This Week in JAMA FREE

Population-based estimates of the current prevalence of obesity and trends in obesity based on analyses of data from the National Health and Nutrition Examination Survey (NHANES) are reported in 2 articles in this issue. In the first article, Flegal and colleagues Article report that in 2007-2008, one-third of US adults were obese and that previously observed increases in the prevalence of obesity do not appear to be continuing at the same rate, particularly among women, and possibly among men. In the second article, Ogden and colleagues Article report that in 2007-2008, approximately 10% of infants and toddlers were at or above the 95th percentile of the weight-for-recumbent-length growth charts (denoting excess weight) and that 17% of children and adolescents aged 2 to 19 years had a body mass index above the 95th percentile (sometimes termed obese). In an examination of NHANES data from 1999-2008, the authors found no significant linear trends in high body mass index except among the very heaviest 6- to 19-year-old boys. In an editorial, Gaziano Article discusses shifts in the major causes of death and disability in the United States, with epidemic overweight/obesity and inactivity emerging as major factors.

High dietary intake of marine omega-3 fatty acids is associated with improved survival among individuals with cardiovascular disease; however, the mechanisms underlying this relationship are not clear. In a prospective cohort study of patients with stable coronary artery disease (CAD), Farzaneh-Far and colleagues investigated the association of omega-3 fatty acid levels at baseline with change in leukocyte telomere length—a novel marker of biological age, which has been found to independently predict morbidity and mortality in patients with cardiovascular disease. In analyses that adjusted for established risk factors and potential confounders, the authors found an inverse relationship between baseline blood levels of marine omega-3 fatty acids and the rate of leukocyte telomere shortening over 5 years among patients with stable coronary artery disease.

Mr Y is an 89-year-old man with an unsteady gait who has experienced multiple falls and several fall-related injuries, including hip and humeral fractures. He lived independently until 3 years ago and now lives with his daughter. Tinetti and Kumar Article discuss falls in community-dwelling older adults, the evidence relating to predisposing risk factors and effective preventive interventions, and challenges to incorporating fall prevention strategies into clinical practice. Readers may submit comments for online posting at http://www.jama.com. A commentary by Katz and Shah Article discusses the need for research and evidence-based interventions to prevent falls among elderly individuals and the importance of programs and policies to reduce the consequences of falls for patients, caregivers, and society.

“This is how it's done; this is how people cope with illness. You go on because there is no choice.” From “Insight.”

A small study raises questions about whether adding ezetimibe to other cholesterol-lowering therapies provides additional benefit in reducing cardiovascular disease risk.

Composite end points in randomized trials

Garnering support for advanced care planning

Influenza A(H1N1) and public trust

Join David Reuben, MD, Wednesday, February 17, from 2 to 3 PM eastern time to discuss medical care in the final years of life. To register, go to http://www.ihi.org/AuthorintheRoom.

How would you care for an 86-year-old woman with progressive congestive heart failure and multiple chronic conditions who is contemplating suicide? Go to www.jama.com to read the case, and submit your response, which may be selected for online publication. Submission deadline is January 24.

For your patients: Information about falls and older adults.