UNC Weight Loss Study Shows Positive Results

From high-intensity training, to low-impact sports, there are many ways to go about staying in shape.

But in an effort to decide which method is best, UNC professor of health and nutrition, Deborah Tate, has compared two popular methods.

“Unfortunately, losing weight and then keeping that weight off proves extremely difficult and challenging for the majority of people. So we took a step back to think, ‘When are the high risk times when people gain weight?’”

Tate found this high risk time is between the ages 18 to 35. Young adults during this period gain an average of 30 pounds – a trend Tate says is becoming increasingly more dangerous.

“We’re getting high blood pressure, high cholesterol and heart disease risk factors earlier than our parents’ or our grandparents’ generation and one reason they suspect this is because of the weight gain.”

The first weight loss method Tate tested was called “slow changes.”

A group of 200 people were told to add 2,000 extra steps and eat 100 less calories per day over a three year period.

“You do that every day, just a little bit, not too burdensome, but every single day. Versus the large changes – that was very periodic.”

The “large changes” group cut their calories by 500 every day and increased physical activity to four hours over an eight week period.

“It buffers you against those weight gains that are going to happen over time so that the result is that you end up at least at, or below, where you would have started.”

Tate found that both methods resulted in healthier body weights for the participants. In addition, the two groups achieved their fitness goals at a higher rate than the control group – people who were trying to lose weight on their own.

“Both of them worked better than the self-guided group over the three years and we actually cut risks of becoming obese in half.”

Tate said one of the keys to success was the daily weigh-ins where participants were encouraged to track their progress.

“You can’t know where you’re trying to go or where you’ve been if you don’t have that regular yardstick or that regular measurement.”

Aside from the improved numbers on the scale, Tate said one of the biggest triumphs of the study is the self confidence it gave the participants and anyone else looking to lose weight.

“This study shows that you can do it and that participants really were able to follow both approaches and adapt their lifestyle.”

Whether that lifestyle includes small changes, or big ones, Tate says both work just fine.


Ban Vaping In Orange County Bars And Restaurants?

It’s no longer legal to smoke inside bars and restaurants in North Carolina.

Should the same policy be extended to vaping?

The Orange County Board of Health is seeking public feedback now on a proposal to prohibit the use of e-cigarettes in the enclosed areas of bars and restaurants. The board proposed the new rule in January, after considering new evidence on the risk of secondhand exposure to e-cigarette vapor (which can contain nicotine and other chemicals).

You can read the proposed rule here.

Get additional information on the rule and the broader issue here, via the Orange County Board of Health.

Not everyone is in favor of the proposed rule: Orange County conservative Ashley DeSena says she’s concerned the county would be imposing restrictions without sufficient evidence of a legitimate public health threat. She discussed the issue earlier this week with WCHL’s Aaron Keck.


If you’d like to weigh in on the proposed rule, you can take an online survey, or send an email to SmokeFreeOC@OrangeCountyNC.gov, through Sunday. There will also be a public hearing this Wednesday, April 27, at 7 pm in the health department’s office at 300 West Tryon Street in Hillsborough.

For more information on how you can weigh in, visit this page on the Health Department’s website.


Orange is Second Healthiest County in State According to Study

Orange County is the second healthiest county in North Carolina, according to a new study.

The study, done by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute looked at factors such as life expectancy, poverty rates, health behaviors and environmental factors among others to determine the rankings.

The study looked at almost every county in all 50 states.

Maisha Simmons is a senior program officer with the Robert Wood Johnson Foundation.

“The rankings show us that where we live matters to our health and that good health is about more than medical care, it’s also about factors like access to healthy food and reliable transportation, as well as safe and healthy schools and neighborhoods,” said Simmons.

Orange County was ranked as having the best clinical care and longest length of life in North Carolina.

But there are some areas where Orange County could improve such as quality of life where Orange County was ranked 7th and physical environment, which considered factors like air quality, housing and commute to work, Orange County was ranked 4th.

But in last year’s study, Orange County was ranked as the healthiest county in North Carolina. This year, Wake County came out on top.

“Look at the data and compare from last year’s ranking to this year but this is only part of the story,” said Simmons, “recognize that there were improvements made as well, even if there was a slip in the rankings.”

The rate of uninsured people and violent crime has gone down in Orange County over the past year.

The study illuminates some inequalities that exist in Orange County too. Income inequality in Orange County is higher than most other counties in the state and the rate of children living in poverty has risen to 13%.

“These are all things that communities can do something about but it also shows us that not everyone has the same opportunity to be healthy,” said Simmons.

Simmons said probably the most disturbing new trend nationwide is a rise in drug overdose deaths due to heroin and opiate use.

“We’ve been hearing about this in the community but the rankings also show us that this is an epidemic for us,” said Simmons, “but we know that there are things that communities can do around this factor and in particular it’s really paying attention to the rates that we are prescribing prescription drugs and thinking about training for our first responders, in terms of responding to these incidents.”

Orange County emergency services have begun using the drug Naloxone, which can reverse an opiate overdose. So far, Orange County Emergency Services have successfully reversed four overdoses with the drug.


March 12 Is Dental Health Day: Get Your Kids Checked For Free

When was the last time you took your child to the dentist?

It may not be fun, but it’s essential – and on Saturday, March 12, you can have your kids’ teeth checked for free.

UNC Walk For Health is joining forces with Piedmont Health Services to offer free dental screenings that day for kids ages 5-17. “Dental Health Day” will take place from 8:15 a.m. to 1:15 p.m. at the Carrboro Community Health Center at 301 Lloyd Street. Dentists Katrina Mattison-Chalwe and Heidi Cook will provide cleanings, exams, flouride treatments and more.

Organizers say it’s important to maintain good dental health, particularly at a young age – especially because your dental health affects your overall health. (Research has linked poor dental health to a higher risk of diabetes and heart disease, among other things.)

William Thorpe of UNC Walk For Health and Debra Markley of Piedmont Health Services joined Aaron Keck on WCHL last week.


Space is limited for Dental Health Day, so if you want to bring your children for free screenings, you’ll need to sign up in advance: call 919-593-1093 to make a reservation.


Health Report Card Released for NC Children

The health of North Carolina children is improving is several key areas, but in other aspects the Tar Heel state is lagging, according to a new study.

The 20th Annual Child Health Report Card was released Monday morning by the child advocacy group NC Child.

The report card found the number of uninsured children has decreased across the state, while the overall dental health improved. Also, the number of high school students graduating on time was up nearly eleven percent for the 2012-2013 academic year, when compared with 2008-2009. Another positive note was the finding the teen pregnancy rate was also down in North Carolina.

Overall health of children at birth was also improved and child fatalities, in general, were down.

There were negatives in the report. It found the percentage of children under age 18 living in poverty was up, and that 36 percent of children age 10-17 were overweight.

Teen cigarette use was down to 13.5 percent; meanwhile the number of teens using “Emerging Tobacco Products,” including e-cigarettes, was listed at 22.4 percent.

The number of high school students who said they had used marijuana in the last 30 days was 23 percent, that’s up from just under 20 percent in 2011. Meanwhile, reported alcohol, cocaine, and prescription pill use was down across the same age group.


NC Scores Low on Public Health Report Card

According to the NC Prevention report card, North Carolina residents are struggling to meet public health goals for tobacco use, nutrition, obesity and physical activity.

Rachel Zuker is the research and evaluation coordinator for the Chapel Hill-based nonprofit Prevention Partners. She says the state’s grades are not looking good.

“Right now, we’re not doing great,” says Zuker. “We have a C in tobacco, a D in physical activity and Fs in both nutrition and obesity, so there’s definitely work to be done.”

The report measures state progress on national public health goals set for 2020.

Tobacco use continues to be the leading cause of preventable death in the US, and here in North Carolina, residents are smoking at a higher rate than elsewhere.

Zuker says this year North Carolina earned a C for tobacco use, down from a B grade last year.

“In tobacco policies, other states have continued to make progress, whereas we’ve kind of stayed the same, so I think we’re seeing ourselves slide a little bit in tobacco, which is too bad, because previously we’d been at a B and we were seeing that as a great area,” says Zucker.

The report points to policy changes at the state and local levels that could lower tobacco use, including designating more smoke-free places and increasing funding for cessation support services.

When it comes to nutrition and obesity, the report suggests economic challenges are hitting families hard. Seventeen percent of North Carolina households face hunger. At the same time, two out of every three adults and slightly more than a quarter of  high school students are overweight or obese, and the problem is more significant for those with lower levels of education and income.

Zuker says obesity and poor diet go hand in hand, as it costs more to eat well.

“You can be malnourished and obese. There’s a difference between malnourishment and obesity.”

Compounding the problem, the majority of North Carolina’s adults are not getting the recommended weekly minimum amount of physical activity.

Zuker says when it comes to changing the state’s health grade, workplace programs can have a big impact.

“People spend so much of their daily lives at work, and so if we see workplaces passing policies to promote cheaper, healthy foods, time for physical activities or access to those facilities, helping employees to quit [smoking], we really see that as key.”

Prevention Partners is launching an initiative with some of North Carolina’s largest employers to try to change the workplace culture to support healthy lifestyles. Zuker says the plan, called Healthy Together North Carolina, could reach up to 20 percent of the state’s workforce.

You can read the full interactive report card here.


30 New Flu Deaths Reported Across State

We are entering the heart of flu season across the Tar Heel state, and this year’s virus is proving difficult to fight.

The most recent numbers from state health officials show a staggering increase in flu deaths. 30 new flu-related deaths were reported across North Carolina for the week ending January 3. That brings the total number of deaths related to influenza to 54, since early October. Last flu season saw 107 deaths in the state.

Earlier this week, officials with the Department of Health and Human Services Division of Public Heath gave an update on the severity of the flu this season. State Epidemiologist Dr. Megan Davies says they began to see widespread flu occurrences in mid-November, with a sharp increase in mid-December.

“Flu activity has been more intense this year, compared with recent seasons,” she says, “as measured by visits to emergency departments and doctor’s offices for flu-like illness.”

Davies says the main strain, to this point, has been H3N2, which is a strain of the virus that tends to cause more severe illness in the elderly.

“About two-thirds of the H3N2 that is circulating,” she says, “has not been well matched to the vaccine, unfortunately.”

Officials are still encouraging North Carolinians to get the flu shot because different strains of the virus may become prominent later in the season.

Other treatments are available, including anti-viral drugs. But not all patients will require these medications, according to Dr. Davies.

“The people who most need these medications are people who are at high risk for influenza complications,” she says. That group includes the elderly, young children, pregnant women, and people with medical conditions including asthma and heart disease.

Dr. Thomas Moore says the flu season typically has a standard length, regardless of when that season starts.

“In general, once they start, widespread flu activity lasts on the order of three months,” he says.

Moore adds that if children begin showing symptoms of the flu, keeping them home from school can help stop the spread of the virus.

“Children with fever should not be going to school,” he says. “And they should be kept home until they’ve been without fever for at least 24 hours, without taking Tylenol or ibuprofen.”

As we expect the flu to remain intense over the next several weeks, there are every-day steps to help lower your chance of contracting the virus: staying away from those who are sick, increased hand washing with soap and warm water, and staying home from school or work if you are showing symptoms.


Town of Chapel Hill Named among Healthiest Companies in Triangle

The Town of Chapel Hill has been named one of the 35 healthiest employers across the Triangle by the Triangle Business Journal.

Jason deBruyn, with TBJ, says he is very excited about a new program that has been launched by the Town of Chapel Hill.

“They do some pretty progressive stuff,” he says. “They have a free employee health clinic. That’s staffed with a nurse practitioner, a registered nurse, and a health coach that are all employed by UNC Health Care.”

deBruyn says that the clinic is open to all town employees – eliminating many of the excuses we use for not going to the doctor.

“By having this clinic on site, and by the Town of Chapel Hill saying that the employees can come during work and get checked out, people are a lot more likely to use it,” he says.

deBruyn says he expects the use of on-site clinics to increase in the area, especially in locations where multiple companies share an office park and can split the healthcare costs.

After a long tenure with their headquarters in Chapel Hill, Blue Cross Blue Shield of North Carolina has transitioned to a more central campus in Durham.

deBruyn says Blue Cross Blue Shield has been on the leading edge of providing a healthy workplace in recent years.

“They offer various incentives to encourage employees to lose as much weight as possible,” he says. “They’ll even group them into teams.”

deBruyn adds that BCBS was one of the first companies in the Triangle to begin offering this program. He says that breaking the participants up into teams can also build strong bonds among the employees.

Overall, the region has actually regressed below the national average in terms of the health workplaces, but deBruyn says a portion of that can be caused by the fact that companies have been working to stay ahead of the curve for so long.

He adds that having healthy employees can be very beneficial to the companies as well.

“There have been some really good studies,” he says, “that show that for every dollar invested in a wellness program – or in some kind of a health benefit outside of traditional health insurance – it returns as many as three, four, sometimes as much as five dollars in work productivity and in less lost time.”

Both the Town of Chapel Hill and Blue Cross Blue Shield of North Carolina have both been on the annual list in recent years. For 2014, BCBS checks in at number 7 in the region and the Town of Chapel Hill ranks 14th.


This Thursday, Join The “Great American Smoke-Out”

Are you a smoker who’s thinking about quitting? There’s no better day to start than Thursday.

That’s the day of the Great American Smoke-Out, a national event held every year by the American Cancer Society.

The Smoke-Out “encourages people who smoke or use tobacco to quit for 24 hours,” says Barbara Silver, the program manager for employee wellness at UNC Family Medicine and the Town of Chapel Hill. “And then if they’re successful, to quit for another 24 hours – and just do it one day at a time, as a prelude to being able to quit altogether.”

If you’re one of the 42 million Americans who smoke, and you’re looking to quit, UNC’s Nicotine Dependence Program is setting up booths around town on Thursday from 11 to 3 as part of the Great American Smoke-Out.

“We’ll have information tables at the (UNC) hospital outside of Starbucks (and) at UNC Family Medicine by the patient entrance,” Silver says. “And then CVS also has been partnering with us because they’re not selling tobacco anymore – (so) we’re going to have some pharmacy students helping us down there on Franklin Street.”

And if you can’t make it to the booths, there’s also a statewide quit line, 1-800-QUIT-NOW. You can call that number at any time – but if you call on Thursday, as part of the Great American Smoke-Out, you can receive even more support.

“If you call 1-800-QUIT-NOW, on Thursday, the Quit Line will give you eight weeks of free (nicotine) patches,” says Silver.

Silver says nicotine patches and other forms of medication can double your chances of quitting successfully.

It’s a hard road to quitting, and there may be stumbles along the way – but Silver says those stumbles are just “bumps on the road to progress.” And it is possible to quit – you just have to take it one day at a time.

Matt Englund of UNC Health Care has been smoke-free for a year.

“(I did it by) spreading out my cravings,” he says. “When you want a cigarette, you just take an extra 15 minutes and try to hold off – then try 30 minutes, then an hour, and eventually you train yourself to realize that you don’t – though you think you need it at that moment – you don’t need it at that moment…

“And work up to the moment when you can take a day. Take two days. Take a week. Do as much as you can – and keep trying until you’re successful.”

England and Silver joined Aaron Keck on WCHL this week.


The Great American Smoke-Out is held every year on the third Thursday in November. For more information, visit the American Cancer Society’s website, Cancer.org – and for more information on programs here in our area, visit the Nicotine Dependence Program’s page, NDP.UNC.edu.


Of Minerals And Men

I recently read a report from the journal Nature noting that the concentration of mercury dissolved in the oceans has more than tripled since the beginning of the Industrial Revolution. A number of questions immediately came to mind, such as, “How did this happen?” and “How concerned should we be?” And thus a Common Science® column was born. However, in the process of writing about mercury, I got off on a bit of a tangent on the critical importance of metals in maintaining good health and in the functioning of biological processes. That tangent eventually grew into this week’s column, which will serve as a prelude to the column on mercury next week.

To understand why metals are biologically important, we first need to review some chemistry. You should remember from high school chemistry that molecules are formed when atoms share electrons as part of a chemical bond.(1) In order for a molecule to participate in a chemical reaction, at least one of its chemical bonds must first be broken. In order for a bond to break, two molecules have to smash into each other with enough energy to break the bond – known as the activation energy barrier.

If you want to encourage a chemical reaction to occur or to make it go faster, there are two strategies that can be employed to overcome the activation energy barrier. The simplest approach is to heat up the reactants. Hot reactants move around faster, and thus smash into one another with greater enthusiasm. The other approach is to use a catalyst. Catalysts help chemical reactions to occur by reducing the amount of energy required for them to occur. Catalysts can be particularly useful if you want to induce a chemical reaction to occur but, due to some constraints, cannot add heat.

In both industrial and biological processes, catalysts often include metal atoms. The reason for this stems from the electrical properties of metals which allow them to either accept or donate electrons. As an example, let’s consider what is perhaps the most famous industrial reaction of all (at least to geeks like me): the reaction of nitrogen (N2) with hydrogen (H2) to make ammonia (NH3), the key component of industrial fertilizers, via the Haber-Bosch Process.(2) Nitrogen molecules consist of two nitrogen atoms bound together with a triple bond, making it one of the most stable and therefore unreactive molecules in the entire universe. Without the use of a catalyst, nitrogen will not react with hydrogen even at extremely high temperatures. Haber and Bosch found that if nitrogen molecules were first allowed to absorb on (stick to) osmium metal, they could be converted to ammonia at a high, but not unreasonable, temperature. The reason this works is that when nitrogen absorbs on osmium, some of the electrons in the nitrogen-nitrogen triple bond are pulled towards the metal, which weakens the bonds between the two nitrogen atoms. Now that this bond has been weakened by the catalyst, the activation energy barrier required to induce nitrogen to react with hydrogen is much lower. The development of the Haber-Bosch process, which today provides the fertilizer to generate approximately half of the food calories produced on Earth, is often rated as the greatest scientific achievement of the 20th century.

Now that we have finished our primer on how metals can catalyze chemical reactions, let’s turn to how that applies to people. The functioning of the human body involves a staggering number of chemical reactions, including the digestion of food, the repair of wounds and injuries, and the formation of new blood cells. Since the temperature of the human body hovers around 98.6 ºF, the only practical way to encourage chemical reactions in the body to go faster is to use a catalyst (3). In order to make sure that all of these needed chemical reactions occur, your body produces over 55,000 different catalysts. Catalysts in biologic systems are called enzymes. Many of the enzymes that your body produces include one or more metal atoms, such as iron, magnesium, manganese, zinc, and selenium. The metal atoms in these enzymes function in an analogous way to the osmium in the Haber-Bosch process. The need for your body to produce metal-containing enzymes is a primary reason that you need to eat a diet that contains a wide range of minerals in sufficient quantities and in the proper ratios. If your diet becomes deficient in minerals, a number of rather bad things can happen to you, including nerve damage, kidney stones, anemia, muscle weakness, birth defects, and, in the extreme, death.

If you have made it this far, you now have an understanding of how a catalyst functions, why metals make good catalysts, and that many processes in the human body rely on metal-containing enzymes. That information alone would constitute a reasonably complete Common Science® column. But I have yet to share with you the basis of my fascination with this topic. So pour yourself another cup of coffee and let’s delve into evolutionary development and biology.

The evolution of our species has occurred over the last 500,000 years. During this time, our bodies have evolved to respond to an impressive array of challenges, including wild swings of climate, devastating plagues, changes in food sources, and competition with other hominid species. While these past challenges were certainly significant, even events like the onset and retreat of ice ages occurred slowly over the course of thousands of years, which gave our ancestors time to react both strategically and biologically. Successful human evolution over the millennia proceeded in equilibrium with the available metal-containing minerals in our diets, which allowed us to create just the right balance of enzymes and go on to become the dominant species on Earth.

Over the last two hundred years, with the advent of fossil fuel use, the growth of industrial agriculture, and the explosion of the human population, we have introduced environmental changes at a rate which is unprecedented in the history or our species. This includes some dramatic shifts in the mineral content of our diets. I have written several times about that fact that the mineral content in the U.S. food supply has fallen by around 30% since the 1940s. While it can be difficult to tease out all of the direct mechanisms, we know that these changes in the American diet over the past several decades have led to dramatic increases in tooth decay, heart disease and diabetes, processes which are all intertwined with the proper or improper functioning of metal-containing enzymes.

The dramatic rise in mercury concentration in the oceans represents a different sort of challenge to the human-metal interplay in our environment and diets. This time, rather than a developing deficiency, we are introducing an excess amount of a metal into our diets, a metal which, far from being essential for good human health, is poisonous to us. This is a development which deserves further exploration. But that will have to wait until next week.

Have a comment or question? Use the interface below or send me an email to commonscience@chapelboro.com. Think that this column includes important points that others should consider? Send out a link on Facebook or Twitter. Want more Common Science? Follow me on Twitter on @Commonscience.

(1) I am aware that in many school districts (including, sadly, the Chapel Hill Carrboro City Schools) it is possible to receive a high school diploma without taking chemistry. This knowledge makes me sad, so I choose to repress it and continue to assume that all of you had chemistry in high school.

(2) If you want to know more about the Haber-Bosch process and its role in driving the human population explosion, please follow this link to Fun with Fritz and Carl.

(3) As you know, when the body is threatened by viruses and bacteria, it will respond by raising its temperature. This strategy is designed to make a number of disease-fighting chemical reactions go faster to defeat the intruder. However, if the body over-corrects and raises its temperature to 104 °F, it can start to cause collateral damage to other body systems by damaging beneficial enzymes. This is why fever of this magnitude requires intervention with medicine and/or physical cooling of the body. In a display of evolutionary solidarity, beneficial enzymes in plants also shut down at this temperature. Sadly, there is no aspirin for basil plants.