Indian court to rule on generic drug industry

NEW DELHI (AP) — From Africa's crowded AIDS clinics to the malarial jungles of Southeast Asia, the lives of millions of ill people in the developing world are hanging in the balance ahead of a legal ruling that will determine whether India's drug companies can continue to provide cheap versions of many life-saving medicines.

The case — involving Swiss drug maker Novartis AG's cancer drug Glivec — pits aid groups that argue India plays a vital role as the pharmacy to the poor against drug companies that insist they need strong patents to make drug development profitable. A ruling by India's Supreme Court is expected in early 2013.

"The implications of this case reach far beyond India, and far beyond this particular cancer drug," said Leena Menghaney, from the aid group Doctors Without Borders. "Across the world, there is a heavy dependence on India to supply affordable versions of expensive patented medicines."

With no costs for developing new drugs or conducting expensive trials, India's $26 billion generics industry is able to sell medicine for as little as one-tenth the price of the companies that developed them, making India the second-largest source of medicines distributed by UNICEF in its global programs.

Indian pharmaceutical companies such as Cipla, Cadila Laboratories and Lupin have emerged over the past decade as major sources of generic cancer, malaria, tuberculosis and AIDS drugs for poor countries that can't afford to pay Western prices.

The 6-year-old case that just wrapped up in the Supreme Court revolves around a legal provision in India's 2005 patent law that is aimed at preventing companies from getting fresh patents for making only minor changes to existing medicines — a practice known as "evergreening."

Novartis' argued that a new version of Glivec — marketed in the U.S. as Gleevec — was a significant change from the earlier version because it was more easily absorbed by the body.

India's Patent Controller turned down the application, saying the change was an obvious development, and the new medicine was not sufficiently distinct from the earlier version to warrant a patent extension.

Patient advocacy groups hailed the decision as a blow to "evergreening."

But Western companies argued that India's generic manufacturers were cutting the incentive for major drug makers to invest in research and innovation if they were not going to be able to reap the exclusive profits that patents bring.

"This case is about safeguarding incentives for better medicines so that patients' needs will be met in the future," says Eric Althoff, a Novartis spokesman.

International drug companies have accused India of disregarding intellectual property rights, and have pushed for stronger patent protection that would weaken India's generics industry.

Earlier this year, an Indian manufacturer was allowed to produce a far cheaper version of the kidney and liver cancer treatment sorefinib, manufactured by Bayer Corp.

Bayer was selling the drug for about $5,600 a month. Natco, the Indian company, said its generic version would cost $175 a month, less than 1/30th as much. Natco was ordered to pay 6 percent in royalties to Bayer.

Novartis says the outcome of the new case will not affect the availability of generic versions of Glivec because it is covered by a grandfather clause in India's patent law. Only the more easily absorbed drug would be affected, Althoff said, adding that its own generic business, Sandoz, produces cheap versions of its drugs for millions across the globe.

Public health activists say the question goes beyond Glivec to whether drug companies should get special protection for minor tweaks to medicines that others could easily have uncovered.

"We're looking to the Supreme Court to tell Novartis it won't open the floodgates and allow abusive patenting practices," said Eldred Tellis, of the Sankalp Rehabilitation Centre, a private group working with HIV patients.

The court's decision is expected to be a landmark that will influence future drug accessibility and price across the developing world.

"We're already paying very high prices for some of the new drugs that are patented in India," said Petros Isaakidis, an epidemiologist with Doctors Without Borders. "If Novartis' wins, even older medicines could be subject to patenting again, and it will become much more difficult for us in future to provide medicines to our patients being treated for HIV, hepatitis and drug resistant TB."

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Chelsea Clinton Raises Profile During Mom's Illness

While Hillary Clinton was in the hospital it was daughter Chelsea -- not the secretary of state or the former president Bill Clinton -- who spoke for the family.

She, along with the State Department, doled out what little information the family wanted to share in a series of tweets and when her mother was released from the hospital, it was Chelsea who delivered the thanks on behalf of her parents, tweeting her gratitude to the doctors as well as those who kept her mother in their thoughts while she recovered from a blood clot.

When Hillary Clinton leaves office, possibly at the end of this month, it will be the first time since 1982 that a Clinton will not be holding a public office.

The watch will be on whether Hillary Clinton makes another run for the White House in 2016, but almost inevitably people will also be watching to see if Chelsea Clinton decides to run for office, too.

"Americans always look for dynasties: Bush, Kennedy, Cuomo, Clinton … it's some kind of continuity. There will always be pressure on her to run for public office," said Hank Sheinkopf, a Democratic political strategist in New York.

"She's learning from the two best politicians in recent American history and she understands when to hold them and when to fold them," Sheinkopf said.

That sense of dynasty could also present a significant hurdle.

James Devaney/Getty Images

Secretary of State Clinton: Mystery Health Issues Watch Video

Secretary of State Hillary Clinton Undergoing Blood-Thinning Therapy Watch Video

"She's got to A, demonstrate that she has the charisma of her father, or B, demonstrate that she has the policy chops of her mother. And I think like most people she is somewhere in between," a former Hillary Clinton aide from her 2008 campaign said. "People are judging her through each of her parents and it's an impossible standard."

Chelsea Clinton, 32, has inched towards a possible political career in recent statements and has become more politically active.

In an interview with Vogue published in August she was more open to it than she has been in the past, telling the magazine, "Before my mom's (presidential) campaign I would have said no," but "now I don't know."

"I believe that engaging in the political process is part of being a good person. And I certainly believe that part of helping to build a better world is ensuring that we have political leaders who are committed to that premise. So if there were to be a point where it was something I felt called to do and I didn't think there was someone who was sufficiently committed to building a healthier, more just, more equitable, more productive world? Then that would be a question I'd have to ask and answer."

Clinton also spoke of a change in her private to public life:

"Historically I deliberately tried to lead a private life in the public eye," she told the magazine. "And now I am trying to lead a purposefully public life."

Besides her work as a special correspondent with NBC, Chelsea Clinton has taken on high profile roles with her father's Clinton Global Initiative. She sits on several corporate boards and has both moderated and sat on panels discussing both women in politics and childhood obesity, among other issues.

She has also worked toward making same-sex marriage legal in New York last year, as well as gay marriage referendums in Maine, Maryland, Wisconsin and Washington state, all of which were successful in November. She has also been active in superstorm Sandy recovery, most notably delivering aid to the devastated Rockaways with her father.

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Delhi gang-rape suspects formally charged

NEW DELHI: Indian police on Thursday formally charged five men with murder, kidnapping and rape following the fatal gang-rape of a young woman that appalled the nation.

"We have filed the charge sheet against the five accused," an investigating police officer told a magistrate hearing the case in the Saket court complex in New Delhi.

The five men, who could face the death penalty if convicted, were not present when the media were allowed into the courtroom. Journalists were initially prevented from listening to proceedings, sparking chaotic scenes outside.

The men face at least seven charges, including murder, kidnapping, rape, robbery and attempting to destroy evidence. The next hearing in the case was set for January 5.

A police charge sheet under Indian law lays out the charges against the accused and details the key evidence against them.

The 23-year-old victim in the gang-rape case, who died at the weekend from her horrific injuries, gave a statement to police immediately after the attack.

Her boyfriend, who was with her at the time and was also attacked, has also given an account.

- AFP/xq

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Samajwadi Party dissolves its youth wings

LUCKNOW: Samajwadi Party on Thursday dissolved all its four youth wings and their national executive with immediate effect.

"The decision to dissolve four youth wings — Yuvjan Sabha, Lohia Vahini, Youth Brigade and Chharasabha has been taken after permission from SP national president Mulayam Singh Yadav", a party release issued here said.

While national general secretary Ram Gopal Yadav dissolved the national executive, SP state president Akhilesh Yadav had done the same with the state executive with these wings.

The party has not cited any reason for this.

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Flu? Malaria? Disease forecasters look to the sky

NEW YORK (AP) — Only a 10 percent chance of showers today, but a 70 percent chance of flu next month.

That's the kind of forecasting health scientists are trying to move toward, as they increasingly include weather data in their attempts to predict disease outbreaks.

In one recent study, two scientists reported they could predict — more than seven weeks in advance — when flu season was going to peak in New York City. Theirs was just the latest in a growing wave of computer models that factor in rainfall, temperature or other weather conditions to forecast disease.

Health officials are excited by this kind of work and the idea that it could be used to fine-tune vaccination campaigns or other disease prevention efforts.

At the same time, experts note that outbreaks are influenced as much, or more, by human behavior and other factors as by the weather. Some argue weather-based outbreak predictions still have a long way to go. And when government health officials warned in early December that flu season seemed to be off to an early start, they said there was no evidence it was driven by the weather.

This disease-forecasting concept is not new: Scientists have been working on mathematical models to predict outbreaks for decades and have long factored in the weather. They have known, for example, that temperature and rainfall affect the breeding of mosquitoes that carry malaria, West Nile virus and other dangerous diseases.

Recent improvements in weather-tracking have helped, including satellite technology and more sophisticated computer data processing.

As a result, "in the last five years or so, there's been quite an improvement and acceleration" in weather-focused disease modeling, said Ira Longini, a University of Florida biostatistician who's worked on outbreak prediction projects.

Some models have been labeled successes.

In the United States, researchers at Johns Hopkins University and the University of New Mexico tried to predict outbreaks of hantavirus in the late 1990s. They used rain and snow data and other information to study patterns of plant growth that attract rodents. People catch the disease from the droppings of infected rodents.

"We predicted what would happen later that year," said Gregory Glass, a Johns Hopkins researcher who worked on the project.

More recently, in east Africa, satellites have been used to predict rainfall by measuring sea-surface temperatures and cloud density. That's been used to generate "risk maps" for Rift Valley fever — a virus that spreads from animals to people and in severe cases can cause blindness or death. Researchers have said the system in some cases has given two to six weeks advance warning.

Last year, other researchers using satellite data in east Africa said they found that a small change in average temperature was a warning sign cholera cases would double within four months.

"We are getting very close to developing a viable forecasting system" against cholera that can help health officials in African countries ramp up emergency vaccinations and other efforts, said a statement by one of the authors, Rita Reyburn of the International Vaccine Institute in Seoul, South Korea.

Some diseases are hard to forecast, such as West Nile virus. Last year, the U.S. suffered one of its worst years since the virus arrived in 1999. There were more than 2,600 serious illnesses and nearly 240 deaths.

Officials said the mild winter, early spring and very hot summer helped spur mosquito breeding and the spread of the virus. But the danger wasn't spread uniformly. In Texas, the Dallas area was particularly hard-hit, while other places, including some with similar weather patterns and the same type of mosquitoes, were not as affected.

"Why Dallas, and not areas with similar ecological conditions? We don't really know," said Roger Nasci of the Centers for Disease Control and Prevention. He is chief of the CDC branch that tracks insect-borne viruses.

Some think flu lends itself to outbreak forecasting — there's already a predictability to the annual winter flu season. But that's been tricky, too.

Seasonal flu reports come from doctors' offices, but those show the disease when it's already spreading. Some researchers have studied tweets on Twitter and searches on Google, but their work has offered a jump of only a week or two on traditional methods.

In the study of New York City flu cases published last month in the Proceedings of the National Academy of Sciences, the authors said they could forecast, by up to seven weeks, the peak of flu season.

They designed a model based on weather and flu data from past years, 2003-09. In part, their design was based on earlier studies that found flu virus spreads better when the air is dry and turns colder. They made calculations based on humidity readings and on Google Flu Trends, which tracks how many people are searching each day for information on flu-related topics (often because they're beginning to feel ill).

Using that model, they hope to try real-time predictions as early as next year, said Jeffrey Shaman of Columbia University, who led the work.

"It's certainly exciting," said Lyn Finelli, the CDC's flu surveillance chief. She said the CDC supports Shaman's work, but agency officials are eager to see follow-up studies showing the model can predict flu trends in places different from New York, like Miami.

Despite the optimism by some, Dr. Edward Ryan, a Harvard University professor of immunology and infectious diseases, is cautious about weather-based prediction models. "I'm not sure any of them are ready for prime time," he said.

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Senate Swears in a Historic 20 Female Senators

Today the Senate will make history, swearing in a record-breaking 20 female senators – 4 Republicans and 16 Democrats – in office.

As the 113th Congress is sworn in today on Capitol Hill, ABC "World News" anchor Diane Sawyer has an exclusive joint interview with the historic class of female Senators.

Diane Sawyer's complete interview will air on World News this evening.

"I can't tell you the joy that I feel in my heart to look at these 20 gifted and talented women from two different parties, different zip codes to fill this room," Sen. Barbara Mikulksi, D-Md., said while surrounded by the group of women senators. "In all of American history only 16 women had served. Now there are 20 of us."

Senator-elect Deb Fischer, R-Neb., becomes today the first women to be elected as a senator in Nebraska.

"It was an historic election," Fischer said, "But what was really fun about it were the number of mothers and fathers who brought their daughters up to me during the campaign and said, "Can we get a picture? Can we get a picture?' Because people realize it and -- things do change, things do change."

The women senators all agree that women will be getting things done in this new Congress, a sign of optimism felt for the new Congress, after the bruising battles of the 112th Congress.

"We're in force and we're in leadership positions, but it's not just the position that we hold. I can tell you this is a can-do crowd," Mikulski said of both Democrats and Republican senators in the room. "We are today ready to be a force in American politics."

And while the number of women in the Senate today makes historic, many of the women agreed that they want to keep fighting to boost those numbers. Sen. Barbara Boxer, D-Calif., said that women are still "underrepresented" in the Senate.

"I think that until we get to 50, we still have to fight because it's still a problem," Boxer said. "I think this class as you look around, Republicans and Democrats... I think that because of this new class and the caliber of the people coming and the quality of the people coming, I think that hopefully in my lifetime -- and I really do hope and pray this is the case -- we will see 50 percent. "

No Sorority Here, Even With the Will to Work Together

The cooperation does not make them a "sorority," Sen. Dianne Feinstein, D-Calif., says. There are real differences in ideology and personality and they don't want their gender to define them as senators.

But the women also admit that they believe having more women in the room would help in fierce negotiations, compromise, and legislating on Capitol Hill, traits they say do not come as naturally to their male colleagues in the Senate. That sentiment enjoys bipartisan support among the women of the Senate.

"What I find is with all due deference to our male colleagues, that women's styles tend to be more collaborative," Sen. Susan Collins, R-Maine, said.

Sen. Claire McCaskill, D-Mo., said by nature women are "less confrontational." Sen-elect Mazie Hirono, D-Hawaii, says that women are "problem solvers."

Sen. Amy Klobuchar, D-Minn., says that women have a camaraderie which helps in relationships that are key to negotiations on Capitol Hill, something she says comes natural to women more than men.

"I think there's just a lot of collaboration between the women senators and... advice and really standing up for each other that you don't always see with the men," she said.

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Syrian rebels attack military airport in northwest

BEIRUT (Reuters) - Syrian rebels, some from Islamist units, fired machineguns and mortars at helicopters grounded at a northern military air base near the main Aleppo-Damascus highway on Wednesday, a monitoring group said.

The al Qaeda-linked al-Nusra Front, Ahrar al-Sham Brigade and other units operating in Syria's northwestern province of Idlib were attacking the Afis military airport near Taftanaz, the pro-opposition Syrian Observatory for Human Rights said.

There was no immediate account of the fighting around the air base from Syrian state media.

Insurgents trying to topple President Bashar al-Assad see his air power as their main threat. They hold swathes of eastern and northern provinces, as well as a crescent of suburbs around the capital, Damascus, but have been unable to protect rebel-held territory from relentless attack by helicopters and jets.

In recent months, rebel units have besieged several military installations, especially along Syria's main north-south artery from Aleppo, its most populous city, to Damascus.

The Observatory's director, Rami Abdelrahman, said Wednesday's attack was the latest of several attempts to capture the base. A satellite image of the airport shows more than 40 helicopter landing pads, a runway and aircraft hangars.

An estimated 45,000 people have been killed in the Syrian conflict, which began in March 2011 with peaceful protests against four decades of Assad family rule but turned into an armed revolt after months of government repression.

In Damascus, Assad's forces fired artillery and mortars at the eastern districts of Douma, Harasta, Irbin and Zamlaka, where rebels have a foothold, activists living there said.

Syria's civil war is the longest and deadliest conflict to emerge from uprisings that began sweeping the Arab world in 2011 and has developed a significant sectarian element.

Rebels, mostly from the Sunni Muslim majority, confront Assad's army and security forces, dominated by his Shi'ite-derived Alawite sect, which, along with some other minorities, fears revenge if he falls.

U.N.-led diplomatic peace efforts have stumbled. Western and many Sunni Arab states demand Assad's immediate removal, an idea resisted by Russia, China and Syria's Shi'ite ally Iran.

The rebels say they will not negotiate unless Assad, who has vowed to fight to the death, leaves power.

More than 110 people, including at least 31 of Assad's soldiers and militiamen, were killed in Syria on the first day of 2013, according to the Observatory, which tracks the conflict from Britain using a network of contacts inside the country.

(Editing by Peter Graff and Alistair Lyon)

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Tennis: Impressive Azarenka reaches Brisbane International quarter-finals

BRISBANE, Australia: World number one Victoria Azarenka moved into the quarter-finals of the Brisbane International with a hard-fought 6-3, 6-3 win over German Sabine Lisicki on Wednesday.

Azarenka was made to work hard for her win by the hard-hitting Lisicki, who traded punishing ground strokes with the top seed but was let down by a high error rate -- 36 unforced errors compared with only nine from her opponent.

In a match much closer than the score suggests, Lisicki had her chances but was unable to take them.

She had eight break points on Azarenka's serve but was only able to convert three, whereas Azarenka -- who won her maiden WTA title in Brisbane in 2009 -- broke Lisicki six times to seize the advantage.

The German also served poorly, landing only 52 per cent of her first serves and sending down five double faults. But she stayed in the match thanks to the quality of her hitting from the baseline.

"I knew what kind of player she is and I felt like she did improve from maybe the last time we played," Azarenka said.

"I just knew that there is something that I have to deal with. So I was prepared to take some bullets today.

"But I just tried to stay focused on executing my game. I knew she was going to make some, she was going to miss some, so I just had to stay with her and look for my chance."

Azarenka now plays Kazakhstan qualifier Ksenia Pervak in the quarter-finals.

Earlier, Germany's Angelique Kerber, the only player to defeat Serena Williams since the French Open in May, came from behind to beat unheralded Puerto Rican Monica Puig in three sets.

The 24-year-old fourth-seed looked in huge trouble as she trailed 1-4 in the third set but fought back to force a tiebreak.

Puig then led 4-0 in the tiebreak only for Kerber to fight back again and take the match 3-6, 6-4, 7-6 (9/7) in two and a half hours.

She will next take on Russia's Anastasia Pavlyuchenkova in the quarter-finals.

"I was just thinking point by point (when she was down in the third set)," Kerber said.

"I was not thinking 'What's happening?' I was just really on court and just trying to hit the ball, move very well, and just fight for every point.

"It was a surprise how she played. I didn't know her before, but I'm sure that she'll be in the top 50 soon."

Sloane Stephens set up a quarter-final against fellow American Serena Williams when she beat Sweden's Sofia Arvidsson 6-3, 6-4. Ukraine's Lesia Tsurenko, who only came into the tournament when Maria Sharapova pulled out, downed Australia's Jarmila Gajdosova 1-6, 6-1, 6-4.

- AFP/fa

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Vadra probe panel is cover up to 'gargantuan land scams': Ashok Khemka

CHANDIGARH: Senior IAS officer Ashok Khemka has termed Haryana's decision to set up a panel to probe his orders to cancel mutation of a land deal between Robert Vadra and DLF as a "cover up to the gargantuan land scams", and sought relevant file notings from the state government.

Four days after the high-level panel submitted its inquiry report into the cancellation of mutation of 3.5 acre of land in Gurgaon, Khemka stood his ground on his findings in the controversial deal.

In a letter to Haryana Chief Secretary P K Chaudhery on Monday, Khemka, who had as Director General of Consolidation of Holdings, cancelled the mutation of land deal between businessman Robert Vadra and real estate giant DLF, wrote that his orders under Sec 42 of East-Punjab Holdings (Consolidation and Prevention of Fragmentation) Act, 1948, were "quasi- judicial and final."

Currently MD of Haryana Seeds Development Corporation, Khemka has also sought a copy of the government order constituting the inquiry committee, its terms of reference and relevant file noting pages constituting the panel.

On being contacted, Khemka said the committee is a "sham to justify possible action against me as a cover to the gargantuan land scams".

"All this kind of humiliation and mental torture is to break me down psychologically," he claimed, adding that "vested interests" in the government have "pre-judged" the matter.

He said he is surprised that the affected individual or the corporate house is "not ostensibly aggrieved."

In his letter Khemka said, "the remedy for the affected party is to challenge the order by way of filing a writ petition in the high court".

Khemka has cited a case in which the Punjab and Haryana High Court had on September 6 last year directed the Hooda government to compile all orders of the DG consolidation, where precious panchayat lands were transferred to influential realtor companies.

"One of my orders pertaining to Chirsi village (Faridabad district) is also under challenge," he wrote.

The probe panel had submitted its report to the state Chief Secretary on December 28.

Congress president Sonia Gandhi's son-in-law Vadra had sold 3.53 acre of land at Shikohpur village in Gurgaon district to DLF.

As DG Consolidation, Khemka had on October 15, last year set aside the mutation on the grounds that the assistant consolidation officer who had sanctioned it was not authorised to do so.

Chaudhery, meanwhile, said he was "examining" the probe panel's report.

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Brain image study: Fructose may spur overeating

This is your brain on sugar — for real. Scientists have used imaging tests to show for the first time that fructose, a sugar that saturates the American diet, can trigger brain changes that may lead to overeating.

After drinking a fructose beverage, the brain doesn't register the feeling of being full as it does when simple glucose is consumed, researchers found.

It's a small study and does not prove that fructose or its relative, high-fructose corn syrup, can cause obesity, but experts say it adds evidence they may play a role. These sugars often are added to processed foods and beverages, and consumption has risen dramatically since the 1970s along with obesity. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.

All sugars are not equal — even though they contain the same amount of calories — because they are metabolized differently in the body. Table sugar is sucrose, which is half fructose, half glucose. High-fructose corn syrup is 55 percent fructose and 45 percent glucose. Some nutrition experts say this sweetener may pose special risks, but others and the industry reject that claim. And doctors say we eat too much sugar in all forms.

For the study, scientists used magnetic resonance imaging, or MRI, scans to track blood flow in the brain in 20 young, normal-weight people before and after they had drinks containing glucose or fructose in two sessions several weeks apart.

Scans showed that drinking glucose "turns off or suppresses the activity of areas of the brain that are critical for reward and desire for food," said one study leader, Yale University endocrinologist Dr. Robert Sherwin. With fructose, "we don't see those changes," he said. "As a result, the desire to eat continues — it isn't turned off."

What's convincing, said Dr. Jonathan Purnell, an endocrinologist at Oregon Health & Science University, is that the imaging results mirrored how hungry the people said they felt, as well as what earlier studies found in animals.

"It implies that fructose, at least with regards to promoting food intake and weight gain, is a bad actor compared to glucose," said Purnell. He wrote a commentary that appears with the federally funded study in Wednesday's Journal of the American Medical Association.

Researchers now are testing obese people to see if they react the same way to fructose and glucose as the normal-weight people in this study did.

What to do? Cook more at home and limit processed foods containing fructose and high-fructose corn syrup, Purnell suggested. "Try to avoid the sugar-sweetened beverages. It doesn't mean you can't ever have them," but control their size and how often they are consumed, he said.

A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage. However, independent experts say the methods are too flawed to make those claims.

The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly higher risk of death than those who were overweight. Many experts criticized that work, saying the researcher — Katherine Flegal of the Centers for Disease Control and Prevention — painted a misleading picture by including smokers and people with health problems ranging from cancer to heart disease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.

Flegal's new analysis bolsters her original one, by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concludes that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concludes that mildly obese people had a death risk similar to that of normal-weight people.

Critics again have focused on her methods. This time, she included people too thin to fit what some consider to be normal weight, which could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.

"Some portion of those thin people are actually sick, and sick people tend to die sooner," said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston.

The problems created by the study's inclusion of smokers and people with pre-existing illness "cannot be ignored," said Susan Gapstur, vice president of epidemiology for the American Cancer Society.

A third critic, Dr. Walter Willett of the Harvard School of Public Health, was blunter: "This is an even greater pile of rubbish" than the 2005 study, he said. Willett and others have done research since the 2005 study that found higher death risks from being overweight or obese.

Flegal defended her work. She noted that she used standard categories for weight classes. She said statistical adjustments were made for smokers, who were included to give a more real-world sample. She also said study participants were not in hospitals or hospices, making it unlikely that large numbers of sick people skewed the results.

"We still have to learn about obesity, including how best to measure it," Flegal's boss, CDC Director Dr. Thomas Frieden, said in a written statement. "However, it's clear that being obese is not healthy - it increases the risk of diabetes, heart disease, cancer, and many other health problems. Small, sustainable increases in physical activity and improvements in nutrition can lead to significant health improvements."

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Online:

Obesity info: http://www.cdc.gov/obesity/data/trends.html

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Mike Stobbe can be followed at http://twitter.com/MikeStobbe

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