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New guidelines are needed to improve the diets of U.S. school children, finds a new government report that would set maximum calorie counts for school breakfasts and lunches.

School meals should have less salt; more vegetables, fruits and whole grains; skim and low-fat milk, and other dairy products, the report from the Institute of Medicine says. It called on the federally funded National School Lunch Program and the School Breakfast Program to update its current policies.

“The program was due for a revision,” said IOM committee chairwoman Dr. Virginia A. Stallings, a professor and director of the Nutrition Center at Children’s Hospital of Philadelphia.

The committee’s job was to make recommendations to the U.S. Department of Agriculture, which runs the school meal program, Stallings said. “We expect that they will take this information and revise the program,” she said.

“These recommendations will become regulations, and schools are required to follow them if they are going to get reimbursed for school meals,” she said.

The IOM recommendations would bring school meals in line with the latest dietary guidelines and reference intakes from the U.S. Department of Agriculture. The current standards for school meals are based on the 1995 dietary guidelines and the 1989 recommended dietary allowances.

Increased funding will be needed to implement the changes because of the higher cost of vegetables and whole-grain foods, the report noted. Also, greater federal meal reimbursement, capital investment and additional training of food service personnel will be required for the recommendations to succeed.

But these changes are needed to assure parents that schools are providing healthful, satisfying meals, Stallings said.

“The school meal programs were established when we were worried about children being hungry and undernourished,” she said. “Now we have to worry both about that safety net for children who may not have enough food, but also balance it with a food supply that will prevent the school meals from contributing to the obesity problem.”

In the past, there had only been a minimum calorie amount, Stallings said. “What the committee is now recommending is a minimum and a maximum,” she said.

The report on healthy school meals suggests lunches contain no more than 650 calories for students in grades kindergarten through five; 700 calories for children in grades six to eight, and 850 for those in grades nine to 12. Breakfast calories should not exceed 500, 550 and 600, respectively, for these grade groups.

To ease the adjustment to lower salt meals, the report calls for reducing sodium over the next decade from today’s average of 1,600 milligrams per lunch to 740 milligrams.

In addition, breakfasts should contain one cup of fruit, and lunches for grades nine to 12 should also contain one cup of fruit. No more than half of the fruit should come from juice, the report says.

Vegetable offerings should increase to three-quarters of a cup a day for grades kindergarten through eight, and one cup a day for grades nine to 12. Starchy vegetables, such as potatoes, should be served less often, and at least half a cup each of green leafy vegetables, orange vegetables and legumes should be provided each week, the report said.

For grains, half of the breads and pasta should be whole grain, Stallings said. Milk served with school meals should be skim or 1 percent fat, she added.

Meat with lunches should be kept to about two ounces for all grades, but can be higher for students in high school. For breakfast, meat should be kept to about one ounce a day for children in kindergarten through grade eight, and two ounces for high school students, the report noted.

The National School Lunch Program is available in 99 percent of U.S. public schools and in 83 percent of private and public schools combined. The School Breakfast Program is available in 85 percent of public schools.

About 30.6 million school children participated in the school lunch program in 2007, and 10.1 million children had school breakfasts. In 2007, schools in the program served about 5.1 billion lunches and 1.7 billion breakfasts, according to the report.

Stallings hopes the recommendations will filter down to the meals parents serve at home. “I do believe that parents will be able to use some of this to talk about the kinds of fruits and vegetables they should be serving at home and other recommendations that are easily implemented, like going to skim or low-fat milk and thinking about sodium both in cooking and table salt,” she said.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said “this update to school nutrition standards is timely, and most welcome.”

School nutrition standards were originally devised to protect children from malnutrition and want, Katz noted.

“But in an age of epidemic childhood obesity, when children are far more likely to get too many calories than too few, and when more and more succumb to what was called ‘adult onset’ diabetes just a generation ago, the time-honored school food standards are clearly obsolete,” he said.

A new study suggests there’s a link between suicide and rural communities that have higher numbers of bars.

However, the research doesn’t confirm that more bars mean more suicides because it does not show cause and effect.

The findings were released this month online and will appear in the December issue of Alcoholism: Clinical & Experimental Research.

Of those who commit suicide, about 20 percent are alcoholics, according to background information in a news release from the journal. Almost all are men, and most are white.

Scientists from the Prevention Research Center in Berkeley, Calif., examined suicide statistics from California for 1995 to 2000, comparing them with the density of bars in rural areas.

Suicides occurred more often in less populous areas, such as rural communities, and in areas with older, lower-income white residents, the study found. Attempted suicide also was more common in rural areas. People who attempted suicide, however, were younger and not from a particular race.

“Although one cannot make the strong statement that more bars cause more suicides, our findings are at least consistent with what we would expect if patronizing bars or other alcohol outlets were in fact causally related to suicide,” Fred W. Johnson, associate research scientist and corresponding author for the study, said in the news release.

It’s possible that a factor other than the presence of bars could be at work, Dennis M. Gorman, interim head and professor of epidemiology and biostatistics at the Texas A&M Health Science Center School of Rural Public Health in College Station, said in the release. He was not involved in the study.

“For example, rural places with lots of bars might be depressing places to live in due to isolation, lack of social ties, etc.,” Gorman said. “This ‘depressing’ context would affect all who live there, both drinkers and non-drinkers.”

A French study estimates that more than 12 percent of people discharged from a hospital into home health care are infected with MRSA, or methicillin-resistant Staphylococcus aureus, and about 20 percent of them may transmit the organism to others in their household.

The researchers, Dr. Jean-Christophe Lucet, of Bichat-Claude Bernard Hospital in Paris, and his colleagues, screened 1,501 hospitalized adults for MRSA before they were discharged and found that 191 (12.7 percent) were infected. For the next year, those found to be infected and other people in their households were checked for MRSA every three months.

The 191 people with MRSA had 188 household contacts who took part in the study. Of those contact, 36 (19 percent) acquired MRSA, but none of them developed an infection. People most likely to be colonized with MRSA included those who were older and those who helped provide health care for the infected person. Sharing the same bed or bedroom did not increase the risk of MRSA transmission, according to the study.

The findings suggest that MRSA transmission is most likely among people who are at high risk for hand contamination while caring for people, the study’s authors noted.

Because no infections developed in any of the household contacts who acquired MRSA, it’s not clear whether such transmission poses a serious public health problem, the researchers said. Regardless, “household contacts should apply infection control measures similar to those recommended in the hospital setting,” they wrote.

Of the people discharged from the hospital with MRSA, about half of those followed for a year were found to be clear of infection, especially those who had become more self-sufficient in daily activities, the researchers said.

The study is in the Aug. 10/24 issue of Archives of Internal Medicine.

Swedish researchers say that immunoglobulin M (IgM) is a reliable predictor of cardiovascular complications in people with type 1 diabetes who have diabetic nephropathy (DN) — kidney damage caused by diabetes.

The study included 139 patients who were followed from 1984 to 2007. Those with increased levels of IgM in their urine at the start of the study were about three times more likely to suffer cardiovascular-related death or to progress to end-stage kidney disease.

The study appears in the journal BMC Medicine.

“To our knowledge, this is the first study to investigate the impact of increased urine IgM excretion on DN disease progression in type 1 diabetes patients,” lead researcher Dr. Omran Bakoush of Lund University said in a news release. “We found that those with increased urinary IgM excretion had a higher mortality from cardiovascular causes and higher disease progression rate to end-stage renal disease. This association is largely independent of the level of albuminuria.”

Bakoush said the “findings may offer a new approach to manage this rapidly increasing patient population. While measurement of albuminuria is routinely used to evaluate and manage patients with diabetes, increased urine IgM excretion would identify more specifically patients at risk for serious cardiovascular complications (death and renal failure). If increased urine IgM excretion does reflect advanced atherosclerotic vascular disease, clinical trials would be justified to test whether modifying atherosclerotic factors also decrease mortality and incidence of renal failure in diabetic patients with or without IgM-uria.”

Benefits of Muscle-Strengthening Activities

As people age, they lose muscle. Muscle-strengthening activities can build muscle tissue and help slow the rate of age-related muscle loss. In addition, strengthening activities can maintain the strength of your bones and improve your balance, coordination, and mobility. Older adults who participate in moderate-intensity muscle-strengthening and balance activities are less likely to have falls.
When to Check with Your Doctor

Doing activity that requires moderate effort is safe for most people, regardless of age. However, if you have a health condition such as heart disease, arthritis, or diabetes be sure to talk with your doctor about the types and amounts of physical activity that are right for you.
Tips for Getting Started
Choose activities that work all seven major muscle groups of your body (legs, hips, back, chest, abdomen, shoulders, and arms), such as lifting weights, working with resistance bands, doing exercises that use your body weight for resistance (such as push-ups and sit-ups), or yoga.
Try to do 8–12 repetitions per strengthening activity. A repetition is one complete movement of an activity, like lifting a weight or doing one sit-up. To develop muscle strength and endurance, the number of strengthening activities needs to be done to the point where it’s hard for you to do another repetition without help.
Strive to increase the weight that you currently lift when it becomes too easy. Muscles are strengthened by progressively increasing the weight you lift over time. When you can lift the weight 8–12 times easily, it may be time to increase the amount of weight at your next session.
You can do muscle-strengthening activities in a number of settings, including your home or a gym. For examples of activities you may want to try, visit Growing Stronger – Strength Training for Older Adults: Exercises, Muscle Strengthening at Home, and Muscle Strengthening at the Gym.
Staying Safe and Avoiding Injury

Muscle strengthening is generally safe for everyone. Here are some things you can do to stay safe while strengthening your muscles:
If you haven’t been active in a while, start slowly and build up.
Choose muscle-strengthening activities that are appropriate for your fitness level.
Maintain good posture when performing all activities.
When picking weights up from the floor (or putting them down), use your legs—not your back.
See a health care provider if you have a health condition.

Muscle-strengthening activities can provide numerous health benefits, particularly as you grow older. There are many ways you can strengthen your muscles, whether it’s at home or the gym. The activities you choose should work all the major muscle groups of your body (legs, hips, back, chest, abdomen, shoulders, and arms).

No matter your age, regular physical activity is one of the most important things you can do for your health. And if you’re an older adult (65 years of age or older), regular physical activity is essential for healthy aging. To get the health benefits of physical activity, not only do you need to do aerobic activities that make you breathe harder and your heart beat faster, but you also need to do strengthening activities to make your muscles stronger.

According to the 2008 Physical Activity Guidelines for Americans, older adults gain substantial health benefits from 2 hours and 30 minutes (150 minutes) a week of moderate-intensity aerobic activity (i.e., brisk walking), in combination with muscle-strengthening activities on 2 or more days a week that work all seven major muscle groups—your legs, hips, back, abdomen, chest, shoulders, and arms.

A new technique that transforms embryonic and adult stem cells into six types of mature white blood cells could produce blood cells with specific defects for use by researchers studying the development and treatment of disease.

The method, devised by University of Wisconsin-Madison researchers, could also be used to grow specific types of immune cells to target specific infections or tumors, or to test the safety of new drugs, they said.

The researchers exposed two types of stem cells to a variety of compounds and eventually found a “recipe” that caused the stem cells to turn into different types of adult cells. Their study appears in the Aug. 10 online edition of the Journal of Clinical Investigation.

“While we now can make almost all types of blood cells from embryonic and adult pluripotent stem cells, the next major challenge is to produce blood stem cells (called hematopoetic stem cells) that might be used in a bone marrow transplant,” study leader Igor Slukvin, an assistant professor in the department of pathology and laboratory medicine, said in a university news release.

Bone marrow transplants can save the lives of patients with blood cancer, but more than one-third of patients can’t find a well-matched bone marrow donor. These patients are at risk for graft-versus-host disease, a sometimes fatal attack on the patient by the transferred immune system. Using blood-forming stem cells created from a patient’s own stem cells should eliminate bone marrow compatibility problems, Slukvin said.

This embarrassing situation of failing to maintain an erection until ejaculation is often referred to as impotence. Whatever its underlying physiological and psychological causes are, this condition was once a taboo subject.

Thanks to recent heavy advertisements on drugs in this category, and much publicity of high-interest stories, taking remedial medications such as Levitra has

become a more accepted norm.

Levitra is an FDA-approved oral medication that is available only by prescription. It works by relaxing your muscles to increase blood flow to the penis. The extra flow of blood will engorge the penis thus helping men get a harder erection. Moreover, Levitra works by preventing blood from flowing out of the penis. This helps you keep a longer-lasting erection. Generally, after the sexual activity ceases, the erection will go away. If the penis persists in staying erect for more than 4 hours, seek medical attention to avoid long-term injury. To buy cheap levitra visit:  Online Pharmacy

Certain other medications can work to inhibit the elimination of enzymes that are stimulated by Levitra. People who are on medications such as erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir) are recommended to take lower dosages of Levitra. In addition, the time between each dosage may need to be extended. Normally a minimal initial dosage of 10 mg per day is recommended.

Common Levitra adverse drug reactions include nausea. Infrequent ADRs include abdominal pain, back pain, photosensitivity, abnormal vision, eye pain, facial oedema, hypertension, palpitation, tachycardia, arthralgia, myalgia, rash, itch, and priapism. The side effects reported in clinical trials include headache, flushing and stuffy or runny nose. In extremely rare cases, report to doctor immediately, if you have a sudden decrease or loss of vision, in one or both eyes.

However, what is special about Levitra is that people with high blood pressure, high cholesterol levels, and even diabetics, have been found to be safely taking this medication. These health factors don’t seem to impede these men from enjoying increased sexual activities after taking it. As with taking any new medications, it is always best to ask your doctor about drug interactions with your existing medications, and with your present medical conditions.

So before taking Levitra, talk to your doctor if you have or have had a history of heart disease such as irregular heart rhythms or angina, or congestive heart failure, or heart attacks. Make your doctor aware of any history of stroke, blood clots, blood pressure problems, kidney disease, liver disease, blood cell disorder, bleeding disorder, stomach ulcers, retinitis pigmentosa, penis deformity, or if, for health reasons, you cannot engage in sexual intercourse.

If any of those conditions apply to you, your physician may choose one of three options. First, he or she may decide to seek an alternative to Levitra all together. He or she may also reduce the regular dosage for your case, or continually observe and test your health during treatment.

A depressed emotional state — feelings of hopelessness and apathy — could have a direct effect on your physical health, new research indicates.

A study of stroke survivors found a slower rate of recovery among those experiencing apathy, caring little about themselves and the world around them. And a study of healthy middle-aged women found an association between hopelessness and unexpected thickening of the carotid artery, the main blood vessel to the brain.

Both findings are reported in the Aug. 27 issue of Stroke.

The apathy study was triggered by a 2006 paper on Parkinson’s disease in a different journal, said Nancy E. Mayo, a professor of medicine at McGill University in Montreal, and lead author of the apathy study. “It said that if patients were apathetic the best thing was just to leave them alone,” she said. “I was incensed that the author said we just shouldn’t care.”

So Mayo launched a study in which 408 family caregivers of stroke survivors filled out apathy questionnaires every four months, asking whether the survivor “waits for someone to do things that he or she can do for self,” or “just sits and watches” and the like.

It’s an admittedly imperfect method of measurement, Mayo said, “but we used what we had.” Reports indicated that a third of the stroke survivors had minor apathy through the first year, with 3 percent having high levels of apathy. Apathy worsened for 7 percent of the survivors, and eased for 7 percent during the year.

Measurements of physical function showed that “even very minor apathy had just as strong an impact on recovery as major apathy,” Mayo said. Answers about the quality of life of the stroke survivors, such as their engagement in social activities, found lesser improvement among those whose apathy worsened.

It’s not clear what can be done to help in such a situation, Mayo said, in large part because very little research has been done on apathy. “You can’t fix what you can’t measure,” she said. “This is a first attempt to sort things out. Since no one is paying attention, it is not surprising there are no treatments for it.”

Drug therapy is a vague possibility, along with behavioral therapy. “We don’t have anything that has evidence-based data other than being kind and enthusiastic,” Mayo said. “Were looking at clues from addiction research. There needs to be a lot of work.”

The report on the physical effect of hopelessness was an offshoot of a nationwide study of cardiovascular disease in women, said study author Susan A. Everson-Rose, an associate professor of medicine at the University of Minnesota.

She and her colleagues singled out 559 menopausal women with no history of cardiovascular disease to answer a two-item questionnaire about their expectations regarding future goals.

A previous study led by Everson-Rose, using the same questionnaire in Finnish men, found an association between hopelessness and cardiovascular disease outcome, she said, as did another study in women with documented cardiovascular disease.

This new study found a direct relationship between rising hopelessness and thickening of the lining of the carotid artery, a risk factor for stroke. Overall, women measuring higher on the hopelessness scale had .02 millimeters more thickening, equal to the amount caused by one year of aging. Women with the highest hopeless scores had an average .06 millimeters greater thickening than those with the lowest scores.

“This doesn’t necessarily mean that hopelessness had a direct physical effect, since it could be operating through mechanisms we didn’t measure,” Everson-Rose said.

But there is a clinical message, she said: “Physicians should tell patients that emotional states can have a physical effect, and that they should seek appropriate treatment for them. Psychiatric treatment for severe depression and hopelessness is warranted.”

Medical imaging tests nearly double the amount of radiation Americans would otherwise be exposed to, new research shows.

CT scans and nuclear imaging contributed to more than three-quarters of the exposure, and more than 80 percent of the procedures were performed on an outpatient, said Dr. Reza Fazel, senior author of a study appearing in the Aug. 27 issue of the New England Journal of Medicine.

“We don’t want to scare people and have them refuse procedures. The individual risk in any patient is very small. If it’s going to benefit the patient, it’s well worth the risk,” said Fazel, who is an assistant professor of medicine in the division of cardiology at Emory University School of Medicine in Atlanta.

But one expert called for further research on the subject.

“It’s striking that such a large proportion of the non-elderly population is being exposed to at least a moderate amount of radiation,” said Dr. Michael S. Lauer, who wrote an accompanying perspective in the same issue of the journal. “This is an opportunity to stimulate us to do the trials we need to do to figure out the value of all these tests.”

In the meantime, he added, “physicians need to know about the risks and communicate them, and patients need to talk with their doctor and understand why they’re getting the procedure.”

Although there are masses of trials demonstrating the benefit of mammographies, the values of other types of tests, most notably cardiovascular ones, are much less clear.

“We’re actually working in a knowledge vacuum,” said Lauer, who is director of the Divisions of Prevention and Population Sciences and of Cardiovascular Diseases at the U.S. National Heart, Lung, and Blood Institute. “What we know is that the radiation exposure that people are getting now might entail a risk but we don’t know the benefit.”

Up to 2 percent of all cancers in the United States may be due to CT scans, Lauer added.

And Harvard researchers reported in March that cumulative exposure to radiation from CT scans alone can increase the risk for cancer by as much as 12 percent.

According to this latest study, the number of CT scans performed since 1992 has quadrupled. The test used most frequently, and with the highest amount of radiation, is a myocardial perfusion scan to assess blood flow through the heart or trace damaged heart muscle. Use of that scan increased more than 6 percent each year between 1993 and 2001, the researchers found.

The authors looked at records on nearly 1 million adults aged 18 to 64 in five regions across the United States: Arizona, Texas, Wisconsin, South Florida and North Florida. All participants were enrolled in the same insurance plan.

During the study period, which lasted from the beginning of 2005 to the end of 2007, almost 70 percent of the participants had at least one imaging procedure that exposed them to radiation.

“That’s a huge proportion,” Fazel said.

Although the mean cumulative exposure was 2.4 millisieverts (mSv) per year, considered a low dose, the design of the study allowed the researchers to find wide variations.

Cumulative doses tended to be higher in women and in older people.

A “sizable minority” received moderate-, high- and very high-intensity doses, defined as 3-20 mSv per year, 20-50 mSv per year and more than 50 mSv a year, respectively.

By way of comparison, health-care workers and those who work in the nuclear industry are only allowed to be exposed to 20 mSv per year.

“More than 2 percent had very high doses, higher levels than radiation workers,” said study author Dr. Andrew J. Einstein, director of cardiac computed tomography research and an assistant professor of clinical medicine at Columbia University Medical Center and New York-Presbyterian Hospital in New York City.