Dead Lotto Winner's Wife Seeks 'Truth'

The wife of a $1 million Chicago lottery winner who died of cyanide poisoning told ABC News that she was shocked to learn the true cause of his death and is cooperating with an ongoing homicide investigation.

"I want the truth to come out in the investigation, the sooner the better," said Shabana Ansari, 32, the wife of Urooj Khan, 46. "Who could be that person who hurt him?

"It has been incredibly hard time," she added. "We went from being the happiest the day we got the check. It was the best sleep I've had. And then the next day, everything was gone."

Ansari, Khan's second wife, told the Chicago Sun-Times that she prepared what would be her husband's last meal the night before Khan died unexpectedly on July 20. It was a traditional beef-curry dinner attended by the married couple and their family, including Khan's 17-year-old daughter from a prior marriage, Jasmeen, and Ansari's father. Not feeling well, Khan retired early, Ansari told the paper, falling asleep in a chair, waking up in agony, then collapsing in the middle of the night. She called 911.

Khan, an immigrant from India who owned three dry-cleaning businesses in Chicago, won $1 million in a scratch-off Illinois Lottery game in June and said he planned to use the money to pay off his bills and mortgage, and make a contribution to St. Jude Children's Research Center.

"Him winning the lottery was just his luck," Ansari told ABC News. "He had already worked hard to be a millionaire before it."

Illinois Lottery/AP Photo

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Jimmy Goreel, who worked at the 7-Eleven store where Khan bought the winning ticket, described him to The Associated Press as a "regular customer ... very friendly, good sense of humor, working type of guy."

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Khan's unexpected death the month after his lottery win raised the suspicions of the Cook County medical examiner. There were no signs of foul play or trauma so the death initially was attributed to arteriosclerotic cardiovascular disease, which covers heart attacks, stroke or ruptured aneurysms. The medical examiner based the conclusion on an external exam -- not an autopsy -- and toxicology reports that indicated no presence of drugs or carbon monoxide.

Khan was buried at Rosehill Cemetery in Chicago.

However, several days after a death certificate was issued, a family member requested that the medical examiner's office look further into Khan's death, Cook County Medical Examiner Stephen Cina said. The office did so by retesting fluid samples that had been taken from Khan's body, including tests for cyanide and strychnine.

When the final toxicology results came back in late November, they showed a lethal level of cyanide, which led to the homicide investigation, Cina said. His office planned to exhume Khan's body within the next two weeks as part of the investigation.

Melissa Stratton, a spokeswoman for the Chicago Police Department, confirmed it has been working closely with the medical examiner's office. The police have not said whether or not they believe Khan's lottery winnings played a part in the homicide.

Khan had elected to receive the lump sum payout of $425,000, but had not yet received it when he died, Ansari told the AP, adding that the winnings now are tied up as a probate matter.

"I am cooperating with the investigation," Ansari told ABC News. "I want the truth to come out."

Authorities also have not revealed the identity of the relative who suggested the deeper look into Khan's death. Ansari said it was not her, though she told the AP she has subsequently spoken with investigators.

"This is been a shock for me," she told ABC News. "This has been an utter shock for me, and my husband was such a goodhearted person who would do anything for anyone. Who would do something like this to him?

"We were married 12 years [and] he treated me like a princess," she said. "He showered his love on me and now it's gone."

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Afghan peace efforts show flickers of life

WASHINGTON/ISLAMABAD (Reuters) - President Barack Obama and Afghan President Hamid Karzai will discuss matters of war, including future U.S. troop levels and Afghanistan's army, when they meet on Friday, but matters of peace may be the most delicate item on their long agenda.

After nearly 10 months in limbo, tentative reconciliation efforts involving Taliban insurgents, the Karzai government and other major Afghan factions have shown new signs of life, resurrecting tantalizing hopes for a negotiated end to decades of war.

Pakistan, which U.S. and Afghan officials have long accused of backing the insurgents and meddling in Afghanistan, has recently signaled an apparent policy shift toward promoting its neighbor's stability as most U.S. combat troops prepare to depart, top Pakistani and Afghan officials said.

In another potentially significant development, Taliban representatives met outside Paris last month with members of the Afghan High Peace Council - although not directly with members of the Karzai government, which they have long shunned.

U.S. officials, speaking on condition of anonymity, said the developments are promising - but that major challenges remain to opening negotiations, let alone reaching an agreement on the war-ravaged country's political future.

Hopes for Afghan peace talks have been raised before, only to be dashed. Last March, the Taliban suspended months of quiet discussions with Washington aimed at getting the insurgents and the Karzai government to the peace table.

Obama is expected to press the Afghan president to bless the formal opening of a Taliban political office in the Gulf state of Qatar as a way to jump-start inter-Afghan talks.

Karzai has been lukewarm to the idea, apparently fearing his government would be sidelined in any negotiations.

TRIP AT A TURNING POINT

Karzai's meeting with Obama, at the end of a three-day visit to Washington, is shaping up to be one of the most critical encounters between the two leaders, as the White House weighs how rapidly to remove most of the roughly 66,000 U.S. troops in Afghanistan and how large a residual force to leave after 2014.

Obama, about to begin his second term in office, appears determined to wrap up U.S. military engagement in Afghanistan. On Monday, he announced as his nominee for Pentagon chief former Nebraska Senator Chuck Hagel, who appears likely to favor a sizeable U.S. troop drawdown.

Other issues on the agenda have plenty of potential for causing friction: the future size and focus of the Afghan military; a festering dispute over control of the country's largest detention center; and the future of international aid after 2014.

Karzai's trip "is one of the most important ones because the discussions we are going to have with our counterparts will define the relations between (the) United States and Afghanistan," Afghan Foreign Minister Zalmay Rassoul told the lower house of parliament this month.

No final announcement on post-2014 U.S. troop levels is expected during Karzai's visit, and the issue is further complicated by Washington's insistence on legal immunity for American troops that remain.

General John Allen, the top U.S. and NATO commander in Afghanistan, recommended keeping between roughly 6,000 and 15,000 U.S. troops in Afghanistan after 2014, but the White House is considering possibly leaving as few as 3,000 troops.

A U.S. official, speaking on condition of anonymity, said the White House had asked for options to be developed for keeping between 3,000 and 9,000 troops in the country.

PAST PEACE HOPES DASHED

Last year, the Obama administration hoped to kick-start peace talks with a deal that would have seen Washington transfer five Taliban prisoners from Guantanamo Bay prison. In return, the Taliban would renounce international terrorism and state a willingness to enter talks with Karzai's representatives.

That deal never came off, and the question now is whether it, or an alternative peace process, can get under way as the U.S. military presence rapidly winds down.

Looking at developments in the last few months, "you could see that there are things happening," said one U.S. official, who was not authorized to speak for the record.

At the end of 2012, Pakistan released four Afghan Taliban prisoners who were close to the movement's reclusive leader, Mullah Mohammed Omar. It appeared to be a step toward meeting Afghanistan's long-standing insistence that Islamabad free those who could help promote reconciliation. A senior Afghan official welcomed the release.

A member of Pakistan's parliament closely involved in Afghan policy-making said there are signs of a shift in the thinking of Pakistan's powerful military. Some in the military, which has long regarded Afghanistan as a battleground in its existential conflict with rival India, are now saying that the graver threat comes from Pakistan's own militants.

"Yes, there is skepticism. The hawks are there. But the fact is that previously there were absolutely no voices in the army with this kind of positive thinking," the parliamentarian said.

"Pakistan has also realized that there won't be a complete withdrawal of the U.S. from Afghanistan," the lawmaker said. "The security establishment realizes it has to compromise somewhere. Hence the Taliban releases. ... Hence the statements from even the most skeptical Afghan officials that there is a change in Pakistani thinking."

Ghairat Baheer, who represented the Hezb-e-Islami faction at last month's peace talks in the Paris suburb of Chantilly, rejected a continued U.S. military presence in Afghanistan, but praised the Pakistan prisoner release as a sign of its good intentions.

WAITING FOR THE TALIBAN

After more than a year of frustration, Obama administration officials are skeptical about luring the Taliban to peace talks, citing what appears to be a deep fissure within the movement between moderates who favor entering the political process and hard-liners committed to ousting both NATO troops and Karzai.

The Taliban's lead negotiator, Tayeb Agha, whom the Obama administration regards as a reliable interlocutor, offered to resign last month in apparent frustration, the Daily Beast website reported.

Taliban envoys have yet to meet officially with Karzai's government, and the insurgents demand a rewriting of the Afghan constitution.

"I don't think anyone knows where (reconciliation) stands. And I mean that because there are a lot of reconciliation talks and a lot of games that are being played in a lot of places," said Fred Kagan, a military analyst at the conservative American Enterprise Institute.

"The likelihood of getting an acceptable deal that actually secures our interests is vanishingly small," he said. "But the probability that you could get the deal and have it implemented in time to make this drawdown timeline make sense is nonsense."

(Additional reporting by Phil Stewart and David Alexander in Washington, and Hamid Shalizi in Kabul. Editing by Christopher Wilson)

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Karzai on US visit as Obama mulls Afghan troop plan

WASHINGTON: President Hamid Karzai will begin a four-day US visit on Tuesday as President Barack Obama weighs how fast to withdraw troops from Afghanistan and whether to leave a "residual force" behind after 2014.

Foreign combat soldiers are due to exit Afghanistan by the end of next year, more than a decade after a US-led invasion brought down the Taliban regime in 2001, but the country remains wracked by Islamist violence.

US officials have reportedly prepared plans for between 3,000 and 9,000 troops to remain to prevent Al-Qaeda militants from re-establishing themselves and to ensure Taliban fighters cannot take the capital Kabul.

But pressure is growing on Obama to end the war rapidly due to deep war weariness in the United States, tightening military budgets and anger over "insider attacks" by Afghan troops on the NATO-led soldiers.

"If Mr. Obama cannot find a way to go to zero troops, he should approve only the minimum number needed," The New York Times said in an editorial this week that called Karzai's government "profoundly corrupt".

Obama will host talks with Karzai at the White House on Friday, the day after the Afghan president meets Secretary of State Hillary Clinton.

US officials have said a decision could be made during Karzai's visit on how many troops stay on in Afghanistan after 2014 - a figure that could determine whether the country tips into a widely-feared civil war.

The talks will also include equipping and strengthening Afghan forces, efforts to negotiate peace with Taliban-led insurgents and a long-term security agreement with the United States, Karzai's office said.

The number of foreign soldiers battling the insurgency in Afghanistan has already fallen to 100,000 from about 150,000. Of those, 66,000 are US troops, down from a maximum of about 100,000.

Afghan army and police are due to take over complete security responsibility from NATO troops by the end of 2014, but there are major concerns they will not be able to face down the country's many warring factions.

More than 60 foreign soldiers were killed in 2012 in "insider attacks" that have bred bitter mistrust and threatened to derail the training of Afghan security forces.

Karzai has expressed support for keeping some US troops in Afghanistan after 2014 but sensitive details - including immunity for American soldiers and the transfer of detainees into Afghan custody - are still under negotiation.

Washington scrapped plans for some troops to remain in Iraq after Baghdad refused to grant US soldiers immunity from prosecution.

Karzai's relationship with Washington has been troubled in recent years and there are fears that attention on his country, heavily dependent on international aid, could plummet after the NATO withdrawal.

A White House statement ahead of the visit said that Obama envisioned "an enduring partnership between the United States and Afghanistan".

Outgoing Defense Secretary Leon Panetta has stressed that any residual force would focus on Al-Qaeda, which was sheltered by the Taliban government that was ousted after the 9/11 attacks.

Friday's talks will come just days after Obama put the finishing touches to his security team, having named his picks to head up the State Department, Pentagon and CIA.

Karzai is expected to visit Asadullah Khalid, his spy chief who was wounded in an attack in Kabul last month, at an American hospital on Tuesday.

- AFP/de

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Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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Giffords, Kelly Launch Initiative to Curb Gun Violence

After she was gravely wounded by gunfire two years ago in Tucson, Ariz., former Rep. Gabrielle Giffords and her husband, Mark Kelly, imagined a life out of the public eye, where she would continue therapy surrounded by the friends, family and the Arizona desert she loves so much.

Gabby Giffords and Mark Kelly Speak Exclusively to Diane Sawyer

But after the slaughter of 20 first-graders and six adults at Sandy Hook Elementary School in Newtown, Conn., last month, Giffords and Kelly knew they couldn't stay silent.

"Enough," Giffords said.

The couple marked the second anniversary of the Tucson shooting by sitting down with Diane Sawyer to discuss their recent visit to Newtown and their new initiative to curb gun violence, "Americans for Responsible Solutions."

"After the shooting in Tucson, there was talk about addressing some of these issues, [and] again after [a movie theater massacre in] Aurora," Colo., Kelly said. "I'm hopeful that this time is different, and I think it is. Twenty first-graders' being murdered in their classrooms is a very personal thing for everybody."

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Full Coverage: Gabrielle Giffords

During their trip to Newtown, Giffords and Kelly met with families directly affected by the tragedy.

"[The] first couple that we spoke to, the dad took out his cell phone and showed us a picture of his daughter and I just about lost it, just by looking at the picture," Kelly said. "It was just very tough and it brought back a lot of memories about what that was like for us some two years ago."

Full Coverage: Tragedy in Newtown

"Strength," Giffords said she told the families in Newtown.

"Gabby often told them, 'You got to have strength. You got to fight for something,'" Kelly said.

The innocent faces of the children whose lives were abruptly taken reminded the couple, they said, of 9-year-old Christina-Taylor Green, the youngest victim to die in the Tucson shooting at a Giffords constituent event.

"I think we all need to try to do something about [gun violence]," Kelly said. "It's obvious to everybody we have a problem. And problems can be solved."

Giffords, Kelly Call for 'Common Sense' Solutions

Giffords, 42, and Kelly, 48, are both gun owners and supporters of the 2nd Amendment, but Kelly had strong words for the National Rifle Association after the group suggested the only way to stop gun violence is to have a "good guy with a gun."

There was a good guy with a gun, Kelly said, the day Jared Loughner shot Giffords and 18 other people, six fatally, at her "Congress on Your Corner" event.

"[A man came out] of the store next door and nearly shot the man who took down Jared Loughner," Kelly said. "The one who eventually wrestled [Loughner] to the ground was almost killed himself by a good guy with a gun, so I don't really buy that argument."

Instead, Giffords and Kelly are proposing "common sense" changes through "Americans for Responsible Solutions."

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Turmoil in Indian court as five accused of rape appear

NEW DELHI (Reuters) - Five men accused of the gang rape and murder of an Indian student appeared in court on Monday to hear charges against them, after two of them offered evidence possibly in return for a lighter sentence in a case that has provoked widespread anger.

The five men, along with a teenager, are accused of raping the 23-year-old physiotherapy student when she boarded their bus after going to the cinema in New Delhi on December 16. She died two weeks later in a Singapore hospital.

The attack on the student has ignited protests against the government and anger towards the police for their perceived failure to protect women. It has also provoked a rare national debate about rising violence against women.

Reuters images showed the men stepping out of a blue police van that brought them from Tihar jail, and walking through a metal detector into the South Delhi court, across the street from the cinema where the victim watched a film before boarding the bus with a male friend on December 16.

Following rowdy scenes in the packed court, the magistrate, Namrita Aggarwal, closed the hearing to the media and the public. The court was cleared and police were posted at its doors before the accused were brought in.

"Keeping in view the sensitivity of this case that has risen, the proceedings including the inquiry and trial are to be held in camera," Aggarwal said, before ordering people not connected with the case out of the courtroom.

A police guard said the five men had their faces covered when they entered the court, where the magistrate was due to read charges against them. The five have already been charged with murder, rape and abduction along with other offences.

Aggarwal said the next hearing would be on January 10. She did not say when the case would go to trial in a separate, fast-track court, set up after the attack on the woman.

Earlier, an argument broke out in court when a lawyer offered to defend the men. He was shouted down by colleagues who said the accused did not deserve representation, given the brutality of the crime.

Two of the accused, Vinay Sharma and Pawan Gupta, moved an application on Saturday requesting they be made "approvers", or informers, against the other accused, Mukesh Kumar, Ram Singh and Akshay Thakura, public prosecutor Rajiv Mohan told Reuters.

Mohan told Reuters he was seeking the death sentence given the "heinous" crime.

"The five accused persons deserve not less than the death penalty," he said, echoing public sentiment and calls from the victim's family.

Members of the bar association in Saket district, where the case is being heard, have vowed not to represent the accused.

GROUNDS FOR APPEAL?

But on Monday, Supreme Court lawyer Manohar Lal Sharma stood up to offer representation to the men. He was booed by other lawyers in the court, where media and advocates had gathered before the men were due to appear.

"We are living in a modern society. We all are educated. Every accused, including those in brutal offences like this, has the legal right to represent his or her case to defend themselves," Lal Sharma said.

"I'm afraid they won't get justice, that's why I have decided to appear for them in the court," Sharma said, but added it was up for the court to decide.

Police have conducted extensive interrogations and say they have recorded confessions, even though the five have no lawyers.

Legal experts say their lack of representation could give grounds for appeal should they be found guilty. Similar cases have resulted in acquittals years after convictions.

Last week, chief justice Altamas Kabir inaugurated six fast-track courts to help reduce a backlog of sex crime cases in Delhi.

But some legal experts have warned that previous attempts to fast-track justice in India in some cases led to imperfect convictions that were later challenged.

The men, most of them from a slum neighborhood, will be offered legal aid by the court before the trial can begin.

The sixth member of the gang that lured the student and a male friend into the private bus is under 18 and will be tried in a separate juvenile court.

The government is aiming to lower the age teenagers can be tried as an adult, given widespread public anger that the boy will face a maximum three year sentence.

The victim, who died on December 29 in hospital in Singapore, where she had been taken for treatment, was identified by a British newspaper on the weekend but Reuters has opted not to name her.

Indian law generally prohibits the identification of victims of sex crimes. The law is intended to protect victims' privacy and keep them from the media glare in a country where the social stigma associated with rape can be devastating.

(Writing by Frank Jack Daniel; Editing by Robert Birsel)

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Tennis: Erratic Janowicz fails in Auckland

AUCKLAND: Jerzy Janowicz's fairy tale rise through the tennis ranks was dealt a blow at the Heineken Open in Auckland on Monday when the Polish fifth seed lost in the opening round to US journeyman Brian Baker.

In his first outing since a breakthrough run to reach the final of the Paris Masters last November, Janowicz was defeated 4-6, 7-6 (7/5), 6-4 after an erratic display in the tournament, a warm-up event for the Australian Open.

While he showed glimpses of the giant-killing form that downed five top 20 players in Paris, including Andy Murray, Janowicz committed 51 unforced errors and 10 double faults to hand the match to Baker.

He took the first set comfortably but lost concentration early in the second, finally rallying at 5-1 down in the third, when it was too late to stop Baker.

"It seemed like he flicked a switch," the American said. "I don't know how many points he won in a row but it seemed like about 15. "Luckily I was able to close it out at the end."

Last year's beaten finalist Olivier Rochus of Belgium defeated Spain's Albert Ramos 6-2, 5-7, 6-2 in blustery conditions that he described as the toughest he had ever played in.

"It was very windy and the ball was going all over the place and it was very tricky but I kept my mind very focused and that's why I won," he said.

Elsewhere, Rochus' compatriot Xavier Malisse overcame some early resistance from Slovak seventh seed Martin Klizan to notch a 7-6 (7/4), 3-6 win.

David Goffin, the third Belgian on centre court during the opening day's play, was not so fortunate, going down 7-6 (7/5), 6-2 to eighth seed Thomaz Bellucci of Brazil.

Austria's Jurgen Melzer will be the only seeded player (sixth) in action when the bottom half of the draw is played on Tuesday, although there will be interest as French wildcard Gael Monfils continues his comeback from a knee injury.

Defending champion and top seed David Ferrer of Spain has a bye into the second round, as do Germans Philipp Kohlschreiber and Tommy Haas, seeded two and three respectively, and American fourth seed Sam Querrey.

- AFP/de

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Kasab pleaded for 'mercy' in a four-line plea

NEW DELHI: Ajmal Kasab, the face of the dastardly 26/11 terror strike on Mumbai who was hanged on November 21, had begged for "daya" (mercy) from the President through his four-line clemency plea written in elementary Urdu, which was rejected.

The hand written petition dated September 12, 2012, which has been made public more than a month after Kasab was hanged, shows glaring Urdu language errors.

The application has been provided to Lucknow-based activist Urvashi Sharma under the Right to Information Act.

In his brief application, Kasab pleaded, "Sir, mujhe fansi ki saza Supreme Court ho gayi hai. Fansi ki saza se mujhe chorr diya jaye. Mere upar daya karo aur muje fansi ki se riha kar de. Apka Ajmal Kasab (sic)."

It was translated by the jail authorities as, "Sir, I have been sentenced by Supreme Court for capital punishment (Hanged till death). It is most humbly and respectfully pleaded to spare me from death sentence and also get me released from the gallows. It is my humble request. Yours"

Pakistani citizen Kasab, the sole surviving terrorist from the 26/11 terror attack, was hanged to death at the Yerawada Jail in Pune on November 21, 2012. He was among the ten terrorists who had entered Mumbai through sea route on November 26, 2008 and launched a three-day mayhem which killed 166 people.

25-year-old Kasab had been lodged in the Arthur Jail Road here ever since he was arrested immediately after the attack in 2008. He was convicted and given capital punishment by the trial court on May 6, 2010 which was upheld by the Bombay High Court on February 21, 2011. The Supreme Court subsequently upheld the sentence on August 29 last year.

His mercy petition was rejected by President Pranab Mukherjee on November 5, 2012.

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Your medical chart could include exercise minutes

CHICAGO (AP) — Roll up a sleeve for the blood pressure cuff. Stick out a wrist for the pulse-taking. Lift your tongue for the thermometer. Report how many minutes you are active or getting exercise.

Wait, what?

If the last item isn't part of the usual drill at your doctor's office, a movement is afoot to change that. One recent national survey indicated only a third of Americans said their doctors asked about or prescribed physical activity.

Kaiser Permanente, one of the nation's largest nonprofit health insurance plans, made a big push a few years ago to get its southern California doctors to ask patients about exercise. Since then, Kaiser has expanded the program across California and to several other states. Now almost 9 million patients are asked at every visit, and some other medical systems are doing it, too.

Here's how it works: During any routine check of vital signs, a nurse or medical assistant asks how many days a week the patient exercises and for how long. The number of minutes per week is posted along with other vitals at the top the medical chart. So it's among the first things the doctor sees.

"All we ask our physicians to do is to make a comment on it, like, 'Hey, good job,' or 'I noticed today that your blood pressure is too high and you're not doing any exercise. There's a connection there. We really need to start you walking 30 minutes a day,'" said Dr. Robert Sallis, a Kaiser family doctor. He hatched the vital sign idea as part of a larger initiative by doctors groups.

He said Kaiser doctors generally prescribe exercise first, instead of medication, and for many patients who follow through that's often all it takes.

It's a challenge to make progress. A study looking at the first year of Kaiser's effort showed more than a third of patients said they never exercise.

Sallis said some patients may not be aware that research shows physical inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. As recently as November a government-led study concluded that people who routinely exercise live longer than others, even if they're overweight.

Zendi Solano, who works for Kaiser as a research assistant in Pasadena, Calif., says she always knew exercise was a good thing. But until about a year ago, when her Kaiser doctor started routinely measuring it, she "really didn't take it seriously."

She was obese, and in a family of diabetics, had elevated blood sugar. She sometimes did push-ups and other strength training but not anything very sustained or strenuous.

Solano, 34, decided to take up running and after a couple of months she was doing three miles. Then she began training for a half marathon — and ran that 13-mile race in May in less than three hours. She formed a running club with co-workers and now runs several miles a week. She also started eating smaller portions and buying more fruits and vegetables.

She is still overweight but has lost 30 pounds and her blood sugar is normal.

Her doctor praised the improvement at her last physical in June and Solano says the routine exercise checks are "a great reminder."

Kaiser began the program about three years ago after 2008 government guidelines recommended at least 2 1/2 hours of moderately vigorous exercise each week. That includes brisk walking, cycling, lawn-mowing — anything that gets you breathing a little harder than normal for at least 10 minutes at a time.

A recently published study of nearly 2 million people in Kaiser's southern California network found that less than a third met physical activity guidelines during the program's first year ending in March 2011. That's worse than results from national studies. But promoters of the vital signs effort think Kaiser's numbers are more realistic because people are more likely to tell their own doctors the truth.

Dr. Elizabeth Joy of Salt Lake City has created a nearly identical program and she expects 300 physicians in her Intermountain Healthcare network to be involved early this year.

"There are some real opportunities there to kind of shift patients' expectations about the value of physical activity on health," Joy said.

NorthShore University HealthSystem in Chicago's northern suburbs plans to start an exercise vital sign program this month, eventually involving about 200 primary care doctors.

Dr. Carrie Jaworski, a NorthShore family and sports medicine specialist, already asks patients about exercise. She said some of her diabetic patients have been able to cut back on their medicines after getting active.

Dr. William Dietz, an obesity expert who retired last year from the Centers for Disease Control and Prevention, said measuring a patient's exercise regardless of method is essential, but that "naming it as a vital sign kind of elevates it."

Figuring out how to get people to be more active is the important next step, he said, and could have a big effect in reducing medical costs.

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Online:

Exercise: http://1.usa.gov/b6AkMa

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Hagel Nomination Stirs Bipartisan Opposition

Two weeks before his inauguration, and with more "fiscal cliffs" on the horizon, President Obama is embracing a showdown with Congress over his pick to lead the Pentagon in his second term.

Obama will nominate former Republican Sen. Chuck Hagel to be the next Secretary of Defense at a formal White House announcement later today, administration officials said.

The president will name counterterrorism advisor John Brennan as the new CIA director to replace David Petraeus, rounding out an overhaul of his national security team.

Obama tapped Sen. John Kerry of Massachusetts last month to become the next Secretary of State.

Hagel is in many ways an ideal pick for Obama, giving nod to bipartisanship while appointing someone with a demonstrated commitment to veterans of Iraq and Afghanistan and to retooling and economizing the Pentagon bureaucracy for the future.

But the nomination of Hagel to replace outgoing Defense Secretary Leon Panetta is also politically charged, expected to trigger a brutal confirmation fight in the Senate, where a bipartisan group of critics has already lined up against the pick.

"This is an in your face nomination by the president to all of us who are supportive of Israel," Sen. Lindsey Graham, R-S.C., told CNN on Sunday. "I don't know what his management experience is regarding the Pentagon -- little, if any, so I think it's an incredibly controversial choice."

Junko Kimura/Getty Images

The criticism stems from Hagel's controversial past statements on foreign policy, including a 2008 reference to Israel's U.S. supporters as "the Jewish lobby" and public encouragement of negotiations between the United States, Israel and Hamas, a Palestinian group the State Department classifies as terrorists.

"Hagel has consistently been against economic sanctions to try to change the behavior of the Islamist regime, the radical regime in Tehran, which is the only way to do it, short of war," Sen. Joe Lieberman, I-Conn., said last month.

The Nebraska Republican has also drawn fire for his outspoken opposition to the 2003 U.S.-led war in Iraq and the subsequent troop "surge" ordered by then-President George W. Bush in 2007, which has been credited with helping bring the war to a close.

On the left, gay rights groups have protested Hagel for comments he made in 1998 disparaging then-President Bill Clinton's nominee for U.S. Ambassador to Luxembourg James Hormel as "openly, aggressively gay." Hagel has since apologized for the remark as "insensitive."

Top Senate Democrats tell ABC News there is no guarantee Hagel will win confirmation and that, as of right now, there are enough Democratic Senators with serious concerns about Hagel to put him below 50 votes.

But that could change, with many top lawmakers publicly vowing to withhold final judgment until Hagel has an opportunity to answer his critics during confirmation hearings. No senator has yet publicly vowed to filibuster the Hagel nomination.

Hagel is a decorated Vietnam veteran and businessman who served in the senate from 1997 to 2009. After having sat on that chamber's Foreign Relations and Intelligence committees, he has in recent years gathered praise from current and former diplomats for his work on Obama's Intelligence Advisory Board as well as the policy board of current Defense Secretary Leon Panetta.

"Chuck Hagel is a tremendous patriot and statesman, served incredibly in Vietnam, served this country as a United States senator. He hasn't had a chance to speak for himself. And so why all the prejudging?" said Sen. Heidi Heitkamp, D-N.D., on "This Week."

"In America, you give everybody a chance to speak for themselves and then we'll decide," she said.

The top Senate Republican echoed that sentiment. "I'm going to wait and see how the hearings go and see whether Chuck's views square with the job he would be nominated to do," Senate Minority Leader Mitch McConnell of Kentucky said.

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