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"content": "\u003cfigure id=\"attachment_15967\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/pepino1976/7619706126/sizes/l/in/photolist-cBjZay-ducrMh-dKTpPK-dKYUzQ-diM3uy-7JLnkS-7JGnFv-8hdW7r-8MTQVj-cuEzCL-cN2XHC-dpvLuP-eaQAZQ-buYDgX-8sSw5d-bfeYQ2-dQnMS9-85JHLn-eQqNd7-8DU6Hm-9c86w9-892GLD-8ZGa1U-dkBvEb-aTEqSR/\">\u003cimg class=\"size-full wp-image-15967\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z.jpg\" alt=\"(Pepino1976/Flickr)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Pepino1976/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Like health care, dental care matters, too. While about 14 percent of Californians lack health insurance, 39 percent \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentalInsuranceInCalifornia.pdf\" target=\"_blank\">lack dental coverage\u003c/a>, according to a 2009 brief from the California HealthCare Foundation.\u003c/p>\n\u003cp>Even if you have dental insurance, it often has coverage limits and varying levels of out-of-pocket spending requirements that differ from health insurance, as a recent Los Angeles Times report\u003ca href=\"http://articles.latimes.com/2013/aug/30/business/la-fi-healthcare-watch-20130901\" target=\"_blank\"> noted\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>First, it's specifically designed to encourage preventive treatment. That's why most dental plans pay 100 percent for preventive services, such as cleanings, X-rays and checkups. Basic restorative services such as fillings and periodontal cleanings are generally covered at 80 percent, and you'll commonly get just 50 percent reimbursement for procedures such as implants and crowns.\u003c/p>\n\u003cp>In addition, they commonly come with low annual maximums that place a cap on what the plan pays toward care — the typical range is $1,000 to $1,500.\u003c/p>\n\u003cp>Even with coverage, the high cost of dental procedures prevents many people from seeking care. In a recent study of Los Angeles residents conducted by Empirica Research, 51 percent with dental insurance say they've delayed care because of cost. That number jumps to 68 percent among those without coverage.\u003c/p>\u003c/blockquote>\n\u003cp>Now, a new website,\u003ca href=\"https://www.brighter.com\" target=\"_blank\"> Brighter.com\u003c/a>, has launched a free (to consumers) service to help connect people with dentists — at a discount. \"The mission was to provide quality, affordable care to everyone,\" said Jake Winebaum, Brighter's CEO. \"Brighter is the first marketplace where dentists are competing for patients based on quality, price and convenience.\"\u003c!--more-->\u003c/p>\n\u003cp>Brighter has recruited a network of some 600 dentists. The individual dentists set their own prices for procedures, and all pricing is transparent on the website. Consumers can search for a dentist any way they like — by geography or by price — and book an appointment online. Patients must pay in full at the time of service.\u003c/p>\n\u003cp>Kate Quirk of Agoura Hills says she and her husband decided to opt out of the dental insurance offered by his employer. She says since they're young and healthy, they decided to pay out-of-pocket for preventive care. She found the website \"straightforward, easy to use\" and that the discounts offered are \"pretty steep, almost unreal.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She said she was skeptical about the quality of Brighter's dentists but checked the ratings listed, including links to Yelp ratings on Brighter's site. She's been very happy with the dentist she chose, Michael Wong, in Santa Monica. His published \"checkup and cleaning\" price is $350, but he offers it for $150 on Brighter. Other Santa Monica dentists charge less than $100 for a checkup and cleaning.\u003c/p>\n\u003cp>Dentists pay $50 for each patient who comes in for an appointment. Dr. Wong said he's seeing about 4 to 6 patients a month from Brighter. He says he's \"interested in doing high-quality dentistry,\" and that he does little other marketing besides Brighter. Most of his practice is word of mouth, and he hopes Brighter may add to that. \"I get a patient in, if they like their treatment, they send friends and family.\"\u003c/p>\n\u003cp>Dr. Goli Javaher, also a dentist in Santa Monica, likes the lack of paperwork. She also observed that it's not fair that uninsured patients pay higher prices than patients with insurance, who benefit from the bargaining power of the insurance company. \"The patients are so grateful,\" she said. It's treating them at the \"same price as insurance.\"\u003c/p>\n\u003cp>Quirk said she started seeing Dr. Wong when she lived closer to Santa Monica than she does now. But she liked him so much she says she may make the drive to continue to see him.\u003c/p>\n\u003cp>\"You've got really happy patients who are getting something they couldn't get before,\" Winebaum said, referring again to what he calls quality, affordable care, \"and really happy dentists who are getting loyal patients.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Brighter is beginning an expansion in southern California outside of Los Angeles. In 2014 the company will expand to other not-yet-announced metropolitan areas outside California.\u003c/p>\n\n",
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"excerpt": "Like health care, dental care matters, too. While about 14 percent of Californians lack health insurance, 39 percent lack dental coverage, according to a 2009 brief from the California HealthCare Foundation.\r\n\r\nEven if you have dental insurance, it often has coverage limits and varying levels of out-of-pocket spending requirements that differ from health insurance",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15967\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/pepino1976/7619706126/sizes/l/in/photolist-cBjZay-ducrMh-dKTpPK-dKYUzQ-diM3uy-7JLnkS-7JGnFv-8hdW7r-8MTQVj-cuEzCL-cN2XHC-dpvLuP-eaQAZQ-buYDgX-8sSw5d-bfeYQ2-dQnMS9-85JHLn-eQqNd7-8DU6Hm-9c86w9-892GLD-8ZGa1U-dkBvEb-aTEqSR/\">\u003cimg class=\"size-full wp-image-15967\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z.jpg\" alt=\"(Pepino1976/Flickr)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Pepino1976/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Like health care, dental care matters, too. While about 14 percent of Californians lack health insurance, 39 percent \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentalInsuranceInCalifornia.pdf\" target=\"_blank\">lack dental coverage\u003c/a>, according to a 2009 brief from the California HealthCare Foundation.\u003c/p>\n\u003cp>Even if you have dental insurance, it often has coverage limits and varying levels of out-of-pocket spending requirements that differ from health insurance, as a recent Los Angeles Times report\u003ca href=\"http://articles.latimes.com/2013/aug/30/business/la-fi-healthcare-watch-20130901\" target=\"_blank\"> noted\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>First, it's specifically designed to encourage preventive treatment. That's why most dental plans pay 100 percent for preventive services, such as cleanings, X-rays and checkups. Basic restorative services such as fillings and periodontal cleanings are generally covered at 80 percent, and you'll commonly get just 50 percent reimbursement for procedures such as implants and crowns.\u003c/p>\n\u003cp>In addition, they commonly come with low annual maximums that place a cap on what the plan pays toward care — the typical range is $1,000 to $1,500.\u003c/p>\n\u003cp>Even with coverage, the high cost of dental procedures prevents many people from seeking care. In a recent study of Los Angeles residents conducted by Empirica Research, 51 percent with dental insurance say they've delayed care because of cost. That number jumps to 68 percent among those without coverage.\u003c/p>\u003c/blockquote>\n\u003cp>Now, a new website,\u003ca href=\"https://www.brighter.com\" target=\"_blank\"> Brighter.com\u003c/a>, has launched a free (to consumers) service to help connect people with dentists — at a discount. \"The mission was to provide quality, affordable care to everyone,\" said Jake Winebaum, Brighter's CEO. \"Brighter is the first marketplace where dentists are competing for patients based on quality, price and convenience.\"\u003c!--more-->\u003c/p>\n\u003cp>Brighter has recruited a network of some 600 dentists. The individual dentists set their own prices for procedures, and all pricing is transparent on the website. Consumers can search for a dentist any way they like — by geography or by price — and book an appointment online. Patients must pay in full at the time of service.\u003c/p>\n\u003cp>Kate Quirk of Agoura Hills says she and her husband decided to opt out of the dental insurance offered by his employer. She says since they're young and healthy, they decided to pay out-of-pocket for preventive care. She found the website \"straightforward, easy to use\" and that the discounts offered are \"pretty steep, almost unreal.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She said she was skeptical about the quality of Brighter's dentists but checked the ratings listed, including links to Yelp ratings on Brighter's site. She's been very happy with the dentist she chose, Michael Wong, in Santa Monica. His published \"checkup and cleaning\" price is $350, but he offers it for $150 on Brighter. Other Santa Monica dentists charge less than $100 for a checkup and cleaning.\u003c/p>\n\u003cp>Dentists pay $50 for each patient who comes in for an appointment. Dr. Wong said he's seeing about 4 to 6 patients a month from Brighter. He says he's \"interested in doing high-quality dentistry,\" and that he does little other marketing besides Brighter. Most of his practice is word of mouth, and he hopes Brighter may add to that. \"I get a patient in, if they like their treatment, they send friends and family.\"\u003c/p>\n\u003cp>Dr. Goli Javaher, also a dentist in Santa Monica, likes the lack of paperwork. She also observed that it's not fair that uninsured patients pay higher prices than patients with insurance, who benefit from the bargaining power of the insurance company. \"The patients are so grateful,\" she said. It's treating them at the \"same price as insurance.\"\u003c/p>\n\u003cp>Quirk said she started seeing Dr. Wong when she lived closer to Santa Monica than she does now. But she liked him so much she says she may make the drive to continue to see him.\u003c/p>\n\u003cp>\"You've got really happy patients who are getting something they couldn't get before,\" Winebaum said, referring again to what he calls quality, affordable care, \"and really happy dentists who are getting loyal patients.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Brighter is beginning an expansion in southern California outside of Los Angeles. In 2014 the company will expand to other not-yet-announced metropolitan areas outside California.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Recipe For Strong Teen Bones: Exercise, Calcium and Vitamin D",
"title": "Recipe For Strong Teen Bones: Exercise, Calcium and Vitamin D",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_15872\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/39255507@N03/4566653777/in/photolist-7Xxi4X-7XxipH-7XAxqo-7XxihR-7Xxion-7Xxicp-7XxijP-7XxhYi-awfLC9-fEG3yB-fEYAfj-fEYC2G-fEYAgY-fEG4vp-fEG2MB-fEG4uc-fEG3zH-fEYAgE-fEYB55-fEYC2W-fEYAgb-fEG3A4-fEG3y2-fEG3xP-7Qw4Yw-7Qw4LN-7QsJKt-7QsJDV-7QsJFP-7Qw4QQ-7QsJCD-7Qw4P1-7Qw4SC-KSPPn-KSPXp-KSEEj-KSEU5-KSQ5T-KSQ4K-KSPNc-KSEM3-KSPRM-KSENE-KSQdX-KSEKE-KSPLX-KSEA1-KSQbe-KSPTg-KSESY-KSPYk\">\u003cimg class=\"size-large wp-image-15872\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/4566653777_3def509bde_o-640x426.jpg\" alt=\"Exercise helps build strong bones for a lifetime, says one expert. (KG Sand Soccer/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exercise helps build strong bones for a lifetime, says one expert. (KG Sand Soccer/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/10/28/240553878/the-recipe-for-strong-teenage-bones-exercise-calcium-and-d\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>It's really only a sliver of time when humans build the bulk of their skeleton. At age 9, the bones start a big growth spurt. And by the time puberty ends, around 14 or 15 years old, the adult-sized skeleton is all but done, about 90 percent complete.\u003c/p>\n\u003cp>But doctors say a lot of children aren't getting what they need to do that. Calcium and vitamin D are essential, sure, but so is lots of time jumping and running.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It's the magic window of time when bone is built.\"\u003c/aside>\n\u003cp>\"It's the magic window of time when bone is built,\" says \u003ca href=\"http://www.childrensnational.org/departmentsandprograms/default.aspx?Id=6112&Type=Program&Name=Bone%20Health%20Program\">Dr. Laura Tosi\u003c/a>, an orthopedic surgeon who directs the pediatric bone health program at Children's National Health system in Washington, D.C. And when it comes to bones, \"bigger is definitely better,\" she says. \"The wider and thicker the bone, the harder it is to break or tear.\"\u003c/p>\n\u003cp>Just about everybody knows that calcium and vitamin D are essential to build strong bones. But children and teenagers are all too often shunning the foods that would help them get enough calcium and vitamin D to build those bones.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Federal health officials recommend that children between the ages of 9 and 18 get 1,300 milligrams of calcium every day. That translates into four to five glasses of milk or the equivalent. According to \u003ca href=\"http://med.stanford.edu/profiles/Neville_Golden/\">Dr. Neville Golden\u003c/a>, an adolescent medicine specialist at the Stanford University School of Medicine, most teens are not drinking anywhere near that amount.\u003c!--more-->\u003c/p>\n\u003cp>Only about 15 percent of high school students are drinking milk, according to a 2011 federal\u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6104a1.htm\">survey\u003c/a>. And only about 9 percent of girls do. In part that's because milk drinking is viewed as \"uncool,\" says Golden, and teens, particularly girls, often think of milk as fattening.\u003c/p>\n\u003cp>But that's not true, he says. One glass of skim milk contains no fat and approximately 80 calories, about the same caloric content as an apple.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Now of course there are other sources of calcium — yogurt and cheese, for example. But lots of kids think those are fattening, too, Golden says. And while vegetables can be a source of calcium, you'd have to eat an awful lot of them to reach the recommended levels — one cup of broccoli has just 42 mg of calcium. Fortunately, there are other food sources, including fortified orange juice, breakfast cereals and tofu.\u003c/p>\n\u003cp>Calcium supplements are often recommended for adults to meet their recommended daily requirement. But for kids, Golden says, it's far better to eat calcium-rich foods. That's because the body absorbs calcium better from food than it does from supplements.\u003c/p>\n\u003cp>Even if boys and girls get the recommended amount of calcium, if they're not also getting vitamin D it won't make a difference. \"You can drink as much calcium as you like, but if you don't have enough vitamin D, you're not going to absorb it,\" Golden says. The vitamin, which is actually a hormone, interacts with the lining of the stomach and intestines to help calcium get absorbed.\u003c/p>\n\u003cp>In 2010, the Institute of Medicine \u003ca href=\"http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-calcium-and-vitamin-D.aspx\">said\u003c/a> that children and most adults need 600 international units of vitamin D a day. They found no evidence of widespread vitamin D deficiency, though people these days spend much less time out in the sun, which stimulates the body's production of vitamin D.\u003c/p>\n\u003cp>Vitamin D is found in foods like fatty fish such as salmon and sardines, but teenage girls were least likely of all age groups to get enough vitamin D in food, according to a 2010 \u003ca href=\"http://jn.nutrition.org/content/140/4/817.full?sid=462ff172-96d3-455d-8958-cf4941c10251\">study\u003c/a>. One interesting point, says Golden: Farmed salmon is not as vitamin D rich as wild-caught salmon. And like calcium, vitamin D is added to foods like milk and orange juice.\u003c/p>\n\u003cp>If a teenager still isn't getting enough vitamin D from fish, milk and other healthy foods, Golden says, a reasonable workaround is taking supplements of about 400 international units per day.\u003c/p>\n\u003cp>Perhaps the secret ingredient to building strong bones for a lifetime is exercise, says orthopedic surgeon Tosi. One \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1359/jbmr.061205/full\">study\u003c/a> found that when children jumped up and down between classes, totaling about 15 minutes a day, they added mass to their leg bones.\u003c/p>\n\u003cp>The bounce is what's important, Tosi says. \"We think the bounce probably sends an electrical or other signal right up the skeleton, saying, 'OK, time to give more, time to build more bone.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So, jumping, jogging, tennis and basketball are all good options. Federal health officials suggest kids get at least one hour of exercise every day.\u003c/p>\n\n",
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"excerpt": "It's really only a sliver of time when humans build the bulk of their skeleton. At age 9, the bones start a big growth spurt. And by the time puberty ends, around 14 or 15 years old, the adult-sized skeleton is all but done, about 90 percent complete.\r\n\r\nBut doctors say a lot of children aren't getting what they need to do that. Calcium and vitamin D are essential, sure, but so is lots of time jumping and running.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15872\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/39255507@N03/4566653777/in/photolist-7Xxi4X-7XxipH-7XAxqo-7XxihR-7Xxion-7Xxicp-7XxijP-7XxhYi-awfLC9-fEG3yB-fEYAfj-fEYC2G-fEYAgY-fEG4vp-fEG2MB-fEG4uc-fEG3zH-fEYAgE-fEYB55-fEYC2W-fEYAgb-fEG3A4-fEG3y2-fEG3xP-7Qw4Yw-7Qw4LN-7QsJKt-7QsJDV-7QsJFP-7Qw4QQ-7QsJCD-7Qw4P1-7Qw4SC-KSPPn-KSPXp-KSEEj-KSEU5-KSQ5T-KSQ4K-KSPNc-KSEM3-KSPRM-KSENE-KSQdX-KSEKE-KSPLX-KSEA1-KSQbe-KSPTg-KSESY-KSPYk\">\u003cimg class=\"size-large wp-image-15872\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/4566653777_3def509bde_o-640x426.jpg\" alt=\"Exercise helps build strong bones for a lifetime, says one expert. (KG Sand Soccer/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exercise helps build strong bones for a lifetime, says one expert. (KG Sand Soccer/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/10/28/240553878/the-recipe-for-strong-teenage-bones-exercise-calcium-and-d\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>It's really only a sliver of time when humans build the bulk of their skeleton. At age 9, the bones start a big growth spurt. And by the time puberty ends, around 14 or 15 years old, the adult-sized skeleton is all but done, about 90 percent complete.\u003c/p>\n\u003cp>But doctors say a lot of children aren't getting what they need to do that. Calcium and vitamin D are essential, sure, but so is lots of time jumping and running.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"It's the magic window of time when bone is built.\"\u003c/aside>\n\u003cp>\"It's the magic window of time when bone is built,\" says \u003ca href=\"http://www.childrensnational.org/departmentsandprograms/default.aspx?Id=6112&Type=Program&Name=Bone%20Health%20Program\">Dr. Laura Tosi\u003c/a>, an orthopedic surgeon who directs the pediatric bone health program at Children's National Health system in Washington, D.C. And when it comes to bones, \"bigger is definitely better,\" she says. \"The wider and thicker the bone, the harder it is to break or tear.\"\u003c/p>\n\u003cp>Just about everybody knows that calcium and vitamin D are essential to build strong bones. But children and teenagers are all too often shunning the foods that would help them get enough calcium and vitamin D to build those bones.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Federal health officials recommend that children between the ages of 9 and 18 get 1,300 milligrams of calcium every day. That translates into four to five glasses of milk or the equivalent. According to \u003ca href=\"http://med.stanford.edu/profiles/Neville_Golden/\">Dr. Neville Golden\u003c/a>, an adolescent medicine specialist at the Stanford University School of Medicine, most teens are not drinking anywhere near that amount.\u003c!--more-->\u003c/p>\n\u003cp>Only about 15 percent of high school students are drinking milk, according to a 2011 federal\u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6104a1.htm\">survey\u003c/a>. And only about 9 percent of girls do. In part that's because milk drinking is viewed as \"uncool,\" says Golden, and teens, particularly girls, often think of milk as fattening.\u003c/p>\n\u003cp>But that's not true, he says. One glass of skim milk contains no fat and approximately 80 calories, about the same caloric content as an apple.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Now of course there are other sources of calcium — yogurt and cheese, for example. But lots of kids think those are fattening, too, Golden says. And while vegetables can be a source of calcium, you'd have to eat an awful lot of them to reach the recommended levels — one cup of broccoli has just 42 mg of calcium. Fortunately, there are other food sources, including fortified orange juice, breakfast cereals and tofu.\u003c/p>\n\u003cp>Calcium supplements are often recommended for adults to meet their recommended daily requirement. But for kids, Golden says, it's far better to eat calcium-rich foods. That's because the body absorbs calcium better from food than it does from supplements.\u003c/p>\n\u003cp>Even if boys and girls get the recommended amount of calcium, if they're not also getting vitamin D it won't make a difference. \"You can drink as much calcium as you like, but if you don't have enough vitamin D, you're not going to absorb it,\" Golden says. The vitamin, which is actually a hormone, interacts with the lining of the stomach and intestines to help calcium get absorbed.\u003c/p>\n\u003cp>In 2010, the Institute of Medicine \u003ca href=\"http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-calcium-and-vitamin-D.aspx\">said\u003c/a> that children and most adults need 600 international units of vitamin D a day. They found no evidence of widespread vitamin D deficiency, though people these days spend much less time out in the sun, which stimulates the body's production of vitamin D.\u003c/p>\n\u003cp>Vitamin D is found in foods like fatty fish such as salmon and sardines, but teenage girls were least likely of all age groups to get enough vitamin D in food, according to a 2010 \u003ca href=\"http://jn.nutrition.org/content/140/4/817.full?sid=462ff172-96d3-455d-8958-cf4941c10251\">study\u003c/a>. One interesting point, says Golden: Farmed salmon is not as vitamin D rich as wild-caught salmon. And like calcium, vitamin D is added to foods like milk and orange juice.\u003c/p>\n\u003cp>If a teenager still isn't getting enough vitamin D from fish, milk and other healthy foods, Golden says, a reasonable workaround is taking supplements of about 400 international units per day.\u003c/p>\n\u003cp>Perhaps the secret ingredient to building strong bones for a lifetime is exercise, says orthopedic surgeon Tosi. One \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1359/jbmr.061205/full\">study\u003c/a> found that when children jumped up and down between classes, totaling about 15 minutes a day, they added mass to their leg bones.\u003c/p>\n\u003cp>The bounce is what's important, Tosi says. \"We think the bounce probably sends an electrical or other signal right up the skeleton, saying, 'OK, time to give more, time to build more bone.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So, jumping, jogging, tennis and basketball are all good options. Federal health officials suggest kids get at least one hour of exercise every day.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Just One in Three Students Deemed \"Fit\" in State Evaluation",
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"content": "\u003cfigure id=\"attachment_15847\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/176683018-e1382634395430.jpg\">\u003cimg class=\"size-large wp-image-15847\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/176683018-640x426.jpg\" alt=\"Among other issues, physical education programs and recess have been cut back in recent years because of budget cuts, (Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Among other issues, physical education programs and recess have been cut back in recent years because of budget cuts, (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams,\u003c/strong>\u003ca href=\"http://www.edsource.org/today/2013/one-in-three-students-makes-the-grade-in-state-fitness-test/40743#.UmlRbRZRYRk\" target=\"_blank\"> EdSource\u003c/a>\u003c/p>\n\u003cp>Only one in three California students earned a “fit” rating in the annual physical fitness test given to more than 1 million fifth, seventh and ninth grade students, according to 2012-13 test results released Wednesday.\u003c/p>\n\u003cp>About 26 percent of fifth graders, 32 percent of seventh graders, and 37 percent of ninth graders scored in the “Healthy Fitness Zone,” a measure defined by the \u003ca href=\"http://www.cde.ca.gov/ta/tg/pf/healthfitzones.asp\" target=\"_blank\">creators \u003c/a>of the \u003ca href=\"https://pftdata.org/files/2012-13_Reference_Guide.pdf\" target=\"_blank\">California Physical Fitness Test\u003c/a>, for all six areas: aerobic capacity, body composition, abdominal strength, trunk extensor strength, upper body strength, and flexibility.\u003c/p>\n\u003cp>In the test, a 10-year-old boy, for example, would be evaluated on his ability to perform a minimum of 12 curl-ups and seven push-ups within a specified time and to run a mile as fast as possible, or run back and forth in a 20-meter distance for as long as possible. Students 13 and older are given the option of walking a mile as fast as possible.\u003c!--more-->\u003c/p>\n\u003cp>Physical education programs and recess have been cut back in recent years because of budget cuts and the pressure to maximize classroom test preparation. Results of the fitness tests are available by county, school, gender, ethnicity and socioeconomic level at the Department of Education’s \u003ca href=\"http://data1.cde.ca.gov/dataquest/\" target=\"_blank\">DataQuest website\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Overall, students made slight improvements in aerobic capacity and body mass index, compared to 2011-12 data, and held relatively steady in the measures of strength, endurance and flexibility. Nearly 94 percent of all students enrolled in fifth, seventh and ninth grade in public schools took the test – some 1.34 million students.\u003c/p>\n\u003cp>“I’m pleased to see the slow shift toward better health continue, but when only about a third of our students are physically fit, we are nowhere near the end of this effort,” State Superintendent of Public Instruction Tom Torlakson, who spoke about fitness on Wednesday at John Muir Fundamental Elementary School in Orange County, said in a \u003ca href=\"http://www.cde.ca.gov/nr/ne/yr13/yr13rel105.asp\" target=\"_blank\">statement\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The simple fact is that healthy kids learn better,” Torlakson said. “To help them succeed in school and in life, California’s young people need more access to physical activity, fresh, healthy food, and clean water.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15847\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/176683018-e1382634395430.jpg\">\u003cimg class=\"size-large wp-image-15847\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/176683018-640x426.jpg\" alt=\"Among other issues, physical education programs and recess have been cut back in recent years because of budget cuts, (Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Among other issues, physical education programs and recess have been cut back in recent years because of budget cuts, (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams,\u003c/strong>\u003ca href=\"http://www.edsource.org/today/2013/one-in-three-students-makes-the-grade-in-state-fitness-test/40743#.UmlRbRZRYRk\" target=\"_blank\"> EdSource\u003c/a>\u003c/p>\n\u003cp>Only one in three California students earned a “fit” rating in the annual physical fitness test given to more than 1 million fifth, seventh and ninth grade students, according to 2012-13 test results released Wednesday.\u003c/p>\n\u003cp>About 26 percent of fifth graders, 32 percent of seventh graders, and 37 percent of ninth graders scored in the “Healthy Fitness Zone,” a measure defined by the \u003ca href=\"http://www.cde.ca.gov/ta/tg/pf/healthfitzones.asp\" target=\"_blank\">creators \u003c/a>of the \u003ca href=\"https://pftdata.org/files/2012-13_Reference_Guide.pdf\" target=\"_blank\">California Physical Fitness Test\u003c/a>, for all six areas: aerobic capacity, body composition, abdominal strength, trunk extensor strength, upper body strength, and flexibility.\u003c/p>\n\u003cp>In the test, a 10-year-old boy, for example, would be evaluated on his ability to perform a minimum of 12 curl-ups and seven push-ups within a specified time and to run a mile as fast as possible, or run back and forth in a 20-meter distance for as long as possible. Students 13 and older are given the option of walking a mile as fast as possible.\u003c!--more-->\u003c/p>\n\u003cp>Physical education programs and recess have been cut back in recent years because of budget cuts and the pressure to maximize classroom test preparation. Results of the fitness tests are available by county, school, gender, ethnicity and socioeconomic level at the Department of Education’s \u003ca href=\"http://data1.cde.ca.gov/dataquest/\" target=\"_blank\">DataQuest website\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Overall, students made slight improvements in aerobic capacity and body mass index, compared to 2011-12 data, and held relatively steady in the measures of strength, endurance and flexibility. Nearly 94 percent of all students enrolled in fifth, seventh and ninth grade in public schools took the test – some 1.34 million students.\u003c/p>\n\u003cp>“I’m pleased to see the slow shift toward better health continue, but when only about a third of our students are physically fit, we are nowhere near the end of this effort,” State Superintendent of Public Instruction Tom Torlakson, who spoke about fitness on Wednesday at John Muir Fundamental Elementary School in Orange County, said in a \u003ca href=\"http://www.cde.ca.gov/nr/ne/yr13/yr13rel105.asp\" target=\"_blank\">statement\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The simple fact is that healthy kids learn better,” Torlakson said. “To help them succeed in school and in life, California’s young people need more access to physical activity, fresh, healthy food, and clean water.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Teens Slurping More Sugary Drinks ",
"title": "California Teens Slurping More Sugary Drinks ",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_15792\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\">\u003cimg class=\"size-full wp-image-15792\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\" alt=\"Arizona Green Tea is popular with teens, but this 23.5 ounce can has 51 grams -- or more than one-third of a cup -- of sugar.(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Arizona Green Tea is popular with teens, but this 23 ounce can has 51 grams -- or more than one-third of a cup -- of sugar. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams\u003c/strong>, \u003ca href=\"http://www.edsource.org/today/2013/more-teens-drinking-sugary-beverages-study-finds/40531#.UmFrIxZRYRk\" target=\"_blank\">EdSource\u003c/a>\u003c/p>\n\u003cp>As the clock ticks toward a 2014 federal ban on the sale of sports drinks at high schools, California teenagers are showing an increasing fondness for the sugary beverages, with an alarming 23 percent spike in the consumption of sports and energy drinks since 2005, according to a \u003ca href=\"http://www.publichealthadvocacy.org/_PDFs/stillbubblingover/PolicyBrief.pdf\" target=\"_blank\">new study\u003c/a>.\u003c/p>\n\u003cp>At the same time, consumption of sugary drinks by young children is declining sharply, according to the study by researchers at the California Center for Public Health Advocacy and the UCLA Center for Health Policy Research. The study tracked youth consumption of the beverages from 2005 to 2012.\u003c/p>\n\u003cp>Both trends – the surge in teens guzzling sugary drinks and the drop in consumption for younger children – are tied to regulations governing the sale of the beverages in California schools, said Harold Goldstein, executive director of the California Center for Public Health Advocacy.\u003c/p>\n\u003cp>“Taking sodas out of schools contributed to a precipitous drop in consumption among younger kids,” he said, “while older kids have switched to sports drinks and energy drinks, and those products are available in schools.”\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In California, soda sales have been banned in elementary and middle schools since 2006 and in high schools since 2009, but \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=49001-50000&file=49430-49436\" target=\"_blank\">a loophole \u003c/a>in the state education code allows the sale of electrolyte replacement beverages, otherwise known as sports drinks, in high school cafeterias, vending machines, snack bars and other on-campus venues. That loophole will close on July 1, 2014, when \u003ca href=\"http://www.fns.usda.gov/cnd/Governance/Legislation/allfoods_beverages.pdf\" target=\"_blank\">new regulations\u003c/a> from the U.S. Department of Agriculture take effect to ban the sale on school campuses of sugary sports and energy drinks that have more than 40 calories in 8 ounces or 60 calories in 12 ounces.\u003c/p>\n\u003cp>“That means your typical 20-ounce Gatorade won’t be in schools,” said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, a nonprofit organization.\u003c/p>\n\u003cp>Some 65 percent of adolescents drink at least one sugary sports drink or soda a day, an 8 percent jump since an earlier survey tracking consumption habits, researchers said.\u003c/p>\n\u003cp>\u003cstrong>Sodas, sport drinks should be \"treats,\" advocates say\u003c/strong>\u003c/p>\n\u003cp>Given the close association between daily sugary beverage consumption and obesity, the rise is cause for alarm for schools that are working to address the effects of obesity on student attendance, self-esteem and health.\u003c/p>\n\u003cp>“California has made real progress in reducing the consumption of sugary beverages among young children,” said Susan Babey, the report’s lead author. “But teens are in trouble.”\u003c/p>\n\u003cp>She said sodas and sports drinks should be regarded as occasional “treats,” not part of a daily meal plan.\u003c/p>\n\u003cp>The study’s most encouraging finding was that young children are consuming markedly fewer sugary beverages. About 19 percent of 2- to 5-year-olds drink a sugary beverage every day, the study said, a 30 percent decline since the earlier survey. Among 6- to 11-year-olds, 32 percent are daily consumers, down 26 percent since 2005-2007.\u003c/p>\n\u003cp>The study was based on data collected in the \u003ca href=\"http://healthpolicy.ucla.edu/chis/about/Pages/about.aspx\" target=\"_blank\">California Health Interview Survey,\u003c/a> the nation’s largest state health survey. Researchers completed interviews with more than 40,000 households.\u003c/p>\n\u003cp>\u003cstrong>Snapshot from one \"open campus\" high school\u003c/strong>\u003c/p>\n\u003cp>Still, banning the beverages from schools won’t stop teenagers from finding the drinks. Some 75 percent of high school campuses in California are “closed” and don’t allow students to leave the grounds without supervision during the school day. “It’s the 25 percent we need to worry about it,” said Wootan at the Center for Science in the Public Interest.\u003c/p>\n\u003cp>At Oakland Technical High School – which has an open campus policy allowing students to leave during lunch – many students sitting on the front lawn at lunchtime Thursday drank from water bottles, while other students returned from local stores with pizza and sugared beverages, including Arizona iced tea, Shasta Cola and a 7-11 Slurpee.\u003c/p>\n\u003cp>Many were well aware of the amount of sugar they were consuming, but didn’t feel it was a serious problem. One student said bottled water was more expensive than his canned iced tea.\u003c/p>\n\u003cp>“I buy it because it tastes good,” said Will, a freshman carrying a can of Shasta Cola.\u003c/p>\n\u003cp>His friend, Ethan, had a 23.5-ounce can of Arizona Green Tea containing 51 grams of sugar. “This has a lot of sugar, but it’s better than soda,” Ethan said. “It’s Arizona and it’s green tea.”\u003c/p>\n\u003cp>Public perception may hold that iced teas and fruit drinks are a better choice than sodas, yet high concentrations of sugar in the beverages make them something to consume in moderation, experts said.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.publichealthadvocacy.org/_PDFs/stillbubblingover/PolicyBrief.pdf\" target=\"_blank\">counties \u003c/a>with the largest declines in percentage of youth drinking soda or other sugary beverages every day included Ventura County, with a 37 percent decrease since 2005; Yuba County, with a 32 percent decrease; and Napa County, with a 31 percent decrease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Counties with the largest increase in daily sugary drink consumption among youth of all ages were Lake County, with a 36 percent increase; Monterey County, with a 29 percent increase; and Solano County, with a 24 percent increase.\u003c/p>\n\n",
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"excerpt": "As the clock ticks toward a 2014 federal ban on the sale of sports drinks at high schools, California teenagers are showing an increasing fondness for the sugary beverages, with an alarming 23 percent spike in the consumption of sports and energy drinks since 2005, according to a new study.\r\n\r\nAt the same time, consumption of sugary drinks by young children is declining sharply, according to the study by researchers at the California Center for Public Health Advocacy and the UCLA Center for Health Policy Research. The study tracked youth consumption of the beverages from 2005 to 2012.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15792\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\">\u003cimg class=\"size-full wp-image-15792\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\" alt=\"Arizona Green Tea is popular with teens, but this 23.5 ounce can has 51 grams -- or more than one-third of a cup -- of sugar.(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Arizona Green Tea is popular with teens, but this 23 ounce can has 51 grams -- or more than one-third of a cup -- of sugar. (Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Jane Meredith Adams\u003c/strong>, \u003ca href=\"http://www.edsource.org/today/2013/more-teens-drinking-sugary-beverages-study-finds/40531#.UmFrIxZRYRk\" target=\"_blank\">EdSource\u003c/a>\u003c/p>\n\u003cp>As the clock ticks toward a 2014 federal ban on the sale of sports drinks at high schools, California teenagers are showing an increasing fondness for the sugary beverages, with an alarming 23 percent spike in the consumption of sports and energy drinks since 2005, according to a \u003ca href=\"http://www.publichealthadvocacy.org/_PDFs/stillbubblingover/PolicyBrief.pdf\" target=\"_blank\">new study\u003c/a>.\u003c/p>\n\u003cp>At the same time, consumption of sugary drinks by young children is declining sharply, according to the study by researchers at the California Center for Public Health Advocacy and the UCLA Center for Health Policy Research. The study tracked youth consumption of the beverages from 2005 to 2012.\u003c/p>\n\u003cp>Both trends – the surge in teens guzzling sugary drinks and the drop in consumption for younger children – are tied to regulations governing the sale of the beverages in California schools, said Harold Goldstein, executive director of the California Center for Public Health Advocacy.\u003c/p>\n\u003cp>“Taking sodas out of schools contributed to a precipitous drop in consumption among younger kids,” he said, “while older kids have switched to sports drinks and energy drinks, and those products are available in schools.”\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In California, soda sales have been banned in elementary and middle schools since 2006 and in high schools since 2009, but \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=49001-50000&file=49430-49436\" target=\"_blank\">a loophole \u003c/a>in the state education code allows the sale of electrolyte replacement beverages, otherwise known as sports drinks, in high school cafeterias, vending machines, snack bars and other on-campus venues. That loophole will close on July 1, 2014, when \u003ca href=\"http://www.fns.usda.gov/cnd/Governance/Legislation/allfoods_beverages.pdf\" target=\"_blank\">new regulations\u003c/a> from the U.S. Department of Agriculture take effect to ban the sale on school campuses of sugary sports and energy drinks that have more than 40 calories in 8 ounces or 60 calories in 12 ounces.\u003c/p>\n\u003cp>“That means your typical 20-ounce Gatorade won’t be in schools,” said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, a nonprofit organization.\u003c/p>\n\u003cp>Some 65 percent of adolescents drink at least one sugary sports drink or soda a day, an 8 percent jump since an earlier survey tracking consumption habits, researchers said.\u003c/p>\n\u003cp>\u003cstrong>Sodas, sport drinks should be \"treats,\" advocates say\u003c/strong>\u003c/p>\n\u003cp>Given the close association between daily sugary beverage consumption and obesity, the rise is cause for alarm for schools that are working to address the effects of obesity on student attendance, self-esteem and health.\u003c/p>\n\u003cp>“California has made real progress in reducing the consumption of sugary beverages among young children,” said Susan Babey, the report’s lead author. “But teens are in trouble.”\u003c/p>\n\u003cp>She said sodas and sports drinks should be regarded as occasional “treats,” not part of a daily meal plan.\u003c/p>\n\u003cp>The study’s most encouraging finding was that young children are consuming markedly fewer sugary beverages. About 19 percent of 2- to 5-year-olds drink a sugary beverage every day, the study said, a 30 percent decline since the earlier survey. Among 6- to 11-year-olds, 32 percent are daily consumers, down 26 percent since 2005-2007.\u003c/p>\n\u003cp>The study was based on data collected in the \u003ca href=\"http://healthpolicy.ucla.edu/chis/about/Pages/about.aspx\" target=\"_blank\">California Health Interview Survey,\u003c/a> the nation’s largest state health survey. Researchers completed interviews with more than 40,000 households.\u003c/p>\n\u003cp>\u003cstrong>Snapshot from one \"open campus\" high school\u003c/strong>\u003c/p>\n\u003cp>Still, banning the beverages from schools won’t stop teenagers from finding the drinks. Some 75 percent of high school campuses in California are “closed” and don’t allow students to leave the grounds without supervision during the school day. “It’s the 25 percent we need to worry about it,” said Wootan at the Center for Science in the Public Interest.\u003c/p>\n\u003cp>At Oakland Technical High School – which has an open campus policy allowing students to leave during lunch – many students sitting on the front lawn at lunchtime Thursday drank from water bottles, while other students returned from local stores with pizza and sugared beverages, including Arizona iced tea, Shasta Cola and a 7-11 Slurpee.\u003c/p>\n\u003cp>Many were well aware of the amount of sugar they were consuming, but didn’t feel it was a serious problem. One student said bottled water was more expensive than his canned iced tea.\u003c/p>\n\u003cp>“I buy it because it tastes good,” said Will, a freshman carrying a can of Shasta Cola.\u003c/p>\n\u003cp>His friend, Ethan, had a 23.5-ounce can of Arizona Green Tea containing 51 grams of sugar. “This has a lot of sugar, but it’s better than soda,” Ethan said. “It’s Arizona and it’s green tea.”\u003c/p>\n\u003cp>Public perception may hold that iced teas and fruit drinks are a better choice than sodas, yet high concentrations of sugar in the beverages make them something to consume in moderation, experts said.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.publichealthadvocacy.org/_PDFs/stillbubblingover/PolicyBrief.pdf\" target=\"_blank\">counties \u003c/a>with the largest declines in percentage of youth drinking soda or other sugary beverages every day included Ventura County, with a 37 percent decrease since 2005; Yuba County, with a 32 percent decrease; and Napa County, with a 31 percent decrease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Counties with the largest increase in daily sugary drink consumption among youth of all ages were Lake County, with a 36 percent increase; Monterey County, with a 29 percent increase; and Solano County, with a 24 percent increase.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Teens Turned Away from Tanning Salons, That's the Good News …",
"title": "Teens Turned Away from Tanning Salons, That's the Good News …",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_15708\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/evilerin/3096163337/in/set-72157608357937086\">\u003cimg class=\"size-large wp-image-15708\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/TANNING-1-640x425.jpg\" alt=\"Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent. (Evil Erin/Flickr)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent. (Evil Erin/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Angela Hart\u003c/strong>\u003c/p>\n\u003cp>California was the first state to \u003ca href=\"http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_0701-0750/sb_746_bill_20111009_chaptered.pdf\">ban people under 18-years-old\u003c/a> from using tanning salons, and now new research takes a look at how well the law is working.\u003c/p>\n\u003cp>In \u003ca href=\"http://www.jaad.org/article/S0190-9622(13)00967-5/abstract\">the study\u003c/a> researchers, including a team at UC San Francisco, surveyed hundreds of tanning salons and found roughly three-quarters of them were adhering with key aspects of the law, although many also misrepresented health benefits of indoor tanning.\u003c/p>\n\u003cp>\"The good news was that the majority of salons were complying with the law,\" said Jack Resneck, the study's senior author and an associate professor of dermatology at UCSF. \"The bad news was that we got rampant misinformation — a lot of which is prohibited by law.\"\u003c/p>\n\u003cp>Resneck said tanning beds can have significant health consequences for young people. Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent, and nationally, the tanning industry aggressively targets minors in advertising.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The researchers said that despite what they called clear evidence of cancer risk, \"indoor tanning remains popular in the United States.\"\u003c/p>\n\u003cp>Nationwide, more than 3.5 million cases of skin cancer are diagnosed each year, according to the study.\u003c!--more-->\u003c/p>\n\u003cp>The survey was conducted in May, 2013. A female medical student who identified herself as a 17-year-old called a random sample of salons in California that advertised on Yellowpages.com, the majority of which were clustered in metropolitan areas. She told respondents that she wanted a base tan before summer, asked how frequently she could tan, whether there were any dangers, and if tanning was good for her.\u003c/p>\n\u003cp>Of the tanning salons she called, 77 percent — 260 out of 338 — told the female caller that she could not use their tanning beds.\u003c/p>\n\u003cp>But some said she could use their tanning beds with a doctor's note, and some told her she could use their facilities with parental consent. In addition, researchers said out of the 338 salons, 61 percent \"made unlawful claims of specific health benefits,\" including vitamin D production, skin disease treatment, prevention of future sunburns, and remedies for depression.\u003c/p>\n\u003cp>\"That was extremely troubling, because we have overwhelming evidence that tanning, especially at an early age, causes cancer, and it's killing people,\" Resneck said. \"When you're young and invincible and there's people telling you tanning is safe, that information is going to be much more believable, even if it's not backed up by facts.\"\u003c/p>\n\u003cp>\"There's a common misconception that tanning helps your health, and is better or the same as the sun,\" Resneck added. \"So we thought this was critical to look at, knowing that the tanning industry is marketing to teenagers, and knowing that early tanning exposure causes cancer.\"\u003c/p>\n\u003cp>Researchers attributed the misinformation to salons workers not being familiar with the law -- or with lack of law enforcement.\u003c/p>\n\u003cp>Resneck said despite lack of education and enforcement, that the study's results were a big leap forward in an industry that doesn't have a lot of good data and that hasn't accurately tracked enforcement of laws that prevent or restrict tanning among minors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California lawmakers were the first to pass an outright ban on minors using indoor ultraviolet tanning salons in 2011. Since, California passed its ban on minors using indoor tanning beds, eight other states have passed similar laws. Statewide, salons that violate the law are required to pay a civil violation fine of $2,500 a day.\u003c/p>\n\n",
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"excerpt": "California was the first state to ban people under 18-years-old from using tanning salons, and now new research takes a look at how well the law is working. \r\n\r\nIn the study researchers, including a team at UC San Francisco, surveyed hundreds of tanning salons and found roughly three-quarters of them were adhering with key aspects of the law, although many also misrepresented health benefits of indoor tanning.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15708\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/evilerin/3096163337/in/set-72157608357937086\">\u003cimg class=\"size-large wp-image-15708\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/TANNING-1-640x425.jpg\" alt=\"Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent. (Evil Erin/Flickr)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent. (Evil Erin/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Angela Hart\u003c/strong>\u003c/p>\n\u003cp>California was the first state to \u003ca href=\"http://www.leginfo.ca.gov/pub/11-12/bill/sen/sb_0701-0750/sb_746_bill_20111009_chaptered.pdf\">ban people under 18-years-old\u003c/a> from using tanning salons, and now new research takes a look at how well the law is working.\u003c/p>\n\u003cp>In \u003ca href=\"http://www.jaad.org/article/S0190-9622(13)00967-5/abstract\">the study\u003c/a> researchers, including a team at UC San Francisco, surveyed hundreds of tanning salons and found roughly three-quarters of them were adhering with key aspects of the law, although many also misrepresented health benefits of indoor tanning.\u003c/p>\n\u003cp>\"The good news was that the majority of salons were complying with the law,\" said Jack Resneck, the study's senior author and an associate professor of dermatology at UCSF. \"The bad news was that we got rampant misinformation — a lot of which is prohibited by law.\"\u003c/p>\n\u003cp>Resneck said tanning beds can have significant health consequences for young people. Exposure to ultraviolet tanning devices before age 30 increases the risk of skin cancer by 75 percent, and nationally, the tanning industry aggressively targets minors in advertising.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The researchers said that despite what they called clear evidence of cancer risk, \"indoor tanning remains popular in the United States.\"\u003c/p>\n\u003cp>Nationwide, more than 3.5 million cases of skin cancer are diagnosed each year, according to the study.\u003c!--more-->\u003c/p>\n\u003cp>The survey was conducted in May, 2013. A female medical student who identified herself as a 17-year-old called a random sample of salons in California that advertised on Yellowpages.com, the majority of which were clustered in metropolitan areas. She told respondents that she wanted a base tan before summer, asked how frequently she could tan, whether there were any dangers, and if tanning was good for her.\u003c/p>\n\u003cp>Of the tanning salons she called, 77 percent — 260 out of 338 — told the female caller that she could not use their tanning beds.\u003c/p>\n\u003cp>But some said she could use their tanning beds with a doctor's note, and some told her she could use their facilities with parental consent. In addition, researchers said out of the 338 salons, 61 percent \"made unlawful claims of specific health benefits,\" including vitamin D production, skin disease treatment, prevention of future sunburns, and remedies for depression.\u003c/p>\n\u003cp>\"That was extremely troubling, because we have overwhelming evidence that tanning, especially at an early age, causes cancer, and it's killing people,\" Resneck said. \"When you're young and invincible and there's people telling you tanning is safe, that information is going to be much more believable, even if it's not backed up by facts.\"\u003c/p>\n\u003cp>\"There's a common misconception that tanning helps your health, and is better or the same as the sun,\" Resneck added. \"So we thought this was critical to look at, knowing that the tanning industry is marketing to teenagers, and knowing that early tanning exposure causes cancer.\"\u003c/p>\n\u003cp>Researchers attributed the misinformation to salons workers not being familiar with the law -- or with lack of law enforcement.\u003c/p>\n\u003cp>Resneck said despite lack of education and enforcement, that the study's results were a big leap forward in an industry that doesn't have a lot of good data and that hasn't accurately tracked enforcement of laws that prevent or restrict tanning among minors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California lawmakers were the first to pass an outright ban on minors using indoor ultraviolet tanning salons in 2011. Since, California passed its ban on minors using indoor tanning beds, eight other states have passed similar laws. Statewide, salons that violate the law are required to pay a civil violation fine of $2,500 a day.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": " Vitamin D Not So Great for Building Bones in Middle Aged Adults After All ",
"title": " Vitamin D Not So Great for Building Bones in Middle Aged Adults After All ",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_15664\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/152162758.jpg\">\u003cimg class=\"size-large wp-image-15664\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/152162758-640x488.jpg\" alt=\"Most people can save their money and skip the Vitamin D supplements. (Getty Images)\" width=\"640\" height=\"488\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Most people can save their money and skip the Vitamin D supplements. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/10/12/232028261/more-evidence-against-vitamin-d-to-build-bones-in-middle-age\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>It's not easy being a wonder vitamin these days. Just when it looks like you're the solution to every health problem, some doctors come along and burst your bubble. Now it's happening to vitamin D.\u003c/p>\n\u003cp>The supplement has been widely promoted to prevent \u003ca href=\"http://www.nlm.nih.gov/medlineplus/osteoporosis.html\" target=\"_blank\">osteoporosis\u003c/a> and fight a host of other ills. But recent studies haven't found much benefit, for bones or for general health.\u003c/p>\n\u003cp>This latest review looks at 23 randomized controlled trials involving more than 4,000 people to study vitamin D's effect on bones. Vitamin D, which is converted into a hormone by the body, makes it easier for us absorb calcium in the intestines. So it's easy to presume that more \"D\" would lead to stronger bones.\u003c/p>\n\u003cp>But this review found that for middle-aged people, taking vitamin D supplements for two years didn't affect bone mineral density in the spine, hip, arm bone and skeleton overall. They did find increased bone density in the neck of the femur bone, where it often breaks in the elderly. The review also found no relation between bone density and taking calcium supplements, people's overall vitamin D levels, length of treatment or age.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The conclusion? \"Continuing widespread use of vitamin D for osteoporosis prevention in community-dwelling adults without specific risk factors for vitamin D deficiency seems to be inappropriate,\" the researchers wrote. The \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61647-5/abstract\">review\u003c/a> was published online in \u003cem>The Lancet\u003c/em>.\u003c/p>\n\u003cp>It could be that bone mineral density in middle-aged women is a poor predictor of who will eventually have osteoporosis, according to an accompanying \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61721-3/fulltext\">commentary\u003c/a> by Dr. Clifford Rosen, an osteoporosis researcher at the Maine Medical Institute. But two other recent analyses also found that vitamin D didn't help prevent fractures.\u003c/p>\n\u003cp>Or it could be that vitamin D and calcium need to be taken together, and that they help only when a person is really low on either or both.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Recent research on vitamin D's role suggests that as long as there's enough calcium circulating in the body, adding D doesn't send more calcium to the bones. It's only when someone's lacking circulating calcium, from food or supplements, that the body steals it from the bones.\u003c/p>\n\u003cp>That finding, Rosen writes, suggests that supplementing both vitamin D and calcium could help prevent hip fractures in the elderly, but probably doesn't build up bones in healthy middle-aged people.\u003c/p>\n\u003cp>That's pretty much the tack taken by the Institute of Medicine. In 2010, the independent body, which sets federal guidelines for dietary intake, \u003ca href=\"http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-calcium-and-vitamin-D.aspx\">determined\u003c/a> that children and adults need 600 international units of vitamin D daily. People over age 70 need 800 IU, the institute recommended.\u003c/p>\n\u003cp>The body makes its own vitamin D when the skin is exposed to sunlight. Some foods — notably fatty fish — contain vitamin D, and others like milk, are routinely fortified with D.\u003c/p>\n\u003cp>But advocates of high-dose vitamin D say that taking high doses of supplemental D — 1,000 to 4,000 IU a day — can prevent cancer, heart disease and other chronic diseases. The Institute of Medicine said there's no evidence that's true.\u003c/p>\n\u003cp>The panel also found no evidence of widespread vitamin D deficiency in Americans.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force, an independent group that advises the government on evidence-based medical treatments, is looking into the broader health effects of vitamin D supplements, so stay tuned.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Earlier this year, the task force said that there's no evidence that taking \u003ca href=\"http://www.npr.org/blogs/health/2013/02/25/172876965/most-people-can-skip-calcium-supplements-prevention-panel-says\">calcium supplements\u003c/a> and up to 400 IU of vitamin D daily protect bones in healthy people. That recommendation didn't apply to people who already have osteoporosis or people over 65 who are at risk of falls.\u003c/p>\n\n",
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"excerpt": "But this review found that for middle-aged people, taking vitamin D supplements for two years didn't affect bone mineral density in the spine, hip, arm bone and skeleton overall. They did find increased bone density in the neck of the femur bone, where it often breaks in the elderly. The review also found no relation between bone density and taking calcium supplements, people's overall vitamin D levels, length of treatment or age.",
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"title": "Vitamin D Not So Great for Building Bones in Middle Aged Adults After All | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15664\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/152162758.jpg\">\u003cimg class=\"size-large wp-image-15664\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/152162758-640x488.jpg\" alt=\"Most people can save their money and skip the Vitamin D supplements. (Getty Images)\" width=\"640\" height=\"488\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Most people can save their money and skip the Vitamin D supplements. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/10/12/232028261/more-evidence-against-vitamin-d-to-build-bones-in-middle-age\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>It's not easy being a wonder vitamin these days. Just when it looks like you're the solution to every health problem, some doctors come along and burst your bubble. Now it's happening to vitamin D.\u003c/p>\n\u003cp>The supplement has been widely promoted to prevent \u003ca href=\"http://www.nlm.nih.gov/medlineplus/osteoporosis.html\" target=\"_blank\">osteoporosis\u003c/a> and fight a host of other ills. But recent studies haven't found much benefit, for bones or for general health.\u003c/p>\n\u003cp>This latest review looks at 23 randomized controlled trials involving more than 4,000 people to study vitamin D's effect on bones. Vitamin D, which is converted into a hormone by the body, makes it easier for us absorb calcium in the intestines. So it's easy to presume that more \"D\" would lead to stronger bones.\u003c/p>\n\u003cp>But this review found that for middle-aged people, taking vitamin D supplements for two years didn't affect bone mineral density in the spine, hip, arm bone and skeleton overall. They did find increased bone density in the neck of the femur bone, where it often breaks in the elderly. The review also found no relation between bone density and taking calcium supplements, people's overall vitamin D levels, length of treatment or age.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The conclusion? \"Continuing widespread use of vitamin D for osteoporosis prevention in community-dwelling adults without specific risk factors for vitamin D deficiency seems to be inappropriate,\" the researchers wrote. The \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61647-5/abstract\">review\u003c/a> was published online in \u003cem>The Lancet\u003c/em>.\u003c/p>\n\u003cp>It could be that bone mineral density in middle-aged women is a poor predictor of who will eventually have osteoporosis, according to an accompanying \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61721-3/fulltext\">commentary\u003c/a> by Dr. Clifford Rosen, an osteoporosis researcher at the Maine Medical Institute. But two other recent analyses also found that vitamin D didn't help prevent fractures.\u003c/p>\n\u003cp>Or it could be that vitamin D and calcium need to be taken together, and that they help only when a person is really low on either or both.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cp>Recent research on vitamin D's role suggests that as long as there's enough calcium circulating in the body, adding D doesn't send more calcium to the bones. It's only when someone's lacking circulating calcium, from food or supplements, that the body steals it from the bones.\u003c/p>\n\u003cp>That finding, Rosen writes, suggests that supplementing both vitamin D and calcium could help prevent hip fractures in the elderly, but probably doesn't build up bones in healthy middle-aged people.\u003c/p>\n\u003cp>That's pretty much the tack taken by the Institute of Medicine. In 2010, the independent body, which sets federal guidelines for dietary intake, \u003ca href=\"http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-calcium-and-vitamin-D.aspx\">determined\u003c/a> that children and adults need 600 international units of vitamin D daily. People over age 70 need 800 IU, the institute recommended.\u003c/p>\n\u003cp>The body makes its own vitamin D when the skin is exposed to sunlight. Some foods — notably fatty fish — contain vitamin D, and others like milk, are routinely fortified with D.\u003c/p>\n\u003cp>But advocates of high-dose vitamin D say that taking high doses of supplemental D — 1,000 to 4,000 IU a day — can prevent cancer, heart disease and other chronic diseases. The Institute of Medicine said there's no evidence that's true.\u003c/p>\n\u003cp>The panel also found no evidence of widespread vitamin D deficiency in Americans.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force, an independent group that advises the government on evidence-based medical treatments, is looking into the broader health effects of vitamin D supplements, so stay tuned.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Earlier this year, the task force said that there's no evidence that taking \u003ca href=\"http://www.npr.org/blogs/health/2013/02/25/172876965/most-people-can-skip-calcium-supplements-prevention-panel-says\">calcium supplements\u003c/a> and up to 400 IU of vitamin D daily protect bones in healthy people. That recommendation didn't apply to people who already have osteoporosis or people over 65 who are at risk of falls.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "It's Time to Rediscover the IUD, Women's Health Advocates Say",
"title": "It's Time to Rediscover the IUD, Women's Health Advocates Say",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_15558\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD0019751-e1381249499865.jpg\">\u003cimg class=\"size-large wp-image-15558\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD0019751-640x465.jpg\" alt=\"Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States.(Spike Mafford/Getty Images)\" width=\"640\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States.(Spike Mafford/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Dana Farrington, \u003ca href=\"http://www.npr.org/blogs/health/2013/10/06/215491647/its-time-to-rediscover-the-iud-womens-health-advocates-say\" target=\"_blank\">NPR\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>What will it take to make intrauterine devices sexy?\u003c/p>\n\u003cp>IUDs are highly effective forms of contraception, but fear of side effects, lack of training for doctors and costs can keep women away. Health organizations and private companies are trying to change that by breaking down misconceptions and broadening access.\u003c/p>\n\u003cp>The contraceptives are inserted into the uterus and can prevent pregnancy for years. And they're reversible. Shortly after they're taken out, a woman can become pregnant.\u003c/p>\n\u003cp>IUDs are more than \u003ca href=\"http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm\" target=\"_blank\">99 percent effective\u003c/a>. The World Health Organization \u003ca href=\"http://bedsider.org/methods/iud#side_effects_tab\">reports \u003c/a>they are \"the most widely used reversible contraceptive method globally.\" But few women in the U.S. use them; the percentage is only in the single digits, in part because IUDs have a checkered past. The Dalkon Shield IUD, marketed nationwide beginning in 1971, was found to raise the \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/00000072.htm\">risk of pelvic inflammatory disease\u003c/a>. Medical complications and deaths sparked lawsuits with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/10117045\">thousands of claimants\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"So we had a whole generation in the '70s and '80s ... where doctors and clinicians weren't trained and women didn't have that option,\" says Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University in St. Louis.\u003c/p>\n\u003cp>That training gap remains, even with newer and safer IUD models, Peipert says. And family medicine residents may no longer be required to get training in contraceptive counseling, as NPR \u003ca href=\"http://www.npr.org/blogs/health/2013/04/26/178863728/family-doctors-consider-dropping-birth-control-training-rule\">has reported\u003c/a>.\u003c/p>\n\u003cp>The two common intrauterine devices in the U.S. are ParaGard, which releases copper to interfere with sperm, and Mirena, which prevents pregnancy with the hormone progesterone. There is still a slight risk of pelvic inflammatory disease. But Bayer Healthcare Pharmaceuticals, the maker of Mirena, says fewer than 1 percent of users of its device get the infection. More common side effects for women using IUDs are irregular bleeding or cramping.\u003c/p>\n\u003cp>Upfront costs also limit access; the price of the device and getting it inserted can cost hundreds of dollars.\u003c/p>\n\u003cp>But Mirena works for up to five years, and the copper IUD up to 10. So over time, they can actually be cheaper than monthly payments for, say, the pill. And IUDs, like other contraceptives approved by the Food and Drug Administration, are \u003ca href=\"http://www.npr.org/blogs/health/2013/06/28/196692098/administration-clarifies-insurance-rules-for-contraceptives\" target=\"_blank\">expected to be covered\u003c/a> for most users under the Affordable Care Act.\u003c/p>\n\u003cp>Peipert and his colleagues figured that if they provided trained experts, educated women about their options and helped with costs, more women would choose IUDs.\u003c/p>\n\u003cp>For their \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23037916\">study\u003c/a>, they enrolled 9,256 teenagers and women, ages 14 to 45. Fifty-eight percent of participants opted for intrauterine devices. Compare that to about \u003ca href=\"http://www.cdc.gov/nchs/data/nhsr/nhsr060.pdf\">5.6 percent\u003c/a> of women using contraceptives who chose IUDs from 2006 to 2010 in the U.S. Plus, the researchers saw a drop in teen pregnancy and abortions in the study group.\u003c/p>\n\u003cp>The initiative, known as \u003ca href=\"http://www.choiceproject.wustl.edu/\" target=\"_blank\">the Contraceptive CHOICE Project\u003c/a>, is expanding to other cities and even possibly to Africa, Peipert says.\u003c/p>\n\u003cp>\u003cstrong>What's Next For Women\u003c/strong>\u003c/p>\n\u003cp>\"We're just getting past the period of the myths and the lack of training and the misconceptions about these methods,\" Peipert says.\u003c/p>\n\u003cp>For one thing, there has been confusion over who should use IUDs. Marketing for Mirena, for example, has been geared toward women who had at least one child. But in September 2012, the American College of Obstetricians and Gynecologists \u003ca href=\"http://www.acog.org/About_ACOG/News_Room/News_Releases/2012/IUDs_and_Contraceptive_Implants_Safe_for_Teens\">issued new guidelines\u003c/a> stating that implants and intrauterine devices \"should be offered as first-line contraceptive options for sexually active adolescents.\"\u003c/p>\n\u003cp>A new brand is designed specifically with younger patients in mind, Peipert says. Skyla is basically a new version of Mirena: slightly smaller, with a lower level of hormone. It works up to three years, as opposed to five with Mirena.\u003c/p>\n\u003cp>Another hormone-releasing IUD could be on its way. In June, a nonprofit pharmaceutical group in San Francisco \u003ca href=\"http://www.medicines360.org/join-the-conversation/whats-new/actavis-and-medicines360-announce-partnership-to-advance-womens-access-to-affordable-iuds/\" target=\"_blank\">announced a partnership\u003c/a> with the global pharmaceutical company Actavis, aiming to reduce cost as a barrier to contraception.\u003c/p>\n\u003cp>Peipert expects even more invention around IUDs in the future.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think we're also going to see in the future other alternative devices. I think we're going to see this market expand,\" he says. \"I think the CHOICE Project has provided good evidence that IUDs are safe, effective, highly desired, and I think we're going to see companies coming up with new ideas, new IUDs, maybe lower-cost alternatives.\"\u003c/p>\n\n",
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"excerpt": "What will it take to make intrauterine devices sexy?\r\n\r\nIUDs are highly effective forms of contraception, but fear of side effects, lack of training for doctors and costs can keep women away. Health organizations and private companies are trying to change that by breaking down misconceptions and broadening access.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15558\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD0019751-e1381249499865.jpg\">\u003cimg class=\"size-large wp-image-15558\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/MD0019751-640x465.jpg\" alt=\"Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States.(Spike Mafford/Getty Images)\" width=\"640\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States.(Spike Mafford/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Dana Farrington, \u003ca href=\"http://www.npr.org/blogs/health/2013/10/06/215491647/its-time-to-rediscover-the-iud-womens-health-advocates-say\" target=\"_blank\">NPR\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>What will it take to make intrauterine devices sexy?\u003c/p>\n\u003cp>IUDs are highly effective forms of contraception, but fear of side effects, lack of training for doctors and costs can keep women away. Health organizations and private companies are trying to change that by breaking down misconceptions and broadening access.\u003c/p>\n\u003cp>The contraceptives are inserted into the uterus and can prevent pregnancy for years. And they're reversible. Shortly after they're taken out, a woman can become pregnant.\u003c/p>\n\u003cp>IUDs are more than \u003ca href=\"http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm\" target=\"_blank\">99 percent effective\u003c/a>. The World Health Organization \u003ca href=\"http://bedsider.org/methods/iud#side_effects_tab\">reports \u003c/a>they are \"the most widely used reversible contraceptive method globally.\" But few women in the U.S. use them; the percentage is only in the single digits, in part because IUDs have a checkered past. The Dalkon Shield IUD, marketed nationwide beginning in 1971, was found to raise the \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/00000072.htm\">risk of pelvic inflammatory disease\u003c/a>. Medical complications and deaths sparked lawsuits with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/10117045\">thousands of claimants\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"So we had a whole generation in the '70s and '80s ... where doctors and clinicians weren't trained and women didn't have that option,\" says Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University in St. Louis.\u003c/p>\n\u003cp>That training gap remains, even with newer and safer IUD models, Peipert says. And family medicine residents may no longer be required to get training in contraceptive counseling, as NPR \u003ca href=\"http://www.npr.org/blogs/health/2013/04/26/178863728/family-doctors-consider-dropping-birth-control-training-rule\">has reported\u003c/a>.\u003c/p>\n\u003cp>The two common intrauterine devices in the U.S. are ParaGard, which releases copper to interfere with sperm, and Mirena, which prevents pregnancy with the hormone progesterone. There is still a slight risk of pelvic inflammatory disease. But Bayer Healthcare Pharmaceuticals, the maker of Mirena, says fewer than 1 percent of users of its device get the infection. More common side effects for women using IUDs are irregular bleeding or cramping.\u003c/p>\n\u003cp>Upfront costs also limit access; the price of the device and getting it inserted can cost hundreds of dollars.\u003c/p>\n\u003cp>But Mirena works for up to five years, and the copper IUD up to 10. So over time, they can actually be cheaper than monthly payments for, say, the pill. And IUDs, like other contraceptives approved by the Food and Drug Administration, are \u003ca href=\"http://www.npr.org/blogs/health/2013/06/28/196692098/administration-clarifies-insurance-rules-for-contraceptives\" target=\"_blank\">expected to be covered\u003c/a> for most users under the Affordable Care Act.\u003c/p>\n\u003cp>Peipert and his colleagues figured that if they provided trained experts, educated women about their options and helped with costs, more women would choose IUDs.\u003c/p>\n\u003cp>For their \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23037916\">study\u003c/a>, they enrolled 9,256 teenagers and women, ages 14 to 45. Fifty-eight percent of participants opted for intrauterine devices. Compare that to about \u003ca href=\"http://www.cdc.gov/nchs/data/nhsr/nhsr060.pdf\">5.6 percent\u003c/a> of women using contraceptives who chose IUDs from 2006 to 2010 in the U.S. Plus, the researchers saw a drop in teen pregnancy and abortions in the study group.\u003c/p>\n\u003cp>The initiative, known as \u003ca href=\"http://www.choiceproject.wustl.edu/\" target=\"_blank\">the Contraceptive CHOICE Project\u003c/a>, is expanding to other cities and even possibly to Africa, Peipert says.\u003c/p>\n\u003cp>\u003cstrong>What's Next For Women\u003c/strong>\u003c/p>\n\u003cp>\"We're just getting past the period of the myths and the lack of training and the misconceptions about these methods,\" Peipert says.\u003c/p>\n\u003cp>For one thing, there has been confusion over who should use IUDs. Marketing for Mirena, for example, has been geared toward women who had at least one child. But in September 2012, the American College of Obstetricians and Gynecologists \u003ca href=\"http://www.acog.org/About_ACOG/News_Room/News_Releases/2012/IUDs_and_Contraceptive_Implants_Safe_for_Teens\">issued new guidelines\u003c/a> stating that implants and intrauterine devices \"should be offered as first-line contraceptive options for sexually active adolescents.\"\u003c/p>\n\u003cp>A new brand is designed specifically with younger patients in mind, Peipert says. Skyla is basically a new version of Mirena: slightly smaller, with a lower level of hormone. It works up to three years, as opposed to five with Mirena.\u003c/p>\n\u003cp>Another hormone-releasing IUD could be on its way. In June, a nonprofit pharmaceutical group in San Francisco \u003ca href=\"http://www.medicines360.org/join-the-conversation/whats-new/actavis-and-medicines360-announce-partnership-to-advance-womens-access-to-affordable-iuds/\" target=\"_blank\">announced a partnership\u003c/a> with the global pharmaceutical company Actavis, aiming to reduce cost as a barrier to contraception.\u003c/p>\n\u003cp>Peipert expects even more invention around IUDs in the future.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think we're also going to see in the future other alternative devices. I think we're going to see this market expand,\" he says. \"I think the CHOICE Project has provided good evidence that IUDs are safe, effective, highly desired, and I think we're going to see companies coming up with new ideas, new IUDs, maybe lower-cost alternatives.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "School Meals Face Rules on Fat, Meat, Veggies – But No Limits on Sugar",
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"content": "\u003cfigure id=\"attachment_15440\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/41284017@N08/7995796099/in/photolist-dbyxBr-dbyAAG-dbyBzy-dbyzdA-dbyC9q-dbyAij-dbyCMQ-dbyDqA-dbyBGE-dbyCE5-dbyzrZ-dbyBZQ-dbyyNU-dbyA6U-dbyBVS-dbyzpL-dbyyKc-dbyBfz-dbyyEx-dbyzx3-dbyzP6-dbyAYu-dbyz2U-dbyzKG-dbyCv3-dbyzg7-dbyBfY-dbyBpQ-dbyxPx-dbywSH-dbyChm-dbyAq4-dbyDmm-dbyASH-dbyARN-dbyB7d-dbyzYC-dbyAud-dbyB8H-dbyz8o-dbyxsB-dbyCYw-8KiC9Y-ayDy68-azaFpD-d6WUpm-cZDSds-e9WPJv-e9WPJe-fh9dsC-abwWoB\">\u003cimg class=\"size-large wp-image-15440 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-640x424.jpg\" alt=\"(Photo: USDAgov via Flickr)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: USDAgov via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Eleanor Yang Su\u003c/strong>, \u003ca href=\"http://cironline.org\" target=\"_blank\">The Center for Investigative Reporting\u003c/a>\u003c/p>\n\u003cp>Almost everything about a school cafeteria meal has a regulation. The federal government caps the amount of fat and salt in breakfasts and lunches. It sets minimum standards for servings of fruit, vegetables, grains, milk and meat.\u003c/p>\n\u003cp>But one widely used and often-overused product has no official limits: sugar.\u003c/p>\n\u003cp>As Congress faces increased scrutiny over subsidies to the sugar industry, nutritionists and anti-obesity crusaders are focusing on the amount of sugar in school meals – and asking whether regulations governing school lunches deliberately exclude limits on sugar to favor a powerful industry.\u003c/p>\n\u003cp>Recent research shows that sugar levels in school meals are more than double what is recommended for the general public. Elementary school lunch menus contain 115 percent of the recommended daily calories from added sugars and fats, according to a \u003ca href=\"http://www.mathematica-mpr.com/publications/PDFs/nutrition/snda-iv_vol1.pdf\">November study\u003c/a> by the USDA’s Food and Nutrition Service. Middle school and high school lunch menus also are sugar- and fat-heavy, averaging between 59 and 74 percent of the recommended amounts.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>About 1 in 5 school lunch menus includes dessert, the federal study said. The most common are cookies, cakes and brownies, some of which are counted as grain requirements. Other popular options are fruit with gelatin, ice cream and pudding.\u003c!--more-->\u003c/p>\n\u003cp>The data from the School Nutrition Dietary Assessment is based on a 2010 survey of about 900 schools across the country and is considered the most comprehensive federal research on school meals.\u003c/p>\n\u003cp>For years, schools added sweets, such as graham crackers or cookies, to bump up calorie counts and meet minimum thresholds. Researchers say that practice is less common now that the USDA has implemented calorie limits. But some say sugary treats still are appealing to school administrators.\u003c/p>\n\u003cp>“Sugar-related products are the least expensive source of calories in the school meal program,” said Matthew Sharp, senior advocate for California Food Policy Advocates. He said many school officials oppose reducing sugar in meals because it would force them to buy more expensive products.\u003c/p>\n\u003cp>The USDA, which administers the national school lunch and breakfast programs, says newly created total calorie limits are designed to discourage extra-sugary and fatty foods. A USDA spokesman noted that as of June 30, about 70 percent\u003cstrong> \u003c/strong>of all schools have shown they’re in compliance with the new plan, which means students are eating healthier meals.\u003c/p>\n\u003cp>Industry representatives at the Sugar Association, a Washington lobbying group, said the USDA based its final rules on “many important and practical considerations.” For one, it said in a statement, “sugar makes many healthful foods palatable so children will eat them, which the science confirms helps\u003cstrong> \u003c/strong>increase intakes of many essential vitamins and minerals.”\u003c/p>\n\u003cp>“We continue to emphasize that the most important consideration of a healthful diet is the nutritional value of the foods and beverages consumed, not the sugar content,” the association said. “Portion control, monitoring caloric intake and being physically active are among the most important tools children can learn for long-term health.\"\u003c/p>\n\u003cp>But researchers say students’ sugar consumption places them at greater risk for obesity, Type 2 diabetes and heart disease. Boys consume an average of about 360 calories – more than 22 teaspoons – of added sugars a day, according to a 2012 \u003ca href=\"http://www.cdc.gov/nchs/data/databriefs/db87.pdf\">report\u003c/a> by the Centers for Disease Control and Prevention. Girls average about 280 calories – more than 17 teaspoons – daily.\u003c/p>\n\u003cp>Even if regulators eventually agree to restrict sugar in meals, schools would face the challenge of finding more healthful processed foods and the money to buy them. The federal government reimburses schools between 27 cents and $2.86 for each lunch served, depending on how much students can pay. Many school districts struggle to run their cafeterias with the current funding.\u003c/p>\n\u003cp>Schools have come to rely on revenue from vending machines, which Sharp says are one of the worst sources of sugary snacks and drinks on campus. He’s optimistic about the new standards released by the USDA that require items sold at school vending machines and snack bars to meet minimal nutrient requirements and limit sodium, sugar and fat.\u003c/p>\n\u003cp>But even as regulators tighten rules, other challenges arise.\u003c/p>\n\u003cp>“In L.A., there’s some neighborhoods where street vendors come around the school at the start of school and during breaks,” said Michael Goran, director of the Childhood Obesity Research Center at the University of Southern California. “The students can easily buy a boatload of sugary products.”\u003c/p>\n\u003cp>For years, researchers have debated how much sugar can be consumed in a healthy diet. USDA \u003ca href=\"http://www.cnpp.usda.gov/dietaryguidelines.htm\">guidelines\u003c/a> say calories from added sugars and solid fats should be limited to 5 to 15 percent of daily calories but provides no specific rule for sugars.\u003c/p>\n\u003cp>According to the CDC, American children \u003ca href=\"http://www.cdc.gov/nchs/data/databriefs/db87.pdf\">consume\u003c/a> about 16 percent of their daily calories from added sugars, which include white sugar, high-fructose corn syrup, honey and other sweeteners.\u003c/p>\n\u003cp>Some academics who believe that Americans are eating too much sugar blame the lack of regulations on the political clout of the food and beverage industry.\u003c/p>\n\u003cp>“Sugar is the only nutrient with no dietary reference intake, and it’s because the food industry doesn’t want it,” said Dr. Robert Lustig, a pediatric endocrinologist at UC San Francisco.\u003c/p>\n\u003cp>Lustig is the author of “Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease” and has been on a crusade against sugar. He argues that it’s addictive and toxic and that in the amounts consumed by Americans, sugar changes metabolism, raises blood pressure and damages the liver.\u003c/p>\n\u003cp>The Sugar Association argues that Lustig's research lacks scientific basis and that sugar consumption is correlated with, but not the proven cause of, health problems like Type 2 diabetes.\u003c/p>\n\u003cp>“We are not consuming enough of it (sugar) for it to have negative health impacts,” said Megan Mitchell, a spokeswoman for the lobbying group. “If the science supported setting an upper limit intake on sugar, they (federal regulators) would do it. There has been no major body of science to come out in support of it. That's why it hasn't happened yet.”\u003c/p>\n\u003cp>USDA officials say school meal regulations are based on independent scientific recommendations and input from all stakeholders. In its statement, the Sugar Association said it “did not lobby or meet with anyone at the U.S. Department of Agriculture with respect to the school lunch rule, nor was the Association involved in the crafting of that rule.”\u003c/p>\n\u003cp>Some say political pushback from food and beverage companies is part of the problem, but regulating sugar is complicated. It can be difficult to differentiate and enforce rules for naturally occurring sugars and added sweeteners, said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest.\u003c/p>\n\u003cp>“These are extra calories that many children can’t afford,” Wootan said. “One-third of children are either overweight or obese. And it contributes to heart disease and diabetes. And in addition to that, oftentimes, the sugary food crowds out more healthy foods that kids need. So kids are overfed and undernourished.”\u003c/p>\n\u003cp>\u003cem>This story was edited by Robert Salladay and copy edited by Pam Hogle and Nikki Frick.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cstrong>The independent, nonprofit Center for Investigative Reporting is the country’s largest investigative reporting team. For more, visit \u003c/strong>\u003ca href=\"http://www.californiawatch.org\">\u003cstrong>www.cironline.org\u003c/strong>\u003c/a>\u003cstrong>.\u003c/strong>\u003c/p>\n\n",
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"excerpt": "Almost everything about a school cafeteria meal has a regulation. The federal government caps the amount of fat and salt in breakfasts and lunches. It sets minimum standards for servings of fruit, vegetables, grains, milk and meat.\r\n\r\nBut one widely used and often-overused product has no official limits: sugar.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15440\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/41284017@N08/7995796099/in/photolist-dbyxBr-dbyAAG-dbyBzy-dbyzdA-dbyC9q-dbyAij-dbyCMQ-dbyDqA-dbyBGE-dbyCE5-dbyzrZ-dbyBZQ-dbyyNU-dbyA6U-dbyBVS-dbyzpL-dbyyKc-dbyBfz-dbyyEx-dbyzx3-dbyzP6-dbyAYu-dbyz2U-dbyzKG-dbyCv3-dbyzg7-dbyBfY-dbyBpQ-dbyxPx-dbywSH-dbyChm-dbyAq4-dbyDmm-dbyASH-dbyARN-dbyB7d-dbyzYC-dbyAud-dbyB8H-dbyz8o-dbyxsB-dbyCYw-8KiC9Y-ayDy68-azaFpD-d6WUpm-cZDSds-e9WPJv-e9WPJe-fh9dsC-abwWoB\">\u003cimg class=\"size-large wp-image-15440 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7995796099_c60447daba_c-640x424.jpg\" alt=\"(Photo: USDAgov via Flickr)\" width=\"640\" height=\"424\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: USDAgov via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Eleanor Yang Su\u003c/strong>, \u003ca href=\"http://cironline.org\" target=\"_blank\">The Center for Investigative Reporting\u003c/a>\u003c/p>\n\u003cp>Almost everything about a school cafeteria meal has a regulation. The federal government caps the amount of fat and salt in breakfasts and lunches. It sets minimum standards for servings of fruit, vegetables, grains, milk and meat.\u003c/p>\n\u003cp>But one widely used and often-overused product has no official limits: sugar.\u003c/p>\n\u003cp>As Congress faces increased scrutiny over subsidies to the sugar industry, nutritionists and anti-obesity crusaders are focusing on the amount of sugar in school meals – and asking whether regulations governing school lunches deliberately exclude limits on sugar to favor a powerful industry.\u003c/p>\n\u003cp>Recent research shows that sugar levels in school meals are more than double what is recommended for the general public. Elementary school lunch menus contain 115 percent of the recommended daily calories from added sugars and fats, according to a \u003ca href=\"http://www.mathematica-mpr.com/publications/PDFs/nutrition/snda-iv_vol1.pdf\">November study\u003c/a> by the USDA’s Food and Nutrition Service. Middle school and high school lunch menus also are sugar- and fat-heavy, averaging between 59 and 74 percent of the recommended amounts.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>About 1 in 5 school lunch menus includes dessert, the federal study said. The most common are cookies, cakes and brownies, some of which are counted as grain requirements. Other popular options are fruit with gelatin, ice cream and pudding.\u003c!--more-->\u003c/p>\n\u003cp>The data from the School Nutrition Dietary Assessment is based on a 2010 survey of about 900 schools across the country and is considered the most comprehensive federal research on school meals.\u003c/p>\n\u003cp>For years, schools added sweets, such as graham crackers or cookies, to bump up calorie counts and meet minimum thresholds. Researchers say that practice is less common now that the USDA has implemented calorie limits. But some say sugary treats still are appealing to school administrators.\u003c/p>\n\u003cp>“Sugar-related products are the least expensive source of calories in the school meal program,” said Matthew Sharp, senior advocate for California Food Policy Advocates. He said many school officials oppose reducing sugar in meals because it would force them to buy more expensive products.\u003c/p>\n\u003cp>The USDA, which administers the national school lunch and breakfast programs, says newly created total calorie limits are designed to discourage extra-sugary and fatty foods. A USDA spokesman noted that as of June 30, about 70 percent\u003cstrong> \u003c/strong>of all schools have shown they’re in compliance with the new plan, which means students are eating healthier meals.\u003c/p>\n\u003cp>Industry representatives at the Sugar Association, a Washington lobbying group, said the USDA based its final rules on “many important and practical considerations.” For one, it said in a statement, “sugar makes many healthful foods palatable so children will eat them, which the science confirms helps\u003cstrong> \u003c/strong>increase intakes of many essential vitamins and minerals.”\u003c/p>\n\u003cp>“We continue to emphasize that the most important consideration of a healthful diet is the nutritional value of the foods and beverages consumed, not the sugar content,” the association said. “Portion control, monitoring caloric intake and being physically active are among the most important tools children can learn for long-term health.\"\u003c/p>\n\u003cp>But researchers say students’ sugar consumption places them at greater risk for obesity, Type 2 diabetes and heart disease. Boys consume an average of about 360 calories – more than 22 teaspoons – of added sugars a day, according to a 2012 \u003ca href=\"http://www.cdc.gov/nchs/data/databriefs/db87.pdf\">report\u003c/a> by the Centers for Disease Control and Prevention. Girls average about 280 calories – more than 17 teaspoons – daily.\u003c/p>\n\u003cp>Even if regulators eventually agree to restrict sugar in meals, schools would face the challenge of finding more healthful processed foods and the money to buy them. The federal government reimburses schools between 27 cents and $2.86 for each lunch served, depending on how much students can pay. Many school districts struggle to run their cafeterias with the current funding.\u003c/p>\n\u003cp>Schools have come to rely on revenue from vending machines, which Sharp says are one of the worst sources of sugary snacks and drinks on campus. He’s optimistic about the new standards released by the USDA that require items sold at school vending machines and snack bars to meet minimal nutrient requirements and limit sodium, sugar and fat.\u003c/p>\n\u003cp>But even as regulators tighten rules, other challenges arise.\u003c/p>\n\u003cp>“In L.A., there’s some neighborhoods where street vendors come around the school at the start of school and during breaks,” said Michael Goran, director of the Childhood Obesity Research Center at the University of Southern California. “The students can easily buy a boatload of sugary products.”\u003c/p>\n\u003cp>For years, researchers have debated how much sugar can be consumed in a healthy diet. USDA \u003ca href=\"http://www.cnpp.usda.gov/dietaryguidelines.htm\">guidelines\u003c/a> say calories from added sugars and solid fats should be limited to 5 to 15 percent of daily calories but provides no specific rule for sugars.\u003c/p>\n\u003cp>According to the CDC, American children \u003ca href=\"http://www.cdc.gov/nchs/data/databriefs/db87.pdf\">consume\u003c/a> about 16 percent of their daily calories from added sugars, which include white sugar, high-fructose corn syrup, honey and other sweeteners.\u003c/p>\n\u003cp>Some academics who believe that Americans are eating too much sugar blame the lack of regulations on the political clout of the food and beverage industry.\u003c/p>\n\u003cp>“Sugar is the only nutrient with no dietary reference intake, and it’s because the food industry doesn’t want it,” said Dr. Robert Lustig, a pediatric endocrinologist at UC San Francisco.\u003c/p>\n\u003cp>Lustig is the author of “Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease” and has been on a crusade against sugar. He argues that it’s addictive and toxic and that in the amounts consumed by Americans, sugar changes metabolism, raises blood pressure and damages the liver.\u003c/p>\n\u003cp>The Sugar Association argues that Lustig's research lacks scientific basis and that sugar consumption is correlated with, but not the proven cause of, health problems like Type 2 diabetes.\u003c/p>\n\u003cp>“We are not consuming enough of it (sugar) for it to have negative health impacts,” said Megan Mitchell, a spokeswoman for the lobbying group. “If the science supported setting an upper limit intake on sugar, they (federal regulators) would do it. There has been no major body of science to come out in support of it. That's why it hasn't happened yet.”\u003c/p>\n\u003cp>USDA officials say school meal regulations are based on independent scientific recommendations and input from all stakeholders. In its statement, the Sugar Association said it “did not lobby or meet with anyone at the U.S. Department of Agriculture with respect to the school lunch rule, nor was the Association involved in the crafting of that rule.”\u003c/p>\n\u003cp>Some say political pushback from food and beverage companies is part of the problem, but regulating sugar is complicated. It can be difficult to differentiate and enforce rules for naturally occurring sugars and added sweeteners, said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest.\u003c/p>\n\u003cp>“These are extra calories that many children can’t afford,” Wootan said. “One-third of children are either overweight or obese. And it contributes to heart disease and diabetes. And in addition to that, oftentimes, the sugary food crowds out more healthy foods that kids need. So kids are overfed and undernourished.”\u003c/p>\n\u003cp>\u003cem>This story was edited by Robert Salladay and copy edited by Pam Hogle and Nikki Frick.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>The independent, nonprofit Center for Investigative Reporting is the country’s largest investigative reporting team. For more, visit \u003c/strong>\u003ca href=\"http://www.californiawatch.org\">\u003cstrong>www.cironline.org\u003c/strong>\u003c/a>\u003cstrong>.\u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Angela Hart\u003c/strong>\u003c/p>\n\u003cp>Who knew playing video games might be good for you?\u003c/p>\n\u003cp>A provocative \u003ca href=\"http://gazzaleylab.ucsf.edu/home/gazzaleylab/Anguera_Nature_2013.pdf\" target=\"_blank\">new study \u003c/a>from researchers at UC San Francisco shows that playing a specially designed video game increased the ability to multitask for people in their 60s, 70s and 80s.\u003c/p>\n\u003cp>Adam Gazzaley of UCSF's Neuroscience Imaging Center led the study. He recruited 174 people over 60 to play NeuroRacer, a custom-built game that forced participants to navigate winding roads, quickly turn left and right, go uphill and downhill -- and then click a button whenever a distracting green sign pops up. Take a look:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.npr.org/templates/event/embeddedVideo.php?storyId=218892225&mediaId=\" frameborder=\"0\" scrolling=\"no\" width=\"600\" height=\"338\">\u003c/iframe>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The participants played the video game three times a week for a month and improved cognitive functions of the brain, not only in multitasking but also in paying attention for longer time spans. In fact, they improved so much that they reached the level of an untrained 20-year-old. This is the first time this kind of improvement has been demonstrated, the researchers noted in their study.\u003c/p>\n\u003cp>Gazzaley explained more on \u003ca href=\"http://www.kqed.org/a/forum/R201309101000\" target=\"_blank\">KQED's \"Forum\u003c/a>\" recently. He said the idea is to identify the brain's \"plasticity,\" meaning its ability to change even as it ages -- a concept that brain researchers haven't always thought possible.\u003c!--more-->\u003c/p>\n\u003cp>\"We've been showing in the brain what happens as we get older,\" Gazzaley said. \"Working memory and sustained attention decline. After telling that sort of bad news for the last decade, around five years ago, I got inspired to see if we could do anything about it.\"\u003c/p>\n\u003cp>The overall goal, Gazzaley said, was to identify what changes in the brain by targeting what he called the \"sweet spot\" in testing study participants. The video game was designed at a level where it's not too difficult to be frustrating, but not so easy that it becomes boring.\u003c/p>\n\u003cp>\"We think that this maximally targets plasticity in the brain by pushing it right at that level of your ability,\" Gazzaley told \"Forum\" host Michael Krasny.\u003c/p>\n\u003cp>The study was published in the journal Nature. The authors wrote that \"a custom-designed video game can ... serve as a powerful tool for cognitive enhancement.\"\u003c/p>\n\u003cp>Gazzaley acknowledged that his approach has its critics.\u003c/p>\n\u003cp>\"I think that the field is controversial, but not because of the foundational concept that the brain is plastic and can change,\" Gazzaley said. \"Every neuroscientist I've ever met believes in the plasticity of the brain. The question is -- and I guess the controversy that ensues around it is -- what is the most appropriate way of tapping that plasticity.\"\u003c/p>\n\u003cp>In designing the study, Gazzaley took his initial idea to his video game friends, who developed the game. Gazzaley was aware of earlier research showing that first-person shooter video games played by younger adults also improved brain functions, such as distraction resistance and the ability to maintain attention levels.\u003c/p>\n\u003cp>\"It's exciting,\" Gazzaley said. \"It shows that video games and the dynamics involved in them can be used to have very powerful impacts on the brain, especially when targeted.\" He said he doesn't expect that this one study is a definitive answer \"but rather a step in how we can go about carefully developing and then validating our tools to change the brain in an impactful way.\"\u003c/p>\n\u003cp>Gazzaley and other researchers are now using the brain-scanning technology built into NeuroRacer to develop more advanced versions of the game, and continue to experiment on improving brain functions.\u003c/p>\n\u003cp>\"In terms of being balanced, this does not imply that all video games are effective,\" Gazzaley said. \"There's a lot more research that needs to be done to understand it.\"\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>Listen to Adam Gazzaley on KQED's Forum:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201309101000.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201309101000.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "Who knew playing video games might be good for you?\r\n\r\nA provocative new study from researchers at UC San Francisco showed that playing a specially designed video game increased the ability to multitask for people in their 60s, 70s and 80s.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Angela Hart\u003c/strong>\u003c/p>\n\u003cp>Who knew playing video games might be good for you?\u003c/p>\n\u003cp>A provocative \u003ca href=\"http://gazzaleylab.ucsf.edu/home/gazzaleylab/Anguera_Nature_2013.pdf\" target=\"_blank\">new study \u003c/a>from researchers at UC San Francisco shows that playing a specially designed video game increased the ability to multitask for people in their 60s, 70s and 80s.\u003c/p>\n\u003cp>Adam Gazzaley of UCSF's Neuroscience Imaging Center led the study. He recruited 174 people over 60 to play NeuroRacer, a custom-built game that forced participants to navigate winding roads, quickly turn left and right, go uphill and downhill -- and then click a button whenever a distracting green sign pops up. Take a look:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.npr.org/templates/event/embeddedVideo.php?storyId=218892225&mediaId=\" frameborder=\"0\" scrolling=\"no\" width=\"600\" height=\"338\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The participants played the video game three times a week for a month and improved cognitive functions of the brain, not only in multitasking but also in paying attention for longer time spans. In fact, they improved so much that they reached the level of an untrained 20-year-old. This is the first time this kind of improvement has been demonstrated, the researchers noted in their study.\u003c/p>\n\u003cp>Gazzaley explained more on \u003ca href=\"http://www.kqed.org/a/forum/R201309101000\" target=\"_blank\">KQED's \"Forum\u003c/a>\" recently. He said the idea is to identify the brain's \"plasticity,\" meaning its ability to change even as it ages -- a concept that brain researchers haven't always thought possible.\u003c!--more-->\u003c/p>\n\u003cp>\"We've been showing in the brain what happens as we get older,\" Gazzaley said. \"Working memory and sustained attention decline. After telling that sort of bad news for the last decade, around five years ago, I got inspired to see if we could do anything about it.\"\u003c/p>\n\u003cp>The overall goal, Gazzaley said, was to identify what changes in the brain by targeting what he called the \"sweet spot\" in testing study participants. The video game was designed at a level where it's not too difficult to be frustrating, but not so easy that it becomes boring.\u003c/p>\n\u003cp>\"We think that this maximally targets plasticity in the brain by pushing it right at that level of your ability,\" Gazzaley told \"Forum\" host Michael Krasny.\u003c/p>\n\u003cp>The study was published in the journal Nature. The authors wrote that \"a custom-designed video game can ... serve as a powerful tool for cognitive enhancement.\"\u003c/p>\n\u003cp>Gazzaley acknowledged that his approach has its critics.\u003c/p>\n\u003cp>\"I think that the field is controversial, but not because of the foundational concept that the brain is plastic and can change,\" Gazzaley said. \"Every neuroscientist I've ever met believes in the plasticity of the brain. The question is -- and I guess the controversy that ensues around it is -- what is the most appropriate way of tapping that plasticity.\"\u003c/p>\n\u003cp>In designing the study, Gazzaley took his initial idea to his video game friends, who developed the game. Gazzaley was aware of earlier research showing that first-person shooter video games played by younger adults also improved brain functions, such as distraction resistance and the ability to maintain attention levels.\u003c/p>\n\u003cp>\"It's exciting,\" Gazzaley said. \"It shows that video games and the dynamics involved in them can be used to have very powerful impacts on the brain, especially when targeted.\" He said he doesn't expect that this one study is a definitive answer \"but rather a step in how we can go about carefully developing and then validating our tools to change the brain in an impactful way.\"\u003c/p>\n\u003cp>Gazzaley and other researchers are now using the brain-scanning technology built into NeuroRacer to develop more advanced versions of the game, and continue to experiment on improving brain functions.\u003c/p>\n\u003cp>\"In terms of being balanced, this does not imply that all video games are effective,\" Gazzaley said. \"There's a lot more research that needs to be done to understand it.\"\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>Listen to Adam Gazzaley on KQED's Forum:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201309101000.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201309101000.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The Primary Care Crunch: Not Enough Doctors and More Patients Coming",
"title": "The Primary Care Crunch: Not Enough Doctors and More Patients Coming",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_14991\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/126488183-e1379026016774.jpg\">\u003cimg class=\"size-full wp-image-14991\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/126488183-e1379026016774.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"564\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/09/126488183-e1379026016774.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/09/126488183-e1379026016774-400x353.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/09/126488183-e1379026016774-320x282.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The full implementation of Obamacare and (potentially) millions more insured is now just over 100 days away, on Jan. 1. Questions abound: W\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/24/young-adults-key-to-obamacare-in-california/\" target=\"_blank\">ill young, healthy people really sign up?\u003c/a> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">How much will my premium be? \u003c/a>\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">How does the Affordable Care Act work anyway? \u003c/a>\u003c/p>\n\u003cp>Floating around in all those Obamacare discussions is another question: Who is going to treat all the newly insured? After all, we already have\u003ca href=\"http://www.chcf.org/publications/2009/06/fewer-and-more-specialized--a-new-assessment-of-physician-supply-in-california\" target=\"_blank\"> a shortage \u003c/a>of primary care doctors. Out of 7 million uninsured in the state, Covered California estimates 1.4 million people could sign up for insurance next year. Plus another 1.4 million people will be newly eligible for Medi-Cal.\u003c/p>\n\u003cp>To address this question, San Francisco's Commonwealth Club invited me to \u003ca href=\"http://www.commonwealthclub.org/events/archive/podcast/primary-care-crunch-anticipating-doctor-shortage-after-obamacare-82813\" target=\"_blank\">moderate a discussion\u003c/a> about the shortage of primary care providers. Kevin Grumbach, a family physician and co-director at UC San Francisco's Center for Excellence in Primary Care, started off by defining the subject at hand.\u003c!--more-->\u003c/p>\n\u003cp>Primary care \"is about having someone who cares for you as a whole person,\" he said. \"What a shocking concept, right.\"\u003c/p>\n\u003cp>Judging from the laughter in the room, audience members hadn't had a lot of experience with being dealt with as a whole person in their medical encounters. Much has been written about \u003ca href=\"https://www.google.com/#q=lack+of+coordinated+health+care+\" target=\"_blank\">the lack of coordination in health care\u003c/a>. One example: when the surgeon confirms the incision is healing nicely, but is seemingly unaware that the patient has moved to ICU due to pulmonary failure. (Examples are not hard to come by; this one happened to the father of a dear friend of mine.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Bob Wiebe, chief medical officer of Dignity Health, pointed to two chief drivers of the primary care shortage: money and work environment. Taking money first, Wiebe noted that medical students often graduate with $200,000 to $300,000 of debt. While primary care doctors might earn $200,000 to $220,000 a year, he said, specialists can make double or triple that amount. In addition, primary care physicians work in a \"hectic, even chaotic environment\" defined by 15-minute appointments with patients.\u003c/p>\n\u003cp>\u003cstrong>Transformation needed\u003c/strong>\u003c/p>\n\u003cp>While \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/14/in-midst-of-physician-shortage-inland-empire-gets-new-medical-school/\" target=\"_blank\">educating more primary care doctors\u003c/a> would help, a bigger change is needed, all three panelists argued. Panelist Patricia Knight had a special perspective. She's a former nurse who became an attorney and now works as a \u003ca href=\"http://pacificcoasthealthadvocacy.com/about.html\" target=\"_blank\">patient advocate\u003c/a>. She talked about nurse practitioners, nurses with advanced training who, along with physician assistants, \"can handle many of the problems that come in and take care of them without ever having to involve the physicians.\" But she also urged caution before rushing ahead. She worries that if we try to \"churn out more nurse practitioners\" they might be lacking in the clinical experience necessary to do an effective job. Amending laws to allow these midlevel health providers to practice more independently has been a\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/09/debate-over-role-of-nurse-practitioners-in-primary-care-responsibilities/\" target=\"_blank\"> hot topic in Sacramento\u003c/a>.\u003c/p>\n\u003cp>Grumbach argued for a new approach to primary care, a team-based approach. \"We need to deploy nurses, physicians, pharmacists, mental health personnel in the team. There's so much work to be done.\" He said that people in the U.S. who have diabetes are twice as likely to have an amputation as someone in Europe. That's because we haven't invested in \"nursing care, the head coaching, the health coaching, the support in how to control your diet, the fundamental primary care to keep that foot healthy so you don't wind up in the hospital.\"\u003c/p>\n\u003cp>Knight called for an innovation in the way people are seen. Instead of having an appointment, going home and then heading off to a specialist appointment at another location, the patient stays in the room and various health professionals come to the patient, all in one visit. She described how this could work for someone with diabetes or heart disease. \"Instead of seeing one (health care provider) in a silo, you have a group, and with the specialties together, (providers) are able to offer a broader scope of care in a concentrated time.\"\u003c/p>\n\u003cp>\u003cstrong>People don't want health care, they want health\u003c/strong>\u003c/p>\n\u003cp>Wiebe pointed to changes already coming, some related to new incentives under the Affordable Care Act. Already there are changes coming in payment systems. Instead of a fee-for-service model where doctors get paid for specific things they do to patients -- tests, treatments -- new approaches, such as a bundled payments, are coming into play. Physicians might receive a lump sum of money, an incentive to keep patients healthy.\u003c/p>\n\u003cp>Knight said that patients have a responsibility to oversee their own health and be more engaged. Patients should \"be prepared to the extent you can be for your appointment ... getting an overview of a condition. That enables you to go in and ask more questions, be prepared, be ready to interact with your team.\"\u003c/p>\n\u003cp>Grumbach believes the Affordable Care Act is a step ahead for the country, making sure that people have health insurance, but beyond that \"we need to fundamentally rethink how we deliver health care,\" he said. \"It does not makes sense to just cover more people with the same shoddy product.\"\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.commonwealthclub.org/events/archive/podcast/primary-care-crunch-anticipating-doctor-shortage-after-obamacare-82813\" target=\"_blank\">Listen to the podcast of the one-hour discussion\u003c/a>.\u003c/p>\n\n",
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"excerpt": "The full implementation of Obamacare and (potentially) millions more insured is now just over 100 days away, on Jan. 1. Questions abound: Will young, healthy people really sign up? How much will my premium be? How does the Affordable Care Act work anyway?\r\n\r\nFloating around in all that Obamacare discussion is another question: Who is going to treat all the newly insured? After all, we already have a shortage of primary care doctors. Out of 7 million uninsured in the state, Covered California estimates 1.4 million people could sign up for insurance next year. Plus another 1.4 million people will be newly eligible for Medi-Cal.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14991\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/126488183-e1379026016774.jpg\">\u003cimg class=\"size-full wp-image-14991\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/126488183-e1379026016774.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"564\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/09/126488183-e1379026016774.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/09/126488183-e1379026016774-400x353.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/09/126488183-e1379026016774-320x282.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The full implementation of Obamacare and (potentially) millions more insured is now just over 100 days away, on Jan. 1. Questions abound: W\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/24/young-adults-key-to-obamacare-in-california/\" target=\"_blank\">ill young, healthy people really sign up?\u003c/a> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">How much will my premium be? \u003c/a>\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">How does the Affordable Care Act work anyway? \u003c/a>\u003c/p>\n\u003cp>Floating around in all those Obamacare discussions is another question: Who is going to treat all the newly insured? After all, we already have\u003ca href=\"http://www.chcf.org/publications/2009/06/fewer-and-more-specialized--a-new-assessment-of-physician-supply-in-california\" target=\"_blank\"> a shortage \u003c/a>of primary care doctors. Out of 7 million uninsured in the state, Covered California estimates 1.4 million people could sign up for insurance next year. Plus another 1.4 million people will be newly eligible for Medi-Cal.\u003c/p>\n\u003cp>To address this question, San Francisco's Commonwealth Club invited me to \u003ca href=\"http://www.commonwealthclub.org/events/archive/podcast/primary-care-crunch-anticipating-doctor-shortage-after-obamacare-82813\" target=\"_blank\">moderate a discussion\u003c/a> about the shortage of primary care providers. Kevin Grumbach, a family physician and co-director at UC San Francisco's Center for Excellence in Primary Care, started off by defining the subject at hand.\u003c!--more-->\u003c/p>\n\u003cp>Primary care \"is about having someone who cares for you as a whole person,\" he said. \"What a shocking concept, right.\"\u003c/p>\n\u003cp>Judging from the laughter in the room, audience members hadn't had a lot of experience with being dealt with as a whole person in their medical encounters. Much has been written about \u003ca href=\"https://www.google.com/#q=lack+of+coordinated+health+care+\" target=\"_blank\">the lack of coordination in health care\u003c/a>. One example: when the surgeon confirms the incision is healing nicely, but is seemingly unaware that the patient has moved to ICU due to pulmonary failure. (Examples are not hard to come by; this one happened to the father of a dear friend of mine.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Bob Wiebe, chief medical officer of Dignity Health, pointed to two chief drivers of the primary care shortage: money and work environment. Taking money first, Wiebe noted that medical students often graduate with $200,000 to $300,000 of debt. While primary care doctors might earn $200,000 to $220,000 a year, he said, specialists can make double or triple that amount. In addition, primary care physicians work in a \"hectic, even chaotic environment\" defined by 15-minute appointments with patients.\u003c/p>\n\u003cp>\u003cstrong>Transformation needed\u003c/strong>\u003c/p>\n\u003cp>While \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/14/in-midst-of-physician-shortage-inland-empire-gets-new-medical-school/\" target=\"_blank\">educating more primary care doctors\u003c/a> would help, a bigger change is needed, all three panelists argued. Panelist Patricia Knight had a special perspective. She's a former nurse who became an attorney and now works as a \u003ca href=\"http://pacificcoasthealthadvocacy.com/about.html\" target=\"_blank\">patient advocate\u003c/a>. She talked about nurse practitioners, nurses with advanced training who, along with physician assistants, \"can handle many of the problems that come in and take care of them without ever having to involve the physicians.\" But she also urged caution before rushing ahead. She worries that if we try to \"churn out more nurse practitioners\" they might be lacking in the clinical experience necessary to do an effective job. Amending laws to allow these midlevel health providers to practice more independently has been a\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/09/debate-over-role-of-nurse-practitioners-in-primary-care-responsibilities/\" target=\"_blank\"> hot topic in Sacramento\u003c/a>.\u003c/p>\n\u003cp>Grumbach argued for a new approach to primary care, a team-based approach. \"We need to deploy nurses, physicians, pharmacists, mental health personnel in the team. There's so much work to be done.\" He said that people in the U.S. who have diabetes are twice as likely to have an amputation as someone in Europe. That's because we haven't invested in \"nursing care, the head coaching, the health coaching, the support in how to control your diet, the fundamental primary care to keep that foot healthy so you don't wind up in the hospital.\"\u003c/p>\n\u003cp>Knight called for an innovation in the way people are seen. Instead of having an appointment, going home and then heading off to a specialist appointment at another location, the patient stays in the room and various health professionals come to the patient, all in one visit. She described how this could work for someone with diabetes or heart disease. \"Instead of seeing one (health care provider) in a silo, you have a group, and with the specialties together, (providers) are able to offer a broader scope of care in a concentrated time.\"\u003c/p>\n\u003cp>\u003cstrong>People don't want health care, they want health\u003c/strong>\u003c/p>\n\u003cp>Wiebe pointed to changes already coming, some related to new incentives under the Affordable Care Act. Already there are changes coming in payment systems. Instead of a fee-for-service model where doctors get paid for specific things they do to patients -- tests, treatments -- new approaches, such as a bundled payments, are coming into play. Physicians might receive a lump sum of money, an incentive to keep patients healthy.\u003c/p>\n\u003cp>Knight said that patients have a responsibility to oversee their own health and be more engaged. Patients should \"be prepared to the extent you can be for your appointment ... getting an overview of a condition. That enables you to go in and ask more questions, be prepared, be ready to interact with your team.\"\u003c/p>\n\u003cp>Grumbach believes the Affordable Care Act is a step ahead for the country, making sure that people have health insurance, but beyond that \"we need to fundamentally rethink how we deliver health care,\" he said. \"It does not makes sense to just cover more people with the same shoddy product.\"\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.commonwealthclub.org/events/archive/podcast/primary-care-crunch-anticipating-doctor-shortage-after-obamacare-82813\" target=\"_blank\">Listen to the podcast of the one-hour discussion\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "More California Parents Opting Out of Vaccines; Look Up Your School Online",
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"content": "\u003cp>\u003cem>\u003cstrong>Editor's note: the story below is from 2013. To see more recent data, please see \u003ca title=\"Vaccine Opt-Out Rate Doubled in 7 Years\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine\" target=\"_blank\">this story published in early September, 2014.\u003c/a>\u003c/strong> \u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Olivia Hubert-Allen and Lisa Aliferis\u003c/strong>\u003c/p>\n\u003cp>Despite the overwhelming medical evidence that childhood vaccinations are exceptionally effective at preventing disease, a growing number of parents are opting out of having their children vaccinated. While state law requires that children be fully vaccinated to enter kindergarten, California parents can get around this requirement simply by filing a personal belief exemption, or PBE, a signed statement saying that vaccines are counter to their beliefs.\u003c/p>\n\u003cp>PBE rates vary across the state, including by county (Marin has the highest \u003ca href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">personal belief exemption rate\u003c/a> in the Bay Area at 7.8 percent), and also by individual school. The California Department of Public Health \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2012-2013%20California%20Kindergarten%20Data.pdf\" target=\"_blank\">compiles vaccination rates\u003c/a> and PBE rates statewide. Below, we've made it easy for you to look up your own child's school and see what the PBE rate is. You can also look at the data by county, city or school district. (PBE data for some schools was not provided.)\u003c/p>\n\u003cp>The column to the far right -- \"%PBE\" -- shows the percentage of children at a kindergarten with a personal belief exemption on file. Ideally, that number should be zero, as it is at many schools statewide. Look up your child's school in the search box:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.kqed.org/news/health/vaccinations/pmerates.jsp\" width=\"640\" height=\"485\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!--more-->James Watt, chief of the communicable disease control division with the California Department of Public Health, called high personal belief rates \"a concern,\" especially \"because in some schools you really do have situations where you fall below a herd immunity threshold, and disease transmission is even more possible.\"\u003c/p>\n\u003cp>\"Herd immunity\" means that there's such a high vaccination rate that those who cannot be vaccinated, such as newborn infants or people with compromised immune systems, are protected.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">Five Things You Should Know About Vaccines\u003c/a>]\u003c/p>\n\u003cp>Schools are ripe places for disease transmission if kids aren't vaccinated. Kids don't have good \"cough etiquette,\" Watt noted, plus \"kids in schools have a lot of contact with each other.\" He stressed that the best thing parents can do is have their own children vaccinated. \"The vast majority of children who are vaccinated are protected.\"\u003c/p>\n\u003cp>A more worrisome issue, he said, is for children who cannot be vaccinated for a medical reason. In that case, parents may want to weigh a school's PBE rate and consider what that means for their own child.\u003c/p>\n\u003cp>\"It's one piece of information that parents can use as they think about schools and their own children and what their risks may be,\" Watt said. \"Different children have different needs.\"\u003c/p>\n\u003cp>In January, a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" target=\"_blank\">new state law goes into effect\u003c/a> requiring parents who want to opt out of vaccines to talk with a health care provider first about the pros and cons of both vaccines and communicable illnesses. Washington state passed a similar law in 2011, and their opt-out rate has since dropped by almost 40 percent.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2012-2013%20CA%20Kindergarten%20Immunization%20Assessment.pdf\" target=\"_blank\">On a countywide basis\u003c/a>, the highest PBE rates are found in a collection of Northern California counties. Alpine, Calaveras, Del Norte, Humboldt, Mariposa, Siskiyou and Tuolomne counties all have PBE rates between 10.5 and 12.5 percent. Trinity County's rate is 15.93 and Nevada County's rate is 22.44, but both these counties have only a few hundred students in school, so it would take just a few children with PBEs to create the high percentage rate.\u003c/p>\n\u003cp>By contrast, San Francisco County's PBE rate is 1.33 percent, and Los Angeles County's rate is 1.88 percent.\u003c/p>\n\u003cp>\u003cstrong>Our methodology\u003c/strong>\u003c/p>\n\u003cp>The state conducts a \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2012-2013%20CA%20Kindergarten%20Immunization%20Assessment.pdf\" target=\"_blank\">kindergarten assessment\u003c/a> of vaccination rates each fall. The data shown above are from the 2012-2013 school year and reflect a survey of more than 500,000 children at 8,220 public and private kindergartens in California. The assessment is done at the school level and reported to local health departments and to the state.\u003c/p>\n\u003cp>The state then compiles \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2012-2013%20California%20Kindergarten%20Data.pdf\" target=\"_blank\">a report of the immunization status\u003c/a> of all kindergarteners, a table with 26 columns of information. More than 90 percent of kindergarteners in the state start school fully immunized. But some children have \"conditional\" status, meaning they are lacking some vaccines but parents intend to get them. Officials told us they do not want to deny entrance to school because the child is not fully up-to-date, but is expected to be soon. Some parents are opposed to vaccines, so they have a \"personal belief exemption\" on file.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To make it easier for readers to look up the PBE rate at their own school, we simplified the state's table. We did not alter the data in any individual column. Instead, we selected six of the 26 columns that we thought readers would find most interesting. In addition, we made the data sortable by county, city, school district and PBE rate. The state publishes a PDF of its data, which is not sortable. We asked the state for its Excel spreadsheet so that we could post this sortable version.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\u003cstrong>Editor's note: the story below is from 2013. To see more recent data, please see \u003ca title=\"Vaccine Opt-Out Rate Doubled in 7 Years\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine\" target=\"_blank\">this story published in early September, 2014.\u003c/a>\u003c/strong> \u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Olivia Hubert-Allen and Lisa Aliferis\u003c/strong>\u003c/p>\n\u003cp>Despite the overwhelming medical evidence that childhood vaccinations are exceptionally effective at preventing disease, a growing number of parents are opting out of having their children vaccinated. While state law requires that children be fully vaccinated to enter kindergarten, California parents can get around this requirement simply by filing a personal belief exemption, or PBE, a signed statement saying that vaccines are counter to their beliefs.\u003c/p>\n\u003cp>PBE rates vary across the state, including by county (Marin has the highest \u003ca href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">personal belief exemption rate\u003c/a> in the Bay Area at 7.8 percent), and also by individual school. The California Department of Public Health \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2012-2013%20California%20Kindergarten%20Data.pdf\" target=\"_blank\">compiles vaccination rates\u003c/a> and PBE rates statewide. Below, we've made it easy for you to look up your own child's school and see what the PBE rate is. You can also look at the data by county, city or school district. (PBE data for some schools was not provided.)\u003c/p>\n\u003cp>The column to the far right -- \"%PBE\" -- shows the percentage of children at a kindergarten with a personal belief exemption on file. Ideally, that number should be zero, as it is at many schools statewide. Look up your child's school in the search box:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.kqed.org/news/health/vaccinations/pmerates.jsp\" width=\"640\" height=\"485\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!--more-->James Watt, chief of the communicable disease control division with the California Department of Public Health, called high personal belief rates \"a concern,\" especially \"because in some schools you really do have situations where you fall below a herd immunity threshold, and disease transmission is even more possible.\"\u003c/p>\n\u003cp>\"Herd immunity\" means that there's such a high vaccination rate that those who cannot be vaccinated, such as newborn infants or people with compromised immune systems, are protected.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">Five Things You Should Know About Vaccines\u003c/a>]\u003c/p>\n\u003cp>Schools are ripe places for disease transmission if kids aren't vaccinated. Kids don't have good \"cough etiquette,\" Watt noted, plus \"kids in schools have a lot of contact with each other.\" He stressed that the best thing parents can do is have their own children vaccinated. \"The vast majority of children who are vaccinated are protected.\"\u003c/p>\n\u003cp>A more worrisome issue, he said, is for children who cannot be vaccinated for a medical reason. In that case, parents may want to weigh a school's PBE rate and consider what that means for their own child.\u003c/p>\n\u003cp>\"It's one piece of information that parents can use as they think about schools and their own children and what their risks may be,\" Watt said. \"Different children have different needs.\"\u003c/p>\n\u003cp>In January, a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" target=\"_blank\">new state law goes into effect\u003c/a> requiring parents who want to opt out of vaccines to talk with a health care provider first about the pros and cons of both vaccines and communicable illnesses. Washington state passed a similar law in 2011, and their opt-out rate has since dropped by almost 40 percent.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2012-2013%20CA%20Kindergarten%20Immunization%20Assessment.pdf\" target=\"_blank\">On a countywide basis\u003c/a>, the highest PBE rates are found in a collection of Northern California counties. Alpine, Calaveras, Del Norte, Humboldt, Mariposa, Siskiyou and Tuolomne counties all have PBE rates between 10.5 and 12.5 percent. Trinity County's rate is 15.93 and Nevada County's rate is 22.44, but both these counties have only a few hundred students in school, so it would take just a few children with PBEs to create the high percentage rate.\u003c/p>\n\u003cp>By contrast, San Francisco County's PBE rate is 1.33 percent, and Los Angeles County's rate is 1.88 percent.\u003c/p>\n\u003cp>\u003cstrong>Our methodology\u003c/strong>\u003c/p>\n\u003cp>The state conducts a \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2012-2013%20CA%20Kindergarten%20Immunization%20Assessment.pdf\" target=\"_blank\">kindergarten assessment\u003c/a> of vaccination rates each fall. The data shown above are from the 2012-2013 school year and reflect a survey of more than 500,000 children at 8,220 public and private kindergartens in California. The assessment is done at the school level and reported to local health departments and to the state.\u003c/p>\n\u003cp>The state then compiles \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2012-2013%20California%20Kindergarten%20Data.pdf\" target=\"_blank\">a report of the immunization status\u003c/a> of all kindergarteners, a table with 26 columns of information. More than 90 percent of kindergarteners in the state start school fully immunized. But some children have \"conditional\" status, meaning they are lacking some vaccines but parents intend to get them. Officials told us they do not want to deny entrance to school because the child is not fully up-to-date, but is expected to be soon. Some parents are opposed to vaccines, so they have a \"personal belief exemption\" on file.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To make it easier for readers to look up the PBE rate at their own school, we simplified the state's table. We did not alter the data in any individual column. Instead, we selected six of the 26 columns that we thought readers would find most interesting. In addition, we made the data sortable by county, city, school district and PBE rate. The state publishes a PDF of its data, which is not sortable. We asked the state for its Excel spreadsheet so that we could post this sortable version.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Hospitals Can Be More Green",
"title": "How Hospitals Can Be More Green",
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"content": "\u003cfigure id=\"attachment_14481\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14481\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/78753430-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Ryder Diaz\u003c/strong>\u003c/p>\n\u003cp>Kaiser Permanente wants to know what’s lurking in their hospitals' mattresses. Mattresses are often treated with brominated flame retardants. And these chemicals usually don’t stay put. They leak into the air or cling to specks of dust and enter our bodies.\u003c/p>\n\u003cp>“Flame retardants can be quite toxic. They accumulate in the environment and in our fat cells,” said Kathy Gerwig, vice president and environmental stewardship officer at Kaiser.\u003c/p>\n\u003cp>Certain beds may contain vinyl or other plastics that when produced or destroyed can release toxins into the environment.\u003c/p>\n\u003cp>The Environmental Protection Agency is currently \u003ca href=\"http://www.kqed.org/news/story/2013/03/28/118491/epa_asks_are_flame_retardants_safe?category=bay+area\">reviewing\u003c/a> the safety of these chemicals, which have been \u003ca href=\"http://ww2.kqed.org/news/2013/03/27/debate-takes-on-safety-of-flame-retardants/\">linked\u003c/a> to increased cancer risk and other health issues.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Gerwig’s team is trying to figure out what’s in their stock. If they prove to be harmful, swapping out hospital beds is bound to be a big undertaking. “We have a lot of mattress,” she said. But if necessary, it's a task Gerwig would embrace.\u003c/p>\n\u003cp>Kaiser hospitals are among more than 100 private and public hospitals in California that are moving toward more sustainable practices for their facilities, said Laura Wenger, executive director of Practice Greenhealth.\u003c!--more-->\u003c/p>\n\u003cp>Non-profit organizations like \u003ca href=\"https://practicegreenhealth.org/\">Practice Greenhealth\u003c/a> and \u003ca href=\"http://www.noharm.org/\">HealthCare Without Harm\u003c/a> are hoping to turn hospitals “green.” The groups help hospitals reduce energy use, cut down on medical waste and make hospitals healthier places to visit or work in.\u003c/p>\n\u003cp>“We have seen many hospitals that are using quite toxic cleaning supplies even in their public areas,” said Wenger. “Why are you exposing all your staff, the general population and visitors to these increased amounts of toxins when there’s really no need for it whatsoever?”\u003c/p>\n\u003cp>Some of these disinfectants can be carcinogenic and exposure may lead to nausea, neurological damage and respiratory problems when emitted into the air.\u003c/p>\n\u003cp>This is a concern for patients but it’s an even bigger issue for hospital staff who spend their working lives in these buildings. \u003ca href=\"http://oem.bmj.com/content/69/1/35.short\" target=\"_blank\">Research\u003c/a> has shown that health care workers who are routinely exposed to chemicals and cleaners like bleach, toilet cleaners, detergents and ammonia had greater odds of developing work-related asthma symptoms.\u003c/p>\n\u003cp>Practice Greenhealth encourages the hospitals it works with to use more sustainable products when safe to do so.\u003c/p>\n\u003cp>But it's not just cleaning supplies and potent disinfectants that are causing concern. Harmful chemicals and toxins are turning up in places you might not expect.\u003c/p>\n\u003cp>Wenger says “chemicals of concern\" have been found in many areas throughout hospitals, \"from inside of medical tubes and various medical devices,\" she says \"to the backing in your carpeting and flooring that have certain emissions\" and even formaldehyde in wall coverings.\u003c/p>\n\u003cp>By 2001, research suggested that DEHP, a chemical used to make plastics and vinyl more flexible, had a range of negative health effects in laboratory animals, including damage to developing reproductive organs.\u003c/p>\n\u003cp>DEHP has been common in hospital equipment like medical tubing, IV bags, and catheters, including equipment used on very sick infants.\u003c/p>\n\u003cp>“We’re trying to help [patients] by giving them lifesaving drugs -- but through a device that might have negative outcomes,” said Krisanne Hanson, the director of sustainability at Stanford University Medical Center.\u003c/p>\n\u003cp>Stanford and other hospitals across the state have eliminated DEPH from intensive care units for infants. Today, only a few products containing DEPH remain in Stanford’s hospitals, says Hanson.\u003c/p>\n\u003cp>Both Stanford and UC San Francisco have also swapped out the harmful neurotoxin mercury from a variety of medical devices, including thermometers and thermostats.\u003c/p>\n\u003cp>Hospitals making a move toward sustainability often ask suppliers to list which toxins are hiding in their products.\u003c/p>\n\u003cp>They even sweat the small stuff, items as small as identification bands.\u003c/p>\n\u003cp>A few years ago, Kaiser found out their regular supplier of ID bands made them with PVC. PVC emits cancer-causing chemicals when manufactured and incinerated. Today, Kaiser’s yearly allotment of about 4.4 million ID bands are made of a more sustainable tyvek material.\u003c/p>\n\u003cp>“There wasn’t a lot of deep thinking about it. It was just, there’s a safer alternative available and it’s affordable, so let’s go with that,” said Gerwig.\u003c/p>\n\u003cp>But sometimes there’s no substitute on the shelf that meets hospital standards. In those cases, Kaiser has asked companies to invent one.\u003c/p>\n\u003cp>Gerwig says that Kaiser sent \"a very loud and clear message to suppliers\" that it wanted safer alternatives \"and the first people who come to us with a safer product that meets our quality and affordability standards, we’re going to go with that.\"\u003c/p>\n\u003cp>A message like that from Kaiser, which buys mountains of supplies for its 37 hospitals, can send manufactures running to the design room.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And that’s a win for other hospitals which now have access to new, sustainable products at affordable prices, said Gerwig.\u003c/p>\n\n",
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"excerpt": "Kaiser Permanente wants to know what’s lurking in their hospitals' mattresses. Mattresses are often treated with brominated flame retardants. And these chemicals usually don’t stay put. They leak into the air or cling to specks of dust and enter our bodies.\r\n\r\n“Flame retardants can be quite toxic. They accumulate in the environment and in our fat cells,” said Kathy Gerwig, vice president and environmental stewardship officer at Kaiser.\r\n\r\nCertain beds may contain vinyl or other plastics that when produced or destroyed can release toxins into the environment.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Gerwig’s team is trying to figure out what’s in their stock. If they prove to be harmful, swapping out hospital beds is bound to be a big undertaking. “We have a lot of mattress,” she said. But if necessary, it's a task Gerwig would embrace.\u003c/p>\n\u003cp>Kaiser hospitals are among more than 100 private and public hospitals in California that are moving toward more sustainable practices for their facilities, said Laura Wenger, executive director of Practice Greenhealth.\u003c!--more-->\u003c/p>\n\u003cp>Non-profit organizations like \u003ca href=\"https://practicegreenhealth.org/\">Practice Greenhealth\u003c/a> and \u003ca href=\"http://www.noharm.org/\">HealthCare Without Harm\u003c/a> are hoping to turn hospitals “green.” The groups help hospitals reduce energy use, cut down on medical waste and make hospitals healthier places to visit or work in.\u003c/p>\n\u003cp>“We have seen many hospitals that are using quite toxic cleaning supplies even in their public areas,” said Wenger. “Why are you exposing all your staff, the general population and visitors to these increased amounts of toxins when there’s really no need for it whatsoever?”\u003c/p>\n\u003cp>Some of these disinfectants can be carcinogenic and exposure may lead to nausea, neurological damage and respiratory problems when emitted into the air.\u003c/p>\n\u003cp>This is a concern for patients but it’s an even bigger issue for hospital staff who spend their working lives in these buildings. \u003ca href=\"http://oem.bmj.com/content/69/1/35.short\" target=\"_blank\">Research\u003c/a> has shown that health care workers who are routinely exposed to chemicals and cleaners like bleach, toilet cleaners, detergents and ammonia had greater odds of developing work-related asthma symptoms.\u003c/p>\n\u003cp>Practice Greenhealth encourages the hospitals it works with to use more sustainable products when safe to do so.\u003c/p>\n\u003cp>But it's not just cleaning supplies and potent disinfectants that are causing concern. Harmful chemicals and toxins are turning up in places you might not expect.\u003c/p>\n\u003cp>Wenger says “chemicals of concern\" have been found in many areas throughout hospitals, \"from inside of medical tubes and various medical devices,\" she says \"to the backing in your carpeting and flooring that have certain emissions\" and even formaldehyde in wall coverings.\u003c/p>\n\u003cp>By 2001, research suggested that DEHP, a chemical used to make plastics and vinyl more flexible, had a range of negative health effects in laboratory animals, including damage to developing reproductive organs.\u003c/p>\n\u003cp>DEHP has been common in hospital equipment like medical tubing, IV bags, and catheters, including equipment used on very sick infants.\u003c/p>\n\u003cp>“We’re trying to help [patients] by giving them lifesaving drugs -- but through a device that might have negative outcomes,” said Krisanne Hanson, the director of sustainability at Stanford University Medical Center.\u003c/p>\n\u003cp>Stanford and other hospitals across the state have eliminated DEPH from intensive care units for infants. Today, only a few products containing DEPH remain in Stanford’s hospitals, says Hanson.\u003c/p>\n\u003cp>Both Stanford and UC San Francisco have also swapped out the harmful neurotoxin mercury from a variety of medical devices, including thermometers and thermostats.\u003c/p>\n\u003cp>Hospitals making a move toward sustainability often ask suppliers to list which toxins are hiding in their products.\u003c/p>\n\u003cp>They even sweat the small stuff, items as small as identification bands.\u003c/p>\n\u003cp>A few years ago, Kaiser found out their regular supplier of ID bands made them with PVC. PVC emits cancer-causing chemicals when manufactured and incinerated. Today, Kaiser’s yearly allotment of about 4.4 million ID bands are made of a more sustainable tyvek material.\u003c/p>\n\u003cp>“There wasn’t a lot of deep thinking about it. It was just, there’s a safer alternative available and it’s affordable, so let’s go with that,” said Gerwig.\u003c/p>\n\u003cp>But sometimes there’s no substitute on the shelf that meets hospital standards. In those cases, Kaiser has asked companies to invent one.\u003c/p>\n\u003cp>Gerwig says that Kaiser sent \"a very loud and clear message to suppliers\" that it wanted safer alternatives \"and the first people who come to us with a safer product that meets our quality and affordability standards, we’re going to go with that.\"\u003c/p>\n\u003cp>A message like that from Kaiser, which buys mountains of supplies for its 37 hospitals, can send manufactures running to the design room.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And that’s a win for other hospitals which now have access to new, sustainable products at affordable prices, said Gerwig.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"order": 9
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"id": "fresh-air",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
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"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"source": "American Public Media"
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"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"rss": "https://rss.art19.com/masters-of-scale"
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},
"mindshift": {
"id": "mindshift",
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"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"meta": {
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"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
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"order": 11
},
"link": "/podcasts/onourwatch",
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},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
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},
"link": "/radio/program/on-the-media",
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"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
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},
"pbs-newshour": {
"id": "pbs-newshour",
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"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
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},
"link": "/radio/program/pbs-newshour",
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"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
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},
"perspectives": {
"id": "perspectives",
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"order": 14
},
"link": "/perspectives",
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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},
"link": "/radio/program/planet-money",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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"rss": "https://feeds.npr.org/510289/podcast.xml"
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
"link": "/podcasts/politicalbreakdown",
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
"meta": {
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"source": "Possible"
},
"link": "/radio/program/possible",
"subscribe": {
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
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