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It won't be nearly as much fun as eating candy bars, but a big study is being launched to see if pills containing the nutrients in dark chocolate can help prevent heart attacks and strokes.
The pills are so packed with nutrients that you'd have to eat a gazillion candy bars to get the amount being tested in this study, which will enroll 18,000 men and women nationwide.
"People eat chocolate because they enjoy it," not because they think it's good for them, and the idea of the study is to see whether there are health benefits from chocolate's ingredients minus the sugar and fat, said Dr. JoAnn Manson, preventive medicine chief at Harvard-affiliated Brigham and Women's Hospital in Boston.
The study will be the first large test of cocoa flavanols, which in previous smaller studies improved blood pressure, cholesterol, the body's use of insulin, artery health and other heart-related factors.
A second part of the study will test multivitamins to help prevent cancer. Earlier research suggested this benefit but involved just older, unusually healthy men. Researchers want to see if multivitamins lower cancer risk in a broader population.
The study will be sponsored by the National Heart, Lung and Blood Institute and Mars Inc., maker of M&M's and Snickers bars. The candy company has patented a way to extract flavanols from cocoa in high concentration and put them in capsules. Mars and some other companies sell cocoa extract capsules, but with less active ingredient than those that will be tested in the study; candy contains even less.
"You're not going to get these protective flavanols in most of the candy on the market. Cocoa flavanols are often destroyed by the processing," said Manson, who will lead the study with Howard Sesso at Brigham and others at Fred Hutchinson Cancer Research Center in Seattle.
Participants will get dummy pills or two capsules a day of cocoa flavanols for four years, and neither they nor the study leaders will know who is taking what during the study. The flavanol capsules are coated and have no taste, said Manson, who tried them herself.
In the other part of the study, participants will get dummy pills or daily multivitamins containing a broad range of nutrients.
Participants will be recruited from existing studies, which saves money and lets the study proceed much more quickly, Manson said, although some additional people with a strong interest in the research may be allowed to enroll. The women will come from the Women's Health Initiative study, the long-running research project best known for showing that menopause hormone pills might raise heart risks rather than lower them as had long been thought. Men will be recruited from other large studies.
Manson also is leading a government-funded study testing vitamin D pills in 26,000 men and women. Results are expected in three years.
People love vitamin supplements but "it's important not to jump on the bandwagon" and take pills before they are rigorously tested, she warned.
"More is not necessarily better," and research has shown surprising harm from some nutrients that once looked promising, she said.
Marilynn Marchione can be followed at HTTP://TWITTER.COM/MMARCHIONEAP
HOUSTON (AP) -- Sara Rodriguez recently received a $4,000 bill for a six-hour emergency room visit to treat a fever. She says she can't pay, but she's also not planning to buy health insurance through the new federal marketplace.
Rodriguez, like others gathered in a Houston gymnasium listening to a presentation about the health care overhaul, says she can't afford insurance, even for $50 a month. With two young children and barely $400 of income a month after paying rent, she struggles to feed her family.
"It's the law, but I'm not interested," the 27-year-old says, explaining that she attended the presentation only because her GED teacher is making her write an essay. "I cannot afford it."
The presentation ends and Rodriguez grabs her belongings and rushes out, forgoing the opportunity to make an appointment for enrollment assistance. The crowd of about 200 quickly dwindles, with some stragglers lingering to schedule appointments.
As a March 31 deadline draws near, this is a daily reality in Texas, where nearly 1 in 4 residents is uninsured, the highest rate in the nation.
Texas stands out among the nation's four most populous states for lagging behind on signups. California, New York and Florida have signed up far more people.
Enrollment helpers here are working days on end, sometimes with no time off, as they make a final push to get people to buy policies.
They count the small victories: If only five people come to a three-hour enrollment event but all sign up, that gets a thumbs' up. No matter that it is just an infinitesimal fraction of the Texans who could be eligible for subsidized coverage, a figure the Kaiser Family Foundation puts at 1.8 million people.
The final weeks of enrollment are sure to be filled with frenetic activity. Mega-enrollment drives are planned almost daily. Weekend and evening events are jam-packed. Hospitals in Dallas will stay open for longer weekday and weekend hours.
At this late stage, education and outreach have largely been abandoned. The goal now is to ensure that everyone who strolls in with paperwork walks out with insurance.
"Sign up! Sign up," is the charge guiding Benjamin Hernandez, Houston's deputy assistant health director, as he helps with a massive effort to reach his region's 1 million uninsured.
Texas' large uninsured population makes it crucial to the success of the entire national program. But the impediments are many.
Some in the state's large Hispanic population are wary of enrolling because of fears that doing so might reveal the existence of family members at risk of being deported.
As of mid-March, enrollment numbers were only slightly more than 295,000, lagging behind Florida, another state with high numbers of uninsured and a governor opposed to the program.
Texas Gov. Rick Perry has erected his own obstacles in the form of additional rules and training requirements imposed on health care "navigators."
Other Texas Republicans have also slammed the program. Lt. Gov. David Dewhurst, forced into a runoff against a tea party candidate after a tight primary, released a TV ad that shows businessmen and women in suits engaged in a high school cafeteria food fight - a metaphor, according to the ad, for the program's glitch-filled rollout.
It's not clear whether the Perry mandates and the intense public criticism of the law have scared off many potential enrollees. But Hernandez believes "lack of information and misinformation are key barriers."
Brenda Sanders, 54, was one of about a half-dozen people who trickled into a recent enrollment event on Houston's north side. Sanders knew the deadline and where to find a plan. She tried to apply, and it appeared she didn't qualify for financial assistance. The $200 monthly premium offered was unaffordable on her income of barely $600 a month, the part-time home care provider said.
"I'm a little disappointed," Sanders said. "Even with Obamacare, it's supposed to be affordable, but for people like me, that are low, low income, it's still not affordable."
And that is another struggle for Texas. The state decided against expanding Medicaid, despite the offer of federal dollars to help cover the costs in the first few years, meaning more than 1 million of the uninsured who do not qualify for subsidies could be left without coverage.
In the meantime, Houston and other areas are zeroing in on crucial populations: younger people and Hispanics. Houston spent about $40,000 on a two-week radio ad buy in English and Spanish. Hernandez also advertised in fitness centers, hoping to reach Hispanic mothers, believed to be the health care decision makers in those families.
Martha Blaine, executive director of the Community Council of Greater Dallas, recently spent just under $10,000 to buy radio spots on seven different Spanish radio stations in North Texas. The spots ran for two weeks in the morning and afternoon drive times and midday to hit stay-at-home moms. One was aimed at young men.
"Their mom will be listening to the other station and tell them to go do it," Blaine said. "We figure we'll hit them with both sides with that one."
Rodriguez has seen and heard all this, but remains adamantly opposed. Sitting alongside her GED classmates at the presentation organized by the Association for the Advancement of Mexican Americans, they run through their expenses: food, clothes, diapers, baby formula, baby sitters.
Sitting next to her is Mayde Arroyo, 32, who makes less than $400 a month working weekends at the Children's Place clothing store. She relies largely on the $780 a month she gets in child support to raise her 11- and 10-year-old boys. Often, she says, she doesn't have the $25 co-pay to take her children to the doctor under the insurance plan they have through their father. She is desperate to also be insured but not optimistic about obtaining coverage.
"I'm not going to work just to pay my insurance," Arroyo says, concluding she can't afford more than $50 a month for a plan.
Rodriguez, meanwhile, looks through the pamphlet she received at the event. An hour later, she's considering at least filling out an application. But even $20 a month is a stretch, she says. Like the $4,000 hospital bill she will ignore, she also shrugs off a penalty imposed by the law on those who are eligible for marketplace coverage but remain uninsured.
"It will just come out of my taxes so it doesn't matter," she says. "And it's way less than what they will take out monthly, right?"
Plushnick-Masti can be followed on Twitter at HTTPS://TWITTER.COM/RAMITMASTIAP .