March 6, 2009
NIH Podcast Episode #0079
Balintfy: Welcome to the 79th episode of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health—the nation's medical research agency. I'm your host Joe Balintfy. And coming up in this episode we cover the old and the young. We’ll conclude our three part series on physical activity looking at its importance for older and younger Americans. But first we’ll have two reports: one on the latest trends in teen drug abuse, and another on hypothermia and older adults. That's next on NIH Research Radio.
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Downward Trend in Teen Marijuana Use Slows; Prescription Drug Abuse Remains High
Balintfy: In this first report, there are signs that the ongoing decline in teen marijuana use in recent years has stalled; however the downward trend in cigarette and alcohol use continues, this according to the 2008 Monitoring the Future Survey. The survey—now in its 33rd year—indicates that marijuana use among eighth, tenth, and twelfth graders, which has shown a consistent decline since the mid-1990s, appears to have leveled off. But roughly 11 percent of eighth graders, 24 percent of tenth graders, and 33 percent of twelfth graders still reported marijuana use in the past year.
Volkow: These are still very unacceptably high numbers.
Balintfy: Dr. Nora Volkow is the director of the National Institute on Drug Abuse.
Volkow: Because a significant portion of high school students take marijuana. And it’s also one of the drugs that then predicts utilization of other types of drugs.
Balintfy: The 2008 Monitoring the Future survey also shows a continuing high rate of prescription drug abuse among teens, with little change seen in the past six years. Nearly 10 percent of seniors reported past year nonmedical use of Vicodin, and 4.7 percent report abusing Oxycontin. Both are powerful opioid painkillers. Dr. Volkow points out that seven of the top 10 drugs abused by twelfth graders in the year prior to the survey, were prescribed or purchased over-the-counter.
Volkow: We have not been able to make a dent in the patter of the use of these drugs. Even though in the past five years we’ve seen significant decreases, that is not the case for prescription medications.
Balintfy: There are some bright spots in the survey—among them, that cigarette smoking is at the lowest rate in the history of the survey. And there continues to be a gradual decline in alcohol use in all grades.
Volkow: Still—so this is very good news—but still, the rate of smoking which is ten percent in tenth graders, daily smoking, and the rate of drinking behavior, which is 25 percent, regular drinking behavior, is unacceptably high. So you can take it both ways: It’s very good news, vis-à-vis the patters the trends, but it’s still not a situation where we can become complacent. We still have a lot of prevention work to do.Balintfy: Dr. Volkow reminds that tobacco and alcohol use by teens has devastating related heath costs. Experts are also concerned by what they see as softening of attitudes about some drugs: In particular a continuing decline among twelfth graders who perceive use of LSD as harmful. Similarly, the proportion of eighth graders who perceive inhalants as harmful has declined, as has their disapproval of inhalant abuse. For more on the survey and the dangers of teen drug abuse, visit www.nida.nih.gov.
Hypothermia: A Cold Weather Risk for Older People
Balintfy: Spring may be around the corner, but cold weather can still be a threat for older people. Less obvious than dangers such as broken bones from falls on icy steps, sidewalks or streets, hypothermia is a cold-weather risk for older adults. Hypothermia occurs when a person's body temperature drops below normal and stays low for a prolonged period of time. Dr. Jack Guralnik at the National Institute on Aging says that with advancing age, the body's ability to endure long periods of exposure to cold is lowered, meaning older adults are especially vulnerable.
Guralnik: It’s important to realize that older people, especially those with chronic diseases like diabetes, can develop hypothermia even in environments that for younger people would just seem chilly.
Balintfy: The best way to identify someone with hypothermia is to look for confusion or sleepiness, slowed or slurred speech, shivering or stiffness in the arms and legs, weak pulse, poor control over body movements or slow reactions. Dr. Guralnik recommends a memory aid that can help recognize hypothermia.
Guralnik: It’s called the -umbles. If you can remember mumbles, stumbles, fumbles and grumbles—it can be irritability. Those four -umbles can help you recognize when hypothermia’s there but people’s behavior and ability to function definitely changes as they develop hypothermia.
Balintfy: Dr. Guralnik adds that someone with hypothermia may look puffy or their skin may feel cold. He says if you suspect that someone is suffering from the cold, and you have a thermometer available, take their temperature.
Guralnik: As you know, normal body temperature is 98.6. If their temperature is below 96 degrees, it is actually a medical emergency. You should dial 911. You should start piling on the blankets. If you have an electric blanket, use that. Make sure you take people to the warmest room in the house. If they’re outdoors, bring them into a warm room and keep a close eye on them until medical help arrives.
Balintfy: Dr. Guralnik also emphasizes the importance of preventing hypothermia.
Guralnik: The best way, of course, is to make sure that people remain warm because as you get older, your ability to maintain body temperature does go down. So in the home, it’s important not to let the temperature go too low. It’s recommended that older people set their thermostats to at least 68 to 70 degrees. There are instances where people, even in the home, have developed hypothermia when the thermostat was set in the low 60s.Balintfy: Dr. Gurlnik explains that outside, it’s important to dress properly by wearing several layers of loose clothing, and wearing a hat, scarf and gloves or mittens. For more tips and information about hypothermia, visit www.nia.nih.gov. And coming up after this break, part three of our series on physical activity. We’ll here more from Dr. Guralnik. Stay tuned.
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Physical Activities Guidelines – Part 3 of 3
Balintfy: Welcome back. In this segment, we’re finishing our three part series about the recently released 2008 Physical Activity Guidelines for Americans. We’ll here more from Dr. Jack Guralnik of the National Institute on Aging; he participated in writing the guidelines; and from Dr. Russell Pate of the University of South Carolina; he served on the Physical Activity Guidelines Advisory Committee. As we heard in the previous episodes, the new Physical Activity Guidelines provide science-based guidance to help Americans improve their health through appropriate physical activity. Dr. Guralnik reminds what these guidelines recommen for levels of adults’ physical activity:
Dr. Guralnik: The adult guidelines include a 150 minutes per week of moderate intensity aerobic activity. These are activities such as walking, water aerobics, gardening. An alternative to that is to do half that time or about 75 minutes per week of vigorous physical activities, activities such as jogging or running, swimming laps, hiking uphill, much more vigorous type activities. In addition to these so-called endurance building activities, the guidelines also recommend that people do strength-building activities at least twice a week. This would include things such as working out with weights, using strengthening machines at a gym or using the kind of elastic bands that people use in many exercise classes to build strength.
Balintfy: These guidelines can vary with age, though not as much as you might think. Dr. Guralnik says that as people age, physical activity should remain an important part of their everyday lives.
Dr. Guralnik: The guidelines for older Americans are not all that different than the guidelines for adults. If older people do not have a serious chronic condition that prevents them from exercising, they really can follow the adult guidelines. It’s only when they do have a condition that can interfere with their ability to exercise that they can do work with their health care provider and come up with some alternative to the adult guidelines.
Balintfy: What are some conditions that older adults should keep in mind regarding physical activity?
Dr. Guralnik: Yeah, one thing that’s particularly relevant for older people is in regard to people who have problems with balance and who may fall, and if you’ve had a fall in any time or if you have any problems with your gait or unsteadiness, then it’s important to add a component to your exercise regimen that will improve your balance, and there are relatively simple exercises that people can work with to improve balance and that have actually been demonstrated in scientific studies to reduce the rate of falling.
Balintfy: Dr. Guralnik points out that older Americans should also consider their condition and how it might affect their physical activity regiment.
Dr. Guralnik: Well, let me start out by saying that older people, even people who have fairly serious chronic disease, should still try to get some activity, that even a little bit of activity is better than none at all. Beyond that, people need to consider what their symptoms are, how their disease affects their ability to function and then come up with a program that’s appropriate for them.
Balintfy: With kids, an appropriate program might mean, having fun…
Dr. Pate: Oh, absolutely and, you know, the Committee’s report did allude to the fact that, you know, we believe that kids can and should meet this activity guideline by participating in activity that they enjoy.
Balintfy: Dr. Russell Pate stresses the importance of why children and adolescents should follow these guidelines and adopt a physically active lifestyle.
Dr. Pate: So one important reason for children to be physically active is their health benefits right away. In the longer term, we think as well that it’s very important for children to develop a physically active lifestyle, have very positive experiences with physical activity as young people and establish a physically active lifestyle that they carry forward into adulthood.
Balintfy: With these important benefits, physical activity can play an important role in keeping children and adolescents healthy. Dr. Pate says the guidelines for young people recommend daily activity.
Dr. Pate: The guidelines for children and adolescents emphasize that young people should be physically active for at least an hour a day, 60 minutes.
Balintfy: Within these 60 minutes a day, a variety of physical activities can develop and strengthen different parts of the body. Dr. Pate explains the different activities that should make up the physical activity of children and adolescents.
Dr. Pate: Much of that overall 60 minutes should be in so-called aerobic activities, sustained whole-body activity, but within that, on a regular basis, we recommend at least three days a week, kids should participate in vigorous intensity physical activity like running. Also within that hour a day of activity, they should regularly engage in muscle strengthening activity, resistance exercise, activities that will, you know, develop the musculature of the body, particularly in the abdominal and upper body musculatures. And then as well, within that 60 minutes a day of activity, we recommend that kids engage in bone-loading, bone strengthening activity. We think they should do that at least three days a week. Those activities would involve bounding and jumping, landing-type activities that apply stress to the skeleton and to which bones of the body respond by developing greater strength. It’s very important that kids develop a strong skeleton. It’s during your early years in life that the skeleton develops and kids that lay down lots of bone as young people are at reduced risk for development of osteoporosis later in life.
Balintfy: While the guidelines for adults and older Americans recommend 150 minutes per week, the guidelines for younger people advocate more regular exercise. Are the guidelines for adults and children different?
Dr. Pate: Well, they are in the sense that we do recommend a higher dose of activity on a daily basis for kids. In adults, of course, a range is recommended — 30 minutes per day, at least, and up to 60 minutes, of course, is recommended. So I guess there’s an overlap here in the recommended dose but for kids, the guideline really begins at 60 minutes of activity per day. You know, otherwise, I think there certainly are similarities in the sense that if you look across the adult guidelines, there certainly is a call for participation in moderate to vigorous activity on a regular and sustained basis, a call for participation in resistance exercise for muscle strengthening purposes. And then, you know, certainly in older adults, there’s a call for activity that really is aimed at promoting bone health and minimizing the risk of falls.
Balintfy: The bottom line is that activity has important health benefits for people of all ages. Dr. Guralnik adds that getting started is key.
Dr. Guralnik: There’s a saying that you should start low and go slow and so the best thing is to get out there and begin, even at a low level. Many people think that if they can’t get out and do higher level activity that it’s just not worth it at all, and this is really not the case.Balintfy: Our thanks to Dr. Jack Guralnik from the National Institute on Aging and Dr. Russell Pate from the University of South Carolina for talking with us. Also thanks to Dr. William Duvall, a Presidential Management Fellow here at NIH, for helping writing this last segment. You can check out the website www.health.gov/PAguidelines for more information on these and other important Physical Activity Guidelines.
Balintfy: That’s it for this edition this episode of NIH Research Radio. Please join us again on March 20th when our next edition will be available for download. I'm your host, Joe Balintfy. Thanks for listening. NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.