Diana Nyad, on 103-mile swim, struggles with shoulder pain, asthma

Endurance swimmer Diana Nyad struggled through ocean swells, shoulder pain and asthma Monday as she attempted to become the first person to swim between Cuba and Florida without a shark cage, according to her team and a CNN staffer on a chase boat.
Both the swells and the 61-year-old swimmer's shoulder pain subsided somewhat and she was "swimming strongly," her team said in a post to Facebook around noon ET.
Follow Nyad on CNN's tracker
The shoulder pain was "down to an 8" following some "therapeutic healing," the message said.
The shoulder pain remained an issue around 2 p.m., about 18 hours into the swim, said CNN staffer Matt Sloane -- who is following Nyad on a chase boat -- in a tweet. She is also having "a little touch of asthma," he said. But he added that Nyad is "still going very strong."
Nyad in good spirits in 18th hour
The attempt to swim from Cuba to Florida is the second for the swimmer, who said at a news conference Sunday that she is fitter today than she was in 1978, when she first attempted the crossing but was unable to finish.
"When I walk up on those shores of Florida, I want to prove to the AARP crowd that it's not too late to go back and write that book or adopt that child," she said.
She jumped into the water at 7:45 p.m. ET on Sunday and expects to swim for roughly 60 hours. She is stopping briefly each hour to eat.
"Nobody decides the swim is over except me," Nyad's team quoted her on Twitter as saying.
Wind, water, one woman's drive
It took several months to gain permission for the swim from Cuban and U.S. authorities. Bureaucratic snags repeatedly threatened to call off the effort -- already called off in 2010 because of weather.
Nyad has been training for the event for two years, swimming up to 12 hours a day.
"I'm almost 62 years old and I'm standing here at the prime of my life," she said Sunday as she prepared to dive into the water at Havana's Marina Hemingway. "I think this is the prime. When one reaches this age, you still have a body that's strong but now you have a better mind."

A team of more than 30 people is supporting Nyad as she attempts the crossing. She has 10 handlers to advise her as she swims, ocean kayakers towing devices to repel most sharks and divers and safety officers trained to distract those that aren't turned away. A doctor is also on hand.

5 ways to get cheaper medical care

It was the worst possible news at the worst possible time. In summer 2009, photographer Joel Maus learned he might go blind if he didn't get a procedure to treat a cornea condition. But there was no way he could afford the $15,000 doctor's fee -- Maus' business had suffered during the recession and since the procedure was considered experimental, his insurance wouldn't pay for it. Maus approached his eye surgeon, Dr. Brian Boxer Wachler, with an idea: In exchange for free surgery, Maus would give the doctor free photos. Boxer Wachler had bartered before with patients -- one had fixed up his 1958 Nash Metropolitan in exchange for his services, and it had worked out well. He thought about how nice it would be to have professional photos of his twin daughters' upcoming fourth birthday party. "He said yes, of course, he would do it," Maus remembers. "And I said, 'Really? Cool!'" Many Americans share Maus' predicament. In a new survey by Deloitte, three out of four consumers said the recent economic slowdown has affected their health care spending. One in four said they had skipped seeing a doctor when they were sick or injured. The Empowered Patient has these ideas for what to do when you can't afford to see the doctor. 1. Barter with your doctor Before bringing it up, think about what your doctor might value. Boxer Wachler, for example, is a car enthusiast and has youn

g children, so car services and photos worked well for him, but when a patient who is an artist offered free paintings in exchange for care, he declined. "If you can't afford care, just go for it," Boxer Wachler says. "It can't hurt to ask. The worst thing that will happen is the doctor says thanks for offering, but no thanks." 2. Pay on credit About half of Boxer Wachler's patients pay on credit -- often over 24 months with no interest. Ask your doctor if he or she has arrangements with credit companies and if not, ask if they would be willing to make them. 3. Negotiate with your doctor When Christina McMenemy's husband lost his job and health insurance, she negotiated a $40 fee for an office visit with her children's pediatrician.

Head Lice Treatment

HEAD LICE:

Head lice can cause severe itching in the head and is an extremely common problem in school going children. If commonly available remedies like combing hair with a very fine comb after shampooing with anti-lice shampoo do not work, a dermatologist may be consulted.

Task force: Evidence for Vitamin D, calcium supplements lacking

The task force found evidence that Vitamin D and calcium supplements increase the risk of developing kidney stones.

 

 Task force: Evidence for Vitamin D, calcium supplements lacking

You’ve seen it added to cereal boxes, gallons of milk and bottles of orange juice. Experts tout its benefits – from strong bones to a strong immune system – and warn of the dangers of Vitamin D deficiency.

The public relations push is working; between 2002 and 2011, sales of vitamin D supplements increased from $42 million to $605 million, according to the Nutrition Business Journal.

New recommendations from the U.S. Preventative Services Task Force could bump those sales even higher, or - if critics are right - confuse consumers as they head down the pharmacy aisle.

After completing a review of existing research, the USPSTF, an independent panel of doctors and experts in prevention and evidence-based medicine, is advising against taking moderate amounts of Vitamin D and calcium supplements because there is not enough evidence to prove the supplements reduce the risk of bone fractures.

More specifically, the USPSTF is recommending against supplements of Vitamin D in daily doses of less than 400 IU (international units), and calcium in daily doses of less than 1,000 milligrams for post-menopausal women.

Doctors currently recommend these supplements for women to prevent fractures; approximately 56% of women aged 60 years and older take supplemental vitamin D, and 60% take a supplement containing calcium, according to the USPSTF report. The report was published in this week’s edition of the Annals of Internal Medicine journal.

The task force found evidence that Vitamin D and calcium supplements increase the risk of developing kidney stones in this population, and insufficient evidence to show that the supplements reduce the risk of fractures.

Basically it boils down to this: “Don't take modest doses, they don't do any good,” says Dr. Virginia Moyer, chair of the USPSTF.

More research is needed, Moyer says, to determine whether higher doses of Vitamin D or calcium would prevent fractures in older men or women. She says the task force will be looking in the future at whether doctors should be screening for Vitamin D deficiencies.

The USPSTF’s recommendations don’t apply to those who are prone to falling, according to the report, or those who have a history of fractures, a documented Vitamin D deficiency or a diagnosis of osteoporosis.

Vitamin D is not actually a vitamin, according to nutrition experts Marion Nestle and Malden C. Nesheim; it’s a hormone produced by the body in reaction to sunlight.

“Like other hormones, vitamin D has multiple roles in the body, not all of them well-understood,” the experts wrote in an editorial about the USPSTF recommendations. As such, Vitamin D supplements must be considered a form of hormone replacement therapy, they wrote, and be subjected to similar probes about efficacy, dose and side effects.

As we’ve seen with recommendations from this group in the past (think prostate or cervical cancer screenings), there are those that disagree with the task force’s conclusion.

“These recommendations fail to recognize the well-established role of calcium and vitamin D in maintaining bone health,” the Council for Responsible Nutrition said in a statement. “If these recommendations are taken to heart, or misconstrued as general recommendations against calcium and vitamin D, consumers could be compromising their bone health and missing out on important other benefits from these nutrients.

“The bottom line: calcium and vitamin D are vital to staying healthy.”

The Centers for Disease Control and Prevention says African-Americans have the highest rates of Vitamin D deficiency - along with the highest bone density and fewest fractures. Approximately 12% of Mexican-Americans are deficient, while only 3% of non-Hispanic whites are at risk.

The Institute of Medicine recommends adults get at least 800 to 1000 mg of calcium daily, depending on their age, and at least 400 IU of Vitamin D. Adults can safely absorb up to 2,500 mg of calcium and 4,000 IU of Vitamin D.

Calcium is most commonly found in dairy products like milk, cheese and yogurt, but it’s also available in green leafy vegetables like spinach and kale. Vitamin D is crucial for helping your body absorb calcium, which is why the nutrients are often talked about together. Vitamin D can be found in fatty fish or fortified foods like cereal and orange juice. It’s also found in sun rays, where it’s absorbed through the skin.

We're eating less fast food - but not by much

Americans are eating less fast food daily than they used to, according to a new report from the Centers for Disease Control and Prevention.  But it's not much less.

Using data from 2007 to 2010, the CDC's National Center for Health Statistics determined adults eat, on average, 11.3% of their daily calories from fast food. That number was 12.8% in 2006– a one and half point difference.

As you would expect, younger adults tend to eat more fast food than seniors. People older than 60 eat approximately 6% of their daily calories from fast food. Among the younger age groups, non-Hispanic black adults eat the most fast food - using more than one-fifth of their daily calories at fast food establishments.

The CDC did not see a significant difference in fast food consumption based on income, according to the report. Only in the 20-to-39 age group did fast food consumption drop as income increased.

Fast food has been linked to the obesity epidemic in the United States. Not surprisingly, obese adults in each age group ate more of their calories from fast food.

Sorority girl drops 107 pounds

Brittni Garcia's family didn't go out for walks; they went out for dinner. And when they were at home, they enjoyed watching movies, playing board games and eating big Mexican-style home-cooked meals.

This lazy lifestyle led Garcia to weigh more than 200 pounds by the eighth grade.

"My mom always said, 'You are a big girl. You are just big-boned,'" said the 25-year-old information specialist. "So I just accepted it."

Through high school and college, her weight continued to rise. But even at 235 pounds, Garcia didn't think her weight was a problem -- until she couldn't fit into her "fat shorts" anymore.

That was December 2009.

It was a typical night for Garcia. She was studying for finals in her sorority house at Eastern Illinois University and wanted to change into some comfortable clothing. She found her red pajama XXL shorts that she normally wore to bed.

As she struggled to pull them up, she realized they were too tight and uncomfortable -- her "big, comfy shorts" no longer fit.

"Tons of emotions ran through my head," she said. "I was afraid that was the way my life was going to be."

That's when Garcia's mentality changed. Being overweight was no longer normal for her.

Heart disease runs in her family, and she realized it was time to address her weight now before it turned into a bigger health problem.

"I wanted to lose weight to challenge myself and show myself I can change, and not change for the world," Garcia wrote in her iReport. "This time, it was for me."

Getting in shape wasn't going to be easy. Going to the gym had been one of her biggest fears for a long time. She was self-conscious about how she looked and sounded when she ran.

"It was hard for me to breathe," Garcia said. "It was embarrassing."

Team loses 400 pounds for Winter Games

Embarrassment about her weight extended to other areas of her life. Although she was president of her sorority, Garcia always felt like she stood out.

"All the sorority girls had cookie-cutter form, and I looked different," she said. "It was really hard for me to connect."

Garcia's involvement in Greek life perpetuated her unhealthy habits; she often went to bars and restaurants to mingle with her college friends. It was difficult to break the cycle, but she found supportive friends who also hit the gym.

"What I tell people is that you find new friends at the gym," she said. "If you don't have the support, it's really hard to do it on your own."

Garcia found one of her biggest supporters through her sorority. She met Nicholas Monreal at a Greek function, and they began dating when she was at her heaviest. But the days of social functions, bar visits and restaurant outings are long gone for the couple.

"He was there when I realized I wanted to change," she said. "To this day, our dates are to the gym. We see excitement in going on walks and runs."

The couple has been together for four years; he proposed in December. Monreal has noticed a significant difference in Garcia over the past few years -- not just physically.

"She's more energetic ... and she's more willing to try new things," he said "She's just working very hard, and she's a better person for it."

On the right track

Since the beginning of 2010, Garcia has lost 107 pounds.

There were setbacks, the biggest of which came this past August when she was in a car accident. She completed three months of physical therapy and wasn't able to go to the gym and do her daily routines for a month and a half.

She was angry at first -- mad at the person who hit her car and stalled her progress at the gym.

But she got over her initial anger, and Garcia went on a walk. This time, she wasn't alone. Her fiance, her parents, her sisters and her aunt encouraged her to stay active. As a result, Garcia went on walks with them and did yoga at a gym.

Girl loses 65 pounds in fight against childhood obesity

After getting back on track with her daily workouts, Garcia realized she also had to better manage her eating habits.

"For the longest, I would go to the gym and go home to eat whatever I wanted," she said. "That's not how it works. I had to learn to eat differently and to learn to like new foods."

She started doing research on proper nutrition. She read books and online articles, shopped at health foods stores and learned to prepare meals that helped her maintain a healthy diet.

Now for two hours every Sunday, Garcia grills chicken, cooks vegetables and packs fresh fruit in preparation for the upcoming week.

"(I) make eating as simple as possible," she said. "If there are a lot of ingredients, I don't want it."

The next step

Down to 128 pounds, Garcia has been left with a lot of loose skin -- particularly around her stomach. She is doing CrossFit exercises and weight training to tighten up the area.

She's also checking off some other goals.

One of the most rewarding moments in Garcia's weight loss journey was completing her first 5K run in 27 minutes.

When she first started training, running three miles took her 48 minutes. Today, she can complete it in less than 25.

"I hadn't been able to walk a lap, let alone run it," she said. "And now when I finish a workout, I really get emotional and I can't believe that I could do it."

She isn't stopping there. Garcia wants to complete a half marathon as well as the Warrior Dash in June. As a result, she might take a pool break in between.

"I really want to fit in my bikini comfortably this summer," she said.

Today, Garcia doesn't shop at plus size clothing stores anymore. She was able to drop from a size 22 to a size 6.

And what happened to her XXL "fat shorts?" She ditched them for a pair of small exercise shorts.

To those just starting their weight-loss journey, she offers this advice:

"Once you start, don't give up. The hardest thing to do is to continue. If you have a bad day, don't make it a bad week.

Overheard: Whose fault is obesity?

This post is part of the Overheard on CNN.com series, a regular feature that examines interesting comments and thought-provoking conversations posted by the community.

Obesity is a huge problem in the United States, and it’s linked to serious illnesses such as diabetes, stroke, heart disease and certain cancers.

A new report suggests that by 2030 nearly half of all Americans will be obese, and these expanding waistlines will translate into billions of dollars of health care costs. The study authors advocate for nationwide interventions to get children and adults to be more physically active and eat healthier.

More than 400 readers commented on the story. The most popular reader comment came from Joe Skinner, who says:

This is something I've been saying forever, the problem isn't "Romneycare" or "Obamacare," it's fat Americans who are the problem and they are more willing to blame politicians for health care cost problems than to say the 300-pound reading on the scale might have something to do with it.

Bruce Force responded that weight loss alone won’t solve the problem:

I agree that we are responsible for our own health but I think this obsession with losing weight is the wrong way to go about it. When we talk about fitness, we never talk about skills and that's unfortunate because that what being fit is about: developing skills in order to survive.

Chichetr proposed the radical measure of taxing overweight people per pound, a comment that got 59 “likes” :

I'm sick and tired of seeing my fellow Americans waddling around from fast food restaurant to fast food restaurant, their giant bellies swaying and bulging out under their shirts. It's absolutely shameful.

I propose that we start charging health care costs by the pound. How many of these people do you think are going to keel over from 1, 2 or 3 heart attacks, strokes, cardiovascular disorders of every kind? The list goes on and on. How many of these people can actually PAY for the tremendous health care costs associated with their weight? Not many.
I as a taxpayer, I refuse to pay for these people. Tax the overweight and obese NOW!

But pgauthi responded with a more pragmatic approach:

Those of us living in the real world realize we can't just let people "take responsibility," because we have decided that everyone has the right to emergency treatment. So as much as it pains me to pay for the lazy obese I would rather pay for their preventive care than for their emergencies.
I would love it though if medicare tax and/or health premiums were based on BMI and cardiovascular fitness.

Delishus Cake represented the point of view that the high cost of healthy foods compared to fattening foods is part of the problem:

If fresh fruit was affordable year round and a salad didn't cost the same as 4 double cheeseburgers people might not be so fat. Low income people typically choose whichever option looks to be the most bang for your buck. If you've got $4 and you want to eat are you going to buy a salad or 2 double cheeseburgers, a large coke, and a fry?

But halfthestory argues the opposite viewpoint:

So tired of hearing the "it costs too much to eat healthy" argument. Plan your budget and buy healthier foods ... fast food is not much cheaper and is much less healthier. It's a lifestyle change and not a financial issue in most cases. It's just easier to justify when you say "it costs too much".

Chemical BPA linked to children's obesity

Finally, the usage of body mass index as a measure of obesity is imperfect, as readers such as CatMagnet noted. Height and weight are the factors that go into calculating BMI, but for some people that is not an accurate assessment of whether they are healthy.

On Twitter, science writer @miriamgordon responded to the story by citing this New York Times article from Tuesday, which notes that obesity as we know it may not be the whole story: “In study after study, overweight and moderately obese patients with certain chronic diseases often live longer and fare better than normal-weight patients with the same ailments.”

Part of the problem is that if you measure obesity with body mass index, you are ignoring other potentially critical measurements of health, including metabolic abnormalities, lean muscle mass and body fat, the article said.

Another science writer, @daviddespain, responded with an article he had written on his blog suggesting that young Asian-American women may be improperly categorized as healthy using the traditional BMI scale; they may have low BMI but high body fat percentage.

The state-by-state obesity data from the Centers for Disease Control and Prevention do not take these deviations from the traditional BMI picture into account, nor do the 2030 predictions.