BRIEFS

All recent editorial material--including original research, review articles, editorials, letters, and book reviews--from JAMA and the Archives Journals is now available online. Users can view complete text versions of the articles and search the single or multiple journals using text words, author names, or related articles. Links to references and abstracts are also included. This collection is available free of charge for a limited time. Users also can receive a free e-mail alert of the journals' tables of contents. To access the online JAMA and Archives Journals articles, visit the AMA's publications Web site at http:// pubs.ama-assn.org.

Most RecentHealth Care Articles

OBESITY INCREASING

Although attempts to lose weight are common in the United States, the prevalence of obesity has been steadily increasing during the past 20 years. On October 27, 1999, JAMA published a theme issue urging that this problem be given higher public health priority. The lead article noted that obesity, defined as a body mass index (BMI) equal to or greater than 30 kg/[m.sup.2], has increased from 12% in 1991 to 17.9% in 1998. Another article concluded that obesity was associated with higher prevalence of high blood cholesterol, high blood pressure, coronary heart disease, osteoporosis, and type 2 diabetes. Other articles dealt with exercise patterns, exercise equipment, the effect of television viewing by children, recent research advances, and physician counseling.

THE USE OF UNCONVENTIONAL TREATMENTS

Using data from the 1996 Medical Expenditure Panel Survey, researchers from Yale University estimated that in 1996, 6.5% of Americans had visits for both unconventional therapies and conventional medical care; 1.8% used only unconventional services; 59.5% used only conventional care; and 32.2% used neither (JAMA 282:651-656, 1999). Chiropractors topped the list of unconventional providers (used by 3.3% of the survey population), followed by massage (2%), herbal remedies (1.8%), spiritual healing (1.8%), nutritional advice (1.1%), acupuncture (0.6%), meditation (0.5%), and homeopathic remedies (0.4%). The researchers concluded that the use of unconventional therapies was substantially lower than had been reported in previous national surveys and was associated with increased use of physician services. Reprints are available from Benjamin Druss, MD, MPH, 950 Campbell Ave., 116A, West Haven, CT 06516.

CANDY BAR PROTEST SUCCEEDS

Nestle USA has agreed to stop using the names "Psycho Sam," "Looney Jerry," and "Weird Wally" for its Tangy Taffy bars. For more than a year, officials of the National Alliance for the Mentally III (NAMI) had tried quietly to persuade Nestle that the names were stereotypes that promoted stigmatization of mental illness. The company maintained that the names were rooted in playful humor that amused children and gave personality to its cartoon characters. It backed down, however, after NAMI called on its network of Stigmabusters and others to protest. Former First Lady Rosalynn Carter also objected.

`NUTRACEUTICAL' BILL INTRODUCED

The Nutraceutical Research and Education Act (HR 3001), introduced by Rep. Frank Pallone (D-NJ), would reward those who do clinical research demonstrating that "natural" substances provide specific health or medical benefit. The bill defines "nutraceutical" as a "dietary supplement, food, or medical food ... that (1) possesses health benefits; and (2)is safe for human consumption in such quantity, and with such frequency, as required to realize such properties." The bill provides that if the FDA approves a petition for approval of a new health claim, the person or company that developed the supporting evidence would be entitled to exclusive use of that claim for ten years. The bill would also establish the Nutraceutical Advisory Council and periodic publication of a Nutraceutical Index listing the claims that have been approved or are still under consideration.

HERBAL GUIDES NOW IN PAPERBACK

The 4th edition of Tyler's Honest Herbal provides a referenced analysis of about 120 herbs and related substances, with each in a separate chapter. Nutrition Forum readers can obtain discounted copies for $21 ($24 Canada) postpaid from Quackwatch, P.O. Box 1747, Allentown, PA 18105. The 3rd edition of Tyler's Herbs of Choice, which discusses the clinical uses, costs $17 ($19 Canada) postpaid.

SOY PROTEIN AND CHD

On October 26, 1999, the FDA authorized the use of health claims about the role of soy protein in reducing the risk of coronary heart disease (CHD) on labeling of foods containing soy protein. The decision was based on evidence that including soy protein in a diet low in saturated fat and cholesterol may help to reduce the risk of CHD. Recent clinical trials have shown that consumption of soy protein compared to other proteins, such as those from milk or meat, can lower total and LDL-cholesterol levels. Foods that carry the claim must also meet the requirements for low fat, low saturated fat, and low cholesterol content; the foods made with the whole soybean may also qualify for the health claim if they contain no fat in addition to that present in the whole soybean. Scientific studies show that 25 grams of soy protein daily in the diet is needed to show a significant cholesterol lowering effect. In order to qualify for this health claim, a food must contain at least 6.25 grams of soy protein per serving. Because soy protein can be added to a variety of foods, it is possible for consumers to eat foods containing it at all three meals and for snacks. The eligible foods include soy beverages, tofu, tempeh, soy-based meat alternatives, and some baked goods. An example of a health claim about the relationship between diet and the reduced risk of heart disease is: "Diets tow in saturated fat and cholesterol that include 25 grams of soy protein a day may reduce the risk of heart disease. One serving of (name of food) provides -- grams of soy protein."