Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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Charlie Sheen downplays Baja encounter with L.A. mayor

Los Angeles Mayor Antonio Villaraigosa found himself sucked deeper into the Charlie Sheen-TMZ-Hollywood gossip vortex Tuesday, with the actor speaking out again about the night they met up at a hotel in Mexico over the holidays.

Sheen made news last month after he tweeted a picture of himself with his arm around Villaraigosa the night of Sheen's bar opening in Baja California, Mexico. The former star of "Two and a Half Men" praised the mayor as a man who "knows how to party." But Villaraigosa downplayed the significance of the image, telling KNBC's Conan Nolan over the weekend that he had only "bumped into" Sheen and engaged in a three-minute conversation.

On Tuesday, Sheen challenged Villaraigosa's account, telling celebrity website TMZ that the mayor was drinking in Sheen's hotel suite in a room full of beautiful women, including at least one porn star. "I memorize 95 pages a week, so the last thing that I am is memory challenged," Sheen told the website. "We hung out for the better part of two hours."

Hours later, Sheen issued a more muted account, saying the mayor had spoken to many other people at the opening of the bar. "I am a giant fan of the mayor's and apologize if any of my words have been misconstrued," the statement said.

By then, however, Villaraigosa found himself fending off related questions at a news conference meant to be devoted to billionaire Eli Broad's new downtown art museum. "Can you just set the record straight for us?" asked one reporter. "What was it? Two hours or three minutes?" asked another. Then came the zinger: "Does what happens in Cabo stay in Cabo?"

Villaraigosa cackled at the Cabo crack but refused to take the bait. "I've said what I'm going to say on that, everybody," Villaraigosa declared. "You had fun. Let's talk about the important things, like a thousand jobs today" — a reference to construction work going on at Broad's museum.

Villaraigosa has frequently bristled at media questions about his personal life, going silent on some occasions and becoming visibly angry on others. Last week, he told KNBC's Nolan that Nolan had asked a "bozo question" about the Sheen photograph. He also noted that Nolan and other newsroom staffers have, like Sheen, asked the mayor to pose for pictures with them.

Sheen has been a TMZ staple, using the website as a platform to talk up his $100,000 gift to celebrity Lindsay Lohan and his porn star "goddesses." And Villaraigosa has glided easily between the world of politics and the entertainment industry since being elected in 2005.

"He's a celebrity mayor. And he's always wanted to be that," said Jaime Regalado, professor emeritus of political science at Cal State L.A. "If you're going to be a celebrity mayor, you have to take the good and the bad and everything in between" when it comes to news coverage.

david.zahniser@latimes.com

kate.linthicum@latimes.com

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Chemical Weapons Showdown With Syria Led to Rare Accord

Muzaffar Salman/Reuters

The violence in Syria continued on Monday. Above, Syrians went to the aid of a man who was wounded when a missile hit the al-Mashhad district of Aleppo.

WASHINGTON — In the last days of November, Israel’s top military commanders called the Pentagon to discuss troubling intelligence that was showing up on satellite imagery: Syrian troops appeared to be mixing chemicals at two storage sites, probably the deadly nerve gas sarin, and filling dozens of 500-pounds bombs that could be loaded on airplanes.

Within hours President Obama was notified, and the alarm grew over the weekend, as the munitions were loaded onto vehicles near Syrian air bases. In briefings, administration officials were told that if Syria’s increasingly desperate president, Bashar al-Assad, ordered the weapons to be used, they could be airborne in less than two hours — too fast for the United States to act, in all likelihood.

What followed next, officials said, was a remarkable show of international cooperation over a civil war in which the United States, Arab states, Russia and China have almost never agreed on a common course of action.

The combination of a public warning by Mr. Obama and more sharply worded private messages sent to the Syrian leader and his military commanders through Russia and others, including Iraq, Turkey and possibly Jordan, stopped the chemical mixing and the bomb preparation. A week later Defense Secretary Leon E. Panetta said the worst fears were over — for the time being.

But concern remains that Mr. Assad could now use the weapons produced that week at any moment. American and European officials say that while a crisis was averted in that week from late November to early December, they are by no means resting easy.

“I think the Russians understood this is the one thing that could get us to intervene in the war,” one senior defense official said last week. “What Assad understood, and whether that understanding changes if he gets cornered in the next few months, that’s anyone’s guess.”

While chemical weapons are technically considered a “weapon of mass destruction” — along with biological and nuclear weapons — in fact they are hard to use and hard to deliver. Whether an attack is effective can depend on the winds and the terrain. Sometimes attacks are hard to detect, even after the fact. Syrian forces could employ them in a village or a neighborhood, some officials say, and it would take time for the outside world to know.

But the scare a month ago has renewed debate about whether the West should help the Syrian opposition destroy Mr. Assad’s air force, which he would need to deliver those 500-pound bombs.

The chemical munitions are still in storage areas that are near or on Syrian air bases, ready for deployment on short notice, officials said.

The Obama administration and other governments have said little in public about the chemical weapons movements, in part because of concern about compromising sources of intelligence about the activities of Mr. Assad’s forces. This account is based on interviews with more than half a dozen military, intelligence and diplomatic officials, all of whom spoke on the condition of anonymity because of the intelligence matters involved.

The head of Germany’s foreign intelligence service, the BND, warned in a confidential assessment last month that the weapons could now be deployed four to six hours after orders were issued, and that Mr. Assad had a special adviser at his side who oversaw control of the weapons, the German newsmagazine Der Spiegel reported. Some American and other allied officials, however, said in interviews that the sarin-laden bombs could be loaded on planes and airborne in less than two hours.

“Let’s just say right now, it would be a relatively easy thing to load this quickly onto aircraft,” said one Western diplomat.

How the United States and Israel, along with Arab states, would respond remains a mystery. American and allied officials have talked vaguely of having developed “contingency plans” in case they decided to intervene in an effort to neutralize the chemical weapons, a task that the Pentagon estimates would require upward of 75,000 troops. But there have been no evident signs of preparations for any such effort.

The United States military has quietly sent a task force of more than 150 planners and other specialists to Jordan to help the armed forces there, among other things, prepare for the possibility that Syria will lose control of its chemical weapons.

Israel’s prime minister, Benjamin Netanyahu, was reported to have traveled to Jordan in recent weeks, and the Israeli news media have said the topic of discussion was how to deal with Syrian weapons if it appeared that they could be transferred to Lebanon, where Hezbollah could lob them over the border to Israel. But the plans, to the extent they exist, remain secret.

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Justin Bartha Is Dating Trainer Lia Smith

01/07/2013 at 07:00 PM EST

Lia and Justin in Hawaii New Years Day

Pacific Coast News

Justin Bartha's "mystery woman" is in fact his girlfriend, trainer Lia Smith, a source reveals to PEOPLE.

The pair recently enjoyed a cozy trip to Smith's native Hawaii and were snapped basking in the sun on Maui on New Year's Day, which got people buzzing about her identity.

"They were very cute with each other," says an eyewitness. "They had their arms around each other and were kissing."

The couple also spent time with Smith's parents on Oahu. Bartha, who currently stars on The New Normal, was previously linked to Scarlett Johansson and dated Ashley Olsen for two years before breaking up in 2011.

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Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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Boy who shot neo-Nazi father had a history of violence, psychologist testifies

The Riverside boy who shot and killed his neo-Nazi father had a history of violence since he was a toddler, but there was no indication that his father condoned such brutality, a mental health expert for the prosecution testified Monday.

Clinical psychologist Anna Salter said the boy, who was 10 years old when he pulled the trigger, told her that his father tried hard to get the boy's violence under control — on occasion beating the child as punishment for an outburst.

"He didn't know what else to do," Salter testified during the juvenile court proceeding in Riverside.

The boy's outbursts included an attempt to strangle a teacher with a telephone cord and stabbing classmates with pencils, Salter testified.

Jeffrey Hall, regional director of a neo-Nazi organization called the National Socialist Movement, was asleep on his living room couch in May 2011 when his son walked downstairs with a loaded .357 magnum revolver, pulled the hammer back and fired.

Salter told the court she found it "very odd" that Hall had not been threatening the boy at the time — they had spent a "family movie night" together hours earlier. The boy told police, however, that he lived in fear and was tired of his father's beatings.

"He said he just wanted to end the father-son thing," Salter testified.

Salter said the boy, at the time of the shooting, knew that killing his father was wrong, admitting as much to police and his stepmother just hours after the shooting.

Chief Deputy Dist. Atty. Michael Soccio, in his opening statement, argued that the boy coldly plotted to kill his father because he was afraid that Hall was about to divorce the boy's stepmother. Soccio said the boy's actions had nothing to do with Hall's neo-Nazi beliefs.

Public Defender Matthew Hardy, however, countered that the boy's moral compass was warped by living in an abusive, violent household where his father, in drunken rages, beat him regularly and where other neo-Nazis often gathered to celebrate their hate-filled and violent beliefs.

The mental health expert for the defense, psychologist Robert Geffner, testified in November that violence, guns and talk of killing permeated the Hall household, which taught the boy that "violence is the appropriate way in his world."

The prosecution's expert attempted to counter that view Monday, telling the court that the boy's violent streak began before he was 3 years old, when his outbursts led his grandmother to refuse to baby-sit him.

Salter said the boy's birth mother reportedly used heroin, LSD and other drugs while she was pregnant and then neglected the boy when he was a baby. Hall and his first wife divorced shortly after the boy was born. Hall won full custody when the boy was 3.

Salter, an expert in child psychology, violence and sexual abuse, was called to testify after the prosecution's initial mental health expert was barred from appearing because he had taken part in a confidential interview of the boy.

In court, the boy sat fidgeting next to his attorney and a juvenile probation officer. The boyish face of a sandy-haired child has been transformed since he first appeared in court two years ago. He appeared thinner and reportedly lost weight since being placed on medication to control his hyperactivity in juvenile hall, where he has been housed since the shooting.

Salter interviewed the boy for six hours in November and described him as well-behaved and direct. She refuted testimony from the defense psychologist that he had been molested by his father, saying the boy told her that he had no memory of that occurring.

During the interview, the boy accused his stepmother, Krista F. McCary, of telling him to kill Hall. McCary has not been charged in connection with the killing. She was convicted in 2011 of child endangerment and weapons charges and placed on four years' probation.

Judge Jean P. Leonard must decide whether the child knew that his actions were wrong at the time of the shooting. If she rules that the boy did not comprehend that his actions were wrong, he would be set free. If she finds the boy responsible for the killing, a hearing will be held to determine punishment. He could remain in juvenile custody until he is 23.

Salter said she believes that the boy could still lead a productive life, if he's given proper care.

"I think [the boy] has a tragic history. I think he has had a tragic upbringing," she said. "I don't think [he] is a hopeless case."

phil.willon@latimes.com

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India Ink: Disbelief in Bihar Village of Man Accused in the Delhi Rape Case

AURANGABAD, Bihar — The family of Akshay Thakur, one of the six accused in the Delhi gang rape case, first learned about the incident and the nationwide protests it has inspired when local police officers came to their house looking for him.

The family owns a television set, but cannot watch it because there is no electricity in the area. Newspapers don’t reach this far.

Their village of Lahangkarma is in the northeastern state of Bihar, on the remote, dusty plains that straddle the border with Jharkhand state. An anti-government insurgency movement, known as Maoists, is active in the area, and attacked the local police station in December 2011.

Family members said they can’t believe that Mr. Thakur, 24, a high school dropout, could have committed the crime. He has admitted to both family and the police that on Dec. 16 he was on the bus where a young woman was gang-raped and fatally beaten, but not confessed to anything more to them. Police identified him Dec. 18 as the “helper” of Ram Singh, the bus driver.

“He loves me very much and I’ll not believe anyone that he is involved in such a dirty thing,” his wife, Punita Devi, said in an interview in the village. Ms. Devi, who married Mr. Thakur in 2010, held their crying year-and-a-half-old son in her arms as she spoke. She did not say how old she was, but appeared younger than the marriageable age of 18.

“We were loving to each other,” she said. “He used to talk to me on the phone whenever he left” the village, she added. Looking distraught and anxious, she spoke loudly and nervously, insisting on his innocence.

In the aftermath of the Delhi rape, debate is raging in India about what might have prompted a group of men to commit such a violent crime against a young woman. The woman, a 23-year old physiotherapy student, was raped several times and attacked with an iron rod, injuring her internal organs so severely that portions of her intestines had to be removed.

India, and particularly north India, has seen a rise in reported gang rapes in recent months, adding fuel to the debate.

On Sunday, Raj Thackery, head of the Maharashtra Navnirman Sena, a right-wing political party, blamed the crime on migrants from Bihar.

“All are talking about the Delhi gang-rape, but no one is asking who did this. Nobody’s asking from where these men came,” he said, according to The Hindu newspaper. “Nobody is mentioning the fact that all these rapists are from Bihar,” he said.

The Bihar police say they are unaware that any of the other men accused in the Delhi rape are from the state. The hometowns of most of the rest of the men have not been made public by the police.

Five of the men accused in case, including Mr. Thakur, have been charged with murder, attempted murder, gang rape and robbery. They have also been charged under section 34 of the Indian Penal Code, which holds each accused individual equally liable for all criminal acts committed together as a group.

According to the police, Mr. Thakur fled Delhi after the rape, traveling first to Jaipur, then making his way by train to his home village. His father, Saryug Singh, a farmer, said he turned his son over to the police. (The surname Singh is often rendered as Thakur is Delhi.)

“I personally handed Akshay over to the police and told them if he is guilty he must be punished,” Mr. Singh said, while wiping tears from his eyes. “What more could I do? I don’t know what will happen and I’m not capable of doing anything more.”

Ms. Devi said she knew that her husband was working as a bus conductor in Delhi. “He had told me over phone he was working on a bus in Delhi for the last two months,” she said. Mr. Thakur had last visited his village six months ago, she said, before returning on Dec. 21.

“When he came here he told me that such an incident had happened and, though he was there in the bus along with others, he had not done anything wrong,” she said.

There is little sign of economic development in the village, and many of its young men migrate to cities, mostly to Delhi, to earn their living. Mr. Thakur had followed his two elder brothers, Vinay Singh and Abhay Singh, who both work in a private company in Gurgaon, the outsourcing mega-city south of Delhi.

After he came to Delhi, he lost touch with his family, they said.

Earlier, Akshay was working at a local liquor factory in the central state of Madhya Pradesh, “but after he went to Delhi he was not in touch with us,” said his brother Abhay Singh, who has been in the village on vacation since Dec. 15.

Rejecting Mr. Singh’s claim he had turned his son in, the local police said they used Mr. Thakur’s mobile phone to track him down. “The moment he came to the village, we arrested him and handed him over to the Delhi police,” said Ajay Kumar, chief of the local Tandwa police station.

The Bihar state government has announced a reward for all the police officers involved in apprehending Mr. Thakur. Along with Mr. Kumar, two other police officials, Brajesh Kumar Singh and Yatvendra Kumar Singh, are on the list of rewardees.

The elder Mr. Singh said that his youngest son had no interest in education and dropped out of Pipadi High School in nearby Tandwa in the 10th grade.

The police said he has no criminal record in the village. “He was never accused in a single case here,” said Mr. Kumar. The village chowkidar, or watchman, Ram Lakhan Paswan, said the family enjoyed a “good reputation” in the area.

The entire family now lives cocooned inside its house, following local protests demanding harsh punishment for Mr. Thakur for having given the village, district and state a bad name.

Malti Devi, Mr. Thakur’s mother, guesses that he might have fallen into bad company in Delhi. “But, he could not commit such a heinous crime”, she said, tears falling down her cheeks. “It would have been better if I had died before seeing all this.”

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‘Facebook Dead’: How to ‘Kill’ Your Friends

Rusty Foster discovered he was dead last week, at least according to Facebook. He had been locked out of his account, which had been turned into a “memorial page,” because someone had reported the Maine man as deceased to the social media site.

He tweeted Thursday, “Facebook thinks I’m dead. I’m tempted to just let it,” then “Did you know that you can report any of your Facebook friends dead & Facebook will lock them out of their account with no evidence needed?”

As one of Foster’s friends discovered, it doesn’t take much to convince Facebook that somebody is dead. By simply going to the ” Memorialization Request” page and filling out a form, including a link to an obituary, anybody can take someone else off Facebook.

The obituary needs to have the same name (or at least a close name), but doesn’t need to match any other details on the profile. The obituary Foster’s friend used to prove Foster’s death was for a man who was born in 1924 and died in 2011 in a different state than the one Foster lists on Facebook as his home state.

Foster, 36, said he never got any notification his account was going to be locked, and only discovered it when he attempted to log in. He filled out a form to report the error, and received a response that began with “We are very sorry to hear about your loss.”

More than a full day later, Foster’s account still hadn’t been unlocked. Buzzfeed, tipped off by Foster, posted an article in which one editor “killed” another editor, John Herrman, on Facebook. According to the article, about an hour after Herrman reported the error to Facebook, his profile was reactivated. About an hour after that, 27 hours after Foster first reported his erroneous death, he was “resurrected” by Facebook and allowed back into his account.

Foster does not know the total amount of time he was “Facebook dead.” He told ABC that nothing was different with his account when he logged back in, only that some of his friends had a little fun with his status.

“The only thing that happened was some of my friends posted little mock-eulogies for me, because word got around that I was locked out, due to a temporary case of death,” Foster wrote in an email with the subject line, “Rusty, the Facebook zombie.”

When pages are memorialized, they are removed from sidebars, timelines and friend suggestions and searches. This is likely to prevent people from seeing their friends who have died pop up on their newsfeed, and to prevent people from hacking into the accounts of dead people.

Foster said he understands the position Facebook is in when it comes to the death of one of its users, but believes there are better options for the social media site.

“There ought to be an email sent to the account’s email address informing it that the account has been reported dead and providing a link or something to dispute the report before any action is taken,” Foster wrote.

Foster said the most frustrating part was not being able to get into his account to “click the ‘I’m not dead’ button that should also be there.”

This has apparently been the same “memorialization” process since at least 2009, when another user took to his personal blog to write about his experience of being “Facebook dead.” In his case, the obituary his friend used to have him declared dead wasn’t even close to his real name. Instead, the man who performed the funeral services had a similar name.

In a statement to ABC News, Facebook said the system is in place in order to respect the privacy of the deceased.

“We have designed the memorialization process to be effective for grieving families and friends, while still providing precautions to protect against either erroneous or malicious efforts to memorialize the account of someone who is not deceased,” the statement reads. “We also provide an appeals process for the rare instances in which accounts are mistakenly reported or inadvertently memorialized.”

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Jordana Brewster Is 'Enamored' with the Idea of Having Twins

01/06/2013 at 05:00 PM EST

Jordana Brewster has babies on the brain – yes, you read that right: plural.

The Dallas star, 32, who has been married to movie producer Andrew Form since 2007, tells Latina she "definitely" wants two kids and is "enamored" by the idea of having twins.

"My dad was a twin, so it runs in the family," she explains. "Fingers crossed. We're thinking about having kids but I don't know when it'll happen. I feel very ready now."

When the couple does eventually expand their family, the children will be raised in a loving home.

"We FaceTime all of the time," Brewster says, of keeping the romance alive long distance. "We love that. There are times when I just say, 'I need to see you now.' And so we FaceTime a lot, or I surprise him and visit him or he does the same. It's super important … Couples shouldn't be apart for too long. We've been married for five years now and we know how important that is because otherwise you just lose touch with each other."

A big part of their bond has come from the way Form inspires his wife on a professional level.

"It's so amazing to have a husband in the business who can challenge me and we can talk about his work and my work and understand each other in that way," Brewster says. "I love getting his feedback and he likes getting mine. And of course, that has pushed me more to consider producing in the future."

And she's not just talking about babies!

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Your medical chart could include exercise minutes

CHICAGO (AP) — Roll up a sleeve for the blood pressure cuff. Stick out a wrist for the pulse-taking. Lift your tongue for the thermometer. Report how many minutes you are active or getting exercise.

Wait, what?

If the last item isn't part of the usual drill at your doctor's office, a movement is afoot to change that. One recent national survey indicated only a third of Americans said their doctors asked about or prescribed physical activity.

Kaiser Permanente, one of the nation's largest nonprofit health insurance plans, made a big push a few years ago to get its southern California doctors to ask patients about exercise. Since then, Kaiser has expanded the program across California and to several other states. Now almost 9 million patients are asked at every visit, and some other medical systems are doing it, too.

Here's how it works: During any routine check of vital signs, a nurse or medical assistant asks how many days a week the patient exercises and for how long. The number of minutes per week is posted along with other vitals at the top the medical chart. So it's among the first things the doctor sees.

"All we ask our physicians to do is to make a comment on it, like, 'Hey, good job,' or 'I noticed today that your blood pressure is too high and you're not doing any exercise. There's a connection there. We really need to start you walking 30 minutes a day,'" said Dr. Robert Sallis, a Kaiser family doctor. He hatched the vital sign idea as part of a larger initiative by doctors groups.

He said Kaiser doctors generally prescribe exercise first, instead of medication, and for many patients who follow through that's often all it takes.

It's a challenge to make progress. A study looking at the first year of Kaiser's effort showed more than a third of patients said they never exercise.

Sallis said some patients may not be aware that research shows physical inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. As recently as November a government-led study concluded that people who routinely exercise live longer than others, even if they're overweight.

Zendi Solano, who works for Kaiser as a research assistant in Pasadena, Calif., says she always knew exercise was a good thing. But until about a year ago, when her Kaiser doctor started routinely measuring it, she "really didn't take it seriously."

She was obese, and in a family of diabetics, had elevated blood sugar. She sometimes did push-ups and other strength training but not anything very sustained or strenuous.

Solano, 34, decided to take up running and after a couple of months she was doing three miles. Then she began training for a half marathon — and ran that 13-mile race in May in less than three hours. She formed a running club with co-workers and now runs several miles a week. She also started eating smaller portions and buying more fruits and vegetables.

She is still overweight but has lost 30 pounds and her blood sugar is normal.

Her doctor praised the improvement at her last physical in June and Solano says the routine exercise checks are "a great reminder."

Kaiser began the program about three years ago after 2008 government guidelines recommended at least 2 1/2 hours of moderately vigorous exercise each week. That includes brisk walking, cycling, lawn-mowing — anything that gets you breathing a little harder than normal for at least 10 minutes at a time.

A recently published study of nearly 2 million people in Kaiser's southern California network found that less than a third met physical activity guidelines during the program's first year ending in March 2011. That's worse than results from national studies. But promoters of the vital signs effort think Kaiser's numbers are more realistic because people are more likely to tell their own doctors the truth.

Dr. Elizabeth Joy of Salt Lake City has created a nearly identical program and she expects 300 physicians in her Intermountain Healthcare network to be involved early this year.

"There are some real opportunities there to kind of shift patients' expectations about the value of physical activity on health," Joy said.

NorthShore University HealthSystem in Chicago's northern suburbs plans to start an exercise vital sign program this month, eventually involving about 200 primary care doctors.

Dr. Carrie Jaworski, a NorthShore family and sports medicine specialist, already asks patients about exercise. She said some of her diabetic patients have been able to cut back on their medicines after getting active.

Dr. William Dietz, an obesity expert who retired last year from the Centers for Disease Control and Prevention, said measuring a patient's exercise regardless of method is essential, but that "naming it as a vital sign kind of elevates it."

Figuring out how to get people to be more active is the important next step, he said, and could have a big effect in reducing medical costs.

___

Online:

Exercise: http://1.usa.gov/b6AkMa

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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