Health & Medicine


Q: My daughter has asthma, and I can’t put her on the school bus because the air is so bad that it triggers an attack. Aren’t there supposed to be standards for the buses? How can I get the school district to clean up its act?

Melanie R., Cincinnati

A: The first step is to check whether your school’s buses comply with the provisions of the Environmental Protection Agency’s Clean Bus Program. The CBP sets emission standards for school buses and mandates a switch to low-sulfur fuel in place of standard diesel. In places where older buses have been retrofitted with diesel particulate matter filters and diesel oxidation catalysts, and use cleaner alternative fuel, particulate matter emissions are cut by 60 to 90 percent. Research shows that this lowers inflammation in kids’ lungs by 16 percent over the whole group, and 20 to 31 percent among children with asthma.

A recent study from the University of Michigan and the University of Washington estimates that once all of our school buses are brought up to the EPA standards, nationally kids would miss 14 million fewer days of school a year because of asthma and other illnesses. This is so compelling that many school districts from California to Maine have gone beyond EPA standards and made school buses healthier than they’ve ever been.

Because the results of this program are so positive, you shouldn’t run into any trouble when you start asking questions about your district’s compliance. But if you do, get a big whistle and blow it! You can’t be the only parent who has a child affected by the buses’ poor air quality. And don’t let anyone tell you that it’s too expensive to upgrade the buses. Federal grants are available to replace school buses or to install retrofit technology at 100 percent of the cost. That should have everyone breathing easier!

Q: I have Type 2 diabetes, and my doctor is always bugging me about losing weight. Now I hear that people with Type 2 who are overweight live longer than those who have Type 2 and are “normal” weight. If that’s true, whoopee, no more diets! What do you think? -- Jan D., Naples, Florida

A: News about the new study you’re referring to has caused a lot of confusion, because it’s been reported as proving you’ll live longer if you’re overweight with Type 2. That’s the wrong take-away.

When you compare people with Type 2 diabetes who are a healthy weight when diagnosed and people with Type 2 who are overweight or obese when diagnosed, you probably are comparing two distinct subsets of Type 2 diabetes. Those who develop it when they are a healthy weight may well have a more dangerous form of the disease than those who don’t develop it until excess fat and metabolic changes create bodywide inflammation that interferes with using glucose for fuel.

Also, the study looked only at outcomes following a “cardiac event.” Although overweight and obese participants with Type 2 diabetes were more likely to have “an event” compared with normal-weight patients with Type 2 who also had a cardiac event, they had a better survival rate. However, this also may indicate that Type 2 diabetes in folks who are diagnosed at a healthy weight is more damaging.

Also, heart disease isn’t the only complication associated with Type 2 diabetes. Conditions such as diabetic nephropathy and dementia can be life-threatening and made worse by metabolic changes associated with excess weight.

If you have Type 2 and are overweight, and your goal is to reclaim your health, there is NO QUESTION that losing weight is step No. 1. Shedding 5 to 10 percent of your body weight may stabilize blood sugar, reduce blood pressure and allow you to become more active. That, in turn, can slash your risk for kidney, eye and nerve problems. So dig into healthy foods in healthy portions and start a walking routine, heading for 10,000 steps a day. Then you can say “Whoopee!”

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at