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Am Fam Physician. 2004;69(1):26

It's official: every bit of physical activity counts. In the report of a 2001 state-based survey on physical activity in Americans, published in the Morbidity and Mortality Weekly Report, the U.S. Centers for Disease Control and Prevention (CDC) expanded its definition of physical activity to include nontraditional forms of exercise such as gardening, vacuuming, and walking while doing errands. Even with the new definition, only 45 percent of American adults get enough physical activity. The CDC and the American College of Sports Medicine recommend that adults engage in moderate-intensity physical activity for at least 30 minutes on most days of the week.

Good news: the doctor-patient relationship is still trusted and valued. As reported in BMJ and at the World Medical Association's annual general assembly in Helsinki, a study of 3,707 patients and physicians in the United States, United Kingdom, Canada, Germany, South Africa, and Japan showed that the patient-doctor relationship is second in importance only to family relationships, and that physicians still are considered to be the most trusted source of health information. In telephone interviews, patients indicated that they feel more confident now than 10 years ago in dealing with the medical profession. The researchers warned that to keep their high status, physicians will have to meet higher expectations of care on the part of their patients.

Welfare work requirements may be an obstacle to breastfeeding, according to survey findings published in Demography. Researchers estimated that breastfeeding rates six months after birth would have been 5.5 percent higher in 2000 if not for the welfare work requirements adopted in 1996. The researchers evaluated data on breastfeeding from annual mail surveys of 100,000 new mothers (1990 to 2000) and compared national trends before and after new state welfare policies took effect. The greatest impact on breastfeeding rates was from combined policies (in 28 states) that require at least 18 hours of work a week and sanction the withholding of all benefits if that work requirement is not met.

Distal forearm fractures have become more common in children and adolescents over the past 30 years. A population-based study conducted in Rochester, Minn., and published in JAMA reports that from 1969 to 2001, the incidence of distal forearm fractures rose 56 percent in girls and 32 percent in boys. The largest increases occurred among children in early puberty. Further studies are needed to determine if the increase is due to changing patterns of physical activity, poor calcium intake, or both.

A benefit from eating fish—it lowers the heart rate. Because a high heart rate is associated with an increased risk of sudden death, this discovery may explain the lower risk of sudden death in people who eat fish regularly, according to a study published in Circulation. In a cross-sectional analysis of 9,758 men 50 to 59 years of age, researchers found that eating fish was linked with a decreased heart rate in the men who did not have a history of coronary heart disease. While it is unclear exactly how fish flesh affects the heart rate, researchers point out that long-chain n-3 fatty acids in fish provide cardiovascular benefits and probably help to prevent fatal cardiac events.

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