Legislation Would Dramatically Expand FDA’s Oversight of Compounding Pharmacies
New legislation proposed from Representative Edward Markey of Massachusetts would give the U.S. Food and Drug Administration (FDA) authority over compounding pharmacies that make and ship over state lines sterile and non-sterile products. This would be more significant than a bill recently approved by a Senate committee, which would give FDA authority only over sterile products, leaving states with the authority over non-sterile products. This has left some concerned that states would be overtaxed by the effort. “State pharmacy regulators vary widely in their ability to oversee large-scale non-traditional compounding," wrote the Pew Charitable Trusts in comments to the Senate health committee that drafted the legislation, according to Reuters. The calls for increased oversight come in response to a 2012 meningitis outbreak which killed 53 people and was linked to steroids produced by the Framingham, Massachusetts-based New England Compounding Center. Read more on infectious diseases.

Study: Diners Dramatically Underestimate Calories in Fast Food
Diners at fast food restaurants dramatically underestimate their caloric intake, according to a new study in BMJ. "Teens underestimate the number of calories in their meals by as much as 34 percent, parents of school-age children by as much as 23 percent, and adults by as much as 20 percent," study Jason Block, MD, in a release from the Robert Wood Johnson Foundation. Researchers found that the average adult meal was 836 calories—but they thought, on average, it was 175 fewer calories. As many as 1 in 4 of the people surveyed missed the mark by at least 500 calories. "These findings tell us that many people who eat at fast-food restaurants may not be making informed choices because they don't know how many calories they're consuming," Block said. "Having the information is an important first step for anyone wanting to make changes." Read more on nutrition.

FDA Approves Marketing of A1c Test for Diabetes
The U.S. Food and Drug Administration is for the first time allowing the marketing of an HbA1c (or A1c) test for the diagnosis of diabetes. A1c tests measure the percentage of hemoglobin A1c bound the glucose; people with diabetes are unable to properly convert glucose. Nearly 26 million Americans are estimated to have diabetes, which untreated can lead to heart disease, stroke and other serious medical conditions. “Providing health care professionals with another tool to identify undiagnosed cases of diabetes should help them provide patients appropriate guidance on treatment before problems develop,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Devices at FDA’s Center for Devices and Radiological Health. Read more on diabetes.

March of Dimes Establishes Research Collaborative on Causes of Preterm Births
Three universities and four hospitals in Ohio have joined with the March of Dimes Foundation to establish a collaborative research program aimed at finding the unknown causes of premature birth. According to the March of Dimes, preterm birth is the most common and costly newborn health problem in the United States, affecting nearly half a million babies each year. It is also the leading cause of newborn death, and babies who survive an early birth often face the risk of lifelong health issues, including vision and breathing problems. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants. “The transdisciplinary approach will increase dramatically the rate of progress in understanding why some babies are born too soon. Ultimately our goal is to use this knowledge to develop effective therapies to prevent preterm birth and enable all pregnancies to proceed to full term,” said ” said Sam Mesiano, PhD, Site Director for the Case Western Reserve University, University Hospitals, and MetroHealth component of the collaborative. One of the focus aims of the research includes the sociobiology of racial disparities in preterm birth. African-American and Hispanic mothers have higher rates of preterm births than do whites. Read more on maternal and infant health.

House, Senate Consider Cuts to SNAP in Farm Bill Reauthorization
The U.S. House and Senate are each considering versions of the five-year Farm Bill reauthorization that would save money in part by cutting the budget for the supplemental Nutrition Assistance Program (SNAP), which helps nearly 48 million Americans purchase food each year. The House version would cut $2 billion and the Senate version would cut $400 million, according to The Washington Post. The House version would also stop certain forms of automatic SNAP benefits. James S. Marks, Senior Vice President of the Robert Wood Johnson Foundation Health Group, said cutting SNAP benefits would violate the fundamental tenet of medicine to “first, do no harm.” “Cutting SNAP is precisely the wrong prescription for our children and the nation's economic recovery. The notion that SNAP benefits are an overly generous handout could not be further from the truth,” he wrote in The Huffington Post, adding “SNAP has the potential to be a public health tool that can help address the complex problems of hunger and obesity.” Read more on nutrition.

CDC: High Rates of Unhealthy Behavior Persist
A new report from the U.S. Centers for Disease Control and Prevention finds that, overall, Americans aren’t making much improvement in their health. About 60 percent are overweight or obese, about 60 percent drink, about 20 percent smoke and about 80 percent don’t meet federal guidelines for exercise. "Changes have not been enormous," said report author Charlotte Schoenborn, a health statistician at the CDC's National Center for Health Statistics. "It's been a very, very slow process of changing awareness of personal choices for healthier ways of life.” Added Rich Hamburg, deputy director of Trust for America's Health: "I think we're in a situation now where we're at a crossroads. We have two paths to go. We're hopeful that if we continue to invest in community-based prevention, if we promote healthy eating and active living, these rates will begin to decrease." Read more on CDC.

Urban Farming, founded by recording artist Taja Sevelle, is a nonprofit organization with a goal of reducing hunger and increasing access to fresh, healthy foods by encouraging people in urban, rural and suburban areas to plant gardens on unused land. There are now over 66,600 community, residential and partner gardens that are part of the Urban Farming Global Food Chain around the world.

NewPublicHealth recently spoke with Taja Sevelle about the group and its plans for the future.

NewPublicHealth: How did you become interested in the issue of Urban Farming?

Taja Sevelle: I was recording a CD for Sony Records in Detroit, Mich., when I began to see the vast amounts of unused land in the city. I knew that numerous jobs were being shipped overseas and a lot of people who had lost their jobs were suffering. So, in 2005 I put my music career on the back burner and started Urban Farming with three gardens and a pamphlet. It was always a global vision that grew rapidly and started to get international coverage quickly.

Even though this seems like a new idea, it really is just reacquainting people with the age-old act of planting food. The World War II victory gardens, for example, are a great model because during that time, 20 million Americans planted gardens and grew almost half of the U.S. produce supply. Recently, when the economic downfall hit around the world, planting a garden became a necessity for many people who may not have been thinking about it previously.

NPH: What are the key goals for Urban Farming?

Howard County has been the healthiest in Maryland since the Country Health Rankings launched in 2010. NewPublicHealth recently spoke with the county’s executive, Ken Ulman, about how the Rankings have helped drive further progress in improving the health of Howard County. Health initiatives introduced by Howard County have included a program that certifies schools as “Healthy Schools,” if they meet criteria in several areas including nutrition and physical activity, and a smoking ban in all county parks. 

NewPublicHealth: Howard County has been consistently been ranked the healthiest county in Maryland. What key factors do you credit for that?

Ken Ulman: We start with some advantages. We have the blessings of a highly educated population that cares deeply about their community and have good jobs, and many, though not all, have [adequate financial] resources and access to care. We also have the advantage of having a nonprofit, the Horizon Foundation, based in Howard County that is dedicated to improving the health and wellbeing of people living and working in our county.

So it’s a combination of policy initiatives coupled with a public that really wants to make progress in these areas.

NPH: Have the County Health Rankings helped drive any of your public health and prevention initiatives?

While laws to help make it easier for everyone to get their veggies are cropping up all over, some would-be planters get stopped in their carrot tracks by regulations that prohibit use of public spaces for planting, or even limit what can be grown on private property, according to a recent article in the Wall Street Journal [note: subscription required]. In some jurisdictions, according to the article, sidewalk gardeners have been fined and may lack the clout to advocate for changing the laws.

>>Bonus Link: Read about Urban Farming, a nonprofit group with high-profile corporate sponsors that supports gardens on unused land.

Doctors’ Knowledge of Lab Test Costs Reduces Unnecessary Testing
Knowing the cost of a laboratory tests makes doctors less inclined to order them for hospitalized patients, according to a new study in JAMA Internal Medicine. About $226 billion was wasted on unnecessary tests in 2011, according to the study from researchers at The Johns Hopkins University School of Medicine in Baltimore. Unnecessary tests also increase the risk of patient harm and false positives. "The rational approach to ordering tests is something we should all be interested in, and something—if we did better—that would save the system money and save the patients the horror of causing harm," said Leonard Feldman, MD, of Johns Hopkins. Read more on access to health care.

Mass. Study Shows Importance of Simplifying Health Insurance Benefits Options
Just six months before open enrollment for the Affordable Care Act’s health insurance marketplaces begins, a new study in the journal Health Affairs shows that some Massachusetts families who enrolled in unsubsidized Commonwealth Health Insurance Connector Authority plans experienced higher financial burdens due to health care costs. The study found that 38 percent saw financial burdens and 45 percent saw higher-than-expected out-of-pocket costs—indicating that lower-income families with increased health care needs and multiple children are at particular risk for higher costs. “Given the complexity of health insurance choices and consumers’ limited understanding of health insurance benefits, policy makers need to reach out and simplify information to promote optimal plan choices for the people,” wrote the study’s authors. Read more on community health.

CSPI Classifies Ginkgo Biloba as ‘Avoid’
The Center for Science in the Public Interest (CSPI) is now recommending people avoid Ginkgo biloba after a National Toxicology Program study linked it to liver cancer in mice and thyroid cancer in rats. The substance can be found in many dietary supplements, herbal teas and energy drinks. "Ginkgo has been used in recent years to let companies pretend that supplements or energy drinks with it confer some sort of benefit for memory or concentration," said CSPI executive director Michael F. Jacobson. "The evidence for those claims has been dubious, at best. The pretend benefits are now outweighed by the real risk of harm." The U.S. Food and Drug Administration has previously sent warning to drink manufacturers stating that the ingredient is not generally considered safe for food. Read more on nutrition.

Small Amounts of Daily Exercise Can Help Teens Quit Smoking
As little as 30 minutes of daily exercise can help kids quit smoking, according to a new study in the Journal of Adolescent Health. It can also help to reduce tobacco use. Researchers found that daily smokers were more likely to reduce or quit smoking if they combined a fitness program with a smoking cessation program, rather than just a cessation program alone. Every teen in the study smoked an average of half a pack of cigarettes each weekday and a full pack a day on weekends. And that was just one of the poor health habits of many of the participants. "It is not unusual for teenage smokers to engage in other unhealthy habits,” said author Kimberly Horn, associate dean for research at the George Washington University School of Public Health and Health Services. “Smoking and physical inactivity, for instance, often go hand in hand.” According to the U.S. Centers for Disease Control and Prevention, about 13 percent of Americans age 18 and under smoke tobacco. Read more on tobacco.

Study: Low Food Security, Exposure to Violence Closely Linked
There is a close correlation between low food security and exposure to violence, according to a new study in Public Health Nutrition. Researchers spoke with forty-four mothers of children age 3 and under who participated in public assistance programs, finding increased exposure to violence, which in turn increased the chance of negative mental health, an inability to continue school and an inability to make a living wage.  The violence included child abuse, neglect and rape. The study clearly demonstrates the need to consider and include violence prevention efforts when establishing policies to deal with hunger. Read more on violence.

Size of Parents’ Social Groups Can Affect Whether Kids are Vaccinated
What they hear from friends and the people in their social group may affect whether parents have their children vaccinated, according to a new study in the journal Pediatrics. Parents who were less likely to vaccinate were also more likely to have large social groups and rely on books, pamphlets and the Internet for information on vaccines. "I think that what needs to be done is that everybody needs to understand the importance of vaccines,” said Joseph Anthony Bocchini, Jr., MD, chairman of Pediatrics Medicine at Louisiana State University Health Sciences Center in Shreveport. “And they're not only important for the people who receive them but they're also important for the community." About 95 percent of kindergarten-aged children are appropriately vaccinated, according to the U.S. Centers for Disease Control and Prevention. Read more on vaccines.

Smaller, Frequent Meals Help Kids Keep Weight Off
Smaller, more frequent meals can help kids ward of overeating and obesity, according to several new studies in the journal Pediatrics. One study found that simply using smaller dishware—thus forcing smaller portions—meant kids ate less; they found that adult-sized dishware led first-graders to take 90 calories more of food. Researchers also found kids who ate more often were 22 less likely to be overweight. "The results are very interesting and confirm our expectations that the impact of plate size on adults in the laboratory also apply to children," said Thomas Robinson, MD, a childhood obesity researcher at Stanford University, according to Reuters. "This study provides very important preliminary evidence that using smaller dishware may help reduce children's energy intakes." Read more on obesity.

Low-calorie Drinks Increasingly Popular for Kids
While sugary drinks remain popular, low-calories drinks are also gaining more and more consumers, according to a new study in the journal Pediatric Obesity. Researchers at the University of North Caroline (UNC) found both that consumption of calories from sweetened drinks was down and consumer of low-calorie drinks was up over a 10-year period. The findings were especially significant for kids. "The food industry is trying many ways to reduce the caloric content of foods and beverages," said Barry M. Popkin, PhD, W.R. Kenan Jr. Distinguished Professor of Nutrition at UNC's Gillings School of Global Public Health. "We are increasingly seeing them replace caloric sweeteners with low-calorie sweeteners. This trend has particularly emerged in the last three to four years as U.S. concern about obesity, diabetes and other complications of consuming excessive sugary high-calorie beverages has increased." Read more on nutrition.

Missed, Delayed Mammograms Increase Death Risk for Older Women
Older women with misses or delayed mammograms are significantly more likely to die from breast cancer, according to new research to be presented at the annual meeting of the American Association for Cancer Research. Researchers found “that 23 percent of women who had their last mammogram five or more years before being diagnosed with breast cancer had advanced cancer, compared with 20 percent of those who had a mammogram six months to a year before their diagnosis,” according to HealthDay. Increased time between mammograms also significantly increased the risk of death from cancer for women age 75 and older. Researchers said more study is needed to examine the connection. "It is possible that the differences in the relationship between screening interval and [death] in older versus younger women may be related to the more aggressive nature of the tumors in younger women, which might obliterate the effects of more screening,” said Michael Simon, MD, leader of the breast multidisciplinary team at the Barbara Ann Karmanos Cancer Institute in Detroit. “Other reasons may include differences in cancer treatment, information that was not available for this [group] of women.” Read more on cancer.

Study: Most Intend to Comply With Mandatory Hurricane Evacuation
Most residents of areas most likely to be hit by hurricanes—no matter their income level—intend to comply with mandatory evacuation orders, according to a new study in the journal Disaster Medicine and Public Health Preparedness. Researchers at The University of Texas School of Public Health did find variations with other demographic differences, such as age, ethnicity and education level. The findings indicate that disaster preparedness should focus more on how to best evacuate the most vulnerable residents, which could include targeted messaging and education. Read more on preparedness.

Breath Test May Identify People Prone to Obesity
A breath test that measures bacterial overgrowth in the stomach could be used to determine whether a person will become overweight, according to a new study in the Journal of Clinical Endocrinology & Metabolism. Researchers found that higher levels of methane and hydrogen from the bacteria Methanobrevibacter smithii were associated with higher BMIs and more body fat. Overgrowth of “bad” bacteria can also lead to bloating, constipation and diarrhea. While noting that obesity is “not a one-size-fits-all disease," study author Ruchi Mathur, MD, director of the outpatient diabetes treatment center at Cedars-Sinai Medical Center in Los Angeles, said this could help identify people who would respond best to particular weight loss methods. Read more on obesity.

Study Finds Most Major Restaurants Post Accurate Nutrition Info
A new study from Consumer Reports found that most major chain restaurants post accurate nutritional information about their food. Shoppers purchased and tested 17 menu items from restaurants and fast-food chains, comparing the results for each item to the same items purchased at other restaurants in the chain. They determined that only two items had higher fat or calorie content than advertised: Olive Garden’s Lasagna Primavera with Grilled Chicken and Outback Steakhouse’s Chicken on the Barbie. “We found that you can usually trust the figures you see,” said editor Leslie Ware. “On average, most of them were telling the truth.” The U.S. Food and Drug Administration is slated to release new regulations regarding nutrition labeling later this year. Read more on nutrition.

CDC: U.S. Kids Consume Nearly as Much Salt as U.S. Adults
The average U.S. kid consumes about as much salt in a day as the average U.S. adult—which is to say far too much, according to a new study in the journal Pediatrics. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found the average youth age 8 to 18 has a daily sodium intake of approximately 3,387 mg; the recommended daily limit is 2,300 mg. Processed foods are one of the biggest culprits. Excessive sodium is linked to a myriad of health issues. "We found that higher sodium intake was associated with higher blood pressure," said Janelle Gunn, a public health analyst with the CDC. "We found among overweight and obese participants (in the study), that for every 1,000 mg of sodium they consumed, their blood pressure response was seven times greater (compared to healthy-weight children)." Read more on nutrition.

Norovirus Top Cause of Pediatric Medical Care for Acute Gastroenteritis
Norovirus will cause about 1 in every 14 children to seek emergency care treatment and 1 in 6 to need outpatient care before the age of 5, according to a new study in the New England Journal of Medicine. Researchers determined the highly infectious norovirus is now the number one cause of the need for medical care for acute gastroenteritis in that age group. From 2009 to 2010 there were about 1 million pediatric medical care visits linked to norovirus. “Infants and young children are very susceptible to norovirus infections, which often result in a high risk of getting dehydrated from the sudden onset of intense vomiting and severe diarrhea,” said Daniel Payne, MD, an epidemiologist in the Division of Viral Diseases at the U.S. Centers for Disease Control and Prevention. Read more on infectious disease.

Study: Online Venting Will Probably Just Make You Angrier
That little bit of relaxation you feel right after responding to an infuriating comment on the internet may just be a brief respite on the path to long-term frustration, according to a new study in the journal Cyberpsychology, Behavior, and Social Networking. Lead author Ryan Martin, an associate professor of human development and psychology at the University of Wisconsin-Green Bay, said the anonymity and social distance of many online sites makes responding quickly and in anger too easy. While there are many good reasons to be angry, he said the healthier approach is to get involved with an issue that frustrates you and try to change things, rather than railing at a stranger on Facebook, Twitter or a blog site. "Most of these sites encourage venting as a way of dealing with anger," Martin said. "They think of venting as a healthy adaptive approach, and it's not." Read more on mental health.