CHICAGO (AP) — The number of American men and women with big-bellied, apple-shaped figures — the most dangerous kind of obesity — has climbed at a startling rate over the past decade, according to a government study.
People whose fat has settled mostly around their waistlines instead of in their hips, thighs, buttocks or all over are known to run a higher risk of heart disease, diabetes and other obesity-related ailments.
Fifty-four percent of U.S. adults have abdominal obesity, up from 46 percent in 1999-2000, researchers reported in Wednesday's Journal of the American Medical Association. Abdominal obesity is defined as a waistline of more than 35 inches in women and more than 40 inches in men.
During the 12-year period studied, the average waist size in the U.S. expanded to 38 inches for women, a gain of 2 inches. It grew to 40 inches for men, a 1-inch increase.
"The increase is a concern. There's no question about that," said Dr. William Dietz, an obesity expert formerly with the Centers for Disease Control and Prevention, now at George Washington University.
The expansion in waistlines came even as the overall level of obesity — as defined not by waist size but by body mass index, of BMI, a weight-to-height ratio — held fairly steady.
"What it suggests is that even though the obesity rate may be stable, fat distribution may be changing, which would mean that we shouldn't be complacent about the plateau," said Dietz, who was not involved in the study.
Dr. Earl Ford, a CDC researcher and the study's lead author, said the seemingly contradictory trends are puzzling. He said it could be that Americans are exercising less and getting flabby. But because fat weighs less than muscle, they are not necessarily getting heavier.
The study cites other possible reasons for the increase in belly fat, including sleep deprivation and certain medicines. Also, researchers said the increase might be related to pesticides, the plastics additive BPA and other chemicals that mimic hormones that can affect weight. But the connection is speculative and unproven.
Belly fat not only makes people look apple-shaped but often means fat has built up deep inside the body, around the liver and other abdominal organs.
Compared with fat that lies closer to the surface, this "visceral" fat secretes lower levels of beneficial hormones and higher levels of inflammatory substances linked to obesity-related ailments, Dr. Lisa Neff, an obesity specialist at Northwestern University. She was not involved in the study.
"In people of the same weight, the person who carries weight around the middle is going to have higher risks" of obesity-related ailments, Neff said.
By 2011-12, the last year studied, 44 percent of men suffered from abdominal obesity, up from 37 percent. The trend was more pronounced among women: By 2011-12, about two-thirds of all women were affected, up from just over half in 1999-2000.
The researchers analyzed data from CDC health surveys and in-person exams. Adults' average age during those years was 45.
Previously released data from the same surveys indicate that about 35 percent of U.S. adults are obese, a level that hasn't budged much in recent years. Those surveys define obesity as a BMI of at least 30. For example, someone who is 5-foot-4 — the average U.S. woman's height — would be obese at 175 pounds.
Ford said that for both kinds of obesity, the bottom-line message for patients is probably the same: diet and exercise.
DANVILLE, Va. (AP) — Starting next month, America's remaining tobacco growers will be totally exposed to the laws of supply and demand.
The very last buyout checks, totaling about $916.5 million, go out in October to about 425,000 tobacco farmers and landowners. They're the last holdovers from a price-support and quota system that had guaranteed minimum prices for most of the 20th century, sustaining a way of life that began 400 years ago in Virginia, when the leaf became the chief cash crop of the Jamestown colony.
Cigarette makers will have paid $10 billion to compensate growers for surrendering their quotas. Growers got another $5 billion from the companies as part of their 1998 settlement of state lawsuits over smoking-related health care costs.
When the last checks are cashed, surviving growers will be on their own, forced to find profits in a tremendously competitive global market. But those who remain in the business are thriving right now: Many are producing more leaf than they have in years, and enjoying higher prices as well.
"I'm not in this for nostalgia purposes," said Steven Barts, a fourth-generation tobacco farmer in Chatham, Virginia. "The day we're not making money is the day we're not doing it."
Many growers took the money and got out, figuring that without guaranteed profits, there was little point in remaining in a dying industry. The number of tobacco farms dropped from 124,270 in 1992 to 16,234 during the last federal crop census in 2007.
But the U.S. tobacco crop is still worth about $1.5 billion, the same as a decade ago, and production is stable, growing less than 2 percent over the last five years.
"The people who can hang on can make a substantial living," said Harry Lea, a leaf dealer and tobacco warehouse owner in Danville, a one-time industry hub where tobacco fortunes in the 1800s built ornate Victorian mansions on a "Millionaire's Row."
Danville still has a huge R.J. Reynolds smokestack in the middle of town, but it hasn't been used for years. Most of its warehouses are empty, and unemployment has soared since anti-smoking laws and health campaigns prompted a continuing 3 percent to 4 percent decline in U.S. cigarette sales. Only 18 percent of U.S. adults now smoke, down from 42 percent in 1964, when the U.S. surgeon general's historic report linked smoking with cancer.
While local economies suffer across America's tobacco country, cigarette makers remain profitable. They are competing for a dwindling market, but getting higher prices with lower production costs, using newer, high-speed manufacturing equipment.
Making a pack of 20 cigarettes costs about 27 cents, and they sell for an average of $5.80. Even after taxes, there's plenty of profit to be had.
Consolidation also is aligning costs with demand. Reynolds American Inc. promises $800 million in savings through its proposed $25 billion merger with Lorillard Inc. The deal would create a formidable No. 2 U.S. tobacco company behind Altria Group Inc., which owns Philip Morris USA, maker of the top-selling Marlboro brand.
U.K.'s Imperial Tobacco would become No. 3, buying Lorillard's Greensboro, North Carolina, factory and some of the combined company's brands. But Reynolds and Altria would form a duopoly, together commanding 85 percent of the U.S. cigarette market. That could leave growers with fewer outlets to sell to, and an anti-trust review is pending.
Chris Haskins, who owns about 50 acres of tobacco not far from Danville, would prefer to have more competition among cigarette makers. But he and other growers are more concerned about global tobacco trends and the advent of e-cigarettes.
Nearly 50 percent of some kinds of U.S. tobacco is exported to countries where consumption is declining less sharply. U.S. shipment volumes fell nearly 3 percent to 285 billion cigarettes last year, while global volumes fell slightly more than 1 percent to more than 5.71 trillion cigarettes, according to market researcher Euromonitor International.
"Without the export market we'd have a continually shrinking volume," Barts said.
Virginia tobacco is still in demand and maybe always will be. Tobacco companies prize the "bright leaf" grown on Virginia's nutrient-rich Old Belt, which produces a mild, light and aromatic taste when smoked.
But tremendous growth in electronic cigarettes is a threat because most of their nicotine is extracted from tobacco in China, said Will Snell, an agricultural economist and tobacco expert at the University of Kentucky.
Some farm groups are lobbying to have these new devices taxed and regulated like other tobacco products, and pushing their makers to use nicotine from U.S. tobacco.
"At this point, there's very little benefit to U.S. tobacco growers" from e-cigarettes, Snell said.
Even the most successful growers acknowledge that their family traditions may end with them. Cities across the South have given up staking their futures on the crop that shaped their past.
In Danville, Japan Tobacco International has the only major processing facility still operating. The town's thriving textile plants also shut down when those jobs went overseas. Danville's National Tobacco-Textile Museum closed in 1990.
Haskins, a fourth-generation tobacco grower, expects to get his last buyout check in October, but says he weaned himself off the money long ago.
"I'm sure it's going to change some situations for other farmers," Haskins said. But "I've been expecting it to be over with. I'm not getting that much as it is anyway. I don't foresee it having a big effect on our operations."
Haskins, 32, isn't sure if his 22-month-old son and another on the way will stay in the business. But for now, he plans to keep farming tobacco just like his great-grandfather did, walking the rows each fall and stripping wide, green leaves off thick stalks to be cured in barns that dot the rolling hills.
"It's something that I was born into that I love to do," he said. "It's something I'm going to continue to do as long as it's legal."
Lush reported from Danville and Felberbaum from Richmond, Virginia. AP Writer Bruce Schreiner in Louisville, Kentucky, contributed to this report.
WEED, Calif. (AP) — They had prepared for wildfires and knew of the drought-parched forests, but the inferno that swirled through the California lumber town of Weed moved so quickly all people could do was flee.
In just a few hours, wind-driven flames destroyed or damaged 150 structures, a saw mill and a church. At times, the fire moved so fast that residents had only a few minutes to get out of the way.
On Tuesday, the "Weed Like To Welcome You" town sign still stood, but nothing else was normal as stunned residents assessed the damage, took stock of what they lost and gave thanks for what was saved.
"At the peak, essentially the entire town was evacuated," state fire spokesman Robert Foxworthy said.
Disastrous as the fire was for the community of 3,000 people, daybreak brought gratitude and relief that there were no reports of death or even serious injuries.
The intense blaze erupted Monday south of Weed. Elsewhere in the state, hundreds of firefighters battled about a dozen other persistent blazes.
Winds gusting up to 40 mph pushed the flames into town, where they quickly chewed through a hillside neighborhood. Officials said a significant number of the structures burned were houses; three firefighters lost their homes in the blaze. The cause is still under investigation.
"It went through here so fast it was unbelievable. I've never seen anything like this," Jim Taylor, a retired butcher who has lived in the town for 30 years said Tuesday. "I'm not a real religious person, but somebody was looking out for me."
Taylor said fire bombers dropped retardant over his house. As his home and his deck furniture turned pink from the retardant, another house nearby erupted into flames. Across the street, pine and oak trees were burned to a crisp, and small flames and smoke drifted up from chunky embers.
The town and the forest that surrounds it were a tinderbox after three years of drought. And Weed's winds are notorious. The steady breezes were what attracted town founder Abner Weed to build his lumber business there in 1897, after he realized that wood dried more quickly when fanned by nature.
The town's saw mill, once the world's largest, was among the structures damaged in the blaze.
"Once the fire kicked off, you had wind driving it from the south. It got into the crowns of trees, and then it was moving extremely quickly from structure to structure, block to block," said Dennis Mathisen, another state fire spokesman.
On Tuesday, chimneys were the only thing still standing in the rubble, and broken pipes spurted water over the blackened landscape. The remnants of the Holy Family Catholic Church were still smoldering, its metal girders twisted on the ground.
"I mean it was devastating," said Maureen Campbell, the church's music minister who was baptized, confirmed and married at the church, along with her children. She lost her home to the fire.
"The house up there is no big deal. It can be rebuilt," she said. "But this is my family church, you know? It's much more endearing to me."
Tasha Davis said she was given two minutes to grab what she could from her apartment and evacuate.
"We then packed my car and sat on the road and just watched everything burn," she said Tuesday in an email from nearby Mount Shasta, where she spent the night with her family.
Fire crews took advantage of calmer winds and firefighting aircraft Tuesday, gaining control in and around Weed. By Tuesday evening, the 375-acre fire was 25 percent contained. Flames still threatened in other parts of California.
In Oakhurst, a foothill community south of Yosemite National Park, a 320-acre fire that damaged or destroyed 71 structures — 37 of them homes — was 50 percent contained. About 600 residents from 200 homes remained evacuated, Madera County sheriff's spokeswoman Erica Stuart said.
Farther north, a wildfire about 60 miles east of Sacramento prompted new evacuation orders, but the number of residents told to flee was not immediately known. The fire, which grew at an explosive rate when it reached a canyon at the fork of the American River, burned nearly 20 square miles. It was only 5 percent contained.
More than 4,000 wildfires have burned in California this year.
Associated Press writers Terry Collins in San Francisco, Raquel Dillon in Weed, Alina Hartounian in Phoenix and Daisy Nguyen in Los Angeles contributed to this report.
JOHANNESBURG (AP) — Since the Ebola outbreak first emerged in West Africa, The Associated Press has been reporting on it. A timeline compiled from AP dispatches since March shows the dreaded disease being identified in a remote part of Guinea and then spreading to another country and then two more nations with authorities being alternately alarmed or confident.
The outbreak is now out of control and the U.S. is planning to send in military personnel and equipment as part of the international effort to try and bring it under control.
March 23: Guinean officials say tests confirm that it is the Ebola virus that has killed 59 people. Health officials and Doctors Without Borders establish treatment centers.
March 28: Health officials confirm Ebola has spread from a remote forested corner of southern Guinea to the country's seaside capital.
March 30: Ebola crosses the border into Liberia, where the health minister says two patients have tested positive for the deadly virus.
April 5: A crowd angry about the Ebola outbreak that is believed to have killed 86 people across Guinea attacks a center in the country where patients are being held in isolation, prompting an international aid group to temporarily evacuate its team.
May 9: The World Health Organization says health workers have made dramatic progress in controlling the Ebola outbreak in West Africa in recent weeks, blaming it for at least 168 people in Guinea and Liberia. There are signs that the spread is slowing but it is not over yet, says a WHO official.
May 30: The first two Ebola deaths are reported in Sierra Leone.
June 12: The Sierra Leone government announces a state of emergency in the Kailahun district because of the Ebola outbreak which has claimed 17 lives in this West African nation, banning public gatherings and closing schools.
June 17: Ebola is now also in Liberia's capital, with a health official saying seven people have died there.
June 18: This appears to be the largest Ebola outbreak ever recorded, says an American doctor who has responded to the outbreak. The World Health Organization attributes more than 330 deaths to Ebola.
June 20: The Ebola outbreak ravaging West Africa is "totally out of control," according to a senior official for Doctors Without Borders, who says the medical group is stretched to the limit in responding.
July 23: The doctor in charge of battling Sierra Leone's current Ebola outbreak has himself become ill with the deadly disease, the country's health minister confirms. He later dies.
July 25: The outbreak spreads to Nigeria, the continent's most populous nation, after a Liberian man with Ebola takes a flight to Lagos and dies there.
July 27: One of Liberia's most high-profile doctors has died of Ebola, a government official says.
July 31: The death toll attributed to Ebola has risen to more than 700 people in West Africa and the disease is moving faster than efforts to control it, the head of the World Health Organization warns as presidents from the affected countries meet in Guinea's capital.
Aug. 17: Liberian officials fear Ebola could soon spread through the capital's largest slum after residents raided a quarantine center for suspected patients and took items including bloody sheets and mattresses.
Aug. 20: The World Health Organization says the death toll from the Ebola outbreak in West Africa is believed to be at least 1,350 people. The U.N. health agency also warned in its announcement that "countries are beginning to experience supply shortages, including fuel, food, and basic supplies."
Aug. 29: Senegalese officials announce that a university student infected with Ebola evaded health surveillance for weeks as he slipped into Senegal, carrying the deadly virus to a fifth West African nation. With mass quarantines, border closures and flight bans failing to contain the outbreak, public health officials intensified efforts to identify and contain the sick.
Sept. 13: Sierra Leone loses a fourth doctor to Ebola, a huge setback to the impoverished country that is battling the virulent disease amid a shortage of health care workers.
Sept. 16: The Obama administration ramps up its response to West Africa's Ebola crisis, preparing to assign 3,000 U.S. military personnel to the afflicted region to supply medical and logistical support to overwhelmed local health care systems and to boost the number of beds needed to isolate and treat victims of the epidemic.
KOEGE, Denmark (AP) — Shaho Pirani says he's just a phone call away from leaving his quiet life in Denmark and joining Kurdish forces battling against Islamic State militants in Iraq.
The 30-year-old Kurd, who fled from Iran with his older brother in 1991, says he feels a moral duty to help the peshmerga, the armed forces of the Kurdish regional government, to fight the "psychopaths" of the Islamic State group.
"I feel so helpless here," Pirani told The Associated Press in an interview in his home in Koege, a tranquil Copenhagen suburb with neatly trimmed lawns and hedges. "I am ready to die for the Kurdish cause."
While more than 2,000 Europeans are believed to have joined the Islamic State organization and other jihadist groups as foreign fighters, a smaller number has left Europe in recent months to fight against the Islamic militants, primarily with peshmerga forces in Iraq's Kurdish north, Kurdish diaspora leaders and security officials say.
Unlike with Islamic State fighters, however, European governments don't show any intention to stop the Kurdish volunteers from getting involved in the conflict. Though they, too, stand to get weapons training and combat experience and could return traumatized by the horrors of war, the Kurdish fighters are not seen as a threat to the West.
"Our focus as a security service will be more on groups like IS and not people going to defend areas against the IS," said Trond Hugubakken, spokesman for the Norway's PST security service.
Traveling to participate in an armed conflict is rarely a crime in itself, so European security officials say they act only if they suspect a fighter has committed war crimes or might engage in terrorist activities after returning.
There are no exact numbers on how many people have left Europe to fight the Islamic State group. But Mehmet Tanriverdi, deputy chairman of the Kurdish community in Germany, said he knew of "dozens" of Kurds who had traveled from Germany and other European countries to join the peshmerga.
Shwan Zulal, an associate fellow at King's College and the director of London-based Carduchi Consulting, said the stream of Kurdish fighters from Britain was "nowhere near the number of people that have gone and joined ISIS."
British authorities might be "somewhat worried" about Britons volunteering to join Kurdish forces, Zulal said. But he could not imagine anyone being prosecuted for "fighting the United Kingdom's enemies."
Britain, Germany, the U.S. and other countries are sending light weapons and ammunition to the peshmerga. Aided by American airstrikes, the Kurdish forces have recovered some territory seized by Islamic State militants in recent months.
Edmond Messchaert, spokesman for the Dutch Justice Ministry on counterterrorism, said Dutch Kurds are not being blocked from joining the peshmerga and would not be prosecuted on return unless they committed war crimes.
It is not as clear-cut when it comes to foreign fighters joining the PKK, a Kurdish rebel group considered a terrorist organization by the European Union and the United States.
Messchaert said any Dutch Kurd who joined the PKK would be committing a crime, though he stopped short of saying they would be prosecuted.
The Swedish security service SAPO's view is that people who fight for the PKK "aren't automatically guilty of a crime," and would be prosecuted in Sweden only if they violated the laws of war or used banned weapons, SAPO spokesman Fredrik Milder said.
The PKK, which has long fought for autonomy in Turkey, and an affiliated party in Syria, are now a key part of the Kurdish resistance against the Islamic State group.
Turkish officials say they have seen signs that Kurdish militants have left Turkey to join PKK forces fighting Islamic militants. German chancellor Angela Merkel has ruled out sending German weapons to PKK fighters.
Horrified by the Islamic State group's ruthless tactics, Kurds in Europe are organizing fundraisers and protests in support of minorities being threatened, including Kurdish-speaking Yazidis.
However, the Kurdistan Regional Government is advising diaspora Kurds against joining the peshmerga because the forces need weapons, not manpower, said Shorsh Kadir Rahem, a KRG representative in Sweden.
"We have old Kalashnikov (assault rifles) from the '60s and '70s while ISIS has much bigger weapons they have taken from Iraq's armed forces," he said.
In Denmark, Pirani said he wants do more than provide humanitarian help. He said he attended a small training camp in June organized by the Iranian branch of the Kurdistan Democratic Party in the Kurdish town of Koya in northern Iraq.
There, he said, he joined Kurds from Norway, Switzerland and Britain for a crash-course on politics followed by weapons training. He provided a photograph of himself posing with an assault rifle at the camp.
Pirani, an unemployed anthropologist whose father was a high-ranking peshmerga, said he is now awaiting a call from party officials to join the Kurdish forces. He said even if he doesn't get called up he will probably go anyway.
"My ex-wife and my mother both say that they want to tie me to a chair to make sure that I don't leave," Pirani said. "They cannot understand that once in a while you have to sacrifice everything to fight for basic rights."
Ritter reported from Stockholm. Associated Press writers Raphael Satter in London, Toby Sterling in Amsterdam, Frank Jordans in Berlin and Desmond Butler in Ankara, Turkey, contributed to this report.