Fewer High School Students Engage in Health Risk Behaviors; Racial and Ethnic Differences Persist

A teenage girl and several teen boys sitting in a classroomFewer U.S. high school students are engaging in health risk behaviors
compared to their counterparts from 15 years ago, according to the 2005 National
Youth Risk Behavior Survey (YRBS), released today by the Centers for Disease
Control and Prevention (CDC). Despite an overall decrease in health risk
behaviors among high school students since 1991, racial and ethnic differences
continue to be evident.

Two highlights of the survey involved seat belt use and alcohol use. High
school students appear to be getting the message to buckle up. The 2005 National
YRBS found only 10 percent of high school students said they rarely or never
wore a seat belt when riding in a car, a dramatic decline from the 18 percent in
2003 and 26 percent in 1991. The percentage of students who report current
alcohol use has also declined dramatically (43 percent in 2005 vs. 51 percent in
1991) since the first YRBS survey.

Other improvements seen during the past 15 years include a decline in the
percentage of high school students reporting ever having sexual intercourse. In
2005, 47 percent of students said they had ever had sexual intercourse, roughly
the same as in the 2003 National YRBS, but down from 54 percent reporting ever
having sexual intercourse in the National YRBS survey in 1991. In addition, 63
percent of sexually active students reported that they or their partner had used
a condom during last sexual intercourse (same as the 2003 National YRBS),
compared to 46 percent in 1991.

“The overall survey results are encouraging because they show us that
persistent efforts to get young people to adopt healthier behaviors can achieve
positive results,” said Howell Wechsler, Ed.D, MPH, director of CDC’s division
of adolescent and school health. “However, the results also illustrate some of
the challenges. One, it does take persistence to achieve results. And two,
despite the overall improvements in health behaviors of teens, racial and ethnic
differences continue to exist.”

Compared with white and Hispanic high school students, black high school
students are least likely to use tobacco, alcohol, cocaine and other drugs, but
most likely to report sexual risk behaviors and sedentary behaviors such as
watching television three or more hours per day. White students are less likely
than black or Hispanic high school students to report physical fighting, sexual
risk behaviors and being overweight, but more likely to engage in frequent
cigarette smoking and episodic heavy drinking. Hispanic students are more likely
than black or white students to report attempted suicide and the use of drugs
like cocaine, heroin and methamphetamines.

“The reasons for these racial and ethnic differences are complex. More
research is needed to assess the impact of education, socio-economic status,
environment, and cultural factors that may contribute to health risk behaviors
among high school students,” Wechsler added.

National, state and local YRBS’s are conducted every two years among high
school students throughout the United States. These surveys monitor health risk
behaviors that lead to unintentional injuries and violence; tobacco, alcohol and
other drug use; and sexual behaviors that can lead to unintended pregnancy or
sexually transmitted diseases. The surveys also measure high school students’
dietary behaviors and physical inactivity that can contribute to overweight.

Nearly 14,000 U.S. high school students participated in the 2005 National
YRBS. Data are presented only for black, Hispanic and white students because the
sample size of students from other racial/ethnic populations was too small for a
meaningful analysis. Parental permission was obtained for students to
participate in the survey. Student participation was voluntary, and responses
were anonymous. States and cities could modify the questionnaire to meet their
needs. The 2005 report includes national data as well as data from surveys
conducted in 40 states and 21 large urban school districts.

The National YRBS is one of three HHS-sponsored surveys that provide data on
substance abuse among youth. The others are the National Survey on Drug Use and
Health (NSDUH), sponsored by the Substance Abuse and Mental Health Services
Administration and a primary source of statistics on substance use among
Americans age 12 and over (www.oas.samhsa.gov/nhsda.htm), and the Monitoring the
Future (MTF) Study funded by the National Institute on Drug Abuse and conducted
by the University of Michigan’s Institute for Social Research
(http://monitoringthefuture.org). MTF tracks substance use among students in the
8th, 10th and 12th grades.

Heart Association Diet Book Offers Recipe for Success

A red heart shape and a medical stethoscope.After being fed a steady diet of faddish and rigid weight-loss plans, Americans
may now have a recipe for permanent success, courtesy of the American Heart

“No-Fad Diet: A Personal Plan for Healthy Weight Loss” is the association’s
first diet book, offering up old-fashioned common sense that is described in the
book as “think smart, eat well and move more.”

The book recommends a three-pronged approach to lasting weight loss:

  • Eat a diet rich in fruits, vegetables, whole grains and lean protein and
    moderate in healthy fats;
  • Become more physically active;
  • Minimize temptations.

The book’s release this month comes as the obesity epidemic threatens the
health of a growing number of Americans. Nearly two-thirds of adults are
overweight or obese, putting them at risk for a variety of ills, including
diabetes, certain cancers, and, of course, heart disease, according to the
federal Centers for Disease Control and Prevention.

“The pendulum is swinging back toward a more reasonable approach to weight
reduction,” said Dr. Robert Eckel, president-elect of the American Heart
Association and assistant professor of medicine at the University of Colorado
School of Medicine. “There is nothing fancy here [in the book]. It’s good, sound
science applied to an everyday approach.”

The book is based on medical research into diet, exercise and behavior with
the common denominator being that no single weight-loss plan works for everyone.
Indeed, there is a menu of three options for cutting back on calories and three
for increasing physical activity.

For example, the “switch and swap approach” recommends making lower-calorie
substitutions. If you usually start your day with a cinnamon roll, try a
cinnamon-raisin English muffin with 2 teaspoons of light tub margarine instead.

For those whose dietary downfall is the quantity of food they consume, the
book outlines “the 75% solution,” in which people eat only three-quarters of the
amount they normally eat. Leaving 25 percent on the plate will help dieters trim
calories from their daily food intake.

And for those who are most comfortable following meal plans, the book has
nearly 200 recipes to try with 1,200-, 1,600- and 2,000-calorie heart-healthy

There are also different suggestions for fitting more physical activity into
the day. Are you someone who spends the majority of the day at a desk? Opt for
the stairs over the elevator and park your car as far as possible from your
office. Or are you energized when you work out with other people? Then,
scheduling exercise classes or team sports may be best for you.

The book also has quizzes to help dieters decide which weight-loss and
activity approach is best for them, and sample forms and questionnaires to help
them gauge their commitment to weight loss, set realistic goals and monitor what
they eat.

To this end, the book recommends keeping food and activity diaries. According
to the National Weight Control Registry, one study found that such diaries
proved valuable to people who lost at least 30 pounds and kept the weight off
for one year or more. This is important because the majority of people who lose
weight will gain it back over time because they can’t stick to a rigid plan.

For this reason, the AHA’s approach is more like a gradual lifestyle change
than a traditional diet, Eckel said.

“There is more to a diet than losing weight. It’s about lifestyle changes
that emphasize physical activity and behavioral changes that are necessary to
accomplish your goals,” he said.

To be sure, the approach is not new. Dietitians have long advocated a diet
rich in fruit, vegetables, whole grains and lean protein and low in fat and
refined sugar. Why then, do the majority of Americans remain overweight?

“A person’s response to food is more complicated than just following a plan,
even for only 25 percent of the time as this diet plan suggests,” said Sharron
Dalton, associate professor in the department of Nutrition, Food Studies, and
Public Health at New York University.

“When our body is overfed and loses its ability to sense fullness and our
mind is stuck with the notion of good/bad food, even the most customized plan
may be more work than pleasure.”

More information

To learn more about the book, visit the American Heart

SOURCES: Robert Eckel, M.D., president-elect, American Heart
Association, and assistant professor of medicine, University of Colorado School
of Medicine; Sharron Dalton, Ph.D., associate professor, department of
nutrition, food studies and public health, New York University, New York City

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