Key findings:

Pakistan and New Zealand teams and officials November 28 observed a minute silence and wore black armbands in memory of young Australian batsman Phillip Hughes to join the world in mourning. Phillip Hughes was a player at Western Suburbs. Pakistani cricket captain Misbah-ul-Haq R stands next to bats and caps placed outside the Pakistani dressing room to match the campaign putoutyourbats" launched in respect of Australian cricketer Phillip Hughes who died after being hit by a ball during a domestic cricket match in Sydney, at the Sharjah cricket stadium in Sharjah on November 28, The Adelaide Oval scoreboard displays a message of mourning after the death of South Australia batsman Phillip Hughes.

Morne de Klerk Photo: Condolences for Australian cricketer Phillip Hughes who died after being hit by a ball during a Sheffield Shield game are displayed on a screen during the fourth one-day international ODI match between Bangladesh and Zimbabwe at the Sher-e Bangla National Stadium in Dhaka on November 28, Munir uz Zaman Photo: Flowers and a baggy green form a tribute at the Lord's Grace Gate today.

A woman looks at flowers amongst other tributes next to a photograph of Phil Hughes outside the Adelaide Oval on November 28, Lord's cricket ground tweeted this photo of the MCC flag lowered behind the Compton Stand at the famed cricket venue on November 27, Hughes was born and raised in Macksville and died on November 27 due to injuries he sustained during a Sheffield Shield game two days prior.

Phillip Hughes dies from head injury at age 25 Hughes condition 'incredibly rare' with only one other case resulting from cricket ball Young cricketers must learn to avoid short-pitched bowling, says expert Cricket helmets have made batsmen feel too safe: Eulogies and tributes for Phillip Hughes Watch: Clarke's tribute to Hughes Hughes remembered In pictures: Quiet achiever with great promise contains footage of fatal injury Jim Maxwell: One of worst days in Australian sport In pictures: Judge lashes former Trump national security adviser Analysis: In just one sentence McCormack highlighted the crisis in the Nationals Groundbreaking director and actress Penny Marshall dead at 75 Glitter fart bomb booby trap rigged to ruin parcel thieves' day Your hotel room looks nothing like the ad?

Here's what you can do Banned from Facebook, 'nights of debauchery': How kids act when dad is a world leader Mysteriously preserved stretch of underwater sand dunes stumps scientists Why is the Northern Territory in so much debt? Preparing babies for emergencies in storm and bushfire season Fact check: Is the Pacific island nation of Tuvalu growing, and not sinking? Locals seek return of historic 'very good water' rock 'Out of touch': NSW Energy Minister splits with federal colleagues on climate policy Christmas beetle-mania is in full swing and their traits may surprise you Far too many women are bracing for a dark side of Christmas that happens each year Isabella disproves her diagnosis by taking first steps Extreme heat wipes out 23, flying foxes Stalker tries to sue woman to track her down after 'love at first sight' in Chinese bookstore Police identify body of boy found dead near Wagga Wagga Why walkable city centres could make Australia richer SPORT Analysis: Perth Stadium can rival the MCG and cement its place as one of the great cricket venues.

Connect with ABC News. Got a news tip? Editorial Policies Read about our editorial guiding principles and the enforceable standard our journalists follow. Helping a lonely person this Christmas If someone you know fits that profile, there are steps you can take to help them feel connected. Making reading fun It can be hard to get teenagers to switch off the screen and pick up a book instead. As of June , 27 states and the District of Columbia had laws that prohibited smoking in indoor areas of worksites, restaurants, and bars; no states had such laws in As of June , 9 states had no laws banning or restricting areas for smoking in private workplaces.

In , 30 of the 50 largest US cities prohibited indoor smoking in private workplaces, through either state or local ordinances. During to , the percentage of nonsmokers with detectable serum cotinine was The percentage was also higher for non-Hispanic blacks People living below the poverty level Global Burden of Smoking Although tobacco use in the United States has been declining, tobacco use worldwide has climbed steeply and is currently responsible for 5 million deaths annually.


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The number of smokers was estimated to have grown from million in to million in Worldwide, tobacco smoking including second-hand smoke was 1 of the top 3 leading risk factors for disease and contributed to an estimated 6. These standards include the use of tax policies to reduce tobacco consumption, a ban on the indoor use of tobacco products, implementation of educational programs about the dangers of tobacco use, and restrictions of the sale of tobacco products to international travelers.

The Health Consequences of Smoking. Center for Behavioral Health Statistics and Quality. National Academy of Sciences; The Health Consequences of Smoking: A Report of the Surgeon General. Current cigarette smoking among adults: Smoking and mental illness: Conditional substance abuse and dependence by diagnosis of mood or anxiety disorder or schizophrenia in the U.

Trends in smoking among adults with mental illness and association between mental health treatment and smoking cessation. Substance Abuse and Mental health Services Administration; The state of US Health, — Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: Smoking-attributable mortality in American Indians: Tobacco control and the reduction in smoking-related premature deaths in the United States, — How Tobacco Smoke Causes Disease: Systematic review of cigar smoking and all cause and smoking related mortality. Myocardial infarction among Danish HIV-infected individuals: Huxley RR, Woodward M.

Cigarette smoking as a risk factor for coronary heart disease in women compared with men: Cigarette smoking, systolic blood pressure, and cardiovascular diseases in the Asia-Pacific region. Ischaemic stroke and combined oral contraceptives: Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: Smoking as a risk factor for stroke in women compared with men: Guidelines for the primary prevention of stroke: Expert Rev Cardiovasc Ther.

Acute effects of waterpipe smoking on blood pressure and heart rate: Annual healthcare spending attributable to cigarette smoking: Am J Prev Med. A Report of the Surgeon General, Community reductions in youth smoking after raising the minimum tobacco sales age to Have Tobacco 21 laws come of age? A clinical practice guideline for treating tobacco use and dependence: Public Health Service report.

Varenicline for smoking cessation in hospitalized patients with acute coronary syndrome. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders EA-GLES: Long-term nicotine replacement therapy: Randomized trial of four financial-incentive programs for smoking cessation. Smith AL, Chapman S. A cost-effectiveness analysis of the first federally funded antismoking campaign. Frieden T, Yox S. Medscape; Feb 6, Four hundred and sixty brands of e-cigarettes and counting: Farsalinos KE, Polosa R.

Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: Ther Adv Drug Saf. A systematic review of health effects of electronic cigarettes. The regulatory challenge of electronic cigarettes. The renormalization of smoking? Acute impact of tobacco vs electronic cigarette smoking on oxidative stress and vascular function. Goniewicz ML, Lee L. Electronic cigarettes are a source of thirdhand exposure to nicotine.

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Tobacco use among middle and high school students—United States, — Trends in awareness and use of electronic cigarettes among US adults, — FDA proposes to extend its tobacco authority to additional tobacco products, including e-cigarettes [news release] Silver Spring, MD: Deeming tobacco products to be subject to the federal Food, Drug, and Cosmetic Act, as amended by the Family Smoking Prevention and Tobacco Control Act; restrictions on the sale and distribution of tobacco products and required warning statements for tobacco products: Risk of all-cause mortality and cardiovascular disease associated with secondhand smoke exposure: State and local comprehensive smoke-free laws for worksites, restaurants, and bars: Meta-analysis of the effect of comprehensive smoke-free legislation on acute coronary events.

Smoking prevalence and cigarette consumption in countries, — A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, — Worldwide burden of disease from exposure to second-hand smoke: NH indicates non-Hispanic; and PA, physical activity.

Abbreviations Used in Chapter 4. Defining and Measuring PA There are 4 dimensions of PA mode or type, frequency, duration, and intensity and 4 common domains occupational, domestic, transportation, and leisure time. The prevalence of inactivity was highest among non-Hispanic black There was substantial variation by state.

The state reporting the highest prevalence of inactivity was Mississippi At each grade level, the prevalence was higher in boys than in girls. More than double the percentage of high school boys The prevalence of students meeting currently recommended levels of physical activity defined as having been physically active at least 60 minutes per day on at least 5 of the 7 days was higher among non-Hispanic white boys More high school boys At each grade level, the proportion was higher in boys than in girls. From to , the computer usage rate increased significantly from The rate of computer use increased much more dramatically from to Structured Activity Participation Despite recommendations from the National Association for Sport and Physical Education that schools should require daily physical education for students in kindergarten through 12th grade, 10 in only Daily physical education class participation declined from the 9th grade Just over half Inactivity was higher among females than males Hispanic and non-Hispanic black adults were more likely to be inactive The proportion of respondents who met the federal aerobic PA guidelines declined with age for both males and females.

Age-adjusted prevalence was Among both males and females, non-Hispanic whites were more likely to meet the PA aerobic guidelines with leisure-time activity than non-Hispanic blacks and Hispanics Chart Education was positively associated with meeting the federal guidelines.

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Adults residing in urban metropolitan statistical areas are more likely to meet the federal aerobic PA guidelines than those residing in rural areas The federal guidelines do not set different PA standards by age, disability status, or other factors. Instead, the federal guidelines recommend being as physically active as abilities and conditions permit.

Adults with a disability defined by the constructs any basic actions difficulty or complex activity limitation were less likely to meet the aerobic PA guidelines than those without a disability For adolescents ages 12 to 15 years, boys in all age groups were more likely to have adequate levels of cardiorespiratory fitness than girls 12 Chart Among adults 20 to 59 years of age, 3. Accelerometry data from NHANES to showed that males engaged in 35 minutes and females in 21 minutes of moderate activity per day.

Levels of activity declined sharply after the age of 50 years in all groups. Mortality According to the WHO, physical inactivity is the fourth-leading risk factor for global death, responsible for 3. The Global Burden of Disease investigators estimated that worldwide, physical inactivity contributed to 2.

This protective effect of PA was dose dependent; the most rapid reduction in mortality per minute of added PA was for those at the lowest levels of PA. These findings suggest that older adults can benefit from PA time far below the amount recommended by the federal guidelines. A study of US adults that linked a large, nationally representative sample to death records found that meeting the aerobic PA guidelines reduced all-cause mortality, with an HR of 0. If this is a causal relationship, this low level of PA would confer a 1.

For participants meeting the PA guidelines, the gain in life expectancy was 3. With television watching as a sedentary activity, 2 hours of television per day is associated with an RR for type 2 DM of 1. In a year study of older male veterans, an inverse, graded, and independent association between impaired exercise capacity and all-cause mortality risk was found. In the Cooper Center Longitudinal Study, an analysis conducted on 16 participants revealed that across all risk factor strata, the presence of low cardiorespiratory fitness was associated with a greater risk of CVD death over a mean follow-up of 28 years.

Both PA beneficial and sedentary time detrimental were associated with mortality risk. A population-based cohort in New South Wales, Australia, of adults followed up for an average of 6. It found that compared with those who reported no moderate to vigorous PA, the adjusted HRs for all-cause mortality were 0. An analysis of pooled data from 6 studies in the National Cancer Institute Cohort Consortium involving males and females followed up for an average of Thus, meeting the minimum PA guidelines for Americans through either moderate- or vigorous-intensity activities was essentially associated with a nearly optimal reduction in mortality risk.

This study supports the view that although healthcare professionals should encourage inactive people to become physically active, they should not discourage adults who are already very active at levels far above those recommended by the guidelines. A study that prospectively assessed the association of continuous inactivity and of changes in sitting time for 2 years with subsequent long-term all-cause mortality found that compared with people who remained consistently sedentary, the HRs for mortality were 0.

Thus, participants who reduced their sitting time over 2 years experienced a reduction in mortality. Although more PA was associated with larger reductions in future all-cause mortality and CVD, in patients with DM, any amount of habitual PA was better than inactivity. Costs The economic consequences of physical inactivity are substantial.

Using data derived primarily from WHO publications and data warehouses, one study estimated the economic costs of physical inactivity account for 1. Costs included visits to general practitioners, medical specialists, and outpatient pathology and radiology services. A study of American adults reported that inadequate levels of aerobic PA after adjusting for BMI were associated with an estimated Healthcare costs included hospitalizations, prescribed medications, outpatient visits hospital outpatient visits and office-based visits , ED visits, and other expenditures dental visits, vision aid, home health care, and other medical supplies.

The prevalence increased from to Among adolescents nationwide, the prevalence of attending physical education classes at least once per week did not change substantively between Among high school students, the prevalence of attendance in daily physical education classes changed in nonlinear ways over time. Attendance initially decreased from to from In , the prevalence of adolescents aged 12 to 15 years with adequate levels of cardiorespiratory fitness based on age- and sex-specific standards was The age-adjusted percentage of US adults who met both the muscle-strengthening and aerobic guidelines increased from Cardiovascular Health Impact Youth Total and vigorous PA are inversely correlated with body fat and the prevalence of obesity.

Among children 4 to 18 years of age, increased time spent engaging in moderate to vigorous PA was associated with improvements in waist circumference, SBP, fasting triglycerides, HDL-C, and insulin. Among children aged 4 to 18 years, both higher activity levels and lower sedentary time measured by accelerometry were associated with more favorable metabolic risk factor profiles. A review of the US Preventive Services Task Force recommendations examined the evidence on whether relevant counseling interventions for a healthful diet and PA in primary care modify self-reported behaviors, intermediate physiological outcomes, DM incidence, and cardiovascular morbidity or mortality in adults with CVD risk factors.

It was concluded that after 12 to 24 months, intensive lifestyle counseling for individuals selected because of risk factors reduced TC levels by an average of 0. Highly active males gained 2. In 3 US cohort studies, males and females who increased their PA over time gained less weight in the long term, whereas those who decreased their PA over time gained more weight and those who maintained their current PA had intermediate weight gain. Among US males and females, every hour per day of increased television watching was associated with 0.

Longitudinal studies commonly report a graded, inverse association of PA amount and duration ie, dosage with incident CHD and stroke. A meta-analysis of 23 studies on the association of PA with stroke indicated that compared with low levels of activity, high RR, 0. In a study involving 1. However, strenuous PA was not found to be as beneficial as moderate PA.

In a large clinical trial NAVIGATOR involving people with impaired glucose tolerance, ambulatory activity assessed by pedometer at baseline and 12 months was found to be inversely associated with risk of a cardiovascular event. Self-reported low lifetime recreational activity has been associated with increased PAD. Primordial and Primary Prevention Community-level interventions have been shown to be effective in promoting increased PA. Communities can encourage walking with street design that includes side-walks, improved street lighting, and landscaping design that reduces traffic speed to improve pedestrian safety.

Schools can provide opportunities for PA through physical education, recess, after-school activity programs, and PA breaks. Despite these recommendations, only one-quarter of students participate in daily PA classes see Structured Activity Participation. Worksites can offer access to onsite exercise facilities or employer-subsidized off-site exercise facilities to encourage PA among employees. Such campaigns include a variety of strategies, such as media coverage, risk factor screening and education, community events, and policy or environmental changes. A systematic review of population-based interventions to encourage PA found that improving biking trails, distributing pedometers, and school-based PA were most cost-effective.

Educating the public on the recommended PA guidelines may increase adherence. Interventions and community strategies to increase PA have been shown to be cost-effective in terms of reducing medical costs PA improves inflammatory markers in people with existing stable CHD. After a 6-week training session, CRP levels declined by In a randomized trial of patients with PAD, supervised treadmill exercise training and lower-extremity resistance training were each associated with significant improvements in functional performance and quality of life compared with a usual-care control group.

Exercise training also improved brachial artery FMD, whereas resistance training was associated with better stair-climbing ability than control. On the basis of a meta-analysis of 34 RCTs, exercise-based cardiac rehabilitation after MI was associated with lower rates of reinfarction, cardiac mortality, and overall mortality. The benefit of intense exercise training for cardiac rehabilitation in people with HF was tested in a trial of 27 patients with stable, medically treated HF.

Exercise training in patients with HF with preserved EF was associated with improved exercise capacity and favorable changes in diastolic function. Global Burden Physical inactivity is responsible for On the basis of the HRs associated with these 2 behaviors 1. Inactivity was estimated to be responsible for 5. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. Guide to the assessment of physical activity: The importance of cardiorespiratory fitness in the United States: Physical activity versus cardiorespiratory fitness: Youth Risk Behavior Surveillance: The power of play: Innovations in Getting Active Summit National Association for Sport and Physical Education.

Moving Into the Future: National Standards for Physical Education. National Association for Sport and Physical Education; Cardiorespiratory fitness levels among U. United States, — and Assessing physical activity and its relationship to cardiovascular risk factors: A comparison of direct versus self-report measures for assessing physical activity in adults: Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in countries, — The association between frequency of physical activity and mortality risk across the adult age span.

Br J Sports Med. Leisure-time aerobic physical activity, muscle-strengthening activity and mortality risks among US adults: Leisure time physical activity of moderate to vigorous intensity and mortality: Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: Schoenborn CA, Stommel M. Adherence to the adult physical activity guidelines and mortality risk. Exercise capacity and mortality in older men: Prediction of year risk for cardiovascular mortality by fitness and risk factor levels: Physical activity, sedentary behavior, and cause-specific mortality in black and white adults in the Southern Community Cohort Study.

Leisure-time running reduces all-cause and cardiovascular mortality risk [published correction appears in J Am Coll Cardiol. Effect of moderate to vigorous physical activity on all-cause mortality in middle-aged and older Australians [published correction appears in JAMA Intern Med. Leisure time physical activity and mortality: Continued sedentariness, change in sitting time, and mortality in older adults. Association between physical activity and risk of all-cause mortality and cardiovascular disease in patients with diabetes: Economic burden of physical inactivity: Eur J Cardiovasc Prev Rehabil.

Physical activity, body mass index and health care costs in mid-age Australian women. Inadequate physical activity and health care expenditures in the United States. Favorable cardiovascular risk profile is associated with lower healthcare costs and resource utilization: Adherence to healthy lifestyle habits in US adults, — Explaining the decrease in U. Kim Y, Lee S. Physical activity and abdominal obesity in youth.

Appl Physiol Nutr Metab. Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents [published correction appears in JAMA. Effect of weight loss with lifestyle intervention on risk of diabetes. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: Exercise for overweight or obesity.

Cochrane Database Syst Rev. Maintaining a high physical activity level over 20 years and weight gain [published correction appears in JAMA. Changes in diet and lifestyle and long-term weight gain in women and men. Physical activity and sedentary leisure time and their associations with BMI, waist circumference, and percentage body fat in 0.

Am J Clin Nutr. Relationship of sedentary behavior and physical activity to incident cardiovascular disease: Physical activity and cardiovascular disease: Am J Lifestyle Med. Oguma Y, Shinoda-Tagawa T. Physical activity decreases cardiovascular disease risk in women: Trends in modifiable risk factors are associated with declining incidence of hospitalized and nonhospitalized acute coronary heart disease in a population. Vigorous physical activity, mediating biomarkers, and risk of myocardial infarction.

Physical activity and stroke risk: Frequent physical activity may not reduce vascular disease risk as much as moderate activity: Physical activity, metabolic syndrome, and coronary risk: Low lifetime recreational activity is a risk factor for peripheral arterial disease. Cost-effectiveness of population-level physical activity interventions: Am J Health Promot. Awareness of national physical activity recommendations for health promotion among US adults. Value of primordial and primary prevention for cardiovascular disease: High cardiorespiratory fitness attenuates risk of short-term mortality after first myocardial infarction: Effects of physical exercise on inflammatory parameters and risk for repeated acute coronary syndrome in patients with ischemic heart disease.

Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: Wen CP, Wu X. Stressing harms of physical inactivity to promote exercise. Percentage of sodium from dietary sources in the United States, to Source: Total US food expenditures away from home and at home, and Data derived from Davis et al.

The score for each metric was scaled continuously within this range. For harmful factors, the level of high intake that corresponded to a zero score was identified as approximately the 90th percentile distribution of US population intake. Both scores are then rescaled to a range of 0 to for comparison purposes.

Servings are defined as follows: Guidelines defined as follows: Sweet potatoes, pumpkin, and squash are considered red-orange vegetables by the USDA and are included in nonstarchy vegetables. Servings defined as follows: Abbreviations Used in Chapter 5. The AHA scoring system for ideal, intermediate, and poor diet patterns uses a binary-based scoring system, which awards 1 point for meeting the ideal target for each metric and 0 points otherwise. The dietary targets remain the same, and progress toward each of these targets is assessed by use of a more granular range of 1 to 10 rather than 0 to 1.

On the basis of the alternative scoring system, between to and to in the United States, the mean AHA healthy diet score improved in both children and adults Chart These improvements were largely attributable to increased whole grain consumption and decreased sugar-sweetened beverage consumption in both children and adults Charts and Other significant changes between and included national increases in nuts, seeds, and legumes 0.

Dietary Habits in the United States: Current Intakes Foods and Nutrients Adults See Table and Chart The dietary consumption by US adults of selected foods and nutrients related to cardiometabolic health is detailed in Table according to sex and race or ethnic subgroups. Average consumption of whole grains was 1.

Average fruit consumption ranged from 1. Average nonstarchy vegetable consumption ranged from 1. Average consumption of fish and shellfish was lowest among Mexican American females and white females 0. Average consumption of unprocessed red meats was higher in males than in females, up to 4. Average consumption of processed meats was lowest among Mexican American females 1. Average consumption of sugar-sweetened beverages ranged from 6.

Females generally consumed less than males. Average consumption of sweets and bakery desserts ranged from 3. Approximately 1 in 3 adults 1 in 2 Mexican American males consumed no more than 2.

Phillip Hughes's death would not have been prevented by a modern helmet or neck guard: review

Average consumption of eicosapentaenoic acid and docosahexaenoic acid ranged from 0. Sodium is widespread in the US food supply, with diverse sources Chart Foods and Nutrients Children and Teenagers See Table The dietary consumption by US children and teenagers of selected foods and nutrients related to cardiometabolic health is detailed in Table Average fruit consumption was low and decreased with age: Average nonstarchy vegetable consumption was low, ranging from 1. Average consumption of fish and shellfish was low, ranging between 0. Average consumption of nuts, seeds, and beans ranged from 1.

Average consumption of unprocessed red meats was higher in boys than in girls and increased with age, up to 3. Average consumption of processed meats ranged from 1. Average consumption of sugar-sweetened beverages was higher in boys than in girls in the 5- to 9-year-old 7. Average consumption of sweets and bakery desserts was higher among 5- to 9-year-old and to year-old boys and girls and modestly lower 4.

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A minority of children in all age and sex subgroups consumed no more than 2. Average consumption of eicosapentaenoic acid and docosahexaenoic acid was low, ranging from 0. Average consumption of sodium ranged from 3. Among children and teenagers, average daily caloric intake is higher in boys than in girls and increases with age in boys. Impact on US Mortality One report used consistent and comparable risk assessment methods and nationally representative data to estimate the impact of all major modifiable risk factors on mortality and morbidity in the United States in and in In , a total of deaths of all causes were attributable to suboptimal diet.

A previous investigation reported the estimated mortality effects of several specific dietary risk factors in in the United States. High dietary salt consumption was estimated to be responsible for annual deaths, low dietary omega-3 fatty acids for 84 annual deaths, high dietary trans fatty acids for 82 annual deaths, and low consumption of fruits and vegetables for 55 annual deaths. Serving fresh vegetables mostly carrots or celery or whole grains did not alter price. As a proportion of income, food has become less expensive over time in the United States. As a share of personal disposable income, average mean total food expenditures by families and individuals have decreased from For any given year, the share of disposable income spent on food is inversely proportional to absolute income.

The share increases as absolute income levels decline. Among forms of fruits and vegetables priced with Nielsen Homescan data, price and calorie per portion of 20 fruits and vegetables were compared with 20 common snack foods, such as cookies, chips, pastries, and crackers. Average price per portion of fruits and vegetables was 31 cents, with an average of 57 calories per portion, compared with 33 cents and calories per portion for snack foods.

Two separate cost-effectiveness analyses estimated that population reductions in dietary salt would not only be cost-effective, but actually cost-saving. Secular Trends Trends in Dietary Patterns In addition to individual foods and nutrients, overall dietary patterns can be very useful to assess diet quality. Adults with greater family income and education had higher scores, and the gap between low and high socioeconomic status widened over time, from 3.

Worldwide, 2 separate, relatively uncorrelated dietary patterns can be characterized, 1 by greater intakes of health-promoting foods eg, fruits, vegetables, nuts, fish , and 1 by lower intakes of less optimal foods eg, processed meats, sugar-sweetened beverages. Between and , both types of dietary patterns improved in high-income Western countries but worsened or did not improve in low-income countries in Africa and Asia. Middle-income countries showed the largest improvements in dietary patterns based on healthful foods, but the largest deteriorations in dietary patterns based on unhealthful foods.

Overall, global consumption of healthy foods improved, but was outpaced by increased intake of unhealthy foods in most world regions. Trends in Dietary Supplements Use of dietary supplements is common in the United States among both adults and children: Supplement use was associated with higher family income, a smoke-free home environment, lower child BMI, and less screen time television, video games, or computers. Of these, one third A multicenter randomized trial in patients with diabetic nephropathy found that B vitamin supplementation folic acid 2.

Trends in Energy Balance and Adiposity Energy balance, or consumption of total calories appropriate for needs, is determined by the balance of average calories consumed versus expended. Nurse Maggie Bolton appears and seems to be well known. The case of most of the missing gold bars is solved. Three boys get up to mischief. A Gipsy woman comes to town and puts a hex on Greengrass. Petrol disappears from cars.

PC Rowan has to attend to his wife after they get a daughter. It's about six weeks later. Ruby Rowan is back. Two neighbors get a peace plan thanks to PC Rowan. Greengrass is out of pocket again thanks to his nephew. A house is for sale that was promised to someone else. Ruby tries to light up Sgt Blaketon, but he is too slow to rush in.

A German visits and ignites hatred. A couple make their 50th visit for their wedding anniversary, but the husband has had enough of the same thing every year. A wife takes the car out on a joyride but her problems are far worse than that. Gina gets into pigeon racing. The father and daughter staying at the Aidensfield Arms make another worry. A strange person with a bag over their head causes havoc in the town residences.

A road accident causes an unneeded problem. The horse fixing game is what is on someone's mind. A past friend of PC Rowan comes to visit him. A house gets robbed, then, soon after, the husband has a heart attack. Sergeant Blaketon follows Greengrass into a cave, who is looking for lost history. There is a cave-in; they both get out, but then Blaketon has the bed next to Greengrass in hospital. PC Rowan becomes a DJ with the local pirate radio station.

Greengrass runs into problems making his own whiskey. Sergeant Blaketon is more interested in the activities of the football club he is president of. A boy gets admitted to hospital; his father should have listened to Nurse Maggie Bolton. The police arrest a lout who beat up three officers at the pub. He manages to escape, and when his girlfriend is attacked in their home, he is the immediate suspect.

But all isn't as it seems. Meanwhile, Greengrass angers a man who has friends in high places, and Nick's admiration for the local schoolteacher grows. The police try to get to the bottom of a spate of burglaries. Nick would like to see more of schoolteacher Jo, but their timing always seems to be off. Meanwhile, Greengrass' shady nephew comes visiting, along with an American 'business associate'.

Greengrass can't resist the temptation to make a bit of money, but things soon go wrong. A taciturn, brooding stranger moves into the village. Soon afterwards, his neighbour is the victim of a campaign of harassment that escalates into something sinister. Schoolteacher Jo suspects child abuse when one of her pupils begins misbehaving, and turning up with bruises.

Greengrass' latest moneymaking scheme involves "borrowing" a stud horse, without its owner's permission. Meanwhile, PC Ventress has a run of bad luck while gambling, and finds himself short of money. Ventress' gambling debts land him in serious trouble, when one of his associates is the prime suspect in the robbery of expensive wines. Lord Ashfordly catches Greengrass red-handed, with a sack full of poached game. A love triangle leads to tragic consequences for the young lady caught in the middle. A fashion photographer brings a touch of glamour to Aidensfield, while the police officers have to deal with a hostage situation.

Meanwhile, the path of true love is not running smoothly for Nick and Jo. Two thugs are terrorising pubs and cafes around the district. Nick suspects that the vicious attacks might have something to do with rivalries in the jukebox provision business. The Aidensfield Arms lease a new jukebox and are soon a victim of the vandalism. A black man turns up in Aidensfield and is immediately suspected when a local farmer is assaulted and robbed.

Meanwhile, Greengrass finds himself mixed up in the illegal sale of banned and dangerous pesticides. Nick's mother turns up unexpectedly, and is determined to get to the bottom of what went wrong between Nick and Jo. Nick meets Jo's parents, but their evening is interrupted when Nick is called out in an emergency. A young boy is assaulted, and Nick's investigation leads him to step on some very influential toes.

Blaketon is worried that his job might be on the line due to a shakeup in the district police force. Meanwhile, Greengrass has a very bad day. The police investigate when a woman estranged from her husband and children turns up dead. Greengrass lends his services to a boxing promoter. Nick saves an attractive young woman from a fire, but she soon develops an unhealthy and dangerous obsession for him.

Greengrass tries his hand at the tourism business, but things do not go according to plan. An ex-convict returns to Aidensfield and tries to get her life back on track. However, she is soon visited by an unwelcome part of her prison past. Greengrass tries to turn a fast buck on some items he bought from a deceased old war hero. Nick and Jo take their relationship to the next level, but she is worried that Eileen doesn't approve.

A suave businessman tries to convince several Ashfordly residents to invest their money with him, but Nick smells a rat. Several people receive anonymous letters revealing embarrassing secrets from their past. An old friend of Eileen shows up to bring happy memories. Greengrass runs into problems with his fish suppliers. Heavy snow threatens Ventress's debut as Father Christmas.

Meanwhile, Nick and Jo witness a plane crash, but when they investigate, the pilot has gone. Nick and Jo announce their engagement and Greengrass enrages Sergeant Blaketon by standing bail for a notorious burglar. Macabre rumours circulate around Aidensfield when a constable disappears after a row with a pig farmer.

Jo's concern about an absentee schoolboy leads to a shocking discovery. A series of violent muggings frustrates the force and poses an ethical dilemma for Nick. Wartime memories are stirred when an ex-soldier comes to the area for a holiday. Nick discovers the complicated history behind a well-dressed woman and her romance with a member of the community.


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Greengrass tries to help an Australian couple. The repercussions of a car accident leave Nick struggling to keep the peace. Nick suspects foul play when a lay preacher is injured in a shooting posse. Nick is plagued by an alcoholic aristocrat and Greengrass has plans for Ashfordly Hall. The police investigate thefts from a fur factory and trespassers on a railway line. A schoolgirl witness a shooting on the moor and Greengrass sets up a pool competition.

Nick and Jo's Wedding day finally arrives, but the groom is stranded on the moors. Sergeant Blaketon's day of retirement is approaching, but he applies for a years extension of service. Sergeant Blaketon struggles to come to terms with his impending retirement and receives bad news from his medical exam. He goes into hospital for more tests but has to wait another week for the results. Meanwhile, PCs Bradley, Bellamy and Ventress deal with the robbery at the pipeline compound, with the latter calling in support from Division after being unable to contact Blaketon.

Once back in the loop, Blaketon intercepts the armed robbers, whose car crashes down an embankment and sets on fire. Greengrass is only seconds behind, and comes to his aid when he collapses and is rushed to hospital. Ventress faces up to some old enemies. Blaketon is recovering in hospital when Dr. Bolton informs him his days on the police force are over due to the risk of another heart attack. A motorbike stunt rider becomes a target of sabotage, and Greengrass vows revenge when his beloved dog Alfred is dosed with rat poison. When a TV repair man is beaten up, Nick finds no shortage of suspects.

A death in custody puts Mike's career on the line. Meanwhile, Greengrass and Bernie move into the taxi business. An old flame of Mike's turns up in Aidensfield, and Greengrass loses his heart to an aristocratic lady poacher. A spate of burglaries results in a young woman being hospitalised. Meanwhile, Greengrass and Bernie try their hand at modern art.

The return of a notorious felon has Blaketon longing for his old job. Nick, Jo and Katie leave Aidensfield and go to Canada. An old army friend of Blaketon causes havoc in the village and Greengrass gets into trouble when he innocently buys some stolen sheep.

Heart Disease and Stroke Statistics—2017 Update

Blaketon finds himself at the wrong end of the law. Greengrass tries to cash in with some scrap motorcycles. A dog taking balls from a golf course for two boys leads onto worse things. A home birth makes Maggie and Neil reconcile their differences. A teenage girl goes missing after the local village dance.

Gina returns to Aidensfield after her Uncle George's funeral. PC Mike Bradley investigates a mysterious case of food poisoning after a neighbourly dispute. Greengrass recovers a debt and finds himself the owner of a python. Gina's Aunt Mary arrives and tells Gina that George's last wish was for Gina to not be alone in the pub. Mike has to make a dramatic rescue after a dangerous radioactive isotope goes missing.

Greengrass turns babysitter — for a champion greyhound. The Aidensfield police investigate a car accident that is not as simple as it seems. Neil and Maggie make a commitment. Respectable bank manager Tim McDonald mysteriously finds all the clocks in his home wound back by two hours such that he was late for work by two hours. The Police find it was Carl Southall, but Carl's campaign of harassment against Tim escalates, and culminates in a bank robbery and an astonishing admission from Tim, from many years ago. Greengrass wants membership of the local golf club, and he gets in after a battle of wills with the Secretary about having "standards".

But he regrets it less than a minute after being admitted. The Aidensfield police investigate a series of mysterious events that appear to be a result of witchcraft. Emotions run high as the police investigate the kidnap of a baby. Greengrass turns to inexperienced hands to help him concrete a drive. A new addition to the Police station leaves Bellamy feeling lovesick. Mike uncovers a complex blackmail case. A secret obsession is uncovered as the police investigate the kidnapping of a teenage girl which has an unexpected result.

UFO sightings are linked to the mysterious death of a cyclist on the moors. Greengrass hatches a plan to save the village from nuclear annihilation. Mike finds himself compromised by a romantic liaison. Mike meets his match in feisty new solicitor Jackie Lambert, and Greengrass becomes a landlord. Maggie questions her marriage when Neil is accused of indecent conduct.

Meanwhile, Greengrass organises a Civil War battle. A pregnant woman fears for her baby after a series of events lead her to believe that her house is haunted. Accusations fly as Maggie is revealed to be the main beneficiary of a patient's will, and Greengrass has a talented visitor who can predict horse race results in his sleep. Lord Ashfordly underestimates the strength of local feeling about access to a footpath across his land. Tragedy strikes Aidensfield following a series of arson attacks.

Meanwhile, Greengrass goes into the leisure business. Gina and Maggie take a short break away from Aidensfield, but Maggie gets a devastating shock when she returns. An eccentric old woman reports an abduction, and Greengrass meets an old friend with an unusual proposal. Gina finds herself accused of taking drugs as she attempts to rekindle her singing career.

A new restaurant is the target of sabotage and an old friend of Gina's comes to stay. Meanwhile, Greengrass thinks he has unearthed his fortune. A snobbish couple recently returned from Africa find it hard to settle in the village, and David sees a car that appears to be driving by itself with no one at the wheel. Mike and Jackie's future looks uncertain when Jackie's Uncle becomes a suspect in a hit-and-run accident.

An army deserter goes on the run in Aidensfield and takes a hostage. Claude organises a dinner party which goes disastrously wrong and Oscar buys the Aidensfield Arms. A flu epidemic causes havoc in Aidensfield, and Maggie has to make tough decisions when her baby Sam is put at risk. A mysterious house becomes the setting for a murder enquiry when an old woman is found dead.

Mary decides to leave Aidensfield for a job as a hotel manager in Sidmouth. Maggie worries that a young girl is about to have an illegal abortion, and Greengrass makes a promise to a dying friend. Tom Drabble and Oscar Blaketon face off in a council election. But Tom is a friend of Greengrass, and Oscar has an old score to settle with Tom. Honor Gable moves in to write a book, but she has her sights set on Mike Bradley.

A group of criminals on Community Service is ordered to clean up the river, but one of them keeps going missing. Mike Bradley and Jackie Lambert get married, but one of the robbers from a train robbery almost scuttles the wedding ceremony. Greengrass's sister visits unexpectedly after her famous cricketer husband passes away.

Greengrass rewrites local history in a bid to turn Aidensfield into a tourist mecca. Greengrass arranges an unusual funeral, while a revelation about Jackie forces Mike Bradley to question his marriage. A lonely old man is visited by a couple who have recently moved in locally, staying in a caravan. Local farmer Nathaniel Clegghorn defends his territory with his shotgun. A local butcher's wife dies, and shortly after, a baby's skeleton is found in the attic.

Two farmers suffer vandalism. Gloria asks Claude and David to move some of her belongings. Someone is slaughtering game from Lord Ashfordly's estate. At first, the motive is unclear they do not seem to be selling venison on the black market , but it turns out to be a much more sinister motive. A recently divorced headmistress receives harassing silent telephone calls. A mother wants to find her daughter she adopted out. Claude deliberately drops a note in the Aidensfield Arms to send the police off in the wrong direction.

Ray Nixon comes back to Aidensfield sometime after serving a 7-year jail sentence — Oscar Blaketon the sergeant at the time apologises for the heavy sentence handed out by the unidentified judge, despite Ray's evidence that implicated the other criminals.

1. ABOUT THESE STATISTICS

But then undesirable things happen at the Aidensfield Arms. Sian Horrocks is raped after running out of petrol in an isolated area — Ben Ealham is the main suspect but the Police have trouble making the charge stick. Greengrass wins in a sheep racing contest, but finds he's fallen for a swindler. Artist Joe Vaughan moves into Aidensfield, but is threatened by various hoodlums including some from his old town, Liverpool.

When his house is burned down, the Liverpudlians jokingly say that he needs a lesson in how to use his barbecue. Blaketon discovers the real truth behind Andy Ryan. Gary secretly visits Lyn at Ashfordly Hall, but gets shot while leaving. Dr Ian Peters checks an accident victim, Sue, after a hit-run accident. Maggie Bolton gets fooled, but Andy Ryan knows the real truth behind the doctor.

Greengrass tries to hire out "borrowed" bikes during a local race. David Stockwell reports an anonymous tip-off Charlie Weller is found dead, and to everyone's surprise, Peggy Turner and her daughter, Lottie, who are boarders in Charlie's house is the beneficiary of his will — changed only one week before. Charlie's nephew — the previous beneficiary — Martin, is incensed. A council planning officer drums up support from Blaketon and others for an industrial estate near Aidensfield, but Blaketon isn't sure. Lord Ashfordly has a horse stolen, and suspicion falls on Roy Brooks who was handed a suspended sentence for horse theft earlier that day.

Bernie Scripps tells a phone caller Greengrass persuades Bernie to use this skill to locate some share certificates for a widow. Police investigate when the week's payroll for the Ashfordly Estate workers goes missing. Julie confronts her husband, Frank McCready, about his gambling, and it escalates to a catastrophic event. Greengrass employs a rather creative interpretation of maritime law. Bernie Scripps persuades Greengrass to go into the mobile Fish 'n' Chips business — but comes up against stiff competition.

A widow is being burgled and robbed repeatedly and Alf Ventress is sympathetic, but Oscar Blaketon wises up. Jackie Bradley's parents make a somewhat unexpected appearance, and they try persuading her to move to South Africa, as they don't approve of her marriage to Mike. A car, stolen off the Amsterdam Ferry, is driven into the river. Andy finally realises that he and Gina are not meant for each other and leaves Aidensfield.

Meanwhile, a singer called Michael arrives helps Greengrass grows some orchids Celia Hanson moves in to the farming village, but has trouble with her car, and her neighbour. Greengrass tries to make money from rubbish disposal, but is nearly killed himself. Anthony Smythe is comforted by Jackie Bradley Lambert after his father's death — but then Jackie and Mike start getting suspicious calls, and a prowler with a camera.

The Smythe family engage Bernie Scripps and Greengrass for the funeral. Edith Benton leaves her poodle, Harvey, in Greengrass's care, and instructs him to enter it into the dog show. But then it gets away from David Stockwell, so they enter Alfred instead. Candlesticks and other items go missing from several churches, and when Alf Ventress runs a church errand for "Mrs Ventress", he gets knocked out stone cold. The Reverend's daughter is in love with the handyman, but the parents don't approve.

Aristocrat Gabriel Firth sacks Judd Holdsworth. He also puts the whole village off-side by barring access to the Heath a public right-of-way on his land , because he has organised a private party on the same date as the annual village bonfire party. But then his house is vandalised and his car tampered with.

Greengrass tries to make money off selling firecrackers. Phil Bellamy and Gina Ward warm to each other. A bunch of noisy old men descend on the Aidensfield Arms, which upsets a neighbour who complains of noise, and later accuses PC Phil Bellamy of 'collusion'. Even Sergeant Nokes thinks the complaint is overrated. Greengrass organises for the men to go game shooting on Ashfordly Estate, but they hear a gunshot, and Matty Lovell is found dead in the forest.

Mike Bradley had earlier found a half-burned letter from Lovell to Charlie Penwarden apparently confessing to fraud, but soon works out that letters can be burned in a deceptive manner. Greengrass gives his views on dying, which helps Maggie decide how to handle Graham's dying mother, Molly Rysinski who wishes to leave hospital to die elsewhere, against Graham's wishes.

Gina Ward "teaches" Phil Bellamy what 'collusion' means. Enid is in Aidensfield to visit her son for his birthday, and visit her friend, Greengrass, who relays a bet for her. Enid witnesses an assault while walking on a hill and reports it at the Police station But the assault is confirmed when a woman matching the description collapses at the Aidensfield Arms and is admitted to hospital.

The perpetrator is a lot closer to home than you would think. Enid's bet was a winning one, but Greengrass can't find the ticket, and he with David Stockwell spends a night in the cells while trying to find the ticket. Nat Cooper and Peter Corcoran are two bumbling robbers. After a failed robbery, Peter accidentally shoots Nat in the foot, and they split. Johnny is not amused when Nat breaks into the Aidensfield Arms. Claude Greengrass helps organise an illegal trap-racing meeting in the streets of Aidensfield. Edna Bostwick sees a light go out in Mrs Carlton's unoccupied house, and has a "terrible feeling", which she reports to the Police.

They check the house, finding nothing, and are not further interested, until nurse Maggie Bolton comes across an intruder a young boy in that house while running an errand. But this is no ordinary burglary, when PC Mike Bradley checks a school jacket left behind. It's from a boarding school some distance away, where the boy's name is given as Tom Bamber. There's a further twist with John Monks, a House Master teacher from the school, who is hunting Tom down. Bernie Scripps meets an old friend, Stanley Leroy, who says he can run tours to meet various singers and stars.

But Blaketon has suspicions about the money when he realises that Danny works at a casino in Leeds, with David Stockwell eventually being led into a trap. Phil Bellamy is led into a different kind of trap while romancing Gina Ward. Gordon Stringer, the new manager of the local bank, is unpopular with the community, and Greengrass. His unpopularity centres around clamping down harshly on overdue loans, such as with Mr Dugdale, and cutting back benefits for bank employees. But he's also refusing to pay Greengrass for a paving job, claiming poor workmanship.

When Mr Stringer's son goes missing, and a ransom note appears, the Police quietly investigates, and David Stockwell winds up in the thick of the action. But the perpetrator demanding the ransom turns out to be an opportunistic criminal. Phil Bellamy plays Father Christmas at the drawing of the pub raffle. This episode is a bit different in that no lovable rogues appear, and also two completely unrelated crimes occur during the show. Jack Hall is resentful against Tony Smith because he has never helped look after Sylvia's mother, who requires constant care.

But then when Police delve into some electricity bills, a very interesting story emerges. She invites Lord Ashfordly into her consortium, Oscar works out that she cannot be trusted, but not quickly enough to save Lord Ashfordly. Maggie Bolton accepts a job at a hospital, so everyone throws a surprise leaving party. Jackie explains to David that Greengrass has gone to be with his sister, and has left Alfred, his property and his truck to David.

Mike is asked to provide a safe house for mentally ill man who is due to give evidence in court in 3 days, but some men are out to kill him before the court day comes. Meanwhile, Bernard's step brother Vernon Scripps arrives in Aidensfield, having not seen his brother in 15 years.

A young hoon Richard Finlay runs Lord Ashfordly off the road, and is picked up for speeding shortly after. But he is reluctantly released by Sgt Craddock when it emerges that his mother is Craddock's dance tutor, whom he fancies. But when Richard clips a bicycle in a hit-and-run, the police are forced to act. When Richard is brought before the court, he is found not guilty, by judge James Green. But there's more to the judge than meets the eye. Lord Ashfordly had managed to drive off again, but his petrol tank was punctured, so he organises the mechanics at Scripps Garage to fix it.

But the trusted Bernie Scripps is out of town, and he needs his Bentley repaired for a wedding in two days' time. A collapse at a quarry mine puts a worker Jacob Fairbrother in hospital and starts a war of words between him and the mine's boss Joe Henderson about unpaid wages four weeks' worth and compensation. And then Joe's wife is found bludgeoned to death.

Jackie Bradley Lambert agrees to act for Jacob Fairbrother but that puts her offside with Edwina, her mother — who is good friends with the Henderson's. Vernon Scripps' attempt to go into the catering business causes a power blackout in Ashfordly, and PC Phil Bellamy's relationship with Gina Ward raises a few eyebrows, and he is warned that a Police officer is not permitted to marry a pub licensee.

Barton is having trouble maintaining her farm despite having Jed Harrison to help. She's also complained about a prowler late at night. Mrs Barton's niece, Glenda Marriot, is trying to make her sell the farm and move into an old people's home there's also a war of words about Mrs Barton letting the farm get into such disrepair.