Researchers have suggested that for otherwise healthy middle-aged women who are overweight or obese, physical activity may be their best option for avoiding heart disease.

These findings were reported in a paper led by authors at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, the University Hospital for Einstein.

Lead author Unab Khan, M.B.B.S.,M.S., assistant professor of pediatrics and of family and social medicine at Einstein and attending physician, pediatrics at Montefiore, said being overweight or obese increases a person's risk for developing conditions such as hypertension, elevated triglyceride levels and elevated fasting glucose levels-all of them risk factors for heart disease, the leading cause of death in the US.

The authors identified 866 overweight and obese women, aged 42 to 52 who were enrolled in the Study of Women's Health Across the Nation/, or SWAN, a multicenter, multiethnic study designed to examine the health of women during their middle years.

The women studied were categorized as "metabolically benign overweight/obese."

Throughout the seven-year study, the women were tested annually for heart disease risk factors. They also completed an annual survey describing their physical activity for the prior 12 months, which ranged from active living, caregiving and doing household chores to exercise and sports.

During the seven years, 373 of the participants-43 percent of the total-had progressed from having at most a single risk factor for heart disease (i.e., metabolically benign overweight/obese) to at-risk overweight/obese, meaning they had developed two or more of the following five heart-disease risk factors: hypertension; low blood level of HDL ("good") cholesterol; elevated blood levels of triglycerides, elevated fasting glucose level (indicating pre-diabetes or diabetes); and elevated levels of C-reactive protein ( indicating inflammation).

Low-to-moderate physical activity-at the start of the study and during it-was the only lifestyle factor found to protect overweight/obese women from becoming at-risk for heart disease. More specifically, women who participated in physical activity during the study were 16 percent less likely to become at-risk for heart disease compared with women who were not physically active.

The study has been published in the Journal of Clinical Endocrinology and Metabolism.

New data on global newborn deaths and stillbirths show 5.5 million "invisible deaths" every year.

A major new Series of papers, published in The Lancet, presents the clearest picture to date of progress and challenges in improving newborn survival around the world, and sets targets that must be achieved by 2030 in order to ensure every newborn has a healthy start.

The research is led by Professor Joy Lawn, at the London School of Hygiene and Tropical Medicine and Save the Children, UK, with Professor Zulfiqar Bhutta at the Hospital for Sick Children, Canada, and the Aga Khan University, Pakistan, in collaboration with more than 54 experts from 28 institutions in 17 countries, and provides the evidence base and foundation for the forthcoming Every Newborn Action Plan, an evidence-based roadmap towards care for every woman, and a healthy start for every newborn baby, which will be launched in June 2014.

The Series shows that almost all of the 5.5 million newborn and stillborn babies who die every year enter and leave the world without a piece of paper; this lack of registration and official recognition reflects acceptance of these deaths as inevitable.

Preterm babies are less likely to be counted, even in rich countries, especially where they are not expected to survive.

The lack of registration is a key reason for slower progress in recent decades for newborn deaths compared to maternal and child mortality reduction - progress which can, and must, be accelerated if international child mortality targets are to be met.

"Throughout the Series, evidence and experience from some of the most improved, as well as the worst affected, countries shows that newborn and maternal deaths are preventable," Professor Bhutta said.

"Our research shows that three million lives can be saved by 2025 if achievable interventions are scaled up to nearly universal coverage, and improving care at the time of birth gives a triple return on investment saving mothers, newborns and stillbirths. Care of small and sick newborns is the next highest impact package, yet this has received little attention up to now, despite extremely cost effective solutions such as antenatal steroids and kangaroo mother care," he added.

A study has revealed that adding vitamin D to asthma treatment to improve breathing only appears to benefit patients who achieve sufficient levels of the supplement in the blood.

According to new research at Washington University School of Medicine in St. Louis, overall, the ability to control asthma did not differ between a study group that received vitamin D supplements and a group that received placebo.

In the study, all patients took an inhaled steroid daily to control their asthma, and all had rescue inhalers in the event of an asthma attack.

The patients were randomly assigned to one of two groups. The treatment group received a loading dose of 100,000 international units of vitamin D3 followed by daily doses of 4,000 units, and the placebo group received identical looking but inactive capsules.

The investigators found no differences between the two groups in all major measures of asthma control. The groups showed no significant differences in the number of treatment failures requiring patients to take more medication, no difference in the number of asthma attacks and no difference in their need for emergency care. Patients taking vitamin D did not report improved quality of life, based on questionnaires.

One way the groups differed, however, was in how successfully they were able to reduce their daily dosages of inhaled steroids. After the first 12 weeks of the study, if the patient's asthma was well-controlled, the investigators cut in half the daily dose of inhaled steroid, reducing it from 320 micrograms per day to 160. Then, after eight more weeks, if the disease remained controlled, they cut the dose in half again. While both groups were able to taper off their doses of inhaled steroid, the vitamin D group was able to reduce its medication more.

By the end of the 28-week study, the vitamin D group was taking an average of 111 micrograms per day, and the placebo group was taking an average of 126.

Compared with placebo, the patients in the treatment group that achieved vitamin D sufficiency in the blood (with an average of 42 nanograms of vitamin D per milliliter) did show improved asthma control. They had 40 percent fewer treatment failures that required more medication and half the number of asthma attacks.

The study has been published online in JAMA.

Researchers have suggested that supplemental vitamin C taken by pregnant smokers improved measures of lung function for newborns and decreased the incidence of wheezing for infants through 1 year.

Cindy T. McEvoy, M.D., M.C.R., of Oregon Health and Science University, Portland, and colleagues randomly assigned pregnant smokers to receive vitamin C (500 mg/d) (n = 89) or placebo (n = 90).

One hundred fifty-nine newborns of pregnant smokers (76 vitamin C treated and 83 placebo treated) and 76 newborns (reference group) of pregnant nonsmokers were studied with newborn PFTs (performed within 72 hours of age).

The researchers found that newborns of women randomized to vitamin C, compared with those randomized to placebo, had improved measures of pulmonary function.

Offspring of women randomized to vitamin C had significantly decreased wheezing through age 1 year (15/70 [21 percent] vs 31/77 [40 percent]. There were no significant differences in the 1-year PFT results between the vitamin C and placebo groups.

"Although smoking cessation is the foremost goal, most pregnant smokers continue to smoke, supporting the need for a pharmacologic intervention," the authors write. Other studies have demonstrated that reduced pulmonary function in offspring of smokers continues into childhood and up to age 21 years. "This emphasizes the important opportunity of in-utero intervention.Individuals who begin life with decreased PFT measures may be at increased risk for chronic obstructive pulmonary disease."

" Vitamin C supplementation in pregnant smokers may be an inexpensive and simple approach (with continued smoking cessation counseling) to decrease some of the effects of smoking in pregnancy on newborn pulmonary function and ultimately infant respiratory morbidities, but further study is required," the researchers conclude.

The study has been published in JAMA.

Certain chemicals that are common in everyday life have been shown to cause breast cancer in lab rats and are likely to do the same in women, US researchers said today.

The paper in the peer-reviewed journal Environmental Health Perspectives lists 17 chemicals to avoid and offers women advice on how to minimise their exposure.

They include chemicals in gasoline, diesel and other vehicle exhaust, flame retardants, stain-resistant textiles, paint removers, and disinfection byproducts in drinking water.

"The study provides a road map for breast cancer prevention by identifying high-priority chemicals that women are most commonly exposed to and demonstrates how to measure exposure," said study author Ruthann Rudel, research director of the Silent Spring Institute.

Some of the biggest sources of mammary carcinogens in the environment are benzene and butadiene, which can come from vehicle exhaust, lawn equipment, tobacco smoke and charred food. Carcinogens can also be found in drinking water, researchers said.

"Every woman in America has been exposed to chemicals that may increase her risk of getting breast cancer," said co-author Julia Brody.

Brody described the paper as the first to comprehensively list potential breast carcinogens and detail ways for experts to measure them in women's blood and urine.

The study also recommends seven ways for women to avoid these chemicals:

- Limit exposure to exhaust from vehicles or generators, don't idle your car, and use electric lawn mowers, leaf blowers and weed whackers instead of gas-powered ones.

- Use a ventilation fan while cooking and limit how much burned or charred food you eat.

- Do not buy furniture with polyurethane foam, or ask for furniture that has not been treated with flame retardants.

- Avoid stain-resistant rugs, furniture and fabrics.

- If you use a dry-cleaner, find one that does not use PERC (perchloroethylene) or other solvents. Ask for "wet cleaning."

- Use a solid carbon block drinking water filter.

- Keep chemicals out of the house by taking off your shoes at the door, using a vacuum with a HEPA (high-efficiency particulate air) filter, and cleaning with wet rags and mops.

The research was funded by the Avon Foundation. The Silent Spring Institute is a 20-year-old organisation made up of scientists who focus on the environment and women's health.