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Health Report: The Latest News In Medicine And Related Topics

Washington, 10 June 1999 (FRE/RL) -- This edition of the RFE/RL Health Report features stories on major new efforts against what many health experts believe are the two worst enemies of good health -- obesity and smoking.


Washington -- A former senior U.S. government official who is now one of the nation's leading private campaigners for better public health is inaugurating a new "cyberspace" program to curb obesity -- a condition he says is almost as dangerous as smoking.

Dr. C. Everett Koop, a former U.S. Surgeon General and head of the public health service, told reporters this week that there is ample scientific evidence to support the view that obesity is deadly. At a Washington press conference dedicating a new Internet site devoted to physical fitness, Koop said:

"There is a clear link between diet and the five leading causes of death and disability in the United States. And they are: coronary heart disease; high blood pressure; stroke; diabetes, and some forms of cancer. Today there is conclusive evidence that, after smoking -- which causes an estimated 450,000 deaths in this country every year -- obesity-related conditions are the second-leading cause of preventable death in the United States. Obesity is causing nearly 300,000 lives lost each year."

Koop also said statistics show that obesity-related ailments cost the U.S. some $99 billion a year. He says that if things do not change, obesity rates and the rates of death related to unhealthy body weights will continue to rise in the years to come.

Obesity is an excess of fat on the body. Experts have settled on a mathematical formula called the Body Mass Index, or BMI, for determining when a person is obese. BMI is a ratio between weight and height. It is a formula that correlates with body fat, and BMI is a better predictor of disease risk than body weight alone. Body Mass Index is calculated as weight in kilograms divided by height in meters squared. An overweight person is defined as having a BMI of between 25 and 29.9, while an obese person's BMI is greater than or equal to 30.

While there may be a genetic component to obesity in some people, the condition is generally the result of eating too much and moving too little. The problem is not confined to the U.S. either. The World Health Organization has published several reports stating that rates of obesity for both men and women are on the rise throughout Central and Eastern Europe and the former Soviet Union.

Koop has been a leading advocate for a leaner America ever since he retired from government service in 1988. He was among the first to take advantage of the power of the computer network known as the World Wide Web, or, the Internet, when he established a site called "Shape Up America!" that offered information on food and fitness to anyone with access to the right computer equipment.

This week, Koop announced the expansion of the Internet site to include a "Fitness Center" that will offer anyone connecting to it a cyberspace library of information on physical activity, including fitness programs for men, women and children of any age.

"Physical activity is the most powerful form of preventive medicine we have available to us today, and yet people don't think of physical activity as medicine; and here's why they are wrong: physical activity is beneficial to virtually every system in the body. There is evidence in the scientific literature showing that physical activity improves the respiratory system, the musculo-skeletal system -- which seems more obvious -- and of course the cardio-vascular system."

He said the goal of the fitness center is to help individuals improve their own health by increasing their physical activity and improving their diet. To access the information, go to the Web address: .


Geneva -- Two well-known international institutions -- the United Nations' World Health Organization (WHO) and the World Bank -- are in the midst of major campaigns to encourage individual member governments to adopt strict tobacco control regimes to induce people to quit smoking, or never start.

In a report released last month, the World Bank said developing countries can prevent millions of premature deaths and much disability if they adopt measures to reduce the demand for tobacco. The World Bank study said tobacco control efforts are especially effective among children, adolescents, and the poor.

The study, "Curbing the Epidemic: Governments and the Economics of Tobacco Control," says that to effectively reduce demand, governments can raise cigarette taxes, ban the advertising and promotion of tobacco products, and provide information on the health risks of smoking directly or through research. They can also increase access to nicotine replacement therapy to help those ready to quit smoking.

In releasing the report, World Bank President James Wolfensohn said: "I am happy that we can present a report with hard evidence that even modest measures by governments can lower tobacco use among children. All my life, especially as a parent, I have been concerned about youth tobacco use. Around the world, children suffer under the delusion that tobacco makes them appear sophisticated. The cruel truth is, it will kill them."

According to the Bank, about 1.1 billion people smoke worldwide. By 2025, the number is expected to rise to more than 1.6 billion. The Bank's study says that with current smoking patterns, about 500 million people alive today will eventually be killed by tobacco use. By 2030, the Bank says tobacco is expected to be the single biggest cause of death worldwide, accounting for about 10 million deaths per year.

The World Health Organization, meanwhile, calls tobacco consumption "the single greatest public health risk," in the world. The WHO is now working on a draft international convention to curb the global spread of tobacco use. According to the WHO, the "Framework Convention on Tobacco Control," is to be adopted no later than May 2003.

Derek Yach of the WHO's Tobacco Free Initiative says the protocols will include measures on cigarette pricing policies, antismuggling programs, tobacco advertising and promotion, and cigarette labelling.


London -- In a report from its Budapest correspondent, the British Medical Journal reports that the Hungarian parliament has approved a so-called non-smokers' rights bill that will become law on December 1.

According to the Journal, the law will require restaurants, pubs, and cafes where food is served to provide continuous ventilation and separate areas for non-smokers. Smoking will be allowed in places of public entertainment where carry out food is served, but it will be banned at indoor sports and other public events. It will also be prohibited in schools in rooms used by students; in rooms visited by patients in medical facilities providing primary care or outpatient services; and in pharmacies. Lighting up in enclosed rooms will be banned in most public institutions, on city mass transport, and on suburban trains and buses. Smoking will be allowed in designated compartments on trains, but such compartments will not be required on trains travelling less than 100 kilometers.

The Journal says about 38 percent of Hungary's 10 million people smoke, and more than 30,000 die every year from smoking related causes.