ADHD children have greater risk of being overweight

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for being overweight, regardless of whether or not they are currently receiving medications for the condition.The results of prior research has suggested that the impulsivity and poor behavioral regulation that is common in children with ADHD may promote certain eating patterns that increase the risk of obesity, co-authors Molly E. Waring and Dr. Kate L. Lapane, from Brown Medical School in Providence, Rhode Island, note.

To investigate further, the researchers analyzed data from 62,887 children and adolescents included in the 2003-2004 National Survey of Children's Health.

Children with ADHD were identified based the response of the parent to the question: "Has a doctor or health professional ever told you that your child has attention-deficit disorder or attention-deficit/hyperactivity disorder, that is, ADD or ADHD?"

The prevalence of ADD or ADHD was 8.8 percent, the authors report in the journal Pediatrics, and approximately half the affected children were taking medication for the condition.

After accounting for demographic factors as well as depression and anxiety, ADHD patients who were not being treated with medication were 1.5-times more likely to be overweight than children without the disorder. The risk for ADHD among those who were currently receiving medications was only about 0.5-times higher than children without ADHD.

"Future work is needed to better understand the longitudinal and pharmacologic factors that influence the relationship between ADD/ADHD and weight status in children and adolescents," the investigators conclude.

Obesity not a contraindication to knee replacement

Obese individuals with arthritic knees should not be denied knee replacement surgery, researchers conclude, based on a new study showing that obese patients benefit from the surgery almost as much as their normal-weight peers.Roughly 55,000 knee replacements are performed every year in England to relieve the pain and disability of knee arthritis, according to the British research team that conducted the study. But in some parts of the country the surgery is offered only to people who are not obese, on the grounds that obesity is itself a risk factor for knee arthritis.

Dr. Cyrus Cooper, at the University of Southampton, and associates monitored the progress of 325 patients for around six years after they had had knee replacement surgery. Their progress was compared with that of 363 "control" patients seen in general medical practices, matched for age and sex, who had not had knee replacements.

At the outset, physical function was markedly worse in the knee replacement patient group than in the control group. However, at follow-up, physical function had improved in the knee replacement patients, while that of controls had worsened.

When the researchers restricted their analysis to participants who were obese, the improvements with knee surgery persisted. In obese patients, physical function increased in surgery patients and deteriorated in controls.

"The long term improvement in physical function that we observed in patients who have undergone (knee replacement surgery) is striking when set against the decline that occurred in (the control group)," Cooper and colleagues say. "These benefits extend to patients who are obese."

"There seems no justification for withholding (knee replacement surgery) from patients who are obese," they conclude.

SOURCE: Annals of the Rheumatic Diseases, online July 24, 2008

Childcare before kindergarten may promote obesity

Participation in a childcare program appears to increase the likelihood that a child will be obese when he or she shows up for the first day of kindergarten, researchers report in the journal Pediatrics.Moreover, the report indicates that the type of childcare makes a difference. For instance, children who receive care from a relative, friend, or neighbor, held at least occasionally in the child's own home, were more prone to obesity than those who received care at a daycare center or nursery school.

Latino children, however, seemed to be the exception. While they were found to be at greater risk for obesity than kids of other races, they were less likely to become obese when enrolled in a childcare program rather than spending the week with a parent.

The study, conducted by Dr. Erin J. Maher, from Casey Family Programs in Seattle, and colleagues, involved nearly 16,000 first-time kindergartners who had or had not been enrolled in childcare, defined as spending at least 10 hours per week in care not provided by a parent.

Childcare was subdivided into four types: 1) paid or unpaid care by a relative, friend, or neighbor, held at least occasionally at the child's home; 2) paid care by a non-relative family outside the child's home; 3) Head Start; and 4) care at daycare center, nursery school, preschool, or pre-kindergarten. Children were considered to be obese if their weight was in the 95th or higher percentile for height.

Overall, kids in childcare were more likely to obese than children not in childcare. Of the various childcare types, care by a relative, friend, or neighbor was most strongly linked to obesity. Compared with other racial groups, white children were less likely and Latino children more likely to be obese.

"Our research points to the need to better understand how the specific features of childcare environments may promote or protect against the development of obesity," Dr. Maher's team concludes. "This understanding can then lead to the development of targeted interventions to reach children and families in childcare settings."

SOURCE: Pediatrics, August 2008.

Lack of REM sleep may raise obesity risk in kids

Studies have shown that children and teens who fail to get the proper amount of sleep each night are more prone to obesity, and researchers now think it may be linked to a particular stage of sleep.
They said not spending enough time in rapid eye movement, or REM, sleep -- the type that is normally associated with dreaming -- significantly increased the odds of obesity in children and teens.

"Our results demonstrated that the short sleep-obesity association may be attributed to reduced REM sleep," said Dr. Xianchen Liu of Western Psychiatric Institute and Clinic in Pittsburgh reported on Monday in the Archives of General Psychiatry.

Ultimately, obesity is the byproduct of taking in more calories than the body needs. But Liu and colleagues wanted to see if they could identify any stage of sleep that appeared especially important.

The researchers studied 335 children and adolescents aged 7 to 17 for three consecutive nights. Their sleep was monitored through polysomnography, which measures sleep cycles and stages by recording brain waves, electrical activity of muscles, eye movement, breathing rate, blood pressure, and other variables.

Weight and height were measured to calculate body mass index, a measure of obesity. They found 15 percent were at risk for becoming overweight and 13 were overweight.

When they compared the sleep patterns among these groups, they found children who were overweight slept about 22 minutes less per night than normal-weight children. They also had shorter REM sleep, less eye activity during REM sleep and a longer wait before the first REM period.

After adjusting for other factors, they found one hour less of total sleep doubled the odds of being overweight, and one-hour less of REM sleep tripled the odds.

"Although the precise mechanisms are currently under investigation, the association between short sleep duration and overweight may be attributed to the interaction of behavioral and biological changes as a result of sleep deprivation," Liu and colleagues wrote.

They said sleep loss causes changes in hormone levels that may affect hunger. It also gives a person more time in which to eat, and makes a person sleepy during the day, which may make them less likely to exercise.

Liu said more research is needed to understand changes in the metabolism that occur when children and teens get too little sleep.

They noted that the obesity rate has more than tripled among children aged 6 to 11 years in the past 30 years, and about 17 percent of U.S. adolescents are now overweight or obese.

Given this, the researchers think doctors, schools and families should step in to ensure that children get enough sleep.

Liu suggests parents establish regular bedtime and wake up times at both weekdays and weekends, improve the sleep environment and address any sleep disorders such as sleep apnea that may be keeping children from getting the sleep they need.

Kids Who Sleep Poorly at Risk for Being Overweight

Getting too little sleep or not spending enough time in rapid eye movement (REM) sleep is associated with being overweight among children and teens, a new U.S. study.For three consecutive nights, researchers assessed the sleep patterns of 335 youngsters, aged 7 to 17. They looked at total sleep time, time spent in REM, and time it took to fall asleep. Body-mass index was checked at the start of the study, and 45 participants (13.4 percent) were overweight, while 49 (14.6 percent) were at risk for becoming overweight.

Compared to normal-weight children, those who were overweight slept about 22 minutes less per night and had lower sleep efficiency (percentage of time in bed that a person is asleep), shorter REM sleep, less eye activity during REM sleep, and a longer wait before the first REM period.

After they adjusted for other factors, the researchers concluded that one hour less of total sleep was associated with a twofold increased risk of being overweight. One hour less of REM sleep was associated with a threefold increased risk.

Although the precise mechanisms are currently under investigation, the association between short sleep duration and overweight may be attributed to the interaction of behavioral and biological changes as a result of sleep deprivation, wrote Dr. Xianchen Liu, of the Western Psychiatric Institute and Clinic in Pittsburgh, and colleagues.

They explained that sleep loss causes changes in hormone levels that may affect hunger, and less sleep also means a person has more waking hours in which to eat. Sleep loss also contributes to fatigue the following day, which may lead to less physical activity and fewer calories burned.

Given the fact that the prevalence of overweight among children and adolescents continues to increase and chronic sleep insufficiency becomes more prevalent in modern society, family- and school-based sleep interventions that aim to enhance sleep hygiene and increase sleep duration may have important public health implications for the prevention and intervention of obesity and type 2 diabetes in children, the authors concluded.

"Furthermore, our results demonstrate an important relationship between REM sleep and high BMI and obesity, suggesting that the short sleep-obesity association may be attributed to reduced REM sleep time and decreased activity during REM sleep," they wrote.

The study was published in the August issue of the Archives of General Psychiatry.

Obesity seen protective in cases of heart failure

Overweight and obese patients with heart failure seem to have a lower risk of dying than their normal-weight counterparts, according to a review of published studies involving more than 28,000 heart failure patients who were followed for an average of nearly three years.There is evidence, Dr. Antigone Oreopoulos told Reuters Health, that a normal body mass index (BMI) "is likely not the ideal BMI" in people with heart failure, which occurs when the heart loses its ability to pump blood efficiently.

Oreopoulos, from University of Alberta, Edmonton, Canada, and associates reviewed nine studies that examined the impact of BMI on mortality. They pooled the data to estimate the risk of death in patients who are underweight, overweight or obese compared to patients with a normal body weight.

According to the researchers, patients who were overweight or obese were less likely to die during follow up compared to their normal-weight peers. Being overweight or obese "remained protective" against death in a "risk-adjusted" analysis.

Heart failure patients who had a normal weight or who were underweight had the highest death rates. "It remains unknown, however, if higher body fat levels are actually the cause of better outcomes in patients with heart failure," the researchers note in the American Heart Journal.

"We believe there is a need for prospective studies to confirm these findings and elucidate potential mechanisms" for the potentially protective effect of increased body weight on heart failure, Oreopoulos and colleagues conclude.

"Our findings," they point out, "are consistent with evidence in other chronic disease populations," including survivors of heart attack and chronic hemodialysis patients, demonstrating lower death rates with higher BMI levels.

SOURCE: American Heart Journal, July 2008.

Britain and France grapple with child obesity problem

To combat the growing problem of child obesity, a French report Tuesday suggested imposing an anti-obesity tax on sweet and fatty foods, while British health officials want to avoid the label "obese" for very overweight children.The French plan would target foods such as pizzas and hamburgers as well as sodas and alcohol.

Drawn up jointly by the French tax and social affairs inspectorates, the report was handed to Budget Minister Eric Woerth and his counterpart for health Roselyne Bachelot late last month, ministry officials said Tuesday.

According to Les Echos newspaper, it calls for the VAT sales tax rate to be lifted from 5.5 percent to 19.6 percent on all food stuffs considered "too rich, too sweet, too salty and which are not strictly necessary."

Meanwhile, health authorities in Britain rejected criticism of plans to use the word "very overweight" instead of "obese" in letters to the parents of schoolchildren.

Officials said research showed the term obese "shuts people down" and was regarded as "highly offensive."

Instead they have recommended that the alternative term be used for children whose body mass index (BMI) exceeds 30.

The National Obesity Forum accused the government of being "prissy" and "namby pamby" by avoiding the word.

The proposals are designed to tackle the growing problem in Britain of overweight children, but the letters will put the onus on parents to contact their doctors or school nurse if they want further information.

Parents will be informed of the child's height and weight and say whether they are underweight, a healthy weight, overweight or very overweight.

Will Cavendish, director of health and wellbeing at the Department of Health, said there was a danger that parents would not react to the information at all if they received a letter containing the word "obese".

"We have not banned (the word obese) but we have chosen not to use it," he said. "There's no point giving them a letter that doesn't have any impact on their behaviour."

Tam Fry, a board member of the National Obesity Forum, however, said experts in the United States had also suggested banning the term obese but had now decided the word was necessary.

"The Americans have gone back to using the term because it's the kind of shock word that makes parents sit up and take notice. It's a nasty word but by God it should sound alarm bells in parents' minds.

"I find this whole approach from the Department of Health a bit prissy and namby pamby."

Two thirds of French men and half of all women aged 35 to 74 are thought to be overweight, according to a study released in June, while one fifth of all adults are obese.

France has taken steps to combat obesity in children with vending machines banned in schools since 2005.

A national programme in Britain now aims to weigh and measure children at age four to five and again aged 10 to 11, but parents can opt out of the process

Overweight problems seen even in infants

New research indicates that problems associated with being overweight occur at a much younger age than previously thought.In a study reported in the journal Pediatrics, overweight infants were at increased risk for developmental delays and possibly breathing problems, such as asthma. Moreover, in most cases, parents were unaware of their child's weight problem.

"Although the consequences of infant and childhood excess body weight may seem to manifest in later years, this perception is inaccurate," Dr. Ron Shaoul, from Bnai Zion Medical Center in Haifa, Israel, and colleagues warn.

"Our findings indicate a need to intervene during these critical years by adopting proper eating habits and active lifestyles," they add.

The findings are based on two studies. The first involved 2139 infants not older than age 2 who were admitted for any reason to the Bnai Zion Medical Center in 2004 and 2005. The second study was community-based and used parental interviews to assess the problems seen in 79 overweight infants and 144 normal-weight infants.

The infants were considered overweight if they had a body mass index (BMI) above the 85th weight-for-height percentile on 2 or more measurements taken at least 3 months part. This means that 85 percent of children their age and gender have a lower BMI, which is a measure of weight in relation to height.

In the first study, the researchers found that infants between the 85th and 94th weight-for-height percentiles actually had fewer hospital admissions and repeat admissions than normal-weight infants. However, higher than expected admission rates were seen in the most overweight infants (95th or higher percentile).

In the second study, overweight infants were more likely than their normal-weight peers to have developmental delays and snoring. There was also evidence that asthma and other breathing problems were more common in overweight infants.

When surveyed, only about 32 percent of mothers with an overweight child believed that their child was overweight.

Parents need to be aware that even infants are at risk for problems related to excess body weight and, therefore, should strive to achieve a normal weight in their young children, Shaoul and colleagues conclude.

SOURCE: Pediatrics, August 2008.

Clinton honors 43 schools for anti-obesity efforts

Former President Clinton is honoring 43 schools for their anti-obesity efforts, including one that banished candy from its building and another that offers a student fitness club.In a ceremony Wednesday at his presidential library in Little Rock, the former president planned to recognize the schools from a dozen states for their participation in the Healthy Schools Program, a joint initiative of the William J. Clinton Foundation and the American Heart Association.

"Despite the rising food prices and constrained budgets impacting programs nationally, these schools are using innovative approaches to curb the country's alarming rates of childhood obesity," Clinton said. "Schools around the country are stepping up and making progress."

The schools being honored include Kenly Elementary School in Tampa, Fla., which banished candy from its building.

A fitness club is offered to students at the Pine Hill Middle School in New Jersey, and the staff does yoga twice a week.

The Healthy Schools Program started in 2006 and now includes nearly 3,000 schools and more than 1.66 million students. It provides in-person support to 1,364 schools and aims to boost that number to 8,000 by 2010.

Obese Men Face Twin Threat From Prostate Cancer

The standard screening test for prostate cancer may not be accurate for obese men, leaving them more vulnerable to the disease, and surgery is less likely to be effective for them, a new pair of studies found."Obese men are more likely to be diagnosed with an aggressive form of the disease," said Dr. Stephen Freedland, an associate professor of urology and pathology at the Duke University Prostate Center, and an author of one of the studies.

The reason: The blood test that looks for elevated levels of the protein prostate-specific antigen (PSA), indicating a heightened cancer risk, doesn't seem as reliable for obese men, Freedland said.

"Our assumption is that these men have more blood volume, so PSA gets diluted, he said. "By the time obese men get to elevated levels, the cancer is more advanced."

The study, published online Friday in the journal BJU International included nearly 3,400 men who had PSA tests. The researchers found that the risk of an aggressive cancer was doubled in obese men diagnosed because of high PSA levels. No such association was found for obese men diagnosed by a digital rectal examination, in which the physician feels for an abnormally large prostate gland.

Prostate cancer is suspected when the PSA reading is 4 or higher. The current recommendation is for men aged 50 and older to be offered an annual PSA test, with explanations of its possible risks and benefits. A federal preventive medicine committee this week said that PSA screening should not be done for men aged 75 and older because the risks outweigh the benefits.

"I'm not sure that we should check obese men more often," Freedland said. "But we should have a higher [PSA] index of suspicion of what is not normal -- 3.4 rather than 4; for really obese men, 3.2."

The Duke study measured obesity using body-mass index, which is a ratio of weight to height. Obesity is defined as a BMI of 30 or more.

A second report from Duke in the same issue of the journal found that excess weight influenced the outcome of surgery for prostate cancer. Men with a BMI of 35 or higher were nearly 60 percent more likely to have a recurrence of the cancer than thinner men, the study of 1,434 men found.

One reason is "the difficulty of operating on obese men in general," said study author Dr. Jayakrishnan Jayachandran, a urology oncology fellow at the Duke Prostate Cancer Center. "The prostate is a narrow thing to operate on, and when there is a big wad of fat in your way, if the abdominal wall is thick, it becomes a technical issue."

The result is that not all the cancer may be removed, which means a recurrence after time, Jayachandran said. "The only thing we can think of is that when you operate on obese people, you have to be more careful," he said.

The studies results apply to men who might not regard themselves as obese, Freedland said. "We can't forget that when we use the term, we are not just talking about very large men," he said. "A man who is 5 foot 9 and weighs 203 pounds would be considered obese."

Jayachandran added, "We are not screening these obese men effectively and are not doing as good a job surgically as could be done."

Fit and fat: Study shows it's possible

It may be possible to be both fat and healthy, researchers reported on Monday, for at least half of overweight adults, and close to a third of obese men and women, have normal blood pressure, cholesterol and other measures of heart health.And being lean does not necessarily protect people, either. Close to a quarter of normal-weight U.S. adults in one study had risk factors for heart disease or diabetes.

"We really don't know as much about obesity as we think we do," Judith Wylie-Rosett of the Albert Einstein College of Medicine in New York, who oversaw the study, said in a telephone interview.

"A considerable proportion of overweight and obese U.S. adults are metabolically healthy, whereas a considerable proportion of normal-weight adults express a clustering of cardiometabolic abnormalities," Wylie-Rosett and Rachel Wildman and colleagues wrote in their report, published in the journal Archives of Internal Medicine.

Wylie-Rosett's team looked at data on 5,440 men and women who were examined and filled out questionnaires for the National Health and Nutritional Examination Surveys between 1999 and 2004. Most did not exercise very much.

They found just over 51 percent of those who were overweight, and 31.7 percent of those who were obese, had healthy levels of cholesterol, blood sugar, blood pressure and other measures linked to heart disease.

These measures have been shown in many other studies to predict heart attacks, strokes, diabetes and other heart disease, although this particular study did not look at whether people suffered any of these problems.

OBESE YET HEALTHY

More than 23 percent of those who were at a healthy weight, as measured by body mass index, had two or more unhealthy readings, the researchers found.

"Our study shows you can still be healthy even if you are obese," Wylie-Rosett said.

Her team did not look at people's diets, but she believes the location of body fat is as important as how much there is. Many studies have shown that having visceral fat, in and among the internal organs, may be more dangerous than having fat thighs or buttocks.

But when Wylie-Rosett's team measured waist circumference, a common way to estimate visceral fat, more than 36 percent of the obese people with what should have been dangerously large waists had healthy blood test results.

A second study suggested that the liver may be the key.

Dr. Norbert Stefan and colleagues at the University of Tubingen in Germany closely examined 314 people, using magnetic resonance imaging to look at precisely how much body fat they had and where it was.

They also found that obese men and women could have healthy hearts and arteries and suggested that having fat on the liver may be what makes the difference.

"Altogether, 10 percent of the study population and 25 percent of the obese subjects had a high insulin sensitivity phenotype or 'metabolically benign obesity,"' they wrote in their Archives report.

"Our data suggest that ectopic fat accumulation in the liver may be more important than visceral fat in the determination of such a beneficial phenotype in obesity," they wrote.

"That's an area that we are very intrigued with as well," Wylie-Rosett said," adding: "If you start stuffing people with calories, it is very much like making pate from goose liver."

Geese are often force-fed to make their livers fatty and thus more suitable for pate-making.

Scientists Create Mice Resistant to Obesity

Researchers have developed a strain of mice resistant to diet-induced obesity.The findings could one day lead to possible drug treatments for obesity in people. They also shed light on the brain circuitry that controls energy homeostasis -- the balance between how much energy (i.e., food) an animal takes in and how quickly it burns that energy.

Dr. Julio Licinio, a professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, called the research a "technological tour de force."

Dr. Bradford Lowell, associate professor of medicine at Harvard Medical School, led the study, which was published online Aug. 10 in the journal Nature Neuroscience.

According to lead study author Qingchun Tong, most research into energy homeostasis has involved what scientists call genetically encoded neuropeptides, rather than small molecule neurotransmitters.

Neurotransmitters "have been postulated to play a very important role in neurocommunication, but in this field, essentially no critical studies have been performed to address this issue," Tong said. "So I set up an experiment to create an animal model in which a particular group of neurons in the brain couldn't release a small neurotransmitter, and by examining those animal models, I could know the function of those molecules."

Tong and Lowell focused on one neurotrasmitter in particular, called GABA (gamma-aminobutyric acid). They developed transgenic, or mutant, mice that lacked the ability to release GABA in a subset of brain cells in the hypothalamus -- the brain region that controls processes such as hunger, thirst and body temperature.

On a normal diet, the normal and mutant mice weighed roughly the same, with mutant mice weighing slightly less. On a high fat diet, however, the mutant mice gained far less weight than the normal mice, even though the two groups ate approximately the same amount of food. The reason: The mutant mice were burning energy at a faster rate, the researchers said.

"We found that the mice without GABA release from AgRP neurons have increased energy expenditure and are resistant to diet-induced obesity," Tong said.

These transgenic mice were also resistant to the effects of the hormone ghrelin, which governs hunger. When normal mice were given ghrelin, their food intake increased. In the mutant mice, however, that effect was dampened, Tong said.

Finally, the researchers shed some light on the brain cell networks controlling energy homeostasis. They found that another group of neurons in the hypothalamus, called pro-opiomelanocortin (POMC) neurons, receive the GABA signal from AgRP neurons.

"The function of AgRP neurons is probably to reserve the energy for maintaining life," Tong said. "So if the animal doesn't have enough food, the animal should have some strategy to preserve energy, and this group of neurons, by releasing GABA, restrains energy expenditure to maintain enough energy to survive under the conditions in which food is not readily available."

According to Licinio, these findings underscore the importance of the GABA neurotransmitter in regulating the relationship between food consumed and energy expended. "I think it makes the role of GABA in obesity much more relevant than previously thought," he said.

Of course, as with all animal studies, it remains to be seen whether the findings can be repeated in humans.

Half of overweight adults may be heart-healthy

You can look great in a swimsuit and still be a heart attack waiting to happen. And you can also be overweight and otherwise healthy. A new study suggests that a surprising number of overweight people — about half — have normal blood pressure and cholesterol levels, while an equally startling number of trim people suffer from some of the ills associated with obesity.The first national estimate of its kind bolsters the argument that you can be hefty but still healthy, or at least healthier than has been believed.

The results also show that stereotypes about body size can be misleading, and that even "less voluptuous" people can have risk factors commonly associated with obesity, said study author MaryFran Sowers, a University of Michigan obesity researcher.

"We're really talking about taking a look with a very different lens" at weight and health risks, Sowers said.

In the study, about 51 percent of overweight adults, or roughly 36 million people nationwide, had mostly normal levels of blood pressure, cholesterol, blood fats called triglycerides and blood sugar.

Almost one-third of obese adults, or nearly 20 million people, also were in this healthy range, meaning that none or only one of those measures was abnormal.

Yet about a fourth of adults in the recommended-weight range had unhealthy levels of at least two of these measures. That means some 16 million of them are at risk for heart problems.

It's no secret that thin people can develop heart-related problems and that fat people often do not. But that millions defy the stereotypes will come as a surprise to many people, Sowers said.

Even so, there's growing debate about the accuracy of the standard method of calculating whether someone is overweight. Health officials rely on the body mass index, a weight-height ratio that does not distinguish between fat and lean tissue. The limits of that method were highlighted a few years ago when it was reported that the system would put nearly half of NBA players in the overweight category.

A number of experts say waist size is a more accurate way of determining someone's health risks, and the study results support that argument.

Dr. Robert Eckel, a former American Heart Association president and professor of medicine at the University of Colorado, said the new research may help dismiss some of the generalizations that are sometimes made about weight and health.

Study co-author Judith Wylie-Rosett emphasized that the study shouldn't send the message "that we don't need to worry about weight." That's because half of overweight people do face elevated risks for heart disease, explained Wylie-Rosett, a nutrition researcher at Albert Einstein College of Medicine in New York.

But, for those without elevated risks, losing weight "might be important only from a cosmetic perspective," she said.

To arrive at the estimates, scientists analyzed nationally representative government surveys involving 5,440 people age 20 and over, and extrapolated to calculate nationwide figures.

The new study, appearing in Monday's Archives of Internal Medicine, used government surveys from 1999 to 2004 that included lab tests and height and weight measurements. Participants reported on habits including smoking and physical activity.

In all weight categories, risk factors for heart problems were generally more common in older people, smokers and inactive people. Among obese people who were 50 to 64, just 20 percent were considered healthy compared with half of younger obese people.

The results underscore how important exercise is for staying healthy, even for people of healthy weight, Wylie-Rosett said.

The authors noted that fat tissue releases hormones and other substances that affect things like blood vessels, cholesterol and blood sugar. The results suggest this interaction varies among overweight and obese people, the authors said.

The results also add to mounting evidence that thick waists are linked with heart risks.

Among people of healthy weight in the study, elevated blood pressure, cholesterol and other factors were more common for people with larger waists or potbellies. This often signals internal fat deposits surrounding abdominal organs, which previous research has shown can be especially risky.

Similarly, among overweight and obese adults, those in the "healthy" category tended to have smaller waists than those with at least two risk factors.

Dr. Lewis Landsberg, a Northwestern University obesity expert, noted that the research didn't look at heart disease, and that not everyone with high risk factors develops heart problems.

Still, he said, the study shows that waist measurements can help assess health.

Obese people can be healthy: study

Some obese people are in good health and are not predisposed to heart ailments, according to a surprise study published in the Archives of Internal Medicine.And yet another study showed that being slim doesn't automatically protect you from heart-related illnesses such as high blood pressure and cholestrol, and diabetes.

In the first study, conducted by Norbert Stefan and a team at the University of Tubingen in Germany, the researchers studied the fat around the internal organs and under the skin of 314 individuals with an average age of 45.

The obese individuals in the study were divided into two groups: those who were resistant to insulin and those who were not. Insulin resistance is a pre-diabetic condition, meaning some symptoms of diabetes are present and progression to full-blown diabetes is likely.

Those who were obese and resistant to insulin had more muscle fat, fat in their livers and thicker carotid-artery walls -- an early sign of artery narrowing, which is a heart-disease risk factor -- than obese individuals without insulin resistance, the study found.

In addition, obese individuals who were not insulin-resistant had no differences in artery-wall thickness from the normal-weight group.

"We provide evidence that a metabolically benign obesity can be identified and that it may protect from insulin resistance and atherosclerosis," the researchers wrote.

The second study carried out by Rachel Wildman at the Albert Einstein College of Medicine in New York examined body weight and cardio-metabolic abnormalities -- including high blood pressure, elevated triglycerides and low levels of so-called good cholesterol -- in 5,440 individuals between 1999 and 2004.

The study found that some obese people are metabolically healthy.

"Obese individuals with no metabolic abnormalities were more likely to be younger, black, more physically active and have smaller waists than those with metabolic risk factors," the authors wrote.

Those of normal weight with health risks were older, less active and had a larger waist than the average population.

Among the US population aged 20 and older, some 23 percent (16 million adults) of normal weight have metabolic abnormalities, while 51 percent (36 million) of overweight adults and 32 percent (19.5 million) of obese adults "were metabolically healthy," the authors wrote.

Clumsy children more likely to become obese adults

Children with poor hand control and coordination are more likely to become obese adults, researchers said on Wednesday.The finding adds to a growing body of evidence linking poorer cognitive function in childhood to obesity and type 2 diabetes in adults.

A study of thousands of British children found those with the worst cognitive and physical function at the ages of seven and 11 years were far more likely to be obese in later life.

"It's not a question of people who are already overweight becoming clumsy because the majority of these children weren't any heavier than their peers," researcher Scott Montgomery said in a telephone interview.

"It was assumed that all the neurological complications associated with obesity were consequences of obesity itself. This suggests that's not the case."

The findings held true even after adjusting for factors likely to influence the results, such as childhood body mass and family social class, he noted.

What lies behind the link is unclear but Montgomery believes it could be a function of factors such as maternal smoking during pregnancy or lack of exercise in childhood. The latter is important for developing fine motor control.

The new study by experts from Sweden's Karolinska Institute and London's Imperial College is based on more than 11,000 individuals participating in Britain's ongoing National Child Development Study, which began in 1958.

Around 8,000 of them were assessed by teachers at age seven years to identify hand control and clumsiness, and just under 7,000 were tested for hand control and coordination at age 11 by a doctor.

The results were published in the British Medical Journal.

Scientists are finding a surprising number of connections between neurological problems and obesity. Earlier this week, U.S. researchers reported that running reduced the risk not only of heart disease but also of neurological diseases such as Alzheimer's -- as well as cancer.

Poor Coordination in Childhood Tied to Adult Obesity

A lack of physical control and coordination in childhood may be tied to an increased risk of obesity in later life, a new study says.The research, published online at BMJ.com Wednesday, adds to previous studies that found poorer cognitive function in childhood may be linked to obesity and type 2 diabetes in adults.

The findings, based on 11,041 individuals in the ongoing National Child Development Study in Great Britain, showed that children who showed poor hand control, poor coordination, and clumsiness at age 7 in testing were more likely to be obese adults. Those with poorer functioning motor skills at age 11 also tended to be obese at age 33.

Adjusting for factors that may influence the results, such as childhood body mass and family social class, did not change the results. However, the study did not delve into specific biological processes that may explain poorer physical control and coordination in childhood with adult obesity.

"Some early life exposures (such as maternal smoking during pregnancy) or personal characteristics may impair the development of physical control and coordination, as well as increasing the risk of obesity in later life," the authors, from Imperial College London and Orebro University Hospital & Karolinska Institute in Stockholm, wrote.

"Rather than being explained by a single factor, an accumulation throughout life of many associated cultural, personal, and economic exposures is likely to underlie the risks for obesity and some elements of associated neurological function," they concluded.

13 Keys to a Healthy Diet

Developing healthy eating habits isn't as confusing or as restrictive as many people imagine. The first principle of a healthy diet is simply to eat a wide variety of foods. This is important because different foods make different nutritional contributions.

Secondly, fruits, vegetables, grains, and legumes—foods high in complex carbohydrates, fiber, vitamins, and minerals, low in fat, and free of cholesterol—should make up the bulk of the calories you consume. The rest should come from low-fat dairy products, lean meat and poultry, and fish.

You should also try to maintain a balance between calorie intake and calorie expenditure—that is, don't eat more food than your body can utilize. Otherwise, you will gain weight. The more active you are, therefore, the more you can eat and still maintain this balance.

Following these three basic steps doesn't mean that you have to give up your favorite foods. As long as your overall diet is balanced and rich in nutrients and fiber, there is nothing wrong with an occasional cheeseburger. Just be sure to limit how frequently you eat such foods, and try to eat small portions of them.

You can also view healthy eating as an opportunity to expand your range of choices by trying foods—especially vegetables, whole grains, or fruits—that you don't normally eat. A healthy diet doesn't have to mean eating foods that are bland or unappealing.

The following basic guidelines are what you need to know to construct a healthy diet.

1 Eat plenty of high-fiber foods—that is, fruits, vegetables, beans, and whole grains. These are the "good" carbohydrates—nutritious, filling, and relatively low in calories. They should supply the 20 to 30 grams of dietary fiber you need each day, which slows the absorption of carbohydrates, so there’s less effect on insulin and blood sugar, and provides other health benefits as well. Such foods also provide important vitamins, minerals, and phytochemicals (plant chemicals essential to good health).

2 Make sure to include green, orange, and yellow fruits and vegetables—such as broccoli, carrots, cantaloupe, and citrus fruits. The antioxidants and other nutrients in these foods may help protect against developing certain types of cancer and other diseases. Eat five or more servings a day.

3 Limit your intake of sugary foods, refined-grain products such as white bread, and salty snack foods. Sugar, our No.1 additive, is added to a vast array of foods. Just one daily 12-ounce can of soda (160 calories) can add up to 16 pounds over the course of a year. Many sugary foods are also high in fat, so they’re calorie-dense.

4 Cut down on animal fat. It’s rich in saturated fat, which boosts blood cholesterol levels and has other adverse health effects. Choose lean meats, skinless poultry, and nonfat or low-fat or nonfat dairy products.

5 Cut way down on trans fats, supplied by hydrogenated vegetable oils used in most processed foods in the supermarket and in many fast foods.

6 Eat more fish and nuts, which contain healthy unsaturated fats. Substitute olive or canola oil for butter or stick margarine.

7 Keep portions moderate, especially of high-calorie foods. In recent years serving sizes have ballooned, particularly in restaurants. Choose a starter instead of an entrée, split a dish with a friend, and don’t order supersized anything.

8 Keep your cholesterol intake below 300 milligrams per day. Cholesterol is found only in animal products, such as meats, poultry, dairy products, and egg yolks.

9 Eat a variety of foods. Don't try to fill your nutrient requirements by eating the same foods day in, day out. It is possible that not every essential nutrient has been identified, and so eating a wide assortment of foods helps to ensure that you will get all the necessary nutrients. In addition, this will limit your exposure to any pesticides or toxic substances that may be present in one particular food.

10 Maintain an adequate calcium intake. Calcium is essential for strong bones and teeth. Get your calcium from low-fat sources, such as skim milk and low-fat yogurt. If you can't get the optimal amount from foods, take supplements.

11 Try to get your vitamins and minerals from foods, not from supplements. Supplements cannot substitute for a healthy diet, which supplies nutrients and other compounds besides vitamins and minerals. Foods also provide the "synergy" that many nutrients require to be efficiently used in the body.

12 Maintain a desirable weight. Balance energy (calorie) intake with energy output. Exercise and other physical activity are essential.

13 If you drink alcohol, do so in moderation. That is one drink a day for women, two a day for men. A drink is defined as 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of 80-proof spirits. Excess alcohol consumption leads to a variety of health problems. And alcoholic beverages can add many calories to your diet without supplying nutrients.

source: wellnessletter.com

Tips for a Healthy Diet

Healthy eating is not about strict nutrition philosophies, staying unrealistically thin, or depriving yourself of the foods you love. Rather, it’s about feeling great, having more energy, and keeping yourself as healthy as possible – all which can be achieved by learning some nutrition basics and incorporating them in a way that works for you.

By developing your own plan for healthy eating, you’ll be able to expand your range of healthy choices to include a variety of delicious. Using guidelines and tips for creating and maintaining a satisfying, healthy diet, you can learn how to approach food in a smarter, healthier way.

Healthy eating begins with learning how to “eat smart”. It's not just what you eat, but how you eat. Paying attention to what you eat and choosing foods that are both nourishing and enjoyable helps support an overall healthy diet.

* Take time to chew your food: Chew your food slowly, savoring every bite. We tend to rush though our meals, forgetting to actually taste the flavors and feel the textures of what is in our mouths. Reconnect with the joy of eating.
* Avoid stress while eating: When we are stressed, our digestion can be compromised, causing problems like colitis and heartburn. Avoid eating while working, driving, arguing, or watching TV (especially disturbing programs or the news). Try taking some deep breaths prior to beginning your meal, or light candles and play soothing music to create a relaxing atmosphere.
* Listen to your body: Ask yourself if you are really hungry, and stop eating when you feel full. It actually takes a few minutes for your brain to tell your body that it has had enough food, so eat slowly. Eating just enough to satisfy your hunger will help you remain alert, relaxed and feeling your best, rather than stuffing yourself into a “food coma”!
* Eat early, eat often: Starting your day with a healthy breakfast can jumpstart your metabolism, and eating the majority of your daily caloric allotment early in the day gives your body time to work those calories off. Also, eating small, healthy meals throughout the day, rather than the standard three large meals, can help keep your metabolism going and ward off snack attacks.

source:helpguide.org

'Standard' Glucose Test May Be Wrong One for Obese Children

SUNDAY, June 15 (HealthDay News) -- The current standard screening test for prediabetes in children often fails to detect the condition, Canadian researchers contend.

Ironically, the findings are from a study group of 172 obese children -- ages 5 to 17 -- who joined a program to help them slim down to a healthy weight.

The standard diabetes test for children is the fasting plasma (blood) glucose test, but it identified almost three times fewer children with diabetes than the glucose stress test, also called the oral glucose tolerance test. The glucose stress test takes longer, because blood is taken from the patient after fasting and again two hours after drinking a sugary solution.

Using the fasting blood glucose test, the researchers found that only 8 percent of the children in the study met the diagnostic criteria for prediabetes. But the glucose stress test indicated that 25 percent of the children had prediabetes.

"A large proportion of the children with prediabetes would not have had their condition recognized," lead author Dr. Katherine Morrison, of the pediatrics department at McMaster University in Hamilton, Ontario, Canada, said in a prepared statement.

The researchers also found the fasting blood glucose test identified metabolic syndrome in only 5.2 percent of the children, while the glucose stress test detected metabolic syndrome in 12.8 percent of the children. Metabolic syndrome is a cluster of risk factors (including high blood sugar) for diabetes and heart disease.

The findings were expected to be presented over the weekend at the Endocrine Society's annual meeting in San Francisco.

"Prediabetes and metabolic syndrome are common in obese children but are not readily identified with the currently recommended test. They require a glucose stress test," Morrison said.

Prediabetes and metabolic syndrome often cause no obvious symptoms, she added. Early detection is important, because changes in diet, regular exercise and moderate weight loss can help prevent or delay diabetes and metabolic syndrome.

Added time, inconvenience and cost are among the reasons why the glucose stress test isn't typically used in children.

"But this research suggests that the recommended test for screening obese children for prediabetes and metabolic syndrome should be changed," Morrison said.

The Cookie Diet

A "Cookie Diet" refers to a diet based on a specially crafted cookie that helps to suppress appetite.

The term "Cookie Diet" has been the subject of a legal battle between two companies that claim to own the rights to the phrase. Those companies are Smart for Life, and Dr Sanford Seigal.

UPDATE July 2007 (Dr Sanford won a preliminary injunction with regard to the Cookie Diet trademark - Smart for Life has been ordered to stop using the name Cookie Diet).

Dr. Seigal first experimented with a cookie formula in 1975. He believe that - for many people - obesity was caused by a faulty thyroid gland.

The basic idea is to consume 6 cookies per day along with a single meal at dinner time. The dinner should be high in lean protein.

Some critics claim a cookie-diet is far too low in calories and is unsustainable.

Source:http://www.diet-blog.com/archives/2005/05/26/the_cookie_diet.php