Life expectancy vs Life with disability

I read a very interesting study this evening that is published in the online version of the journal Obesity.
Life Expectancy and Life Expectancy With Disability of Normal Weight, Overweight, and Obese Smokers and Nonsmokers in Europe

BY: Istvan M. Majer, Wilma J. Nusselder, Johan P. Mackenbach and Anton E. Kunst

The sample population included over 60,000 persons pretty evenly split between males and females.  The average age was between 44 and 50 (there were nine countries included).  The information on health status, disability, weight, education, smoking status and more was gathered through self report in a standardized survey.  The populations were tracked over time and the researchers could assess disability and death, but for the most part, this information is subject to several biases.  For instance, a person might give false information because they couldn't recall or because they did not want to tell the interviewer something that might make the interviewer "judge" them.  This information is certainly helpful and we can look at associations between factors and outcomes. It is also important to note that the information refers to groups of people, many times what is true for a population is not true for an individual.


In this study, the researchers compared normal weight non smokers (they were considered the baseline, or referent group), to normal weight, overweight and obese smokers and non smokers.  Former smokers were excluded from the analysis due to the many variances amongst former smokers (quit date, years smoked, amount smoked, etc).


Still they did gather smoking status, and the sample characteristics showed a wide range of population smoking rates that were disturbingly high.  Greece, Spain and Denmark were all over 35% for men, no country had below 25% (for men).


What this study shows is a relationship between being overweight and living longer and living longer with disability or disease.  Smoking did not provide more disability - nor less, but it shortened the life expectancy in total.


The authors felt that smoking cessation would increase life and losing weight would increase years of life without disability. In other words, stop smoking and live longer, lose weight (or maintain a normal weight) and live better. 

The authors did not note a difference between men and women, but I saw a definite difference in disability years in the chart that they provided.  I am actually going to see if I can post it in here. 

It shows four graphs.  The two on top are for men (non smoker v smoker) and the two on the bottom are for women. [we must remember that these are pooling of data from 9 countries which are not necessarily similar]

They also compare persons by education, but I feel like the more telling factor would have been income.  In this chart, and in the sample, women live several years longer than men, but they also have more years of living with disability.  For instance, low educated obese women had about 20 years LWD (living with disability) and men in the same category have 14.7.  In every block, the women have more years of disability.  The authors also calculated percent of life lived with disability - that was interesting too.  Again, the differences are not between smokers and non smokers(for percent of life spent disabled), but between men and women.  I am actually very curious why the graphics point this out but the scientists do not emphasize it.  You know what that means - I will have to email the lead author (okay I am back - email sent :)). 

 I do not say this to be fickle, but because for instance, in the obese category for non smokers, men have 19% of disability years and women have 28% - it is substantial.  If it is not significant - well there are not statistics to make inferences- thus I wrote to ask.

Take home message - don't smoke and do lose weight because those extra ten years won't mean near as much if you cannot do anything.  :)

Okay I got the chart in  -  for education purposes.  Note that the bottom half is disease free life expectancy and the top is life with disability.  Do you see the differences between the various groups?



From the study published in Obesity 3-17-2011 Majer, et al.



Hand Breaded to what end?

We can add this to the same obfuscation category as the "natural cut" french fry-

Sorry for the ten dollar word, but as I sat staring at the screen wondering just what to call this advertising tactic it was the only word that came to me.  Hand breaded and natural cut are not euphemisms - the foods are really prepared in that way - but the phrases are certainly intended to confuse the consumer and to make things unclear - so obfuscate it is -

What are the advertisers, and in this case it's Hardees, trying to cover up?  I am thinking the 21 grams of fat in the 5 piece meal.  In other words, hand breaded does not mean grilled - it doesn't even mean baked - it is still a food fried in oil (having similar fat and calories as those that are NOT hand breaded).  Much in the same way as those natural cut french fries are in fact, FRIED.  And as I was writing this and going back and forth between fast food websites, I began to wonder if both of these word trickeries were from Hardees and in fact, it is so. 

Hand breaded chicken tenders and natural cut fries - put them together and you have 35 grams of fat which I believe is close to many persons recommended total fat amount for the day - oh, and just for fun - that also includes 1760 mg of sodium(salt) -

What is to be lauded here is that the companies ARE posting the nutrient content on line in easy to read formats.  In the end, you decide what you want to eat, when and where - my main goal is that you know what that decision entails with regard to fat, cals, sugar, salt etc.

E cig Update

In looking at my little blog list here on the desk, I decided to choose the item that I have the least interest in  - so maybe that is the order for the rest of the week - least to most interesting.

When I was working as a tobacco treatment specialist/educator, I followed the news on all things tobacco and nicotine pretty closely.  If you'll recall, I provided an overview of the new Family Smoking Prevention and Tobacco Control Act and the changes that it would impose over the years.

The first tier included a change in the advertisement warning labels on smokeless products, the outlaw of flavored cigarettes (except the most popular flavor), the rise in the excise tax and the removal of the word(s) light or low tar from cigarette packs.  The next tier will include the expanded warning label on the cigarette packs - the warning will be larger (50% of pack) and graphic in nature.

Hm m- it seems I do still have a little passion for the issue. 

 At about the same time that this law was passed, July 2009 I believe it was - kiosks and on line websites were advertising and selling electronic cigarettes which were purported to be "safer" and in some cases, "treatments" for nicotine addiction.

There were two problems with that. One is that you cannot say that something is safe unless you have proven it to be so _ esp tobacco products (since the FDA took over their regulation) AND if you are calling something a "treatment" then you mean it is a medicine and THAT is a whole other bag of regulation.

I wrote about the issue and fell on the side of those that believed the manufacturers were claiming e cigs to be nicotine replacement therapy (medicine), like nicotine patches, without doing the safety and efficacy trials.  The FDA was also of this opinion, but the supreme court sided with the e cigarette makers in saying that it was a tobacco product, not a medicine.  It can still be regulated by the FDA but in the same way as cigarettes and not by the medicine division.  Here is the latest FDA update.

I am disappointed.

Pneumonia and X Rays

The results of a study out of Canada were used in several news stories yesterday.  The study involved persons who had been diagnosed with pneumonia (thru an X ray) and who later had additional X rays to rule out lung cancer.  From the total sample of persons, they tracked new cases of lung cancer, at three time points.  They then looked at who was diagnosed with lung cancer to see if there was a statistical difference between those who were and were not . 

 From this, they could make recommendations on how to treat future pneumonia patients.  In other words, who would have a perceived benefit that was greater than the risk in having follow up X rays.

The study found a correlation between age (+ 50), gender (male) and smoking status (+). None of this is new - and the amount of lung cancer cases that were diagnosed in the five years was only 172 out of nearly 3400 cases. 

 Smoking is already associated with both pneumonia and other lung ailments so some scientists and physicians feel that smokers with pneumonia should always be reassessed for lung cancer after 90 days.  (I am ambivalent about this - and did not see this in the actual research abstract)

The study authors only recommended that persons over age age of 50  have the additional X Ray. 

 A fellowr blogger noted (quite smartly) that anyone who gets pneumonia should discuss this with their doctor because generally healthy people do NOT get pneumonia.  Lifestyle factors can cause the illness - like smoking. 

Here is the abstract to the research study.

Scoop that Poop

Throughout this day I had several "thoughts" on what to write in the blog tonight.  I have something left over from yesterday, I watched a Webinar which demonstrated a very cool interactive resource you have to see, and I came across an article about X rays which is always a topic of interest - but as I dallied with some last minute surfing I came across the How To for the day on my iGoogle home page.  

It was a link to a WikiHow page which I will attach after just a few more words.  It is blog relevant because sometime last year I remember telling you that I heard some people talking in my apartment complex and one said, "Oh they forgot their poop." Or something like that (I found the post, its at the end of this odds and ends) - and LA posted afterwards about how bad it is when people do not scoop their poop - okay , their DOG's poop.  The poop dialogue went on a bit - not that people should not clean up after their pets, just that oh my gosh, there are little poop scooping kiosks for goodness sakes and today - an actual HOW TO - which I can't resist sharing with you. 

(tomorrow we can get back to why x rays are not healthy)

Cross Training Pays Off

With some trepidation, I took my bicycle out from its little space in the entryway of my apartment building today.  I had not ridden my bike for at least five months.  Prior to November, I had been riding  back and forth to campus several days a week. I cannot tolerate cold.  Even today in the 70* weather my eyes teared and my nose ran!

Still it was a beautiful day and as I was not going to run, the thought of riding was appealing.  I first took the bike for a little test spin - recalling that bad fall last September and my difficulty stopping and starting on hills - intersections and the whole business of CARS on narrow streets. 

I  rode about a mile or so on near flat roads and stopped and started at several places just to prove to myself that I had not forgotten everything I learned (the hard way) last year.  It went okay so I decided that I would ride the bike to campus today (where I was going for my twice weekly weight lifting session). 

I did worry a great deal about my ability to manage the  steep hills that I would face on the way. 

There were a couple of times last fall that I did not think I could make it up one in particular.  I was considering going to campus on the hilly road with less traffic and coming home on the busier, flatter road.  The busier road actually has bike lanes. 

But - instead - I did the 2.5 mile hilly road both ways and though my quads did burn, I did not at any time feel like I would not make it.  So,  the months of yoga, pilates and gym work helped me retain - even build - my core and lower body strength. 

I wore my helmet of course :)

candy, drugs and stocks - Odds and Ends

A strange combination of items for tonight's post - let me explain.  I had only meant to log on to make a quick little follow up to last night's Easter related comment and was side tracked by a news story that led me to add a couple of more things.

First - I just wanted to point out that I used our recent holiday to say something positive about eggs, but not candy :)

Second - I came across a term I had not heard before, though it was easy to google and is not a new term.  The term was really a phrase - ethical drugs.  Do you know what makes a drug "ethical?"  The definition is "drugs that are provided by prescription only".  In other words, not drugs that are over the counter drugs or supplements.  Isn't that odd that these medicines, many of which are harmful, over prescribed and sometimes sold on the street, are considered "ethical." 

Third - Would you like to get an idea of how important and effective health care reform is and maybe how drug companies are not themselves "ethical" ?  Read a blog about pharmaceutical company JNJ in which the analyst gives reasons why the company did NOT have a good year - i.e. profits were down or absent - I will quote the article, which means I should link it, which means you will also see where I first read the phrase, "ethical drugs."   When the article refers to efforts to control health care spending (below) it means that the company is under pressure to lower the price of its drugs or that benefits programs are limiting their use in its recipients...
    "It has suffered from a host of issues including:
continuing efforts to control health care spending in developed countries with Obama care exacerbating the US situation,"

Fourth - An article about saving energy and replacing light bulbs caught my attention.  One of the reasons is that I had meant to update my readers on my experience with lightbulb replacement - after I put in the CFL bulbs, my power bill went up.  I bet that was a coincidence - right?? I will let you know next month.  More frustrating, in this article is reference to two light bulb types that meet the new energy standards and do not contain mercury.  Why didn't Duke Energy 1) offer me this kind, and or 2) tell me that the ones they were giving away had mercury in them.

Fifth - The CDC recently released a report noting that many states have comprehensive smoking bans and that they expect the entire country to have them in the future (ten/twenty years).  Comprehensive means that there is no indoor smoking in bars, restaurants OR work places.  The reason these bans are important is the high correlation of  disease and death related to second hand smoke.  In response to this news, a blogger in Kentucky noted that her state has the least indoor smoking laws, is second only to NC in (US)tobacco production and has the highest rate of new lung cancers.  Yes  indeed - smoking kills.

Eggs!

Seems like a good time to mention that eggs can be a good source of energy.  A boiled egg has about 70 calories, 6 grams of protein and very little saturated fat.  Though the egg does have cholesterol - about 187 mg - blood cholesterol is more often associated with a high saturated diet - a diet high in red meat and fried foods.  So in moderation and without frying, the egg can be a great addition to your menu.  (BTW - for a gazillion reasons I would not recommend raw eggs, but one of them is that there is more cholesterol in raw than hard boiled eggs)
To learn all about what is in an egg, check out this web link.  Enter the word egg in the search box and then pick the type you'd like to investigate.




Happy Easter to those who Easter

 

Wind Farm Update

I had so many interesting things to read today, but could only scan over them.  Two that I set aside for a closer look are research studies.  One equates ANY alcohol use with an increase cancer risk.  The study conclusion was that in regards to cancer incidence, there is no safe level of alcohol intake - this counters my previous statements that alcohol has therapeutic benefit for some persons.  The quote in Medscape attributed 10% of all cancers in men to alcohol use and 3% of cancers in women to alcohol use.  Apparently, alcohol in small doses is good for the heart, but always increases cancer risk compared to those who do not drink at all - all other things being equal.

The other study that caught my eye, but not my full attention, regards the protective effects of strawberries in regards to esophageal cancer - this cancer is closely tied to smoking.  Strawberries - I eat them almost every day! 

But let's see - if I also have two drinks a week - does that cancel out the strawberry effect?

Lastly, I cannot believe it has been a year since this post on the Wind Farm in Nantucket Sound.  A year ago I noted that approval had been given for the project.  Today I read that the federal government gave the "go ahead" for the project so that construction can actually begin - really?  Somehow I think I need to wait until I actually see the turbines.

BTW, it occurred to me this afternoon that I am learning SO much in my classes and with my assistantship work.  It is like all these little bits of information are starting to form some shape in my brain - nice.

Odds and Ends

The few points I have for today all come from my classes this week or my work related to my professors interests, except the last one...

Teen Pregnancy and Birth:   Teen pregnancy is not my area of interest or study so the statistics that were presented in one of my classes this week rather surprised me.  Our guest speaker noted that 1 out of 3 teen aged girls become pregnant each year and that 1 out of 6 give birth.  I actually stopped and asked her if she meant that when they interview women who have had children that they say they had their first child during their teens, but no - 30% of girls aged 15 to 19 become pregnant each year.  I believe the number has gone down just a bit as the CDC number for 2009 is 3 in 10 which is a bit less than 1 in 3 (our guest also said that the ages were 15 to 20, and I would want to know the age breakdown). Wow either way.  Still, the bigger debate among some in academia is whether teen pregnancy is a problem or the fact that young mothers drop out of school and that their children become teen mothers - in other words, if the system was more supportive of the mothers the "problem" may not manifest as it does.  Glad this is not my area of study :)

Truckers and Disease:  I heard a presentation and read an article involving the spread of disease with and through truckers.  The transmission is  based on several factors associated with a culture of sex and drugs that is perpetuated through social networks both on line (Internet contacts and then meet ups) and through physical channels at truck stops.  Truckers also expose their partners to the germs or viruses they encounter and are often traveling coast to coast and transporting goods.  The researcher who spoke with us had studied sexually transmitted diseases and blood borne infections but is now looking at chronic diseases in truckers, specifically associated with the work environment - fast food, sedentary behavior = obesity.  I just found the article - or book chapter - that the professor who spoke with us has written.  It is available on line here.  This whole truck chaser and truck subculture is fascinating.  It goes way beyond the stereotype of truck stops and hitch hikers.

Bicycle Related Injury/Death and Helmet Use:  I am going to link the two resources from which I learned most of this information.  As I mentioned before, one of my professors has conducted research in Greensboro on helmet use prevalence - who is wearing helmets.  I am helping to write the paper and doing additional research for this purpose.  The reports that I review consistently show that people do not wear helmets, and  that men, specifically those 45 to 54, are more often  than women or children to be killed in pedalcyclist accidents and that the most common age for death and injury is 41 and 31.  I would consider as a hypothesis that the children, who suffer more injury but less death, are being protected by helmet laws.  Only 13 states do NOT have helmet laws, though no state has an all age state law, some states have city laws that cover all ages.  With regard to fatalities, they are most always from head injury.  The rate of death is declining, and again, I imagine that is from the helmet laws.  In 2009, there were just over 600 deaths in the country.  The highest number of fatalities was in Florida with 107.   These statistics can be found on the National Highway Traffic Administration website.  The state helmet laws are described on the Bicycle Helmet Safety Institutes's website.

Cyclist Near Miss:  This afternoon, I turned onto the street where I live which also hosts a beautiful arboretum.  As I passed the entrance, on my right, a cyclist came up the little hill and turned left - into the facing traffic lane - in other words, right in front of me.  I almost hit him.  He was wearing a helmet, and he was a man about 50 years old.

RRI:  When looking at a journal for bicycle articles, I saw a study about running injuries.  The researchers wanted to see if novice runners would have more RRI than more seasoned runners.  They made many comparisons beyond length of time running.  They also analyzed the possible effects of duration of event, exertion or effort, age, gender etc.  They did find that people who had been running less than 3 months had more injuries but it was related to training error, not running itself.  They did not find any significant predictors of injury nor high rates of injury.  It was cool that they reported their results even though they did not find what they expected.  From this article I learned the term - RRI.  Running related injury.

Pancakes!:  I made butternut squash pancakes TWICE this week and I had not made them prior to this.  They were so very good - I made a video for my You Tube channel so that I could share this super low calorie alternative to potato pancakes, but I have not posted it yet.  I think I will make them for my Mom when I visit next month.  MMMM Good.

Childhood Obesity - Attacking on all Fronts

Yesterday I linked you to a news story about a sugar tax.  In seeing the same story on Face Book my sister, quite understandably, suggested that we teach people to moderate as opposed to taxing them. 

Every public health graduate from the bachelors to the master's level enters the field with exactly those intentions.  We are taught strategies to motivate persons to make lifestyle choices that will reduce their risk of disease; chronic, communicable and acute as well as how to promote injury prevention.  As one of those MPH practitioner's I learned that even my favorite theory (Social Cognitive/Learning Theory)-  making things relevant and teaching skills - was falling short.  It has everything to do with why I am now in a doctorate program in NC.

The rates of obesity and the chronic health diseases that accompany it have not abated and so, we learn, the situation is complex.  It requires health education programs and everything else we can throw at it.  

Recalling another health crisis - raising taxes on cigarettes, after we educated on lung cancer and COPD, put in controls on advertising, and offered assistance for quitting is what finally got the smoke rates down from 43% to 19% in the USA.  It really took all of those actions.

The article I am linking to today is from a peer reviewed research journal and the scientists suggest ways to "create an environment in which youths are encouraged to eat a healthier diet."  It speaks to the magnitude of the problem and thus the complexity of the solution.

No Interpretations Needed

I am going to link to two stories tonight because they are both spot on things that I believe and have written about and would write about again.  There is no need for me to regurgitate, or qualify them -


The first regards the rationale behind a sugar tax - though I have written about soda taxes, I am just as comfortable with this approach and will be passing this article around the community obesity coalition that I am a part of in Greensboro NC.


The second is another expert's advice to adopt the Mediterranean style diet - and by diet I mean foods that you eat every day - foods that fill your plate, not a plan that you employ for weight loss.  I eat a plant based diet that is Volumetrics based....


PS  - I have just read about terrible storms in the south with many lives lost.  The weather system is moving east through ALA, GA, parts of Fl, SC and NC even to VA by tomorrow - my heart is saddened by the losses and I hope that the advance warning will protect those in the path of these storms.  Apparently, the devastation is related to a phenomena called straight line wind, which comes out of a thunderstorm as opposed to the circular winds from  tornados - which are also a part of this system.  Be safe.

Weight and Memory

Studies that associate being overweight/obese with Alzheimer's and other types of dementia are available.  The ones that I have read speak of blood flow as one of the factors - in that, these overweight persons may have high cholesterol and plaque buildup which slows blood flow and high blood pressure which also impacts the circulatory system.  Knowing that studies such as this exist, the newspaper article I just came across makes sense.

This popular press piece refers to a study that I have not reviewed.  It talks about weight loss through surgery which I am not particularly fond of - that being said, one of the "experts" quoted in this story does say that it isn't only about weight, but a healthy lifestyle - eating health promoting foods and exercising (while maintaining a weight that is healthy for you).  Anyway, the study is looking at the inverse of what I began this post with - if there is memory impairment from weight gain - will there be memory improvement from weight loss - curious?

Read the story here.

Chips? Really - that's your visual?

I did a double take as I was leaving the student rec center today - and by rec I mean gym, fitness, treadmills, bikes and weights - not pool tables and darts....

On the wall was a poster that said something like "Rec Center Staff.. all that and a bag of chips."   This slogan was superimposed on a big bag of potato chips  - yellow and red - i.e. Lays. 

Now that's a health communication opportunity gone terribly awry...

Odds and Ends

Wear and Tear - I was saddened to hear a report this morning that referred to degenerative osteoarthritis in young, fit men.  This condition is more often found in older and or obese persons whose joints suffer the effects of wear and tear from excess weight and subsequent gait imbalance. These young men are suffering this painful condition after serving several years or more at war while having to carry heavy equipment day after day.  Here is a link to an article that seems to have preceded the story that I heard today.

Happy Meter - A report came out this week that ranked the states in the USA according to measures of mental well being.  No state received a 100 and the distance between the highest and lowest was only ten points or so.  The happiest state was Hawaii at 71 and the least happy was/is West Virginia at 61.  My three states were tied, Florida, NY and NC at 65 which is crazy - Florida should be up there with Hawaii.  Interestingly, the lowest five are also the highest in obesity and smoking status.  You can see the report and how the measures were calculated here.

Core Walk - Okay for those of you who don't visit the You Tube channel, I will try to explain this exercise with words.  This is very good for the core muscles, your abs and back.  This allows you to retain good balance.  It is not an impact exercise and it doesn't involve getting down on the floor - in other words, No Excuses.  The process is simple, just take very slow steps across the room as if you are doing a slow motion high knee march.  You pause with the leg up and then step, going forward as if slow motion marching, and hold the other leg up, it is just a hesitation.  Go slow - feel the body catch to balance you.  You can go ten paces and then turn and do the same coming back.  Repeat every other day.

Delaying Puberty (girls) - The age of first menstruation has lowered significantly over the past ten or so years.  It seems that as the rates of overweight and obesity went up, the age of puberty went down.  It is not a good thing for a girl to have her period when she is 9-12 years old - estrogen is the enemy it seems.  Some of the phenomena is related to the mother's own history, but a good case has been made regarding the environmental impact - weight, hormones in foods, chemicals, etc.  This article from the USA Today offers some suggestions that do not appear to be risky even if I cannot at this time vouch for their validity.

Parking Lot Exasperation

For the record - I had to spell that word phonetically in a google search engine to remember how to really spell it - thank goodness for phonetics and that early parochial school education :)  I wrote eggzasperation HA!!

So what got me exasperated?, you might ask - and I would be obliged to answer....

I was attempting to leave the grocery store parking lot this afternoon when a back up of multi directional proportions occurred - no one in and no one out - not right not left not front not back - all because someone just HAD to have that fourth spot from the front - REALLY?

To which I was compelled to "shout", "Good grief! 
Are you afraid you'll burn a calorie or something?"

sigh - end of semester time is high stress - I could find myself on the wrong end of a punch....

fruitless

Today I went to my first meeting of the NC Fruit and Vegetable Coalition.  The coalition has been in existence for ten or more years.  It once promoted the 5 A Day campaign and is now behind the "Fruits and Veggies, More Matters" initiative. 

At this day long meeting, they served baked goods and coffee.  No fruit.  Seriously.

Ice cream!

My usual fat free sugar free bargain brand ice cream has been missing from the grocer freezer for about a month now.  In the meantime I have tried the Skinny Cow bars (yum) and a Weight Watchers latte bar (yuk), but both are a little higher in calories than my ice cream was and also much more expensive.

I decided to go ahead and try another 'carton' ice cream and chose the lowest calorie I could find - that is calorie per gram - gotta watch those labels or you will end up with a 2 tablespoon serving size :)

There were not many flavor options of this brand where I shop, but as I looked for the picture on the website, I found many more flavors, some higher and some lower in calories - per gram.  You can check them all out here. I hope to find that chocolate brownie one, myself.

What I really wanted to share is that this particular low calorie brand was especially creamy - in my opinion.  And that would be Blue Bunny.  Not new - but definately improved.

Odds and Ends

Hello all - I am being a bit stubborn with myself this evening as I do not have the time to post well and as a perfectionist, posting poorly is anathema.  However, I want to write because Dinahsoar had a great question and because I may not get many more chances to post this month - finals (papers, proposals, exams etc).  So without further ado, here are a couple of notes - saving the cholesterol testing to the end.

NIH:  The National Institutes of Health has released its final report on a strategy to address obesity through research.  This indicates which topics of research they are willing to fund.  The highlights are as follows and the press release is available here.  I am excited because the proposals that I have been working on address many of the areas of interest noted in this report.  The full report itself  is very specific, but here is a highlight of the research recommendations:
•discover key processes that regulate body weight and influence behavior

•understand the factors that contribute to obesity and its consequences

•design and test new approaches for achieving and maintaining a healthy weight

•evaluate promising strategies to prevent and treat obesity in real-world settings and diverse populations

•use technology to advance obesity research and improve health care delivery
 
Lung Cancer:  Out this week - the rates of death from lung cancer among women have been decreasing at a steady pace.  Lung cancer, most often but not always associated with smoking, takes decades to develop and only a few years to kill.  Deaths from lung cancer for men have declined before that of women.  Here is why.  Men began to smoke first, and to smoke more, at first.  At about the time women began to smoke, evidence came out to suggest that smoking kills men.  Men began to quit and as time passed they had less cases of death from lung cancer.  Then reports came out that smoking also kills women, and then women began to quit, though there is some evidence to suggest that women have more difficulty in quitting.
 

Watch those Packages:  My environmental level obesity prevention strategy still includes labeling initiatives.  I would like to see nutrient content available for meals/foods at work, school, restaurants and grocers.  This includes steam tables and vending machines.  So, I am a label reader.  I know that I have alerted my readers to this before, but I have a perfect example to back up this advice.  Even when you buy a product on a regular basis you should review the label periodically.  Content can change for many reasons, but it can change - that is the point.  I noticed that the bread I usually buy for my french toast has gone back and forth in calories per slice.  It is not enough to make a difference, but enough to make a point.  I imagine that there was an error and someone called them on it - but I could be wrong :)
 
Cholesterol Testing:  The question that I was asked has to do with why a fingerstick cholesterol test might differ from a venous draw and if one was better than the other at detecting high cholesterol and triglyceride levels.  First I want to take a moment to share some epidemiology 101, because I love that subject so much.  There are several terms associated with diagnostic tests.  They include, reliability, validity, sensitivity, specificity, positive predictor value and negative predictor value.  A test is reliable if it gives the same results over time.  For example, a food scale tells you the weight in grams of a certain item.  The same amount of grams is provided each time you weigh it.  Validity has to do with whether or not that is the correct weight.  A test can be reliable and not valid.  (there is also reliability among testers and between them)  Test sensitivity has to do with how accurate a test is in detecting who HAS a disease and test specificity is related to determing who does NOT have the disease.  Thus we have true positives and false positives, true negatives and false negatives.  The positive predictor value is more individualized.  How accurate is the test is finding the disease in this certain person, and vice versa?  This was not exactly the question that Dinahsoar asked however.  She wanted to know if one of the tests were more accurate than the other.  It is exactly that type of question that gets at sensitivity and specificity.  How would we know the accuracy of a test if we could not compare it to something?  The something is considered the gold standard.  I did find some information about this issue and I think that Dinahsoar and some of you may really like to read this article by Dr. Mark Deeg, but in summary:  There are some things that can have an impact on cholesterol levels from time one to time two even if the same test is used.  That is important.  Most of the time the difference is just a few percentage points, but triglyceride levels can vary by 20 to 30%.  The fingerstick total cholesterol level is often 2-4 % higher than a venous blood draw.  The way the test is conducted, the time of day, the condition of the patient and of course, the lab itself can all affect the levels.  I would not compare my results from two different types of tests.  I would think that the venous blood draw was more accurate - if there was not lab error.  I would repeat the blood test, same conditions, same lab etc if I had a concerning result.  If you are going to have your blood fats checked, I would check out this article, it is informative.