Dog Health

DALLAS (AP) -- Heart patients should be regularly screened for signs of depression, the American Heart Association recommended Monday.

Depression is about three times more common in heart attack survivors and those hospitalized with heart problems than the general population, according to the recommendations published in the journal Circulation. The authors said only about half of heart doctors say they treat depression in their patients - and not all those diagnosed with depression are treated.

"I think we could reduce considerable suffering and improve outcomes," by screening, said Erika Froelicher, professor of nursing at the University of California, San Francisco. "I know we can do more."

While there's no direct evidence that heart patients who are screened fare better, depression can result in poorer outcomes and a poorer quality of life, the panel said. Depressed patients may skip their medications, not change their diet or exercise or take part in rehabilitation programs, they said.

Anyone from cardiologists to nurses to primary care doctors can and should be involved in determining whether a patient is depressed, said Froelicher, who was co-chair of the panel that wrote the recommendations.

The panel suggests that heart patients be screened by first asking two standard questions: In the past two weeks, have you had little interest or pleasure in doing things? Have you felt down, depressed or hopeless?

If the patient answers yes to one or both, a questionnaire is recommended to determine if the patient is depressed and the severity. If depression is indicated, the patient may need to see a professional qualified in treating depression, the panel said, adding that treatment options include antidepressants, seeing a psychotherapist and exercise.

"Some physicians are qualified to treat it - others may be more comfortable referring the problem to a qualified mental health professional," Froelicher said.

Psychiatrist Michelle Riba said the statement's emphasis on frequent screening is important.

"What you want to see in a particular patient is how they do over time," said Riba, past president of the American Psychiatric Association, which has endorsed the heart association's recommendations.

One doctor said screening isn't enough; patients need close monitoring to make sure they get help.

"A lot of patients with depression don't follow up on it," said Dr. Mary Whooley, a professor of medicine at the University of California, San Francisco, who was not on the panel.

Barbara Forman, 62, struggled with depression after her double bypass about five years ago. She said she spent most of her time at her Englewood, Ohio, home sitting in her chair, frequently crying for no reason. When she did get out, she was often winded, even from a walk up a sidewalk to deliver cupcakes to her grandchild's classroom.

"I'm thinking, is this the way it's going to be for the rest of my life? Since I've had a heart event, is my life over?" she said. "It also made me afraid to do things. I didn't know how a heart attack felt. I would think, 'Is this a heart attack?'"

A couple of months after she got home she called Mended Hearts, a group affiliated with the heart association that provides support to heart patients, and talked to someone who let her know depression was common in heart patients.

Her family doctor sent her to a psychologist, and after some initial reluctance, she started taking an antidepressant. That, along with starting a walking routine and volunteering with Mended Hearts and the heart association, improved her outlook.

"You can't sit in your house and just vegetate," she said. "Over the last 18 months to two years - It's really gotten better."

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On the Net:

American Heart Association: http://www.americanheart.org

Mended Hearts: http://www.mendedhearts.org

© 2008 The Associated Press.

WASHINGTON (AP) -- No more wondering where your hamburger came from, or where your lettuce and tomatoes were grown: Starting this week, shoppers will see lots more foods labeled with the country of origin.

It's a law years in the making but timely, as China's milk scandal and the recent salmonella-tainted Mexican peppers prompt growing concern over the safety of imported foods.

Still, hold the import-bashing: Numerous outbreaks in recent years have come from U.S.-produced foods, like spinach grown in California.

Until now, shoppers have had little clue where many everyday foods - meats, fresh fruits and vegetables, certain nuts - originate. That's what the so-called COOL law, for country-of-origin labeling, changes.

Those who want to buy local - or who prefer, say, Chilean grapes and New Zealand lamb - can more easily exercise their purchasing power. Those worried about lax safety regulations in certain countries can avoid those imports. And the next time tomatoes are suspected of food poisoning, consumers may be able to tell investigators they bought only ones grown in a certain region, speeding the probe.

"We do see it as an important step on the road to a more comprehensive system for tracing food items" during outbreaks, says Caroline Smith DeWaal of the Center for Science in the Public Interest.

"It will be a very good thing because we'll have a lot more information," adds Jean Halloran of Consumers Union. But, "you can still be fooled by the COOL label."

How? There are bunches of exceptions. Fresh strawberries get a label but not chocolate-covered ones. Raw peanuts? Label. Roasted ones? No label. Those popular pre-washed salad mixes? Sometimes.

Here are some common questions as shoppers navigate the change:

Q: What does the new law require?

A: That retailers notify customers of the country of origin - including the U.S. - of raw beef, veal, lamb, pork, chicken, goat, wild and farm-raised fish and shellfish, fresh or frozen fruits and vegetables, peanuts, pecans, macadamia nuts and whole ginseng. (The aim was big agricultural commodities; ginseng was added for fear of imports masquerading as U.S.-grown.)

Q: Where will I see the country of origin?

A: Anywhere it fits. The rubber band around asparagus; the plastic wrap on ground beef; the little sticker that says "Gala" on an apple. If a food isn't normally sold in any packaging - such as a bin of fresh green beans or mushrooms - then the store must post a sign.

Q: Aren't many foods already labeled?

A: Some fresh produce already uses origin labeling as advertising. "Fresh from Florida" or "Jersey Grown" or "Vidalia Onion" tags don't have to be changed under the new rules; the shopper should realize they're all U.S. products.

The COOL law mandating such labels first passed in 2002, but lobbying by grocery stores and large meatpackers led Congress to delay the U.S. Department of Agriculture from implementing it. Seafood labeling was phased in first, in 2005 - a key change given recurring safety problems with fish and shellfish from certain countries, including China.

Q: What's the biggest exception?

A: The labels aren't for processed foods, meaning no label if the food is cooked, or an ingredient in a bigger dish or otherwise substantially changed. So plain raw chicken must be labeled but not breaded chicken tenders. Raw pork chops are labeled, but not ham or bacon. Fresh or frozen peas get labeled, but not canned peas. Raw shelled pecans, but not a trail mix.

Q: What if the foods are merely mixed together?

A: They're exempt, too. So cantaloupe slices from Guatemala get labeled. Mix in some Florida watermelon chunks, and no label. Frozen peas, labeled. Frozen peas and carrots, no label. As for bagged salads, USDA considers iceberg and Romaine to be just lettuce, so that bag gets a label. Add some radicchio? No label.

Q: Must all stores comply?

A: No. Meat and seafood sold in butcher shops and fish markets are exempt.

Q: What if companies buy food from various places - beef from both U.S. and Mexican ranchers, for instance?

A: That's a bone of contention between large U.S. meat producers and smaller ranchers that produce exclusively U.S. animals. Tyson Fresh Meats, for instance, says it's too expensive to separate which of its cattle came from which country. So in a July letter to customers, Tyson said it would label all beef "Product of the U.S., Canada or Mexico." The National Farmers Union is protesting; USDA is considering the complaints.

Q: Aren't country labels on some processed foods?

A: Yes, tariff regulations have long required that a food put into consumer-ready packaging abroad be labeled as an import; that doesn't apply to bulk ingredients.

Q: When does the change take effect?

A: The law goes into effect Tuesday, although USDA won't begin fining laggards until spring. Violations can bring a $1,000 penalty.

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EDITOR's NOTE - Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

On the Net:

USDA: http://www.ams.usda.gov

© 2008 The Associated Press.

WASHINGTON (AP) -- The Senate majority leader is putting pressure on other senators to vote quickly on a U.S.-India nuclear cooperation accord, even as opponents of the pact urge careful consideration of an endeavor that would reverse three decades of U.S. nuclear policy.

Despite passage in the House, at least one senator, acting anonymously, has used the Senate's rules to block the accord from coming to a vote in the Senate. Lawmakers are trying to deal with a financial crisis before they leave for the year to campaign for the November elections, but Senate Majority Leader Harry Reid is suggesting that he might call senators back to work in about two weeks for a vote on the accord if objections are not cleared up soon.

Reid spokesman Jim Manley said Monday that Reid, D-Nev., was "doing what he can to try to get it done."

Opponents, meanwhile, are urging the Senate not to rush a deal that would allow U.S. civilian nuclear trade with India in exchange for safeguards and U.N. inspections at India's civilian nuclear plants. Military plants would be off-limits.

Daryl Kimball, executive director of the Arms Control Association, said "legislators should understand what they're voting for before they vote on it. This has not been fully vetted."

The deal is a priority for President Bush and is supported by senior lawmakers of both political parties. It received a boost this month when the 45-nation Nuclear Suppliers Group of countries that supply nuclear material and technology agreed to lift a ban on civilian nuclear trade with India.

Critics say opening India to new nuclear material could spark an atomic arms race in Asia by allowing India to use the extra nuclear fuel that the deal would provide to free up domestic uranium for its weapons program.

India built its bombs outside the Nuclear Non-Proliferation Treaty, which provides civil nuclear trade in exchange for a pledge from nations not to pursue nuclear weapons. The country has faced a nuclear trade ban since its first atomic test in 1974.

Lawmakers must overcome a U.S. law that says they may not ratify the accord for 30 working days after receiving it from Bush on Sept. 10. Lawmakers also were required to hold hearings to study the deal. The Senate's single hearing included only Bush administration officials and no outside witnesses or critics of the agreement.

Speaking after the House approved the accord, Rep. Ed Markey, D-Mass., said it was "outrageous that such a critical vote, one that will forever change the global nonproliferation regime, was taken without the benefit of full congressional review and oversight, as required by the law."

Sharon Squassoni, a nonproliferation analyst with the Carnegie Endowment for International Peace, said the deal has been "a case study in how things should not be done."

"This kind of congressional approval is a farce, and the reason why it's happening is the tremendous political pressure being exerted by the Bush administration on behalf of the Indian government" and Indian-American political action committees, Squassoni said.

© 2008 The Associated Press.

MEXICO CITY (AP) -- Abraham Leon was getting a checkup when he found out he had high blood pressure and was at risk of developing diabetes.

On the spot, the 5-foot-6-inch, 240-pound lab researcher joined "Vamos Por Un Million de Kilos" (Let's Lose a Million Kilos), a national campaign to get Mexicans to collectively trim about 2 million pounds.

The project is one of several new efforts to fight obesity in Mexico, which is on track to catch up with the United States within a decade as one of the world's fattest countries, according to the Mexican government. Nearly half of Mexico's 110 million people are overweight, and the number of fat children has climbed 8 percent a year over the last decade.

"The longer we carry this excess weight, the more serious the problem becomes," said Dr. Samuel Flores Huerta, director of the Department of Community Health at Children's Hospital. "Obesity is costing this country a lot of money."

Mexico is working to mandate more physical education in public schools and encourage employers and unions to give workers time for exercise. The administration of President Felipe Calderon says it has built or renovated more than 800 public sports facilities around the country. The National Institute of Public Health is promoting food education and healthier choices in schools, such as fruits and vegetables instead of chips and soda.

Mexican cuisine has always been high in fat and carbohydrates. But for decades, people living in small villages could not grow enough crops to eat a lot and had to travel long distances to gather more food.

Now, as the middle class grows and more people move to cities seeking work, diets have become laden with processed and fast foods. At the same time, doctors say, Mexicans spend more time in sitting in cars or watching TV.

The country has the disease rates to prove it. According to government statistics, new cases of high blood pressure increased 24 percent in Mexico in just six years, from 2000 to 2006. New cases of Type 2 diabetes, believed to be linked in part to obesity, jumped 31 percent during that time.

Companies spend a lot to market unhealthy foods in Mexico, said Margarita Safdie, an investigator at the public health institute. In one so-called health-conscious promotion, a company offered a free bottle of water to anyone buying two soft drinks.

"It should be the other way around," Safdie said. "It's not that healthy food is much more expensive. What happens is that calories have become cheaper."

At Alvaro Lozano's taco stand in downtown Mexico City, customers line up every day for a choice of fatty meats on two corn tortillas washed down with a sugary soft drink. He said his customers are more concerned about money and time than about health.

Mexicans have also developed a taste for fast food.

"The food is good, and sometimes I don't feel like cooking," said Ana Lopez, 35, a Mexico City homemaker dining at Kentucky Fried Chicken on the Zona Rosa pedestrian mall.

"Vamos Por Un Million de Kilos" came out of a promotional campaign by the Televisa media company, launched after its sports department noticed a certain irony.

"Some of our sportscasters were talking about fitness while they themselves were obese," said Rafael Bustillos, Televisa director of sport. "It was after that that we decided to start creating awareness about this issue."

Advertisers sponsored spots encouraging viewers to eat healthier foods and showing easy and free ways to exercise in a country where few can afford gym memberships. Then the Mexican Institute of Social Security signed on, recruiting clinic patients like Leon for the weight-loss challenge. The campaign reached its goal in just four months with 2 million people.

"We only recommend that people lose a half to a full kilo (1 to 2 pounds) a week," said Dr. Ernesto Krug, a public health unit director. "More than that is not healthy."

The campaign is now starting a second phase, "Vamos Por Mas Kilos" (Let's Lose More Kilos), targeted more widely, including at adolescents.

Leon, 39, has dropped 40 pounds since May. Before his checkup, he ate tacos, burgers and whatever his wife prepared, and didn't exercise. Now he has learned to cook so he can choose healthy ingredients. He takes the stairs at work and walks at least twice a week with his wife. He also tries to be a role model.

"I have tried to tell my brother to do what I did. He's overweight," Leon said. "But he won't listen to me."

Leon plans to lose 20 more pounds. But already he worries less about heart disease and more about how to replace his baggy wardrobe.

"I think that it has paid off," he said. "Physically, I feel great and more secure with myself."

© 2008 The Associated Press.

Health is under the spotlight at the Conservative Party conference where the Tories will set out their ideas for reorganising the NHS.