat less, or you can move more. Eating less means you’ll be hungry a lot, and that’s uncomfortable, unpleasant and, for most people, not sustainable. Moving more, on the other hand, can allow you to eat until you’re full and keep body fat off – or even lose it.

Therefore, we wanted to know how much a person who eats until they’re full might have to move to offset the calories they’re eating.

It’s easy to add in extra steps – for example, park a little farther from the grocery store or take an extra trip to the mailbox.

Step counts for weight loss

Currently, our model applies to young adults, but we are now collecting data for middle-aged and older adults too. To use this model, you need to first have your body composition determined, a service that is being offered by increasing numbers of fitness centers and medical practices. With our model, you must determine your body weight and fat weight in kilograms – to do this, simply divide your weight in pounds by 2.2.

With this information in hand, our model can provide a step count target that is specific to a person’s current body weight and body fat percentage, and their goal for fat loss and weight reduction.

For example, our model predicts that a woman weighing 155 pounds (70 kilograms) with 30% body fat currently accumulates an average of about 8,700 steps per day. If she wants to lose about 10 pounds and reach a body fat percentage around 25%, she could consult the model and discover that people who maintain that body composition accumulate an average of about 545 steps per kilogram of fat per day. Since she currently has about 46 pounds (21 kilograms) of fat, her goal would be to accumulate a total of 11,450 steps per day.

While that may seem at first glance to be a sizable increase in daily steps, most people can accumulate 1,000 steps in 10 minutes or less. So even with a comfortable pace, this additional daily dose of walking would take fewer than 30 minutes. Furthermore, steps can be accumulated throughout the day, with longer or more frequent trips, or both, to restrooms, vending machines and the like.

While steps certainly can be accumulated in dedicated walking sessions, such as a 15-minute walk during lunch hour and another 15-minute walk in the evening, they can also be accumulated in shorter, more frequent bouts of activity.

Researchers have learned a great deal in the past 70 years about appetite and energy expenditure: Appetite imposes a drive for food based largely on our fat-free mass, no matter how active or inactive we are, and we must accumulate enough physical activity to counter the calories that we take in through our diet if we want to maintain an energy balance – or exceed our intake to lose weight.

The Conversation is a platform for journalism by academics.

Ky. children 10-17 have nation's 2nd highest obesity rate, 19.6%; adult rate of 37.7% is 9th highest, a slight improvement from 2021

Map from Trust for America's Health State of Obesity report

Kentucky Health News graph from state data

By Melissa Patrick

Kentucky Health News

Kentucky ties with Wisconsin for the nation's ninth-highest adult obesity rate, an improvement from second-highest last year, but Kentucky children aged 10-17 still have one of the nation's highest rates, No. 2, after ranking first last year.

The 20th annual State of Obesity report from Trust for America's Health says 37.7% of Kentucky adults are obese and nearly 72% of the state's adults are either obese or overweight, tied for sixth place with Delaware. Among the state's high-school students, 19.6% of them are obese and 16.2% are overweight.

Nationally, the report says the number of obese adults continues to rise, noting that 22 states had an 2022 adult obesity rate at or above 35%, up from 19 states in 2021. A a decade ago no state had an adult obesity rate at or above 35%, the report says.

"Since TFAH’s initial report, published in 2004, the national adult obesity rate has increased by 37 percent and the national youth obesity rate increased by 42 percent," says the report. 

The national adult obesity rate is 42% and the national rate for children ages 2 to 19 is nearly 20%, according to the report.  

The good news is that from 2021 to 2022, Kentucky's adult obesity rate declined 6.4%, or 2.6 percentage points, to 37.7% from 40.3%. But that was still above the levels of 2018, 2019 and 2020.

West Virginia (41%), Louisiana (40.1%), Oklahoma (40.0%), and Mississippi (39.5%) have the highest rates of adult obesity. The District of Columbia (24.3%), Colorado (25.0%), and Hawaii (25.9%) have the lowest adult obesity rates.

“It’s critical to recognize that obesity is a multifactored disease involving much more than individual behavior,” Dr. J. Nadine Gracia, president and CEO of Trust for America's Health, said in a news release. “In order to stem the decades-long trend of increasing obesity rates we have to acknowledge that the obesity crisis is rooted in economic, health, and environmental inequities. Ensuring all people and communities have equitable opportunity and access to healthy food and physical activity is fundamental to addressing this crisis.”

Kentucky continues to struggle with all of these conditions. It ranks fifth worst for the percentage of adults with diabetes (15%) and hypertension (40.3%), and nearly 27% of its adults are physically inactive, ninth worst. 

The report shows that more adult men than adult women are obese in Kentucky: 38.7% of men and 36.7% of women, a switch from last year's report. Kentucky's adult men have the second highest obesity rate in the nation; its women rank 18th, tied with Texas.

By age, Kentucky adults between 45 and 64 have the highest obesity rate, 42%. That's followed by those 25-44 (41.2%), 65 and older (33.7%) and 18 to 24 (24.1%). 

"Solving the nation’s obesity crisis will require addressing the economic and structural factors that impact where people live and their access to employment, transportation, healthcare, affordable and healthy food, and places to be physically active," says the report, which includes policy steps to address the crisis that they say should be taken by federal, state and local officials and stakeholders. They include: 

• Fully fund the Centers for Disease Control and Prevention's proven chronic disease and obesity prevention programs so they reach every state.
• Make healthy school meals available for all students and increase access to Supplemental Nutrition Assistance Program (SNAP) and other nutrition support programs.
• Implement a mandatory front-of-package labeling system on food packaging to help consumers make informed choices.
• Close tax loopholes and eliminate business-cost deductions for advertising unhealthy food to children.
• Make physical activity and the built environment safer and more accessible for everyone, including by increasing federal education funding for health and physical education and investing in active transportation projects like pedestrian and bike paths.

As a whole, Kentucky seniors are the third most unhealthy in the nation, ranking better than only Louisiana and Mississippi

Photo from Getty Images via Kentucky Lantern

By Sarah Ladd

Kentucky Lantern

New data shows Kentucky among the worst states for key health points among senior citizens, including tooth extractions, food insecurity, insufficient sleep and more.

The statistics, published in the America’s Health Rankings Senior Report in May, show Kentucky seniors have the most tooth extractions.

As a whole, Kentucky seniors rank second for insufficient sleep, exercise and cognitive difficulties; third for food insecurity, and sixth for obesity.

As a whole, Kentucky seniors are the third most unhealthy, healthier only than their counterparts in Louisiana and Mississippi.

Dr. Michael Stockman, a geriatric physician based in Minnesota, said there is a “bright side” of the report: Older Kentuckians, generally, don’t drink too much or have severe housing insecurities, and they consume sufficient fruits and vegetables.

For older Kentuckians not to drink excessively “is great because excessive drinking can lead to things like liver disease, diabetes,” said Stockman, who works for UnitedHealthcare. “It can also interfere with the medications that people are taking as well.”

The United Health Foundation released the report, which examines the health of older adults with 52 measures including social and economic status, physical environment, clinical care, behaviors and more. The rankings are based on data available up to March 8.

Kentucky had higher rates of physical inactivity than the national average, the report showed, which Stockman said can itself lead to poor health.

Nationally, 31% of seniors 65 and older are physically inactive, while the number jumps to 37% in Kentucky.

“It’s important to do those simple daily things like walking 30 to 45 minutes a day to really make a positive impact on overall health and well being,” Stockman explained.

Exercises like walking, stretching, yoga and tai chi can all help strengthen the body and prevent falls, which can lead to fractures, he said.

Social isolation

Kentucky seniors are at high risk of social isolation, the report says, a fact exacerbated by the Covid-19 pandemic. The report ranks Kentucky ranks fifth in social isolation among older adults.

“The pandemic did really create a social isolation amongst all of us. I think seniors were disproportionately affected and it … worsened during that pandemic,” Stockman said. “Being socially isolated puts people in a very vulnerable situation, particularly as they’re going through stressful life events common with aging, such as losing maybe a close friend or a family member, or as they move into retirement. Being socially isolated can lead to, really, a decline in a person’s cognitive functioning. It can increase the risk of depression and decrease the overall quality of life of older adults.”

The bright side to that point, though, is that there are more households now with access to high-speed internet than in 2019. The internet can help seniors gain access to telehealth appointments, stay in contact with family and friends and participate in social activities.

Kentucky seniors seem to be closing the gap in high-speed internet. From 2019 to 2021, 9 percent more of them used broadband, while the national increase was 7 percent.

Foundation for a Healthy Kentucky and state agency start effort to encourage Kentuckians to improve immunity and overall health

One of the graphics used to promote the campaign

A new campaign encourages Kentuckians to boost their overall health and immunity to combat chronic conditions and Covid-19, the effects of which are still being felt across the state.

“Raise Your Guard, Kentucky” is a partnership between the Foundation for a Healthy Kentucky and the state Cabinet for Health and Family Services to encourage Kentuckians to adopt habits that will improve their health and reverse negative health impacts.

Since the pandemic began about three years ago, chronic conditions such as diabetes, obesity and cardiovascular disease have increased in Kentucky, especially among African Americans. 

“Kentuckians have long struggled with chronic conditions, but the pandemic has certainly made it worse,” said Ben Chandler, president and CEO of the foundation. “We don’t have to accept this as status quo. We can take action to help our bodies be in better condition to fight off the next virus – whether that’s a new Covid-19 variant, the flu, or another illness, as well as combat chronic disease.”

“Raise Your Guard, Kentucky” encourages people to:

• Eat well: Emphasize fruits and vegetables, lean protein, whole grains and low-fat or fat-free dairy. Limit saturated fats, cholesterol, salt and added sugars.
• Move more. Physical activity is one of the most important aspects of overall health.
• Stay up to date on all immunizations. Children and adults need protection from vaccine-preventable diseases including measles, shingles, flu, and Covid-19.
• Schedule annual check-ups and screenings: Preventive check-ups with your health-care provider and dentist can catch potential issues in the early stages. Get recommended screenings, including mammograms, colonoscopies, bone density and lung cancer screenings.
• Maintain a healthy weight: Excess weight can affect how your body functions. It can also lower vaccine effectiveness for numerous diseases including influenza, hepatitis B and tetanus.
• Drink lots of water: Getting enough water every day is important to prevent dehydration, a condition that can cause unclear thinking, mood change, your body to overheat, and lead to constipation and kidney stones.
• Get enough sleep: Studies show not getting enough sleep can negatively affect the immune system and is linked with many chronic diseases and conditions.
• Quit smoking and vaping. They harm the immune system and can make the body less able to fight off disease.
• If you drink alcohol, drink in moderation. Over time, excessive alcohol use can weaken the immune system and lead to various short- and long-term health impacts such as heart disease, cancer, and increased risk of getting sick from a cold or virus.
• Try to minimize stress. Long-term, stress promotes inflammation and an imbalance of immune cell function. Learning to cope with everyday stressors and challenges is vital for success in life, school and work.
• Wash your hands. Good personal hygiene can prevent the spread of infection.

“Small healthy choices add up to a big positive impact to ensure that every Kentuckian has the opportunity to reach their full human potential,” said Dr. Steven Stack, commissioner of the state Department for Public Health. “Working together, we can create the conditions that enable every Kentuckian to thrive.”

The “Raise Your Guard, Kentucky” campaign includes a video series featuring everyday people from across the state who share why and how they stay healthy:

• Lacretia Dye, an associate professor at Western Kentucky University, hosts a community yoga class each week.
• Fannie Callahan, a Beattyville retiree, walks every day to prevent diabetes and improve her overall health.
• Kota Young, the Caldwell County judge-executive, has a passion for his community. He shares how he stays healthy so he can better serve.
• Harlan Holmes, a Bowling Green man who learned at 25 that his blood pressure was alarmingly high. He began a “couch to 5K” program, reduced his blood pressure to healthy levels, and has continued running to maintain his health.
• Bethany Pratt of Louisville, an urban farmer, teaches others how to grow their own food, even with limited space.
• Mike Wilkinson of Lexington visits Red River Gorge to climb and hike for physical and mental stress relief.

Kentucky organizations are encouraged to download the videos, graphics, and other educational materials to share with their contacts and use on social media. Materials may be downloaded for free here. Additional videos will be added.

The foundation says it has engaged with nearly 2,000 Kentuckians through focus groups, surveys and polls to learn their perspectives on Covid-19 vaccines and boosters, as well as the pandemic, in general. “Raise Your Guard, Kentucky” messages and delivery vehicles reflect the insights gleaned from this input and are culturally relevant and responsive to the audience. The campaign's resources are available in English, Spanish and Swahili. Learn more at RaiseYourGuardKY.org.

How to create a successful fitness plan this spring

Photo from PeopleImages | iStock / Getty Images Plus

By Dr. Robert G. Hosey

University of Kentucky

Scientists have found that regular participation in aerobic exercise has been shown to decrease levels of stress, stabilize mood, improve sleep and improve self-esteem. Just five minutes of aerobic exercise can help alleviate and stimulate anti-anxiety effects. Here are some tips to create a successful fitness plan this year.

Preliminary checks: Before you start working up a sweat, schedule a visit to your doctor to gauge on your overall health. Discuss any aches, pains or limitations that might impact your plans to get active. Your doctor can also assess your cardiovascular health and help you understand how and when to increase your exercise intensity.

Make a plan: Exercise should be planned for a time in the day when you feel rested and have the most energy. If you are planning to exercise outside, avoid extreme temperatures (warmer than 85 degrees F or colder than 32 degrees F). Remember to dress appropriately for the weather and wear comfortable, supportive footwear. An indoor contingency plan for exercise can help you stay active even during spring showers.

Don’t forget to warm up and cool down: Aerobic exercise, such as walking or biking, is recommended for those getting started with a new routine. Your exercise session should start with a warm-up period of slow walking or low-resistance bicycling and end with a cool-down segment at similar intensity.

At the end of exercise, stretch the major muscle groups used by holding each stretch for 20-30 seconds. This can minimize injury and fatigue and increase flexibility.

Make it manageable: Begin your exercise routine with an amount of time that is manageable, something as short as a five-minute walk around the neighborhood. Once you’re comfortable exercising for that long, slowly increase the duration of your sessions.

Don’t push yourself too hard, either. You should be able to maintain a conversation at all times of exercise without experiencing breathlessness.

Hydrate, hydrate, hydrate: Drinking water is important, especially when you’re exercising more. Staying hydrated helps your muscles work more efficiently and helps your heart pump blood more easily. Make sure to drink plenty of water before you exercise — it’ll help your body perform at its best.

Buy a durable water bottle and carry it with you at work and when you run errands. Having a water bottle by your side will remind you to drink throughout the day.

Have fun: Exercise shouldn’t be a slog, so make sure you’re doing something that you enjoy and makes you feel good. A successful start of a new routine will keep you motivated to continue and progress.

Fitness trackers and fitness apps are additional options to stay engaged and monitor progress. Enlisting a companion for exercise will add an element of support and keep the activity enjoyable.

Robert Hursey, M.D., is physician with UK HealthCare Orthopaedic Surgery and Sports Medicine and professor of family and community medicine in the UK College of Medicine.

American Heart Month and Black History Month are the same month, and are related; Blacks are likelier to have heart disease

By Dr. Daniel Brunner

In February, we commemorate both American Heart Month and Black History Month, which presents an opportunity for us to raise awareness about cardiovascular health, remember the contributions of African Americans who helped shape the nation and reflect on the continued struggle to overcome disparities. As February ends, I urge everyone to commit to mind the teachings of American Heart Month and Black History Month throughout the year. That’s because a particular disparity that impacts the African American community is heart disease – the leading cause of death for African Americans and all adults across the U.S.

Daniel Brunner, M.D.

According to the Centers for Disease Control and Prevention, more than 20 million U.S. adults — approximately 7% of the U.S. population — have heart disease. The disparity lies in the fact that nearly 48% of African American women and 44% of African American men have some sort of heart disease. This is a lot higher than the 36% of white, non-Hispanic adults in the U.S. who have heart disease. In Kentucky, where heart disease is the commonwealth’s leading cause of death, 11.8% of the African American population has been diagnosed with a cardiovascular disease — higher than the national average of 9%.

While many factors contribute to their increased risk, what matters is that heart disease is killing Black Americans at a higher rate than any other group in the U.S., and the best way to fight this disparity is to successfully treat the risk factors.

Here is what people need to know:

Screening: Getting screened by a medical professional will help identify risk factors for heart disease early enough to treat it. Medical screening will identify if there are genetic risks or if factors such as weight, environment and habits are putting a person at higher risk of disease and death. Getting screened at least once a year is crucial for all adults.

Medication management: It’s not only important for people to take prescribed medication as directed for heart disease and other conditions that cause heart disease (such as diabetes, high cholesterol and high blood pressure), but is also important to communicate with a doctor to help manage conditions and adjust medication when required.

Staying active: Staying physically active reduces and helps manage weight. It may reverse early diabetes and cut cholesterol levels. It can even help control stress and hypertension. All it takes is 30 minutes a day, at least five days a week of exercise that is enjoyable, like walking, running, swimming, cycling, dancing, playing a sport or anything that gets the heart pumping.

Diet: It is extremely important to watch your diet to help maintain a healthy weight and heart. Certain ethnic food or diets and sugar-sweetened beverages are widely embraced in many communities. Some diets may be associated with a significantly increased risk of heart disease. With risk factors as high as they are, it is critical to be diligent with limiting foods that are rich in sugar, fat, calories and sodium.

Lifestyle choices: While it is not possible to change genes that are inherited, it is possible to make lifestyle changes that can influence heart health. Cutting smoking, getting six to eight hours of quality sleep at night and refraining from overeating could make a positive difference in heart health. Also important is cutting stress, since stress can increase hormones that elevate blood pressure. If stress continues long-term, it can lead to permanent hypertension, an irregular heart rhythm or a permanent heart condition.

Fighting back against heart disease doesn’t have to be undertaken alone. It’s obvious that people need their doctors to help, but in many cases, people can also turn to their health insurer for support. Many health plans offer special assistance in the form of case managers who work with patients and providers to determine a course of action that best serves a patient’s needs.

Accessing no-cost screenings, managing medication, and utilizing benefits designed to help members stay active or access diet programs are key to ensuring a healthy life. Reach out to your health plan to manage the thing that is most important – your health.

Daniel Brunner, M.D., is medical director for Anthem Blue Cross and Shield Medicaid in Kentucky. He is an emergency medicine physician based in Northern Kentucky.

Kentucky adults have second highest obesity rate in nation, and children 10-17 in state have the top U.S. rate for that age group

By Melissa Patrick
Kentucky Health News

A new report says Kentucky has the second highest adult obesity rate in the nation, and Kentucky children aged 10 to 17 have the nation's highest rate for that age group.

The Trust for America's Health 19th annual report says four of every 10 Kentucky adults are obese. And 72.3 percent are either obese or overweight, third in the nation. Among the state's high-school students, 18.4% are obese and another 17.8% are overweight.

The report says the national adult obesity rate keeps rising, with 19 states having a rate over 35%, up from 16 in 2021. The report notes that a decade ago, no state had an adult obesity rate at or above 35%.

Map from Trust for America's Health report; click it to enlarge

From 2020 to 2021, Kentucky's adult rate increased 10 percent, 3.6 percentage points, from 36.6% to to 40.3%.

Kentucky's rate is just a bit lower than West Virginia's 40.6%. Alabama ranks third at 39.9%. The District of Columbia, Hawaii and Colorado have the lowest rates, ranging from 24.7% to 25.1%.

"These persistent increases in obesity rates underscore that obesity is caused by a combination of factors including societal, biological, genetic, and environmental, which are often beyond personal choice," says a news release from Trust for America's Health. "The report’s authors conclude that addressing the obesity crisis will require attending to the economic and structural factors of where and how people live.

Obesity is associated with a many different health conditions and is estimated to increase U.S. health-care spending by $170 billion every year, the Trust for America's Health report says. 

"Obesity increases the risk of a range of diseases for adults—including higher rates of complications and serious illness from Covid-19, as well as type 2 diabetes, high blood pressure, heart disease, stroke, arthritis, depression, sleep apnea, liver disease, kidney disease, gallbladder disease, pregnancy complications, and many types of cancer—and an overall risk of higher mortality," the report says. 

Kentuckians struggle with all of these conditions. Nearly 14% of the state's adults are diagnosed with diabetes and 40.3% are diagnosed with hypertension, ranking Kentucky fifth for both conditions. 

The report says Kentucky women's obesity rate is 40.9%, while men's rate is 39.8%, plus or minus 2.7 percentage points.

Obesity rates by county in 2018-20, the latest range available, are published by the Foundation for a Healthy Kentucky at kyhealthfacts.org.

Child obesity: When it comes to age, Kentuckians between 45 and 64 have the state's highest obesity rate, 46.2%. That's followed by those 25 to 44 (42.5%), 65 and older (35.3%), and 18 to 24 (28.2%). 

The rate for Kentuckians 10 to 17 is 23.8%, the nation's highest. Nationwide, nearly 20% of children between the ages of 2 to 19 are obese. "These rates more than tripled since the mid-1970s," the release says. "Black and Latino youth have substantially higher rates of obesity than do their white peers." 

Getty Images photo via University of Missouri

One way to help children and their families address childhood obesity is through an electronic health records that help doctors monitor body-mass index, the basic measure of obesity, according to a University of Missouri School of Medicine study.

The three-year study found that a tool called FitTastic was an effective in decreasing BMI in children, especially young children. It works by helping health-care providers communicate with families about five daily lifestyle behavior goals: At least one hour per day of physical activity, limiting screen time to two hours a day or less, three daily servings of low-fat milk or calcium, at least four servings of water instead of sugary drinks, and at least five servings of fruits and vegetables. 

“We found a nearly 20% more favorable BMI pattern in the FitTastic group compared to the control group when looking specifically at children who were either overweight or obese,” said the principal investigator, Dr. Amy Braddock. “The data was especially favorable for younger children, between the ages of 2 and 5 years old.”

Body mass index is calculated by dividing a person's weight in pounds by their height in inches times two, and then multiplied by 703. An adult is considered obese if their BMI is 30 or higher, and is considered severely obese if that level is 40 or above. Children's BMI are compared to other children of the same age and sex, since there are fluctuations in their growth and development. 

The Trust for America's Health report includes a detailed list of recommended policy actions to address the social and economic drivers that contribute to obesity. The actions can be implemented at the federal, state and local levels. They include:

• Advance health equity by strategically dedicating federal resources to the efforts that reduce obesity-related disparities;
• Decrease food insecurity while improving nutritional quality of available foods;
• Change the marketing and pricing strategies that lead to health disparities;
• Make physical activity and the built environment safer and more accessible for all;
• Work with the healthcare system to close disparities and gaps from clinic to community settings

“The continued increase in rates of obesity across all population groups is alarming,” Dr. J. Nadine Gracia, president and CEO of Trust for America’s Health, said in the release. “Policies and programs to reduce obesity need to be implemented at a systems level. We must advance policies that address the community, institutional, and structural factors that are barriers to healthy eating and physical activity and that exacerbate health inequities.”

Data for the report is based in part on the Centers for Disease Control and Prevention's Behavioral Risk Factors Surveillance System, a continuous national poll.

Here are some simple tips to help you stay healthier as you age: Keep your mind and body active, keep exploring . . .

Photo illustration from iStock/Getty Images Plus

By Kelly Parsons
University of Kentucky

What goes up and never comes down? Your age!

September is Healthy Aging Month, an observance designed to celebrate the positive aspects of growing older.

Keeping in touch with your neighbors, community and world around lowers the risk of dementia. Staying social and engaged improves your brain health. There are many ways you can engage in activities, including programs at your local senior center, the Silver Sneakers program and volunteering.

Aging can be filled with opportunities for self-growth and exploration of the world around us. Healthy Aging Month reminds us that engaging in social and productive activities has been shown to lower blood pressure, improve mood and live longer.

We experience significant changes as we age: retirement, moving to a new area, changes in health status or mobility can all impact our ability to stay connected. These events can result in a loss of connection which can cause you to become isolated and/or feel lonely.

Here are five ways to celebrate Healthy Aging Month and promote healthy aging in your life:

Get active: The body is the vessel of the soul. That is why taking care of it is one of the most important elements of healthy aging. When it comes to exercising, keeping a routine is key. Finding a workout partner, joining a dance class, or getting outside and enjoying some fresh air are all great ways to stay active and have fun while doing it! Sooner than you know it you’ll be looking forward to your next workout. (Research on chimpanzees suggests it's physical inactivity that makes us frail, National Geographic reports.)

Keep your mind sharp: Keeping your mind active will allow you to stay as mentally sharp as you’ve ever been. Learning new recipes, playing word or number games, learning to play a musical instrument or joining a book club are fun ways to exercise your mind.

Keep exploring: Keep your life exciting by visiting new places, volunteering and traveling. Local libraries, senior centers and universities have programs for all interests. For example, the University of Kentucky has the Office of Lifelong Learning (OLLI) program, which offers educational and enrichment opportunities for people age 50 and older.

Stay on top of your health status: Over time, it can be easy to lose track of routine doctors' visits, but as we age it is more important than ever to stay on top of our health. Make this September the month to re-up on annual shots and checkups. Remember, Medicare will pay for your annual wellness visit. Keeping up with your health conditions can help prevent serious health issues.

Stay motivated: Sometimes, getting older can take a toll on your mental and emotional health. Know that you are not alone. Finding a community can help to keep you motivated.

Whether you're in your 40s or in your 80s, it's never too soon (or too late) to begin your journey of healthy aging. Celebrate Healthy Aging Month by making the choice to take care of yourself for yourself.

Reducing screen time can help children be more physically active

Illustration by Becky Wright, Happiful

Reducing screen time seems to encourage children to be more physically active, but it's unclear whether it can help them get better sleep.

A study by researchers at the University of Southern Denmark involved 89 families from 10 municipalities in the region. The researchers assigned each family to one of two groups: 45 families (including 86 children and 82 adults) were assigned to the intervention group and told to limit the amount of time they spent using electronic devices, and 44 families (95 children and 82 adults) were assigned to a control group and told to continue using electronic devices as usual. In the intervention group, some of the adults could not give up their smartphones because of work, but in each family, at least one adult was able to relinquish their smartphone and replace it with a non-smartphone. The participants in the intervention group were allowed up to 30 minutes of necessary screen time a day for activities such as coordinating appointments.

The intervention lasted two weeks. The researchers determined that was long enough for the participants to adapt to a life with less screen time while still remaining compliant with the study. To be considered compliant, participants had to have no more than seven hours of screen media use during the period. Screen media use was measured with noncommercial apps and a television monitor developed in-house and installed by a research team member. The study is published in JAMA Network.

After the two weeks, the researchers noticed a significant difference in rates of physical activity between two groups. Children in the intervention group averaged 45 more minutes of moderate to vigorous physical activity, while children in the control group averaged just 1 minute more. There was also a far greater difference in how much time children in the intervention group engaged in leisure, non-sedentary activities than in children in the control group.

No significant difference was found in adults between the groups. Nor was there a significant difference in any of the children's or adults' sleeping habits, including total sleep duration, sleep onset latency, wake after sleep onset in children and adults, or the duration of stage of sleep lasts in children or adults. The researchers noted how the results for sleep parameters in children are not consistent with evidence from a systematic review of trials targeting screen media use (often in combination with co-interventions). 

The researchers said the large effect on physical activity suggests that the high levels of recreational screen media use seen in many children should be a public health concern and emphasizes the importance of developing and implementing measures to balance recreational screen media use to prevent physical inactivity in children.

Regular, moderate exercise may slow Parkinson's symptoms

Seniors exercise. (Photo by the Parkinson's Foundation)

Regular, moderate exercise one to two hours a week by people with early-stage Parkinson's disease may help slow the damage it does to the body and the mind.

A study published in Neurology, the medical journal of the American Academy of Neurology, looked at 237 people in the early stages of the disease with an average age of 63. They were followed by researchers for up to six years. Their exercise levels at the start of the study were determined by using a questionnaire that measures time and intensity of activity during the previous week: leisure activity, like walking and biking; household activity, such as gardening; and occupational activity, like taking care of others. Other tests measured verbal and memory skills and how much time it took participants to complete mental tasks.

Researchers used a common test to rate each person’s Parkinson’s symptoms on a scale of zero to four, with higher scores indicating more severe impairment. The average score of people who got less than one to two hours of moderate to vigorous exercise once or twice a week increased over six years from 1.4 to 3.7, but those who got above-average levels of moderate to vigorous exercise increased from a 1.4 to 3.0.

Similar results were seen in the cognitive tests. One cognitive test that researchers used was a common paper-and-pencil test used to measure mental processing speed. The test gives the participant 90 seconds to match numbers with geometric figures and has a maximum possible score of 110. People who got less than 15.5 hours of work per week, on average, dropped from a 44 to a 40 on the test six years later. Those with more than 15.5 hours a week dropped only one point, from 44 to 43.

“Although medications can provide people with Parkinson’s some symptom relief, they haven’t been shown to slow the progression of the disease,” said study author Kazuto Tsukita. “We found that regular physical activity, including household tasks and moderate exercise, may actually improve the course of the disease over the long run. Best of all, exercise is low cost and has few side effects.”

Researchers note that the study does not prove that maintaining an exercise program will delay the effects of Parkinson’s disease. It only shows an association.

Looking to be more active in 2022? Here are some tips

Photo by Julia Larson from Prexels

The American Chiropractic Association recently released five strategies to help people establish a more active lifestyle.

The release came in early January, when people normally try to become healthier and lose weight, but pandemic restrictions during the past two years have caused many people to be even less active than normal. If you have been less than active the past year or two, consider the following strategies to help you get moving again:

• Just start moving. According to Matthew Dimond of the ACA, the type of exercise is less important than whether or not a person is moving. In his words: "Make it fun."

• Be consistent. After getting started, the most important thing is consistency. “The human body—and the human mind for that matter—like normalcy,” DiMond explains. “Wherever you currently are is what your body likes to do. The initial effort can be monumental; being consistent with it will create a habit.”

• Be accountable. Consider finding an exercise partner or activities that involve other people. Such connections can often inspire, drive, and motivate people to focus on their health goals and move forward.

• Be safe. When starting to move again after being inactive, assume you will not be as physically fit as you once were. Be aware of your limits and focus on what works for you, rather than comparing yourself to others or to your previous fitness level. Also be mindful of any pain you experience. 

• Identify your motivation. Motivation can be a challenge for people who start to move after a period of inactivity. “Willpower is not enough,” DiMond says. He encourages people to define their goals in terms of “what” instead of “why.” Ask yourself what you are trying to accomplish and create measurements based on that goal. Do you want to run a 5K? Do you want to walk your dog every day or be able to pick up your grandchild? Determine your “what” and set metrics to achieve it.

“Brief periods of inactivity usually aren’t that big of a deal,” DiMond says. “However, long-standing inactivity will lead to more fatigue, tiredness, and lethargy. Depending on where you are in the lifespan, muscle fiber types can start to change, and that can be detrimental. In the elderly, less movement and decreasing load demands can have a negative impact on their quality of compact bone.”

Doctors tell patients to 'take their exercise pills' because physical activity is good for your mind, not just for your body

Wendy Suzuki, a neuroscientist at New York University, gives a TED talk.

By Arash Javanbakht

Associate professor of psychiatry, Wayne State University

Republished from The Conversation

As with many other physicians, recommending physical activity to patients was just a doctor chore for me – until a few years ago. That was because I myself was not very active. Over the years, as I picked up boxing and became more active, I got first-hand experience of positive impacts on my mind. I also started researching the effects of dance and movement therapies on trauma and anxiety in refugee children, and I learned a lot more about the neurobiology of exercise.

I am a psychiatrist and neuroscientist researching the neurobiology of anxiety and how our interventions change the brain. I have begun to think of prescribing exercise as telling patients to take their “exercise pills.” Now knowing the importance of exercising, almost all my patients commit to some level of exercise, and I have seen how it benefits several areas of their life and livelihood.

We all have heard details on how exercise improves musculoskeletal, cardiovascular, metabolic and other aspects of health. What you may not know is how this happens within the brain.
How exercise improves the brain.

Brain biology and growth

Working out regularly really does change the brain biology, and it is not just “go walk and you will just feel better.” Regular exercise, especially cardio, does change the brain. Contrary to what some may think, the brain is a very plastic organ. Not only are new neuronal connections formed every day, but also new cells are generated in important areas of the brain. One key area is the hippocampus, which is involved in learning and memory and regulating negative emotions.

A molecule called brain-derived neurotrophic factor helps the brain produce neurons, or brain cells. A variety of aerobic and high-intensity interval training exercises significantly increase BDNF levels. There is evidence from animal research that these changes are at epigenetic level, which means these behaviors affect how genes are expressed, leading to changes in the neuronal connections and function.

Moderate exercise also seems to have anti-inflammatory effects, regulating the immune system and excessive inflammation. This is important, given the new insight neuroscience is gaining into the potential role of inflammation in anxiety and depression.

Finally, there is evidence for the positive effects of exercise on the neurotransmitters – brain chemicals that send signals between neurons – dopamine and endorphins. Both of these are involved in positive mood and motivation.

Exercise improves clinical symptoms of anxiety and depression

Researchers also have examined the effects of exercise on measurable brain function and symptoms of depression and anxiety. Exercise improves memory function, cognitive performance and academic achievement. Studies also suggest regular exercise has a moderate effect on depressive symptoms even comparable to psychotherapy. For anxiety disorders, this effect is mild to moderate in reducing anxiety symptoms. In a study that I conducted with others among refugee children, we found a reduction in symptoms of anxiety and PTSD among children who attended eight to 12 weeks of dance and movement therapies.

Exercise could even potentially desensitize people to physical symptoms of anxiety. That is because of the similarity between bodily effects of exercise, specifically high-intensity exercise, and those of anxiety, including shortness of breath, heart palpitation and chest tightness. Also, by reducing baseline heart rate, exercise might lead to signaling of a calmer internal physical environment to the brain.

It is important to note that the majority of studies examined the effects of exercise in isolation and not in combination with other effective treatments of clinical anxiety and depression, such as psychotherapy and medication. For the same reason, I am not suggesting exercise as a replacement for necessary mental health care of depression or anxiety, but as part of it, and for prevention.

There are other perks besides the neurobiological impacts of exercise. When going out for a walk, one gets more exposure to sunlight, fresh air and nature. One of my patients befriended a neighbor during her regular walks, leading to regular taco Tuesdays with that new friend. I have made some great friends at my boxing gym, who are not only my motivators, but also a great supporting social network. One might pick a dog as their running mate, and another might meet a new date, or enjoy the high energy at the gym. Exercise can also function as a mindfulness practice and a respite from common daily stressors, and from our electronic devices and TV.

By increasing energy and fitness level, exercise can also improve self-image and self-esteem.

Practical ways for a busy life

So how can you find time to exercise, especially with all the additional time demands of the pandemic, and the limitations imposed by the pandemic such as limited access to the gyms?

Pick something you can love. Not all of us have to run on a treadmill (I actually hate it). What works for one person might not work for another. Try a diverse group of activities and see which one you will like more: running, walking, dancing, biking, kayaking, boxing, weights, swimming. You can even rotate between some or make seasonal changes to avoid boredom. It does not even have to be called an exercise. Whatever ups your heartbeat, even dancing with the TV ads or playing with the kids.

Use positive peer pressure to your advantage. I have created a group messaging for the boxing gym because at 5:30 p.m., after a busy day at the clinic, I might have trouble finding the motivation to go to the gym or do an online workout. It is easier when friends send a message they are going and motivate you. And even if you do not feel comfortable going to a gym during the pandemic, you can join an online workout together.

Do not see it as all or none. It does not have to be a one-hour drive to and from the gym or biking trail for a one-hour workout vs. staying on the couch. I always say to my patients: “One more step is better than none, and three squats are better than no squats.” When less motivated, or in the beginning, just be nice to yourself. Do as much as possible. Three minutes of dancing with your favorite music still counts.

Merge it with other activities: 15 minutes of walking while on the phone with a friend, even around the house, is still being active.

When hesitant or low on motivation, ask yourself: “When was the last time I regretted doing it?”

Although it can help, exercise is not the ultimate weight loss strategy; diet is. One large brownie might be more calories than one hour of running. Don’t give up on exercise if you are not losing weight. It is still providing all the benefits we discussed.

Even if you do not feel anxious or depressed, still take the exercise pills. Use them for protecting your brain.

UK starting to offer diabetes prevention program through local extension agents trained to deliver it; first one was successful

Downloadable chart explains diabetes prevention program used by University of Kentucky.

By Katie Pratt
University of Kentucky

The University of Kentucky is helping prediabetic Kentuckians prevent or delay developing type 2 diabetes through a collaboration between the UK Cooperative Extension Service and UK HealthCare’s Barnstable Brown Diabetes Center.

UK extension agents deliver the Centers for Disease Control and Prevention’s National Diabetes Prevention Program to people who have prediabetes or are at a high risk for developing type 2 diabetes.

Prediabetes and diabetes are big problems in Kentucky. According to the 2019 Kentucky Diabetes Report, 10 percent of Kentucky adults have been told by a medical professional that they have prediabetes, 12% have diabetes, and Kentucky has the nation's fourth highest mortality rate from it.

The prevention program teaches evidence-based ways to make lifestyle changes to eat healthier, increase physical activity and improve coping mechanisms. The program includes weekly meetings for the first six months with the goal of losing 5% to 7% of body weight. The second six months has fewer meetings, as the focus turns to keeping the weight off.

People who successfully complete the year-long program lower their risk of developing type 2 diabetes by more than 50%, research has shown.

The collaboration between Barnstable Brown and Extension began in Washington County, where it has been successful. Scott County is to be next.

In Washington County, 12 adult participants lost an average of 5.6% of body weight, and 75% met the weight-loss goals they set at the start of the program. Also, 100% of participants stayed in the program, and said they appreciated the information and the sharing of personal stories.

Zoom meetings allowed them to continue the sessions during the pandemic. It hit about halfway through the program, which began in September 2019.

Extension agent Cabrina Buckman

“The participants were so good about being flexible, and stuck with me,” said Cabrina Buckman, Washington County extension agent for family and consumer sciences, who led the program. “I tried to keep them engaged along the way by providing them with packets and newsletters. They enjoyed Zoom once they got the hang of it.”

Buckman added, “As a result of the program, individuals overcame certain nutrition-related obstacles including making healthier snack choices and buying less junk food for snacks. Participants shared they made healthy changes to their activity by walking, ordering walking sticks and being more active overall each day. Most importantly, participants shared that throughout the program they learned they were a work in progress and tried to have more patience with themselves.”

The Barnstable Brown center was already offering the Diabetes Prevention Program to patients on UK’s campus in Lexington.

“Partnering with Extension allows Barnstable Brown to increase our breadth and depth for DPP services across Kentucky,” said Laura Hieronymus, the center's associate director of education and quality services. “This collaboration shows that extension agents can successfully deliver this program.”

In order to present the program, extension agents are trained as program lifestyle coaches. This training is coordinated through Barnstable Brown. The agents also receive support from UK specialists in family and consumer sciences.

“This program is incredibly effective at helping people reduce their diabetes risks, so we are excited that our extension agents have the opportunity to be trained through Barnstable Brown to offer it,” said Heather Norman-Burgdolf, assistant extension professor for food and nutrition in the UK College of Agriculture, Food and Environment.