Preventing obesity and smoking can save lives, but it doesn’t save money, researchers reported Monday.It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars.”It was a small surprise,” said Pieter van Baal, an economist at the Netherlands’ National Institute for Public Health and the Environment, who led the study. “But it also makes sense. If you live longer, then you cost the health system more.”In a paper published online Monday in the Public Library of Science Medicine journal, Dutch researchers found that the health costs of thin and healthy people in adulthood are more expensive than those of either fat people or smokers.Van Baal and colleagues created a model to simulate lifetime health costs for three groups of 1,000 people: the “healthy-living” group (thin and non-smoking), obese people, and smokers. The model relied on “cost of illness” data and disease prevalence in the Netherlands in 2003. The researchers found that from age 20 to 56, obese people racked up the most expensive health costs. But because both the smokers and the obese people died sooner than the healthy group, it cost less to treat them in the long run.On average, healthy people lived 84 years. Smokers lived about 77 years, and obese people lived about 80 years. Smokers and obese people tended to have more heart disease than the healthy people.Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on.The cost of care for obese people was $371,000, and for smokers, about $326,000.The results counter the common perception that preventing obesity will save health systems worldwide millions of dollars.”This throws a bucket of cold water onto the idea that obesity is going to cost trillions of dollars,” said Patrick Basham, a professor of health politics at Johns Hopkins University who was unconnected to the study. He said that government projections about obesity costs are frequently based on guesswork, political agendas, and changing science. “If we’re going to worry about the future of obesity, we should stop worrying about its financial impact,” he said.Obesity experts said that fighting the epidemic is about more than just saving money.”The benefits of obesity prevention may not be seen immediately in terms of cost savings in tomorrow’s budget, but there are long-term gains,” said Neville Rigby, spokesman for the International Association for the Study of Obesity. “These are often immeasurable when it comes to people living longer and healthier lives.”

They argued for more than a year across America. They disputed whether a Messiah came to save us, whether God has a master plan, whether believers and unbelievers face an afterlife. They were irreverent, accusatory, supportive, blunt, profound.What came out of all this word-wrangling? A firm cementing of the friendship that had crumbled since they roomed together at Davidson College in the early ’80s. And an 80-minute film called “Purple State of Mind” meant to build a philosophic bridge between red- and blue-state combatants on many topics, notably modern Christianity.Craig Detweiler and John Marks are credited as co-directors on the film, which premieres locally Thursday at Davidson College and Monday at Christ Episcopal Church in Charlotte.Detweiler is the Charlottean who found Christ at Davidson after being a high school hellraiser (East Meck, class of ‘81). Marks is the Texas-raised guy who left Christianity behind in college.California-based Detweiler went on to write or direct movies (”The Duke,” “Extreme Days”) and teach film at Biola University and Fuller Theological Seminary. Marks worked for “60 Minutes” and lives in Massachusetts, writing nonfiction (”Reasons to Believe,” a look at U.S. Christianity) and fiction (”Fangland,” a novel about vampires in the news media that Hilary Swank’s company optioned for a film.)Though they lost touch, they never lost the desire to wrestle with ideas. So when Detweiler proposed they compare world views on camera, Marks agreed.”The best kind of college dorm life is poking and prodding and testing unexplored thoughts,” says Detweiler, who wrote the book “A Matrix of Meanings: Finding God in Pop Culture.” That’s the feel of their film, which consists mostly of four long, spontaneous discussions.”I don’t think we would’ve talked about that stuff unless we did it on camera,” says Marks. “We don’t live near each other. We’re not kin. There was a real break between us. The last time I saw him, I’d have said he was a fire-breathing Bible-thumper, a view I was familiar with and was not interested in. He felt I’d gone over to nihilism and despair, and he wasn’t interested in that.”Neither wanted to convert the other or declare an intellectual “winner” in the conversations.”If somebody wins, somebody loses,” says Detweiler. “I’d rather have a synthesis where we gain wisdom and share something.”Stereotypes of believers/nonbelievers may (lead to) assumptions about divides that aren’t true. As a nation, we may agree on much more than we realize. We’re trying to re-emphasize our common humanity and hopes, as people of faith and people of doubt. And those categories keep shifting. Maybe your allegiances shift as you listen to the film.”Working as co-editorsRealizing noble ambitions can be difficult. They acted as co-editors, a process that can be as contentious as having political foes design a voting district.”I’d say the first two passes back and forth were shared editing,” says Marks. “But I was on the road a lot, and he ended up having it for the back half of the process. I had a certain frustration with the filmmaking process; we’d had heated arguments about the structure of the film, and I was concerned that (he) not skew the debate. Finally, it was time for it to go to an editor who didn’t know either of us.”Along the way, the amiable adversaries found one big thing in common, says Marks: “We married similar women, people who were wonderfully indulgent but took us with a grain of salt and knew how to draw the line.”A stronger relationshipAnd though the movie didn’t deflect either from his chosen career path, it also knocked them into an orbit they can now share.”We’re talking to each other every three days,” says Detweiler, who travels with Marks to churches and community forums to present the film. (They defend each other when audience members jump on them.) “The relationship is stronger than ever, more honest than ever, though it took four deep discussions in the film before we got down to core levels of honesty.”"(This) friendship is warm and rich, but it hasn’t papered over the divide,” says Marks. “Both of us have been made acutely aware of the ways we see the world. The divisions in the country are real. The divisions between us are real, and we have to negotiate that. It was a rough ride, but it was fruitful for sure.”`Purple State of Mind’Craig Detweiler and John Marks will present their film at 8 p.m. Thursday in Hance Auditorium on the Davidson College campus, and Monday at 7 p.m. at Christ Episcopal Church, 1412 Providence Rd. Both events are free and include Q-and-As.• To buy the DVD or learn about it or its creators: www.purplestateofmind.com.

What N.C. organization is least senior-friendly? Hard to say, but the state’s license plate offices may have a shot at the title.At most of the state’s 123 offices, customers wait their turn by standing in line. The wait can be short. But at busy offices, like the ones in Charlotte, customers may stand an hour or more.That’s annoying for anyone. But for some customers, including those who are elderly, disabled or pregnant, the stand-up waits can be painful or impossible.I did some research on North Carolina’s license plate offices after hearing from reader Louis Smith, an architect who visited the Independence Boulevard location after moving here from Michigan. The stand-in-line system, along with the lack of a restroom and several other issues, struck Smith as such poor service that he wrote state leaders to complain. The state doesn’t require public restrooms or seating.Smith offered suggestions to improve service, including adding more chairs and letting customers sit after taking a number — a system similar to the one used by N.C. driver’s license offices. (North Carolina conducts driver’s license and license plate business in separate offices.)It’s not the first time the Department of Motor Vehicles has heard that idea. In 2006, former Mecklenburg County commissioner Lloyd Scher sent the same suggestion to the state after standing in line at the South Boulevard office following a knee replacement.But don’t look for changes soon.I asked Portia Manley, the DMV’s assistant director of vehicle services, if the state was satisfied with current services.”Yes we are,” she said.Most offices outsourcedNorth Carolina’s license plate offices are outsourced to individual contractors, with the exception of two state-run offices — in Raleigh and on Brookshire Boulevard in Charlotte. A stand-in-line system is used in most N.C. offices, including those in Mooresville, Hickory, Monroe and Lincolnton. Some offices, including Mooresville’s, lack any seating. (Mooresville officials say they’ll pull a chair from the back if you need one.)Along with the Brookshire office, Charlotte has license plate offices on Independence and South boulevards. They handle transactions involving registrations, titles, license plates and handicapped placards.Contractors at both offices say they doubt a take-a-number system would work.”I just never have figured out how the logistics would work,” says Sandra Elliot, contractor for the South Boulevard office. Benches and chairs now line a wall, she says, so customers can sit next to the line if they wish and move to the next seat as the line moves.Wanda Sturgill, who runs the Independence office, says she’s never tried a take-a-number system, “but I can guarantee it wouldn’t work.” She worries that customers would leave the office after taking a number and fail to return when the number was called.Sturgill says customers who can’t stand in line can ask someone in line to save their place while they sit on a nearby bench.Unfortunately, many people don’t know that’s what they’re supposed to do.Warren Privette, for instance, has Parkinson’s disease and uses a cane. When he visited the Independence branch in January, he stood 30 minutes to get a handicapped parking sign for his car.Afterward, he told me, his back was killing him. “They definitely need some seating arrangement for older people,” he said.Requiring people to stand probably doesn’t violate disability laws, experts say, as long as there’s a plan to accommodate people with disabilities.But Smith, the architect, doesn’t think individuals who have difficulty standing should have to ask someone to save their place in line. “It’s really leaving people to the mercy of the crowd,” he says.`Common sense’ serviceSeveral people who recently visited the Independence office agreed there must be a better system.”If you have somebody like me who has hip problems, you wouldn’t want to stand that long,” said one older woman who’d stood an hour and 45 minutes.And Melissa Ballard said she thought of her father as she waited in line 90 minutes. He couldn’t have done it.Vicki Smith, executive director of Disability Rights North Carolina, says she’s long had a concern that the state abdicates responsibility when it privatizes services and allows contractors to get by with poor service.”What citizen of North Carolina wants to stand in line for two hours without sitting down?” she asks. “A lot of this is just common sense and good service. And it’s unfortunate that we frequently have to find a legitimate legal reason to get good service.”After I told Sturgill that some people don’t realize they’re permitted to have someone hold their place, she added signs saying benches are reserved for customers who are physically disabled.”We try to do everything we can to help the customer,” she said.If N.C. officials decide they want to improve services, they could look to South Carolina, which overhauled its DMV system a few years ago.In South Carolina, driver’s license and license plate services are provided at the same offices. At a minimum, offices have seating with a take-a-ticket system. Larger offices also offer greeters. They make sure customers have required documents before they begin waiting, then send them to the right clerk.How long are the waits? No more than about 15 minutes, says Beth Parks, with the S.C. Department of Motor Vehicles.And that’s while you’re sitting down. — Reporters Dan Duffey, Mark Hames, Julia Oliver and Kathryn Thier contributed to this story. As We AgeWant to make a suggestion?To contact the N.C. Department of Motor Vehicles with comments, go to www.ncdot.org/dmv/contact/ and click on “suggestions, comments, feedback.” Or call 919-715-7000.Where are services good, bad?Have you seen businesses or government services that do a good job accommodating customers who are older or have disabilities? Who needs to improve customer service? Let me know: 704-358-5271 or pkelley@ charlotteobserver.com — PamKelley

If you don’t have direct deposit for your Social Security check, now’s the time to get it.That’s the message of a new U.S. Treasury campaign that urges seniors and others who get federal benefits in the mail to switch to direct deposit.About 80 percent of federal benefit payments are deposited directly. But nearly 390,000 N.C. recipients still get checks in the mail.Many are folks who like to have their checks in their hands, says Maryanne Dailey, who heads the Better Business Bureau Consumer Foundation.So why go direct deposit?• It gives you immediate access to your money.• It eliminates the risk of lost or stolen checks. Thieves know when checks arrive in mailboxes.• It gets the money to your account when you’re out of town or in the hospital.With consumer fraud rampant, seniors “need to empower themselves. This way, they have total control,” Dailey says.The U.S. Treasury has made it easy to set up direct deposit. Call 800-333-1795 or go to www.godirect.org.

The Tracy Reese runway was the intersection of chunky knits, metallics, nature-inspired prints, geometric patterns and paisley. And it worked quite well.Reese’s collection had a definite menswear influence (”It’s a Man’s Man’s Man’s World” by the late James Brown was mixed into the runway soundtrack). But it was also unmistakably feminine, with modern twists on classics such as pleated skirts, cinch-waisted dresses and shifts.Shades of gray and blue reigned, with greens and pinks used as spot-on accents. Black and blue were paired on dresses and sweaters, while blades of grass and oversized roses brought a fresh appearance to classic dress shapes.Loose knits in a deliciously modern oatmeal were shown as a double-breasted sweater coat, a crewneck, a cardigan and other versions of cozy and functional silhouettes.Reese used headbands as the base for accessories such as berets and oversized hats, as well as the anchor for sprays of feathers. Feather embellishments are an emerging trend on the fall 2008 runways, turning up on the runways at Herve Leger, Baby Phat and Miss Sixty, among others. If The Shoe Fits RachelSutherland

A day doesn’t go by that you don’t hear some new claim about how a particular food can help you live a better life. Here are a few we investigated to see if they live up to the hype.Promise activ SuperShots drinks www.promisehealthyheart.com/products_supershots.aspClaims: It is “clinically proven to help remove cholesterol from your body” and drinking it “at least once a day with meals, as part of a diet low in saturated fat and cholesterol … could reduce your LDL (bad) cholesterol level.”Facts: A serving provides 2 grams of plant sterols. According to Dawn Jackson Blatner, R.D., of the American Dietetic Association, the claims “are true. Foods containing at least 0.4 grams per serving of plant sterols, eaten twice a day with meals for a total daily intake of at least 0.8 grams, as part of a low-saturated-fat, low-trans-fat and low-cholesterol diet, may reduce the risk of heart disease.”Fiction: That we all need to drink this daily. It might help — but only if you have high LDL (bad) cholesterol.Concerns: “The product has to be consumed regularly, like medication, in order to maintain the effects,” says Blatner. Additionally, the ingredients list is not for “purists.” It contains added sugar, canola oil, citric acid, mixed tocopherols, guar gum, xanthan gum, natural and artificial sweeteners, sucralose, maltodextrin, yellow and red dye, etc.The bottom line: While it could help those with elevated LDL cholesterol, the product does require a commitment to daily use and will add calories.Minute Maid Enhanced Orange Juices (Heart Wise, Active, Enhanced Pomegranate Blueberry) www.minutemaid.com/NewProducts.jspClaims: Drinking Minute Maid enhanced juices provides health benefits such as improved joints, reduced cholesterol, nutrients to benefit the brain and body and overall better nutrition.Facts: The Active product is made with 750 milligrams of glucosamine HCl per 8-ounce serving. Heart Wise has 1 gram of plant sterols per serving. And the Enhanced Pomegranate contains 50 milligrams of DHA omega-3 per serving, along with other nutrients.Fiction: That your body is missing these nutrients, and if you drink this “enhanced” orange juice you’ll be OK. With reference to the Active juice, there is still very little proof that glucosamine helps joints. In addition, in terms of all the juices mentioned, scientists aren’t sure why, but it appears that getting nutrients in their natural state helps promote good health. Thus, we’re not sure that “enhancing” foods has the same effect.Concerns: Heart Wise: “Drinking enough (two 8-ounce glasses) to get a therapeutic dose would add 220 calories to your diet — which … could theoretically add 20 pounds in a year,” says Blatner.Bottom Line: You’re better off eating an orange and drinking water. However, if you’re already drinking juice, this might not be a bad replacement. “Replacing fruit juice with an enhanced version to boost your intake of plant sterols (Heart Wise) or glucosamine (Active) or DHA (Pomegranate Blueberry) may not hurt, but it may not give you the magic bullet you’re looking for,” says Elisa Zied, M.S., R.D.Welch’s Grape Juicewww.welchs.comClaims: It has twice the antioxidant power of orange juice and will help protect your immune system. “Welch’s 100 percent Grape Juice was ranked the No. 1 Antioxidant Beverage among over 1,000 commonly consumed foods and beverages in an independent study measuring antioxidant capacity per serving.”Facts: Grapes are a powerful source of antioxidants — as are other foods such as blueberries, coffee, pomegranates, etc.Fiction: Grape juice helps protect you from disease. “Grape juice alone will not protect your immune system and promote heart health. It is one food that can be added to a balanced diet of other fruits, vegetables, whole grains and beans to prevent disease,” says Blatner.Bottom Line: You’re probably better off eating grapes.Diet Detective CharlesStuartPlatkin

I’ve heard that consuming too much cinnamon can be harmful, but what, exactly, is the acceptable limit? I eat two tablespoons on my cereal each morning just because I like the flavor and I don’t need added sugar.Some cinnamon (Chinese or cassia cinnamon) is contaminated with a natural compound called coumarin. In excess, this can harm the liver of sensitive individuals. Coumarin also may interact with blood thinners like Coumadin (warfarin) to increase the risk of bleeding.Two tablespoons of cinnamon daily is a very big dose. You should have your liver enzymes checked when you see your doctor. People who use cinnamon to help lower blood sugar take one-quarter to one-half teaspoon before meals.Unfortunately, cassia cinnamon is not labeled with the amount of coumarin it contains. This makes it hard for consumers to tell how much they are getting.Macaroon magicQ. Thank you so much for writing (a long while back) about IBS and coconut macaroon cookies. It works. I suffered with chronic diarrhea for years and have been healed for the past two years. We have heard from other readers that coconut helps combat diarrhea. You can read stories from people who have tried it at www.peoplespharmacy.com. Not everyone who suffers with irritable bowel syndrome (IBS) benefits from coconut macaroons, however.People’s Pharmacy

Q. Since it’s gotten colder, I’d like to exercise indoors, but I’m on the second floor of an apartment building, and I can’t go thumping around without my downstairs neighbors getting annoyed. Between money and time constraints, a gym is out. How I can get moving without freezing or noise violations? Getting busted for aerobicizing would make you my hero. But to keep your record clean, let’s skip the jumping jacks. Even with your feet firmly planted on the floor, you can still work every muscle in your body, including the heart, promises Mike Everts, founder of the FIT Personal Training gym in Washington.When one of his clients faced a similar predicament, Everts devised an exhausting abs circuit, and there was never a peep of complaint from the neighbors. Everts hauls a bunch of toys with him that you might find useful. In addition to such standards as resistance bands and stability balls, his new favorite is a suspension system that hooks into a door jamb, allowing users to leverage their body weight to engage several muscle groups simultaneously. But there’s only one gizmo you really need: a mat. With that, you can get away with stuff like lunges.Then, find moves you can string together without stopping. “You can do resistance training to get your heart rate up,” Everts explains. If you have a pair of dumbbells, do lateral arm extensions. “You bring your arms up like a snow angel,” Everts said.What are shin splints?Q. Running lately has caused me to develop painful shin splints. I am running outside on asphalt, not concrete. But every time, I am forced to slow my pace and can’t figure out how to alleviate this problem. I’m guessing you have a definition for shin splints — probably something along the lines of “agony all along the front of the leg below the knee during running.” And that puts you a step ahead of the medical profession. It may be a common problem, but “what exactly shin splints is hasn’t been pinned down,” explains Julie Gilchrist, a physician with the National Center for Injury Prevention and Control.One popular belief is that the pain stems from pronation of the foot. So consider your shoes. Do you have enough shock protection? Are your sneakers reaching retirement age? It’s about six months, if you’ve been using them regularly. Play a little guess and check, listen to your body’s cues and hopefully you can find a way to keep up your hobby.It’s all in how you liftQ. I’m a 55-year-old paramedic and spend a lot of time lifting people far larger than my 180-pound weight. Last year I developed bilateral epicondylitis — tennis elbow, to you. I went through physical therapy, was pronounced sound, went back to work, and now the tennis elbow is back. What exercises can I do to strengthen my arms and compensate for this chronic condition? It sounds as if your stretcher-lugging technique could use some work, says Tim McCullough, a physical therapist. Building more arm strength won’t help. “If you’re already ticking it off by overusing it, you may end up overwhelming it with exercise,” McCullough said.A better bet is to get someone to examine your lifting form. McCullough has a hunch you’re always lifting with your palms facing down (when you should be lifting with palms up to reduce the strain on your tendons), and not taking full advantage of strength in the rest of your body. You need to think about lifting with your legs.To manage the pain, try stretching. Here’s a classic: Stick one arm straight in front of you and hang the palm down so it’s facing your chest (”like you just dunked a basketball,” McCullough says). Then take the other hand and apply pressure to the back of the first hand. Hold for 30 seconds.Talk to a professional about your other options.

Planning to tackle that New Year’s resolution by investing in home equipment? The February edition of Consumer Reports includes a buyer’s guide for treadmills and ellipticals, and reviews a number of “as seen on TV” devices as well. It’s a good overview, with some useful cautionary advice.According to the magazine’s tests, for example, those fancy gizmos that promise a great belly or great legs typically do no more than common exercises you can perform on your own without investing hundreds of dollars. Surprised?The article includes recommendations for best buys and a checklist of issues — space, noise, ergonomic fit, electronic features — to keep in mind while shopping for a treadmill or elliptical. It reminds you how important it is to try a lot of machines, and also to realize that spending less for equipment that breaks or is ill-suited to your body or exercise style does not save money.The issue does not cover stationary bikes. If you’re thinking of buying one, you’ll want to answer some basic questions about how you plan to use it. If you intend only lighter workouts, you can probably get away with spending a few hundred dollars. Used equipment is another option. If you have back problems, consider a recumbent, in which you recline, with your legs extended in front.If you intend a more intense use, you might be happier with one of the many spin cycles now on the market. Schwinn, Vision Fitness, Lemond and others all have models that hover around $1,000. Keep in mind you’re paying for extra steel, weight and engineering, not electronics. They typically lack the onboard computers and programmed workouts you’ll find on standard stationary bikes.You can make up for that by using a heart rate monitor along with a spinning or race DVD, or by turning to places such as Bicycling magazine for ideas about how to design your own program.

Some exercise is good, but more is better — at least when it comes to cutting risk of death in the immediate future.That’s the conclusion of a study of 15,660 Caucasian and black men (average age 59) who were given treadmill tests to determine their level of fitness.The men, tested in Washington, D.C., and Palo Alto, Calif., were followed for about seven years.Those who were in the “very highly fit” category had a 70 percent lower death risk during that time period than those in the “low fit” category.Those considered moderately fit had about a 50 percent lower death risk compared with the low-fit group.Moderate fitness isn’t that difficult to achieve, says Peter Kokkinos, director of an exercise testing lab at the Veterans Affairs Medical Center in Washington and lead author of the study published last week online in Circulation: Journal of the American Heart Association.”You need to take a brisk walk for 30 minutes four to six times a week,” Kokkinos says. “It’s not as easy as taking a pill, but let’s be reasonable here.”But upping that activity into a fitter zone, which ultimately yields more benefits, doesn’t take much more: “Add a little jogging, push yourself a little bit,” he says.