Each year, the U.S. Centers for Disease Control and Prevention (CDC) compiles data on obesity rates in the United States. State health departments use standard procedures to collect data through a series of monthly telephone interviews with U.S. adults. Obesity is determined by using height and weight information to calculate a number called the “body mass index” (BMI). An adult who has a BMI of 30 or higher is considered obese. Following is a list of the states with the LOWEST percentage of the adult population who are obese with the percent in parentheses.

The top 10 leanest states in America are:

1. Colorado (18.7% of adults are obese)
2. Connecticut (21.2%)
3. Massachusetts (21.3%)
4. Vermont (21.3%)
5. Hawaii (21.4%)
6. Rhode Island (21.4%)
7. Washington DC (21.8%)
8. Montana (21.8%)
9. Utah (21.8%)
10. California (22.6%)

For information on how to achieve and maintain a healthy weight, see the Healia Health Guide on Weight Management. If you have questions about your weight and how it affects your health, or to find support from others who are also struggling with weight management, join the Healia Health Community on Obesity and Overweight.


_{Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, [2007].}

_{Photo: Alpha TangoBravo, Flickr, Creative Commons}

Below is a list of the top 15 healthiest countries in the world as ranked by Forbes magazine. To arrive at their rank, research staff at Forbes examined statistics such as pollution; the percentage of a country's population with access to improved drinking water and sanitation; infant mortality rates; the rate of prevalence of tuberculosis; the density of physicians per 1,000 people; undernourishment rates; and healthy life expectancy for men. Forbes eliminated from the analysis the countries that did not have statistics in every measure (including some that would likely have made the top 15 such as Ireland, Belgium, and Norway.

The 15 healthiest countries in the world are:

1. Iceland
   This small Scandinavian island in the North Atlantic is the healthiest country in the world due to its long healthy life expectancies, low pollution levels, high density of physicians per capita, and low TB and infant mortality rates.
2. Sweden
   The largest of the Scandinavian countries – both in area and population – Sweden has some of the cleanest air in the world. Its infant mortality rate and TB prevalence are some of the lowest in the world. But the physician density, while relatively high, is not enough to knock Iceland from the top spot.
3. Finland
   Rounding out the top three is yet another Scandinavian country. Finland shares the clean air, low TB prevalence, and low infant mortality rate of its regional brethren ahead of it on the list, but comes up just a little short on those measures to crack the top two.
4. Germany
   The German health care system, one of the best in the world, provides one of the highest physician densities on the list and Germany’s clean air solidifies its position in the top five.
5. Switzerland
   Switzerland has the second-highest health spending per capita of all the countries considered and has one of the world’s highest physician densities and longest healthy life expectancies. However, its air pollution levels are higher than the others in the top five.
6. Australia
   Australia has an excellent health care system that requires insurance companies to charge policyholders the same premiums regardless of their status or past. The country also has some of the world’s cleanest air, but its relatively high TB prevalence keeps it out of the top five.
7. Denmark
   While this forth Scandinavian country to make the list has some of the highest income taxes to help pay for the country’s universal health care coverage, the Danish health care system isn’t very efficient, perhaps due in part to its having one of the lowest physician densities on the list. The country does have one of the highest healthy life expectancies on the list.
8. Canada
   Canadians enjoy one of the world's longest life expectancies despite having the lowest physician density on the list. Our neighbor to the north also has one of the lowest TB rates, but gets marked down for its relatively high infant mortality rate.
9. Austria
   Austria has a relatively high physician density and a low infant mortality rate, but its poor air quality and high TB prevalence prevent it form climbing any higher on the list.
10. Netherlands
    This highly urbanized, densely populated nation suffers from pollution in the water, air, and soil, but its low TB rate and average healthy life expectancy keep in the top ten.
11. United States
    The U.S.far outspends any other country on health care, but 15% of the population still lacks health insurance. However the U.S does have the lowest infant mortality rate in the world, the second-highest healthy life expectancy, and a low TB rate.
12. Israel
    Israel has one of the highest levels of air pollution on the list, but its physician density is the highest in the world and life expectancy is average for the countries on the list.
13. Czech Republic
    The Czech Republic has one of the list’s lowest healthy life expectancies as well and relatively poor sanitation and high TB prevalence. However, the country now boasts one of the world’s lowest infant mortality rates.
14. Spain
    A high physician density, healthy life expectancy, and low infant mortality rate make Spain a pretty healthy place to live, but a high tuberculosis rate and air pollution temper this somewhat.
15. France
    France’s excellent health care system, clean air and high density of physicians per capita landed it on the list, while poor wastewater treatment and a high tuberculosis rate kept France from climbing any higher.

_{Source: Forbes Special Report: World's Healthiest Countries, Allison Van Dusen and Ana Patricia Ferrey, April 08, 2008.
Photo: keeshu, MorgueFIle license}

Complementary and alternative medicine and therapies have existed for centuries and continue to be practiced today. Treatments include a range of health practices and products from dietary supplements to acupuncture. Some people use these medicines and therapies to treat specific diseases and health conditions, and others use them for holistic or spiritual reasons. Although studies have shown that some complementary and alternative medicine and therapies are effective for certain indications, the effectiveness of most of these therapies has not yet been shown scientifically.

The top 6 complementary and alternative medicines and therapies among American adults in 2007 are:

1. Dietary supplements (17.7% of people): These include a range of herbs, botanicals, vitamins, and minerals such as fish oil, glucosamine, and Echinacea.


2. Deep breathing exercises (12.7%): These exercises involve slow and deep inhalation and exhalation. Deep breathing is believed to relieve stress and provide relaxation.


3. Meditation (9.4%): This ancient discipline has its origins in Eastern spiritual teachings. People are taught to focus their minds to achieve a heightened sense of awareness, tranquility, and balance.


4. Chiropractic treatment (8.6%): Chiropractors attempt to modify the spine and joints to help relieve pain and improve well-being. Common indications are for the back, headaches, and other injuries.


5. Massage (8.3%): Massage therapists knead muscles and tendons to improve function of connective tissues and to promote calmness and pain relief.


6. Yoga (6.1%: Many types of yoga involve controlled breathing, stretching, and meditation to achieve balance physically, mentally, and spiritually.

For additional information, join the Complementary and Alternative Medicine Support Group on Healia Communities


_{Source: CDC, National Health Statistics Reports, No. 12, based on data from the 2007 National Health Interview Survey conducted by the CDC; http://nccam.nih.gov/news/2008/nhsr12.pdf}

_{Photo: judepics, Flickr, Creative Commons}

If you are looking for a little help with your upcoming New Year’s resolution to shed those extra pounds, the U.S.Food and Drug Administration recommends that you stay away from the computer. Yesterday the FDA issued a warning to consumers to avoid 28 weight loss products sold online because they contain unlisted ingredients that may be dangerous.

The pills are mostly promoted and sold on various Web sites but some are also sold in retail stores. They are sold under names such as Perfect Slim, 2 Day Diet, and Zhen de Shou. Most of the diet pills appear to be coming from China, but for others the provenance is unknown.

Many of the products are touted as “natural,” or “herbal,” or as new versions of "ancient Eastern remedies,” but actually contain potentially harmful ingredients not listed on the product labels or in advertisements. FDA testing found that the pills contained high doses of a powerful anti-obesity drug, as well as a suspected carcinogen and a pharmaceutical that has not been approved by the FDA.

Many of the pills contain sibutramine, a powerful appetite suppressant that is related to amphetamine. Sibutramine is the active ingredient in the prescription drug Meridia, which is used to treat obesity. But FDA testing found that some of the diet pills contain nearly three times the recommended daily dose.

Even at recommended doses, possible side effects of sibutramine include high blood pressure, seizures, tachycardia, palpitations, heart attack, and stroke, especially in people with a history of heart problems. Sibutramine can also interact with other medications but since it is not listed as an ingredient, people taking the pills are unlikely to be aware of these risks.

Rimonabant, another ingredient found in some of these products, was evaluated, but not approved by the FDA for marketing in the United States. The drug, which is approved in Europe, has been associated with increased risk of depression and suicidal thoughts and has been linked to five deaths and 720 adverse reactions in Europe over the last two years.

Several of the pills also contain phenolphthalein, a solution used in chemical experiments and as a laxative that is being withdrawn from the market because it increases the risk of cancer.

According to the FDA, if a product sounds too good to be true, it probably is. If you are taking one of the diet pills on the list, the FDA recommends you taking these pills stop immediately and consult your healthcare professional right away.

The list of tainted pills can be found here on the FDA’s Web site.

For information on healthy ways to lose weight, see the Healia Health Guide on Weight Management. If you want to connect with others interested in losing weight and exchange stories of weight loss successes and frustrations, join the Healia Health Community for Weight Management.

Related blog post: Quick Tips for Eating Healthy and Making Your New Year’s Resolution Come True


_{Photo: tacit requeim, Flickr, Creative Commons}