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.

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.

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.

Clinton County's obesity rate falls after years of foundation-funded program for improvement of the community's health

Five years ago, the Foundation for a Healthy Kentucky gave the Clinton County schools the first installment of a $400,000 grant to help improve the county's health status, with emphasis on children. Now, in the last year of the grant, foundation and school officials say it has helped children achieve a healthier weight and reduced the county's overall obesity rate.

"The obesity rate in Clinton County has improved so much that we no longer qualify for a CDC grant we had been receiving for the past three years, and using collaboratively with the Healthy Hometown Coalition," Dr. Paula Little, assistant superintendent of schools, chair of the coalition and a director of the foundation said in a foundation press release.

Little said she didn't know the rate, just that it had fallen below the 40 percent required for the grant from the Centers for Disease Control and Prevention's High Obesity Program, which through the University of Kentucky promotes healthy eating and active living in Clinton and five other counties: Elliott, Letcher, Lewis, Logan and Martin.

Albany Mayor Nicky Smith, vice-chair of the Clinton County coalition, said "We have seen positive changes in community activity and awareness of health issues. I feel that our children have benefited from improvements in healthy eating and physical activity that they will carry with them throughout their lives."

The coalition has spent grant money on "walking paths, playgrounds and other spaces to provide more places where children can be physically active," said the press release, which has a complete list of grant activities. "The coalition has increased physical education and added programs in the schools to increase classroom movement, expanded nutrition programs, and supported policy changes to ensure increased physical activity and better nutrition for area students."

"The Clinton County coalition is a great example of a community coming together to identify a significant local health issue and develop a comprehensive plan to make an actual, measurable improvement," said Ben Chandler, president and CEO of the foundation.

The Clinton County grant was one of seven in the foundation's $3 million "Investing in Kentucky's Future" program, focused on children. "We'll be taking what Clinton County and the other six IKF grantee communities have learned and sharing it all over the state," Chandler said, "so other local health coalitions can implement in their own areas what has proven successful here."

This is Heart Month, and it's still winter, so here's a reminder of the need to be physically active for cardiovascular health

February is American Heart Month, so the state Department for Public Health is encouraging Kentuckians to increase their physical activity to reduce the risk of heart disease and stroke. It is promoting the hashtag #MoveWithHeart on social media to connect with others and get information about exercise, physical activity and improving cardiovascular health.

"Heart disease is the second leading cause of death among Kentuckians, with more than 10,000 people dying each year from heart disease," the department said in a news release. "A major risk factor for heart disease is physical inactivity. Research shows that being physically active can help lower the risk of heart disease and stroke. When we protect our hearts, we care for our cardiovascular health. During the cold months, physical activity can be even more challenging. It’s important that Kentuckians make an effort to move more throughout the day. "

Federal guidelines suggest physical activity that gets our hearts beating faster and leaves us a little breathless for at least 2.5 hours each week. "You can break up that activity into small manageable chunks: 10 minutes here, 20 minutes there, it all adds up," the health department says. "In addition to physical activity, these healthy changes can help Kentuckians lower their risk of developing heart disease:" 

• Watch your weight.
• Quit smoking and stay away from secondhand smoke.
• Control your cholesterol and blood pressure.
• If you drink alcohol, drink only in moderation.
• Get active and eat healthy.

Bonita Bobo, the health department's coordinator for heart disease and stroke prevention, said “All Kentucky children, women and men should try to build activity into your day by taking the stairs, parking farther away from your destination, and stepping away from that computer screen.”

Study of 140,000 Americans with an average age of 69 finds that any level of regular walking can help us live longer

Photo by Justin Horrocks, NPR.org

Regular walking can lower your risk of death, even if you don't meet the minimum recommended level of physical activity, according to an American Cancer Society study.

“Going for a walk at an average to brisk pace can provide people with a tremendous health benefit. It’s free, easy, and can be done anywhere,” Alpa Patel, lead investigator of the study, told Cancer Society reporter Stacy Simon.

The study, published in the American Journal of Preventive Medicine, analyzed data from a study of almost 140,000 people who had participated in the society's Cancer Prevention Study II Nutrition Cohort. The average age of participants in the study was 69.

The study report notes previous studies have found that walking has been associated with lowering the risk of breast cancer, colon cancer, heart disease and diabetes. It adds that physical inactivity accounts for about 11 percent of the health-care costs in the U.S.

Public-health guidelines say adults should get at least 150 minutes of moderate activity, or 75 minutes of vigorous activity, spread throughout the week. Only half of U.S. adults meet this recommendation, according to the federal Centers for Disease Control and Prevention.

And while the study found that those who met or exceeded the recommended level of physical activity through walking had a 20 percent lower mortality risk, it also found that older adults who walked less than two hours per week  had a lower death risk than those who got no exercise at all.

Patel told Nick Mulcahy of Medscape that the study evaluated walking at "an average pace," which is a speed that "may cause you to eventually feel a slight increase in your breathing and will allow you to cover roughly a mile in 20 minutes."

"Walking is simple, free and does not require any training, and thus is an ideal activity for most Americans, especially as they age," says the report.

In a region blessed with nature's hidden splendor, organized hiking could be a way to improve the health of Central Appalachia

Breathitt County Hiking Club walks the Copperas Creek Trail
in the Red River Gorge. (Outside photos by Josh Mauser)

An Eastern Kentucky man is working to improve the health of his county one person at a time through a monthly hiking club, Lyndsey Gilpin of Louisville reports for Outside.

Stephen Bowling, Breathitt County's 45-year-old library director, told Gilpin that he created the Breathitt County Hiking Club to get people in and around Jackson out into nature in hopes of improving their health and alleviating the sense of fatalism that is pervasive in the community. The trips usually attract around 20 people.

“A little bit here, a little bit there. We’ll get them moving,” Bowling told Gilpin.

Appalachia is "isolated geographically and culturally" and is a "prime example of the rural-urban wellness divide," Gilpin writes, noting that one in four people in Eastern Kentucky live below the poverty line; that nearly half of the 14,000 people who live in Breathitt County are obese; that about a third of them smoke; and that a third of them are physically inactive. The unemployment rate is almost 12 percent.

Those factors give Breathitt and surrounding counties some of the country's lowest health rankings, along with low life expectancy driven by unemployment, relatively low education levels, limited physical activity and poor access to health care and healthy foods, according to the annual Robert Wood Johnson Foundation County Health Rankings Report.

“It’s a depressed area economically, but also emotionally and physiologically,” Bowling told Gilpin. “We’re told constantly that we’re the least healthy people, we are this, we are that, and people don’t feel empowered to change that. Some people aren’t willing, and some people aren’t able.”

So Bowling, who has hiked hundreds of miles on the Appalachian Trail and in the Southeast, decided to share his love of backpacking with others in his community through a hiking club, which meets once a month on a Sunday, always after church.

He told Gilpin that he the club isn't a "one-and-done solution to all the public health woes facing Breathitt County," but added, "If we solve one problem at a time, or help someone get in shape one person at a time, we’ve completed our goal.”

Stephen Bowling helped rookie hikers on the trail.

Gilpin met up with Bowling and his hiking club in early June when he and a group of 14 hikers, most with no hiking experience, headed off to Copperas Creek Trail in the Red River Gorge, about 40 minutes away.

“Wow, this is just amazing,” said 47-year-old Julie Stamper, one of the hikers, as she put her cigarette out and stuffed the butt into her backpack. “I’ve never been to a place like this before.”

Bowling and others believe more access to public lands and increased opportunities for physical activity can help address some of these health problems and research supports this idea, Gilpin reports.

"Ironically, rural communities tend to be cut off from public land, leaving them with the fewest choices for outdoor activity and exercise," Gilpin writes, reporting that most Southeastern states have less than 5 percent federal public land and in Kentucky it's even less at 4 percent.

For example, Gilpin writes, "Only 17 percent of Breathitt county residents live within a half-mile of a park or within three miles of an accessible recreational facility; meanwhile, 98 percent of New York county residents and 100 percent of San Francisco county residents have such access to a park within a half-mile or a recreational facility within just one mile."

The Red River Gorge is part of the Daniel Boone National Forest, which is vast but is at least a half-hour from Jackson. With few places to exercise, “Many people rely on the local high school to keep its running track unlocked and open to the public,” Mark Holmes, director of the North Carolina Rural Health Research and Policy Analysis Center, told Gilpin.

Gilpin notes that rural Southern regions are looking at North Carolina and Colorado for ways to make public lands profitable and accessible, and that the state recently created the Kentucky Mountain Regional Recreation Authority, "a group run by community members from around the state that will develop, maintain, monitor, and promote local trails."

State Representative Chris Fugate, who sponsored the bill, told Gilpin that his goal is to connect 17 counties through a trail system. “Some of the most beautiful places are hidden away,” Fugate said. “We haven’t done a good enough job of promoting and taking care of ourselves here.”

Gilpin writes, "How these types of local programs fare and how public lands prove to help the situation could inform the conversations of policymakers moving forward."

Grant County coalition wins passage of 'complete street' policies to improve the health of its citizens

Grant County High School student Brookynn Scudder urged
the Crittenden City Council to adopt a complete-streets policy.

A Grant County coalition has embraced a policy to make future streets in the county safer for all potential users, and one city's effort to enact such policies involved the county's youth.

The Fitness for Life Around Grant County coalition partnered with the Foundation for a Healthy Kentucky to adopt "complete streets" policies that ensures future projects are planned and designed around not only automobiles, but also pedestrians, bikers, motorists and transit riders of all ages and abilities.

Grant County is the first in Kentucky to enact a county-wide complete street policy, and such policies have also been enacted in its four towns: Corinth, Crittenden, Dry Ridge and the county seat of Williamstown.

Ben Chandler, president and CEO of the foundation, called complete-street rules "pro-health policies" that make it easier for community members to make healthier choices.

"People are more likely to forgo their cars when they have convenient, well-lit and well-maintained sidewalks, walking paths and bicycling lanes," he said in a news release. "And one of the best arguments for complete streets laws is they don't require a large up-front appropriation, because they guide future planning efforts and maintenance priorities."

Grant County's coalition is part of the foundation's "Investing in Kentucky's Future" initiative, a five-year, $3 million program, that provided matching grants and training to seven multi-sector community health coalitions across the state to address children's health issues. FFLAG selected childhood obesity as one of its issues to address under the foundation grant.

"The Foundation grant requirements, training and other support for changing systems and policy really spurred us to look at how we could improve walkability in our communities," Elizabeth Steffer, a health educator with the Northern Kentucky Health Department, which is a member of the FFLAG coalition, said in the release. "These new policies will lead to behavior changes that will long outlive the grant."

Example of the Grant County High School students' walkability assessment
presented to the Crittenden City Council to promote complete-street policies

Grant County youth played an active role in getting the policy passed in Crittenden, the most recent city in Grant County to pass the policy. Under Steffer's leadership, youth from Grant County High School worked with the coalition and the Step It Up Kentucky! campaign to get the policy passed.

The effort involved eight students who did a walkability assessment of Crittenden and then compiled their observations and photographs into a presentation to the Crittenden City Council in May, asking members to adopt the complete street policy, which they did on June 6.

"The students told council members that they had the power to make Crittenden healthier, and their presentation made all the difference in getting the ordinance passed," Steffer said.

Student Blake White said in the release that his work on the project was meaningful because it would help ensure the safety of his younger brother, who loves to ride his bike around the community.

The 2016 Kentucky Health Issues Poll found that one in four Kentucky adults rated their neighborhoods only a fair or poor as a place to walk, jog or bike. Two in 10 said their neighborhood was either somewhat unsafe or not at all safe for exercise.

"In addition to encouraging physical activity, enhancing community walkability attracts business investment and increases small business revenue," Chandler said.

Taylor Mill and Independence in Northern Kentucky have also passed complete-street policies.

Study finds dog owners walk 22 more minutes per day, at a pace that improves health; Ky. seniors rank very low for physical activity

WebMD photo

By Melissa Patrick
Kentucky Health News

Dog owners walk on average 22 more minutes per day compared to people who don't own a dog, says a recent study.

"Not only did we see an increase in exercise, but also the exercise was at a moderate pace," study author Daniel Mills of the University of Lincoln, in the United Kingdom, told Allison Aubrey of NPR.

The study, published in the journal BMC Public Health, found at times the dog owners walked around 3 miles per hour, which the Centers for Disease Control and Prevention considers moderate intensity.

"Prior studies have shown that moderate-intensity walking is just as effective as running in lowering the risk of high blood pressure, high cholesterol, Type 2 diabetes and other conditions," Aubrey reports.

The study included men and women aged 65 and older who agreed to wear an activPAL monitor, which measure speed, distance and other factors 24 hours a day. Participants also self-recorded information about their own and their dog's demographics, daily responsibilities and sleep/wake times. The study started with 43 pairs of dog owners and non-dog owners.

And in addition to the additional 22 minutes of walking at a brisk pace, the study said participants added almost 3,000 additional steps per day and sat less often, though the total time spent sitting didn't vary much.

"The national physical-activity guidelines call for 150 minutes a week of moderate-intensity exercise, and that's what they got in this study," Robert Sallis, a family physician with Kaiser Permanente in California, told Aubrey about the study. Sallis was not involved in the research.

"If you look at studies on pet ownership, people who own pets seem to live longer than those who don't own them," Sallis said. He added that it's not just the increased activity that improves a persons health, but is also the companionship that pets provide which can lead to lower rates of depression and stress.

Kentucky's seniors are ranked third in the nation for physical inactivity, according to America's Health Rankings. They also ranked last in health outcomes, which measured things like self-reported health status, premature deaths and frequent mental distress.

Harvard Medical School also touts the many health benefits of having a pet, but cautions that they can be expensive to care for, require a lot of work, can pose sanitary risks and that they can sometimes pose a health hazard for older adults.

"If you have problems with gait and stability and your pet can get under your feet or jump up and knock you over, then falls and broken bones are a real danger," psychiatrist Dr. Greg Fricchione, director of the Harvard-affiliated Benson-Henry Institute for Mind-Body Medicine, said in the article.

For a fee, the medical school has published a special health report called "Get Healthy, Get a Dog," that offers advice on how to choose the best pet to suit your lifestyle, as well as the role of service dogs.

Southern Kentucky weekly starts a column from a recovering addict in the same week it publishes another health testimonial

Clinton County (Wikipedia map)

From 2012 to 2015, the last year for which figures are available, 25 people died of drug overdoses in Clinton County, a community of 10,000 people on the Tennessee border south of Lake Cumberland. This spring, a local doctor was indicted on charges of illegally prescribing painkillers to six people, three of whom died in 2014. The county is among the 54 in Kentucky, out of 220 in the U.S., considered most at risk from an outbreak of HIV or hepatitis C from intravenous drug use. Clearly, Clinton County has a drug problem.

Last week, on an inside page of the weekly Clinton County News, a new column appeared, with a standing headline, "An Addict's Corner," with the subhead "the Journey of an Addict." It was written by local resident Phillip Lee, who told how he became addicted to crystal methamphetamine, lost his wife, cars and homes, lost contact with his children and grandson, and put him behind bars again and again for 17 years. "I'll get down to specific details in later articles," he wrote. "I'll tell you all I remember going through." Lee credits his religious faith for his recovery.

Alan Gibson, editor and publisher of the paper, said in an email that Lee "came to me a few weeks ago with a hand-written article in his hands. He was proposing the column in an effort to help others who might be facing addiction problems, as well as families who were dealing with problems with other loved ones. He wanted to submit the column on a weekly basis under a pen name, or either anonymously. I told him he should be able to own up to his writings and be proud of his message to others as well as his accomplishments. He pondered about 10 seconds and signed the column and left it with me." He has submitted two more. "I also offered to put his photo in the header like we do some of the other regular headers, but he opted out of that," Gibson wrote. "If it helps just one person, I'm glad to offer up the space." To read Lee's first column, click here.

In the same edition of the paper, recent high-school graduate Thomas Holsapple wrote a column for the Twin Lakes Wellness Center, describing how his family had turned its health around after the death of his grandmother, who was overweight and had been a smoker, and how he took the next step by exercising regularly at the center in Albany. "Even after the first night I could feel the energy it gave me and how it entirely lifted my spirits. . . . Keeping myself in shape and eating healthy has changes my life, and the lives of my friends and family." For his column, headlined "Health and Fitness: My Story," click here.

The Clinton County News is a hotbed of testimonials about health, which can be an effective motivator for others to get healthier. The Clinton County Healthy Hometown Coalition, funded by the Foundation for a Healthy Kentucky, has had a regular column that often featured articles by local residents saying how they made themselves healthier. One of those was from Julie Holsapple, the mother of Thomas Holsapple.

Organized sports provide about 20 minutes of real exercise per hour of activity; CDC says children should exercise an hour a day

Wikipedia

By Melissa Patrick

Kentucky Health News

We live in a world where children are more likely to participate in organized sports and activities than to spend time running and playing outside. Most parents seem to think this is a pretty good substitute for exercise, but a new study says otherwise.

The study, published in the Journal of Sports Sciences and Medicine and Science in Sports and Exercise, found that "between sitting while listening to instructions, standing in line while waiting their turn and other parts of practices, only about 30 percent of practice time is actually spent in moderate to vigorous exercise," says the Kansas State University news release.

"In an hour-long practice, the children are still getting about a third of the physical activity they need for the day, but it's still a little bit less activity than people would expect," said Katie Heinrich, director of the KSU kinesiology department's Functional Intensity Training Lab,

The Centers for Disease Control and Prevention says children and teens should have an hour or more of moderate to vigorous physical activity each day, including bone and muscle strengthening activities at least three days a week.

Most of Kentucky's middle school and high school children don't get the recommended amount of physical activity.

According to the 2015 Kentucky Youth Risk Behavior Survey, 63 percent of Kentucky's high-school students said they had not been physically active for at least an hour a day in five or more of the seven days prior to the survey, and 80 percent of them reported they hadn't had an hour of physical activity per day on all seven days.

The results were only a little better for middle-school students, with 52 percent saying they had not been active in five of the seven days prior to the study and 71 percent not active in all seven days.

Heinrich added that the findings of this study doesn't mean organized activities aren't important, noting that in addition to providing some exercise, they also provide "structure, companionship and character-building opportunities." But in addition to this, she said parents need to make sure children have at least 40 minutes a day of active unstructured playtime.

"Organized sports are valuable, but free play activities are needed as well," Heinrich said. "It's important to provide children with opportunities for both."

Foundation's $3 million program is helping seven counties become healthier in several ways, independent evaluation says

A initiative focused on children's health is helping the Foundation for a Healthy Kentucky change community policies and environments, improve physical activity and nutrition, and strengthen health coalitions in seven Kentucky communities, according to an independent evaluation released by the foundation today.

The grants in the five-year, $3 million "Investing in Kentucky's Future" initiative are also providing useful lessons for place-based grantmakers, said the evaluation by the Center for Community Health and Evaluation, a research center of the Kaiser Permanente Washington Health Research Institute.

The initiative is aimed at reducing the risk that today's school-aged children will develop chronic disease later in life. It has made matching grants for community health coalitions in Breathitt, Clinton, Grant, Jefferson, McCracken, McLean, and Perry counties. All are focused on preventing and reducing childhood obesity except the Louisville coalition, which is working to foster resiliency in children facing traumatic events and other experiences that can lead to toxic stress in childhood and chronic health conditions in adulthood.

"The real value of the Investing in Kentucky's Future initiative is that it's fostering the ability of these seven Kentucky communities to keep improving their residents' health long after the grant period ends," Charlie Ross, chair of the foundation's board of directors, said in a news release. "Yes, the grants have helped build some beautiful walking trails and playgrounds and ensure healthier foods at park concessions, but they've also created lasting partnerships, changed school and community policies, and developed the skills of a cross-sector coalition of people committed to making a healthier future for their children."

The evaluation listed five lessons from the initiative:

1. Community-Driven Grant Approach: Allowing community health coalitions to study and determine their own health priorities and the solutions they would employ is leading to greater grantee engagement, but also to more diverse strategies.
    
2. Coalition Approach: Requiring grantees to use or create a coalition of partners from a variety of sectors is helping build community support for the work. School engagement has been particularly important for the initiative, which focuses on school-aged children.
    
3. Planning Phase to Promote Equity: Recognizing that communities have various levels of ability to compete for and implement grant programs, the foundation included funding for a required a planning phase during which grantees would develop a structured business plan to address their selected issue. The planning phase made the grant more accessible to communities with fewer resources.
    
4. Sustainability Elements: Grant requirements that were focused on sustainability ─ the planning phase, a 50 percent cash match, a focus on changing policies in the community, and an evaluation ─ have given coalition members skills and experience to them continue to improve the health of their communities.
    
5. Shorter-Term Evaluation Measures: The foundation recognized that significant changes in complex health issues take more than five years to see, so it focused its evaluation on shorter-term changes that have been proven to lead to longer-term health improvements.

Investing in Kentucky's Future is entering its fourth year, but some communities' grants will extend into 2019 because they started later than others. The grantees are: Partnership for a Healthy McLean County, Purchase Area Connections for Health (McCracken County), Fitness for Life Around Grant County, Breathitt County Health Planning Council for Children, Perry County Wellness Coalition, Clinton County Healthy Hometown Coalition, and the Bounce Coalition (Jefferson County).

A copy of the evaluation, "Toward a Healthier Kentucky: Lesson Learned from Evaluating Place-Based Community Health Improvement," is available here. 

Exercise cuts the risk of damage to your heart, even if you're among the 35 percent of Kentuckians who are obese

Consumer HealthDay photo

Exercise not only lowers the risk of heart damage in middle-aged adults and seniors, but can also reduce the levels of heart damage in those who are obese, according to a new study.

"The protective association of physical activity against [heart] damage may have implications for heart failure risk reduction, particularly among the high-risk group of individuals with excess weight," lead author Dr. Roberta Florido said in an American College of Cardiology news release.

Kentucky adults struggle with obesity and sedentary lifestyles, and the state leads the nation in heart disease.

Thirty-five percent of Kentucky's adults are obese, and one-third of them reported in 2015 that they hadn't had any physical activity or exercise in the 30 days before they were surveyed. And 27.5 percent of Kentucky's seniors are obese, with 39 percent of them reporting no physical activity in the 30 days prior to the America's Health Rankings survey.

The study, published in the Journal of the American College of Cardiology, examined more than 9,000 people without heart disease between the ages of 45 and 64. Researchers then grouped the participants according to how much exercise they got based on the American Heart Association's recommended guidelines of at least 75 minutes a week of vigorous activity, or 150 or more minutes of moderate to vigorous activity.

Then, to measure damage to the heart, they assessed blood levels of high-sensitivity troponin T, a marker of heart damage that has been shown to be associated with future heart failure.

"Individuals with lower levels of physical activity were significantly more likely to have elevated levels of high sensitivity troponin, suggesting higher heart damage," says the release.

For example, the study found that those in the "intermediate" category of activity (those who exercised, but less than the AHA recommendations) were 34 percent more likely to have heart damage and those who did not exercise at all were 39 percent more likely to have heart damage than their peers who met the guidelines for exercise.

Further, the researchers looked at the role of exercise on the troponin levels of obese adults and found that the obese participants who got the recommended level of physical activity had lower levels of troponin compared to those who did not exercise at all, "which indicates that the protective association of physical activity and heart damage may be stronger among individuals with obesity, a group at particularly high risk for future heart failure," says the release.

"Promoting physical activity may be a particularly important strategy for heart failure risk reductions among high risk groups such as those with obesity," Florido said.

Study finds exercise is good for the heart at all ages, even among those who are obese; Ky. is a sedentary and obese state

Consumer HealthDay photo

Exercise not only lowers the risk of heart damage in middle-aged adults and seniors, but can also reduce the levels of heart damage in those who are obese, according to a new study.

"The protective association of physical activity against [heart] damage may have implications for heart failure risk reduction, particularly among the high-risk group of individuals with excess weight," lead author Dr. Roberta Florido said in an American College of Cardiology news release.

Kentucky adults struggle with obesity and sedentary lifestyles, and the state leads the nation in heart disease.

Thirty-five percent of Kentucky's adults are obese, and one-third of them reported in 2015 that they hadn't had any physical activity or exercise in the 30 days before they were surveyed. And 27.5 percent of Kentucky's seniors are obese, with 39 percent of them reporting no physical activity in the 30 days prior to the America's Health Rankings survey.

The study, published in the Journal of the American College of Cardiology, examined more than 9,000 people without heart disease between the ages of 45 and 64. Researchers then grouped the participants according to how much exercise they got based on the American Heart Association's recommended guidelines of at least 75 minutes a week of vigorous activity, or 150 or more minutes of moderate to vigorous activity.

Then, to measure damage to the heart, they assessed blood levels of high-sensitivity troponin T, a marker of heart damage that has been shown to be associated with future heart failure.

"Individuals with lower levels of physical activity were significantly more likely to have elevated levels of high sensitivity troponin, suggesting higher heart damage," says the release.

For example, the study found that those in the "intermediate" category of activity (those who exercised, but less than the AHA recommendations) were 34 percent more likely to have heart damage and those who did not exercise at all were 39 percent more likely to have heart damage than their peers who met the guidelines for exercise.

Further, the researchers looked at the role of exercise on the troponin levels of obese adults and found that the obese participants who got the recommended level of physical activity had lower levels of troponin compared to those who did not exercise at all, "which indicates that the protective association of physical activity and heart damage may be stronger among individuals with obesity, a group at particularly high risk for future heart failure," says the release.

"Promoting physical activity may be a particularly important strategy for heart failure risk reductions among high risk groups such as those with obesity," Florido said.

Better-off Kentuckians exercise more; foundation CEO says policymakers can help increase access to exercise venues

By Melissa Patrick
Kentucky Health News

Health status and income matter when it comes to being physically active. Kentucky adults who reporting good health and higher incomes also saying they are more physically active than those reporting fair or poor health or lower incomes, according to the latest Kentucky Health Issues Poll.

"One of the things policy makers and communities can do is make it easier for residents to get exercise in their own neighborhoods," Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, a poll sponsor, said in the news release. "The U.S. Office of Disease Prevention and Health Promotion says all adults should avoid inactivity, and those who participate in any amount of physical activity will gain at least some health benefits."

The poll, conducted Sept. 11 through Oct. 19, found that eight in 10 Kentucky adults said they were physically active, with 30 percent of this group reporting they were "very physically active" and 49 percent of them reporting they were "somewhat physically active."

However, these responses varied by health status and income.

Almost nine out of 10 Kentucky adults who reported excellent, very good or good health said they were very or somewhat physically active, compared to only 54 percent of those reporting fair or poor health. And those with higher incomes reported more activity than those with lower incomes, 84 percent and 76 percent respectively.

The survey also asked respondents if their neighborhood is a good place to walk, jog or bike. It found that 76 percent said their neighborhoods were excellent, very good or good for these activities, while 24 percent said their neighborhoods were only fair or poor.

But when asked if they had sidewalks and road shoulders to walk on, the results weren't as positive. Half said their neighborhoods rated excellent, very good or good for this measure and 44 percent said their neighborhoods rated fair or poor.

The survey also asked about safety for exercise; 46 percent said their neighborhoods were safe, 35 percent said they were somewhat safe and 19 percent said their neighborhood was somewhat unsafe or not safe at all for exercise.

Neighborhood exercise conditions also varied by region. Excellent, very good or good neighborhoods for physical activity were reported by 84 percent from Louisville; 81 percent from Lexington; 78 percent from Western Kentucky; 77 percent from Northern Kentucky; and 61 percent from Eastern Kentucky.

Two-thirds of Kentucky adults said increasing their level of exercise would improve their overall health. One-fourth said it would make no difference and 7 percent said it could make their health worse. This attitude varied with education. Those with more education were more likely to say that increased activity would improve their health, compared to those with less education who were more likely to say it would make no difference.

"The foundation is funding demonstration projects to improve neighborhood conditions, such as the health park in Paducah that includes a walking trail, playground and community garden. Kids who learn good physical activity habits will grow up to be healthier adults," Chandler said.

The poll was funded by the foundation and Cincinnati-based Interact for Health. It surveyed a random sample of 1,580 Kentucky adults via landlines and cell phones, and has an error margin of plus or minus 2.5 percentage points.

Sedentary older women who don't exercise are 'biologically older' than active women, study of their chromosomes shows

Photo from Center for Advancing Health

By Melissa Patrick
Kentucky Health News

A study has found that older women who sit for more than 10 hours a day and also have low physical activity have "biologically older" cells than those who are less sedentary, suggesting the importance of exercise all through life.

And Kentucky's seniors need to get up and take notice, because they are ranked third in the nation for physical inactivity, according to America's Health Rankings.

The researchers found that older women who have less than 40 minutes of moderate-to-vigorous physical activity per day and are sedentary for more than 10 hours a day are biologically eight years older than women in the study who were more active. Future studies will examine how exercise relates to biological age in younger populations and in men, says a news release about the study.

“Our study found cells age faster with a sedentary lifestyle. Chronological age doesn’t always match biological age,” said Aladdin Shadyab of the University of California San Diego Health Sciences, lead author of the study report.

Researchers determined the biological age of the older women by measuring the tiny caps found on the ends of their DNA strands, called telomeres, which protect chromosomes from deterioration and progressively shorten with age. The sedentary women in the study had shorter telomeres.

"As a cell ages, its telomeres naturally shorten and fray, but health and lifestyle factors, such as obesity and smoking, may accelerate that process. Shortened telomeres are associated with cardiovascular disease, diabetes and major cancers," says the release.

About two out of every seven Kentucky seniors are obese, almost 28 percent, and 12.4 percent of Kentucky seniors smoke, putting the state in the top five. The national average is 8.8 percent. Kentucky also has some of the highest rates of heart disease, diabetes and cancer in the nation.

The study, published online in the American Journal of Epidemiology, included nearly 1,500 women, ages 64 to 95. It was part of the larger Women's Health Initiative, a national, longitudinal study that investigates the causes of chronic disease in older women. Data was gathered from questionnaires and a device worn for seven days that tracked their activity.

“We found that women who sat longer did not have shorter telomere length if they exercised for at least 30 minutes a day, the national recommended guideline,” Shadyab said. “Discussions about the benefits of exercise should start when we are young, and physical activity should continue to be part of our daily lives as we get older, even at 80 years old.”

1 in 9 in Ky. have been diagnosed with diabetes, and you could have it and not know it; here are symptoms and risk factors

KentuckyHealthFacts.org map with latest available data, adapted
by Kentucky Health News; click on map to view a larger version

One of nine people have diabetes in Kentucky, which has "all the social ills that cause diabetes to fester," Laura Ungar and Darla Carter report for The Courier-Journal. "Chief among them is poverty, which makes it tough to eat well, find safe places to exercise or get to the doctor and avoid complications such as blindness and amputations."

Dr. John Buse, diabetes center director at the University of North Carolina, told the Louisville newspaper that a colleague once told him: “Diabetes is a death sentence for the poor and a nuisance for the wealthy.” One in five Kentuckians live below the federal poverty line, third among the states. Other major risk factors include obesity (35 percent of Kentuckians are obese, fifth in the nation) and physical in activity (fourth in the nation).

Diabetes in the state "has skyrocketed in the last two decades and shows no sign of slowing," the reporters write. "Kentucky’s rate of diagnosed diabetes shot up from 4.3 percent in 1994 to 11.3 percent in 2014, ranking the state sixth worst in a nation that has seen diabetes double over that time." The disease "takes thousands of lives each year and the American Diabetes Association estimates related medical costs and lost productivity total around $3.85 billion in Kentucky."

Because those figures are based on poll questions asking people if a doctor has ever told then they have diabetes, the actual numbers are larger because many people have diabetes and don't know it. The C-J reports, "You may notice no symptoms at all, but here are some common ones, according to the American Diabetes Association:

• Frequent urination
• Feeling very thirsty 
• Feeling very hungry - even though you are eating
• Extreme fatigue
• Blurry vision
• Cuts or bruises that are slow to heal
• Weight loss, even though you are eating more (Type 1)
• Tingling, pain or numbness in the hands or feet (Type 2)

"Anyone 45 years or older should consider getting tested for diabetes, especially if you are overweight," the reporters write. "If you are younger than 45 but are overweight and have one or more additional risk factors, consider getting tested. They include: 

• Having a parent, brother or sister with diabetes
• Being African American, American Indian, Asian American, Pacific Islander or Hispanic American/Latino heritage
• Having a prior history of gestational diabetes or birth of at least one baby weighing more than 9 pounds
• Having high blood pressure measuring 140/90 or higher
• Having abnormal cholesterol with HDL ("good") cholesterol of 35 or lower, or a triglyceride level of 250 or higher
• Being physically inactive (exercising less than three times a week)

Report shows race and ethnicity matter when it comes to health

When it comes to health, your race and ethnicity matter, says a recent Foundation for a Healthy Kentucky report.

A study of federal and state polling data found that multiracial and black Kentuckians tend to report higher rates of smoking, obesity, asthma and poor mental health than their white counterparts, and that black and Hispanic Kentuckians are less likely to have health insurance than white Kentuckians.

"This report helps us see how race and ethnicity make a difference in how healthy you are, just as previous Foundation reports have shown that where you live and your education and income levels affect your health status," Susan Zepeda, outgoing president and CEO of the foundation, said in a news release.

Findings from the report, Health Disparities in the Commonwealth, A Report on Race and Ethnicity and Health in Kentucky, are based on federal and state Behavioral Risk Factor Surveillance System polling from 2011 through 2013. It is the third in a series of reports exploring health disparities in the state, with the first focusing on geographic disparities and the second on socioeconomic disparities.

The report looked at access to health care and preventive services, a variety of social and behavioral health indicators and health outcomes of Kentucky adults of different racial and ethnic groups.

Access to health care and preventive services

The report said there are "significant associations" between racial and ethnicity and access to care in Kentucky.

Lines atop bars indicate confidence intervals, or possible range
of percentages. The percentage given is the most likely one.

It found that white Kentuckians were less likely to forego medical care due to cost and Hispanics were most likely. Although, overall Kentucky adults forego medical care due to cost at a higher rate than the rest of the nation.

"Nearly 1 in 5 Kentucky adults (19.1 percent) reported that there was a time in the prior year when they needed to see a doctor but could not because of the cost," says the report. "Access to care was considerably more limited for Hispanic adults in Kentucky, with nearly 1 in 3 adults (28.9 percent) unable to afford needed medical care."

It also found that white Kentuckians were more likely to have a personal doctor than other races and ethnicities; and that black (25.6 percent) and Hispanic Kentuckians (34.1 percent) were less likely to have health insurance than white Kentuckians (16.7 percent).

Black Kentuckians reported they were less likely to have an annual flu shot (34.3 percent) than white Kentuckians (40.1 percent), whereas white Kentuckians were "significantly less likely" to have been tested for HIV than other racial or ethnic groups in Kentucky, 28.8 percent.

"The Centers for Disease Control and Prevention recommends that HIV screening be provided to everyone, as part of their routine health care, unless they decline to be tested," says the report.

Social and Behavioral Health

As for risky behaviors, except for binge drinking, Kentucky adults were more likely to smoke, be physically inactive, have limitations due to other health conditions and be overweight or obese than the rest of the nation. And these risky behaviors were higher in some racial and ethnic groups than others.

For instance, multiracial Kentuckians reported the highest rate of smoking in the state, 41.3 percent, between 2011-2013. The state's smoking rate, 27.9 percent, was significantly higher than the nation's rate of 19 percent. This group was also most likely to have activity limitations due to health conditions.

"Smoking increases the risk of cancer, heart disease,stroke and other chronic conditions, exacerbates asthma, and reduces overall health status," says the report.

The report also noted that while 66.9 percent of Kentucky adults were overweight or obese, black Kentuckians were "significantly more likely" to be overweight or obese (72.9 percent) than whites (66.8 percent), Hispanics (62.8 percent) and others (51.1 percent). The national average was 63.5 percent.

"Obesity is both a chronic disease and a risk factor for other diseases,including heart disease, stroke, type 2 diabetes and certain cancers," says the report.

On a positive note, Hispanics in the state reported getting more physical activity than other Kentucky adults or the average American.

Health outcomes

Overall, Kentucky adults reported poorer health status than the national average (23.2 percent and 18.1 respectively). Although Hispanic Kentuckians reported fair or poor health at a similar rate as other Americans.

Multiracial (24.4 percent) and other race (22.6 percent) adults in Kentucky were more likely to report poor mental health than white (15 percent) or black Kentuckians (14.8 percent).

Multiracial Kentuckians also reported slightly more asthma diagnosis (27.2 percent) compared to white (14.7 percent) and black (17.1 percent) Kentuckians.

Hispanic and other race Kentuckians were slightly less likely to report having diabetes.

The report says the foundation "believes that health disparities can be eliminated, and that they must be eliminated," and that this report helps to understand and monitor where they exist.

Zepeda said, "Understanding these disparities is an important step in enacting the policy changes and programs that can reduce and ultimately eliminate them."