Under the new rule, employers with a religious objection to offering contraceptive coverage as part of their health care plans wouldn’t have to provide it directly. Instead, the requirement to provide that coverage free of charge would fall on the insurance companies.

Some Catholics believe the president’s new rule resolves the religious liberty issues. But others, including key bishops, say it is smoke and mirrors.

‘A First Step’ Or Nothing ‘Substantial’?

In a statement, Timothy Dolan, the head of the U.S. Conference of Catholic Bishops, said the president’s new rule is “a first step in the right direction.” He said the bishops are reserving judgment until they see the details.

But Archbishop Thomas Wenski already sees big problems ahead. Wenski, who heads the Catholic archdiocese of Miami, has said in the past that he couldn’t comply with the health care mandate. Friday’s announcement has not changed his mind.

“I think what he’s offered today is a smoke screen in which he has decided to kick the can down the road in the hope that the controversy will go away,” Wenski says. “I think he is mistaken.”

Wenski says this is a unilateral decision. The White House didn’t consult the bishops, as far as he knows. He says the rule still mandates that employees of Catholic charities, hospitals and universities receive birth control coverage.

“I don’t believe he’s offered us anything really substantial,” Wenski says. “We still have serious issues and these are issues of religious freedom.”

Wenski notes that shifting the burden to insurance companies doesn’t solve the religious liberty problems either — since many dioceses and charities are self-insured, and would be violating their religious principles.

Ending A Stalemate?

But Sister Carol Keehan, who heads the Catholic Health Association, was cheered by the White House response.

“I think that they listened to us and they heard the things that we were most concerned about, and we’re pleased,” she said.

Keehan, whose association oversees some 600 Catholic hospitals, believes everyone wins. Women get the health care they want, the church does not have to pay for or endorse birth control, and the stalemate is ended. Now, she says, the country can implement health care reform, which has at its core a principle dear to the church — helping the poor and uninsured.

The Rev. Thomas Reese, a Jesuit priest at Georgetown University’s Woodstock Theological Center, agrees. For the past few weeks, he says, the bishops have dominated the debate. They’ve drawn support from both conservative and liberal Catholics.

“The bishops were getting support because people saw this as a religious liberty issue. They were not supporting the bishops in their opposition to contraceptives,” he says.

Reese believes that by ensuring that religious groups do not have to pay for or recommend birth control coverage, that religious liberty issue has gone away. And in the end, most Catholic women want, and use, birth control.

Archbishop Wenski of Miami says the two sides will keep talking, but in the end, there’s only one right outcome: “The best thing would be rescission — to take back the whole mandate and go back to the status quo before.”

That’s something the administration has said it will not do. [Copyright 2012 National Public Radio]

Even some Democrats, who generally support the policy of requiring most employers to offer no-cost contraception, were unhappy with the rule’s reach.

But the change unveiled by the White House isn’t expected to completely quell the uproar raised by Catholics and others who say the policy violates their freedom of religion.

The change would allow employers that have religious objections to offering contraception as part of their health plans to turn the responsibility over to insurance companies instead.

As a result, “nurses, teachers, janitors and others” who work for religious-based hospitals, universities and social service agencies “will still have access” to contraception without having to pay a copay or deductible, a senior administration official told reporters on a conference call Friday morning.

But at the same time, he said, “religious liberty will be fully protected.”

Women’s groups were cautiously pleased with the change.

“We believe the compliance mechanism does not compromise a woman’s ability to access these critical birth control benefits,” said Planned Parenthood President Cecile Richards. “However, we will be vigilant in holding the administration and the institutions accountable for a rigorous, fair and consistent implementation of the policy, which does not compromise the essential principles of access to care.”

Sister Carol Keehan, president of the Catholic Health Association, which oversees more than 600 Catholic hospitals, praised the change in a statement. “We are pleased and grateful that the religious liberty and conscience protection needs of so many ministries that serve our country were appreciated enough that an early resolution of this issue was accomplished,” she said. “The unity of Catholic organizations in addressing this concern was a sign of its importance.”

Before the change, the Rev. Tom Reese of Georgetown University’s Woodstock Theological Center told NPR there was no reason for Catholic bishops to settle on the issue, because they’ve been winning the public relations battle. “They’re getting support from progressive Catholics and conservative Catholics,” Reese says, “so the bishops are on a roll.”

The White House just released a summary of what’s in the works. Here’s the statement in its entirety.

FACT SHEET: Women’s Preventive Services and Religious Institutions

Thanks to the Affordable Care Act, most health insurance plans will cover women’s preventive services, including contraception, without charging a co-pay or deductible beginning in August, 2012. This new law will save money for millions of Americans and ensure Americans nationwide get the high-quality care they need to stay healthy.

Today, President Obama will announce that his Administration will implement a policy that accommodates religious liberty while protecting the health of women. Today, nearly 99 percent of all women have used contraception at some point in their lives, but more than half of all women between the ages of 18-34 struggle to afford it.

Under the new policy to be announced today, women will have free preventive care that includes contraceptive services no matter where she works. The policy also ensures that if a woman works for religious employers with objections to providing contraceptive services as part of its health plan, the religious employer will not be required to provide contraception coverage, but her insurance company will be required to offer contraceptive care free of charge.

The new policy ensures women can get contraception without paying a co-pay and addresses important concerns raised by religious groups by ensuring that objecting religious employers will not have to provide contraceptive coverage or refer women to organizations that provide contraception. Background on this policy is included below:

Section 2713 of the Affordable Care Act, the Administration adopted new guidelines that will require most private health plans to cover preventive services for women without charging a co-pay starting on August 1, 2012. These preventive services include well women visits, domestic violence screening, and contraception, and all were recommended to the Secretary of Health and Human Services by the independent Institute of Medicine of the National Academy of Science.

Today, the Obama Administration will publish final rules in the Federal Register that:

Exempts churches, other houses of worship, and similar organizations from covering contraception on the basis of their religious objections.

Establishes a one year transition period for religious organizations while this policy is being implemented.

The President will also announce that his Administration will propose and finalize a new regulation during this transition year to address the religious objections of the non-exempted religious organizations. The new regulation will require insurance companies to cover contraception if the non-exempted religious organization chooses not to. Under the policy:

Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.

Religious organizations will not be required to subsidize the cost of contraception.

Contraception coverage will be offered to women by their employers’ insurance companies directly, with no role for religious employers who oppose contraception.

Insurance companies will be required to provide contraception coverage to these women free of charge.

Covering contraception saves money for insurance companies by keeping women healthy and preventing spending on other health services. For example, there was no increase in premiums when contraception was added to the Federal Employees Health Benefit System and required of non-religious employers in Hawaii. One study found that covering contraception lowered premiums by 10 percent or more. [Copyright 2012 National Public Radio]

Patients at hospitals in Maryland, Mississippi, Louisiana, Maine and New Hampshire were most likely to get blood infections caused by central lines, which are narrow tubes inserted in a major vein to inject medicine or fluids or to perform tests.

Hawaii, Alaska, South Dakota, Kansas and Indiana had the lowest rates, according to the data, which cover the first three months of 2011.

The Centers for Disease Control and Prevention, the source of the data CMS is publishing on its Hospital Compare website, says there were about 41,000 infections throughout hospitals linked to central lines in 2009. A line that hasn’t been cleaned or is inserted incorrectly can lead to germs getting into a patients’ bloodstream. CMS says treating these infections adds about $17,000 to a hospital stay.

About a fourth of the patients die from the infection, which should be preventable if hospitals follow cautionary guidelines. As required by the 2010 federal health law, Medicare is gearing up to financially penalize hospitals with high rates of infections that are caused by the institutions.

The new data cover intensive care units at 1,146 hospitals. Medicare’s evaluation found 187 hospitals ICUs with more central-line infections than at institutions of a similar type and size. Another 386 hospitals had no central line infections during the first three months of last year, according to the data. CMS didn’t publish data for 2,232 hospitals, either because the hospital didn’t have an ICU unit or had too few or no cases to evaluate.

Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said hospitals welcomed the new data as more accurate than Medicare’s previous infection data, which came from bills hospitals submitted to Medicare.

The new data include all patients — not just those covered by Medicare — and are based on medical records rather than bills.

Foster cautioned that the period covered by the data is short, just three months, so she said the information will become more reliable as it expands in the future. “We are very supportive of good quality information being up on Hospital Compare,” Foster said.

Also, during the past decade central line infections among ICU patients have fallen quite a bit, according to a previous estimate from the CDC. The decline in infections means from 3,000 to 6,000 lives were probably saved.

For more info, check out the state figures, as calculated by CMS, in the chart on the left. The lower the score, the fewer central-line infections there were. [Copyright 2012 National Public Radio]

Well, those campaigns seem to have worked.

A study out this week has found that the amount of trans-fatty acids in some Americans decreased significantly — 58 percent among white adults between 2000 and 2009. Researchers at the U.S. Centers for Disease Control and Prevention, who published their findings in the Journal of the American Medical Association, say that is “substantial progress.”

The history of trans fats is pretty fascinating, as Dan Charles’ recent post demonstrated. The invention of hydrogenation turned cottonseed oil (and later, soybean oil) from a liquid into a solid that was perfect for baking and frying. Back in the in the 1980s, health activists actually promoted oils containing trans fats. Crisco, made from partially hydrogenated vegetable oil, was promoted as a good alternative to lard.

But by the mid-1990s, health activists began denouncing trans fats as scientific studies turned up evidence that they increased artery-clogging forms of cholesterol.

Then in 2006 the U.S. Food and Drug Administration began requiring food manufacturers to label trans fats on nutrition labels. That prompted health departments to push restaurants to limit their use of the oils in food and publicize the health risks associated with them. New York, Philadelphia, Baltimore, and California are among the jurisdictions that have banned most trans fat from restaurant food.

Now that food-makers and restaurants have switched to alternatives like sunflower oil, that has left much smaller amounts in the food supply. While the CDC’s study looked only at the trans fat levels in blood of white adults, it says an analysis of other race and ethnic groups is underway.

But as the Center for Science in the Public Interest pointed out yesterday in a statement, it’s still not that hard to find trans fats in the grocery store if you go looking for it. Pop Secret Popcorn and Pillsbury’s Buttermilk Biscuits have a lot of trans fats; the Long John Silver’s seafood chain hasn’t given the oils up either.

Even products that say “zero trans fat” aren’t entirely accurate. The FDA allows foods to contain up to 0.5 grams of trans fat per serving and still be labeled as having zero grams. [Copyright 2012 National Public Radio]

Leona Maricle was diagnosed with Parkinson’s two years ago. At the time, she was teaching math, and she says she had experienced the telltale tremors of Parkinson’s for a number of years. She learned how to cope.

“The students began to notice that my hands were trembling,” she recalls, “so I started learning how to compensate by keeping that hand under the table and using the other hand to pass out papers, interact with students and hand out pencils.”

But soon it became clear that Maricle just couldn’t give teaching her “best” anymore. She retired at 67.

Parkinson’s disease, a progressive disorder of the nervous system, affects movement and motor control. “I would need to think two or three times about moving a particular part of my body,” says Maricle. “When I was sitting in a chair and needed to get up, it would take two or three mental messages to my muscles to actually move my body.”

Maricle had difficulty walking upstairs, downstairs, to the car or just down the street. So it’s no wonder that, when she heard about a new study at the nearby Oregon Research Institute to look at the potential benefits of Tai Chi for Parkinson’s patients, she jumped at the chance. Hoping for help but also loving all things Chinese, Maricle saw the study as a perfect fit for her.

The study, which appears in the current New England Journal of Medicine, was headed by research scientist Fuzhong Li, who practices Tai Chi himself. Tai Chi is sometimes described as “meditation in motion,” because it promotes serenity through gentle movements, connecting the mind to the body. It has been shown to benefit loss of balance during normal aging and can help relieve stress. Typically, the positions and postures of Tai Chi involve slow, focused movements that flow from one to the next.

In the study, Li divided Parkinson’s patients into three groups. One group did resistance training with weights. Another, stretching classes. And the third took up Tai Chi. Each group participated in a 60-minute class twice a week for six months.

When they finished, Li found that the Tai Chi patients were stronger and had much better balance than patients in the other two groups. In fact, Li says their balance was “four times better than those patients assigned to the stretching group and about two times better than those in the resistance-training group.”

That led to significantly fewer falls for patients in the Tai Chi group. Leona Maricle says that before Tai Chi, she lost her balance eight to 10 times a day. Now it hardly ever happens. She recently even saved herself from what would have been a sure fall before Tai Chi. It was raining and dark, and she tripped on the curb as she got out of her car. She was able to actually hop onto the curb and steady herself.

“That would have been a fall for sure six or eight months ago,” she says.

Researchers don’t know exactly how Tai Chi works to restore balance. UCLA psychiatrist and brain scientist Michael Irwin says it may work by literally re-training areas of the brain that control movement.

“There’s a memory component of our nerves, and they’re receiving signals from our body all the time that are integrated by the brain,” Irwin says. “And it may be that what happens with Tai Chi is that it’s bringing awareness of the brain to these areas of the body” — thereby strengthening those areas of the brain. [Copyright 2012 National Public Radio]

Do you take it?

About one-third of diners (out of several hundred) who were given that choice at a Chinese takeout restaurant said yes, according to a study out today in the journal Health Affairs. The diners who chose the smaller noodle and rice dishes also ended up eating less overall — and avoided overeating — compared with those who ordered a full serving.

“People are willing to downsize, but you have to ask them do it,” lead author Janet Schwartz, a psychologist and assistant professor of marketing at Tulane University, tells The Salt. “They’re not going to do it on their own.”

Indeed, hardly any patrons in Schwartz’s study asked for a smaller portion right off the bat. Considering portion size isn’t really programmed into the way we order at restaurants, according to Schwartz. And her paper argues that calorie labeling alone isn’t having much of an impact either. In fact, most people use a well-rehearsed script when ordering.

Still, Schwartz says many people think restaurant portions are too big. And the U.S. Department of Agriculture’s latest dietary guidelines recommend smaller portions of grains like rice and noodles than what was served at the Chinese restaurant in the study. For example, the USDA recommends that a man (like me) between 19 and 30 years old eat no more than 8 ounces of grains a day. The full serving size of rice or noodles at the Chinese food restaurant was 10 ounces — and that’s just the side for lunch.

Schwartz parsed other nuances of decisions around portion size in several small experiments in the study. The researchers first looked to see if diners would compensate the loss of starches with more of the main entree (they didn’t) and if a 25-cent discount for a smaller portion had more of an influence (it didn’t).

Next they looked to see if displaying calorie content made a difference. Interestingly, about 21 percent of people chose to downsize before they knew how many calories were in a meal, as opposed to 14 percent who chose to downsize after they had that information. Lastly, researchers weighed the leftovers of 30 percent of the customers. The group that purchased a full order left an average of 2 ounces on the plate, as did the group that downsized.

So why did so many people choose a smaller side dish? And why did this tactic seem to work when others seemed to fail?

The first key was telling people that they could reduce their calorie intake by just having a little bit less food — “less of things they didn’t even come in for,” Schwartz says.

The second key was to ask customers before the servers started piling food onto the plate. Exercising self-control early on to restrict portion size is much easier than when already faced with a table full of temptation, she says. Basically, it’s harder to decide to stop eating when you’re knee-deep in a meal and choose to throw away or wrap up the leftovers. Diners often feel obligated to clean their plates as if their grandmothers were watching.

So what about just getting rid of the starches altogether and offering a healthful alternative like fruits or veggies? Well, Schwartz says those options tend to test well in consumer studies, but they don’t translate to sales in the real world. How often have you picked the apples over the salty fries?

“We’re trying to get people to think about not just what they eat, but how much they eat,” she says. “What this study brings to the table is an actual reduction of calorie intake, something that just labeling foods with a calorie count hasn’t done.”

The New York City Department of Health launched its own effort to regulate portion sizes in January. The ad didn’t go over well with some, though, because the unidentified, overweight man in the photo has a leg missing. The limb was digitally removed to depict a possible effect of Type 2 diabetes — a chronic disease that overeating can lead to. [Copyright 2012 National Public Radio]

That’s the surprising result of a new study that compared the food preferences and weight of babies who fed themselves finger food with those who were spoon fed.

Both groups of children had equal exposure to snack foods. But the babies who fed themselves preferred carbohydrates like toast, pasta, or potatoes, while the spoon-fed children went for sweets when given a choice.

You’d think the children who controlled their own eating would be heavier, but not so. The spoon-fed crew was the one that was more likely to be obese as toddlers. Eight of the 63 spoon-fed children became obese, while none of the 63 self-feeding children were.

“That was interesting,” says Ellen Townsend, an associate professor of psychology at the University of Nottingham in England, who led the study. “Maybe with spoon feeding, if you’ve lovingly prepared a delicious portion, and you might want to get that portion into that child. There may be a temptation to try to get in and extra spoonful or two.”

The “self-weaning babies” might like carbs because they’re easier to chew and tend to have nice textures, the researchers say. They want to do further research to see if breast feeding and picky eating play a role.

The study, which was published in the journal BMJ Open, was small, and based on parents’ recollections. But Townsend says it should reassure parents that it’s OK to let the child take care of food choices, as long as the parents are providing nutritious options like fruits and vegetables, proteins, and iron-rich foods like hard-boiled eggs or strips of meat.

The good news is that most of the children were of a healthy weight, regardless of how they were fed as babies.

As for Townsend, she was holding her 9-month-old daughter when I called her in England today. What’s that baby eating for dinner?

“She’ll sit down with us tonight and have pork chops, string beans, some baby sweet corn, and probably some potatoes,” Townsend says.

Like many parents with more than one child, she doesn’t have the time to cook up special baby food. And her children seem perfectly happy to eat what’s on the family table. [Copyright 2012 National Public Radio]

The Food and Drug Administration just warned doctors and consumers that popular medicines called proton pump inhibitors may raise the risk for chronic diarrhea caused by Clostridium difficile, a bacterium that you’d rather not have colonizing your intestines.

The drugs include Nexium and Protonix and over-the-counter remedies Prilosec and Prevacid. If you’re taking these drugs (or others in tables 1 and 2 here) and have diarrhea that won’t let up, the FDA says you should see your doctor right away.

These drugs suppress stomach acid, which may help protect against infection with the germ. Your doctor can test to see if you’ve got an infection with C. difficile, the agency says, and treat it.

Why did the FDA issue this advice now?

After looking at a database of problem reports for the drugs and various published studies, the agency concluded that “the weight of evidence suggests a positive association between the use of PPIs and C. difficile infection and disease.”

Now, that’s not ironclad proof, but the agency says it’s strong enough to tell the world about. The agency says the studies show that using PPIs may raise the risk for infection by 1.4 to 2.75 times.

FDA said it wants makers of the drugs to add information about the risk to the instructions for the drugs.

Hints about problems with PPIs have been mounting for a while. Some studies published two years ago in the Archives of Internal Medicine highlighted the possible heightened risk of infection with C. difficile for people taking the drugs.

“The increases in the risk of Clostridium difficile infection with PPIs are not at all modest,” an accompanying editorial said at the time. And the editorial advised doctors to think it over before prescribing PPIs. [Copyright 2012 National Public Radio]

The report shows that about 7 percent of U.S. teen girls between the ages of 15 to 19 were pregnant in 2008 — a decline from the high of more than 11 percent in 1990. Abortions among teen girls fell from a peak of more than 4 percent in 1988 to about 1.8 percent in 2008, the latest year for which data are available.

While overall rates have dropped, there is still a major gap separating white, Hispanic and black teenagers.

Non-Hispanic white teen pregnancy rates fell by 50 percent from their peak; Hispanic teen pregnancy rates, 37 percent; black teen pregnancy rates, 48 percent.

Yet, according to the report, “the abortion rate among black teenagers was four times the rate for non-Hispanic whites, while the rate among Hispanic teenagers was twice the rate for non-Hispanic white teenagers.”

“The disparity has pretty much been unchanged,” said Kathryn Kost, a Guttmacher researcher and co-author of the report. “If you think of these rates as lines on a graph, they are all going down, but the distance between them is pretty much unchanged.”

The report does not distinguish between married and unmarried teens.

Kost said the increase in contraceptive marketing has helped to reduce pregnancies, but Heather Boonstra, a senior public policy associate at Guttmacher said the cost of contraceptives continues to be a factor. Boonstra said increasing the age limit for dependent health care coverage to 26 will increase access to birth control for many teens.

“There’s plenty of evidence that shows that if you take away cost in the equation,there is going to be better contraceptive use, fewer unintended pregnancies, fewer abortions, better birth outcomes,” she said. “The health care reform law was not designed with teens in mind, but … the more parents that are insured, the more teens or their dependents are insured, so certainly that will help.”

Bill Albert, the chief program officer of The National Campaign to Prevent Teen and Unplanned Pregnancy, said the decreased rates are a sign of progress, but more remains to be done. He noted that 3 in 10 girls are pregnant by age 20.

“In a way the message is let’s celebrate today, and then get back to work this afternoon,” Albert said. “I think this underscores the need to continue to invest as the current administration has in proven efforts to prevent teen pregnancy.” [Copyright 2012 Kaiser Health News]

But the resignation of Karen Handel, an outspoken opponent of the reproductive health group, hasn’t slowed down foes of Planned Parenthood.

Even as Handel was on her way out the door, two anti-abortion groups were releasing a report intended to push Republicans in Congress to continue their investigation of Planned Parenthood.

A 23-page memo from the Susan B. Anthony List and the Alliance Defense Fund outlines what those groups’ leaders say are a series of funding irregularities uncovered in various state and federal audits of Planned Parenthood affiliates.

“These problems reveal a pattern of gross financial mismanagement,” said Marjorie Dannenfelser, president of SBA List.

Steven Aden, the Alliance Defense Fund’s senior counsel, added, “The 10 state audits amounted to nearly 8 million dollars in waste, abuse and potential fraud.”

Planned Parenthood, however, brushed off the accusations. “This document is part of a campaign by conservative groups seeking to outlaw access to reproductive health care and uses recycled or overstated allegations,” the organization said in a statement.

The Planned Parenthood statement also noted that “the same groups pushing for a congressional inquiry have also been behind the pressure campaign aimed at the Susan G. Komen for the Cure Foundation and other important organizations.”

But in her first public statements since resigning, Handel said it was Planned Parenthood making things political. “The last time I checked, private nonprofit organizations have a right and a responsibility to be able to set the highest standards and criteria on their own without interference, let alone the level of vicious attacks and coercion that has occurred by Planned Parenthood,” she told Fox News. “It’s simply outrageous.”

Handel, however, who ran unsuccessfully for governor of Georgia in 2010 on a platform that included defunding Planned Parenthood, acknowledged that she urged Komen to defund the organization. Komen officials have now apologized for that decision. [Copyright 2012 National Public Radio]