Studies show exercise boon for obesity, diabetes

Walking a bit more each day can help people control their Type 2 diabetes but obese people trying to keep weight off may need to exercise harder than they had thought, according to a studies published on Monday.Simply walking 45 minutes more each day helped people with diabetes use blood sugar better, Michael Trenell of Britain's Newcastle University and colleagues wrote in the journal Diabetes Care.

"People often find the thought of going to the gym quite daunting, but what we've found is that nearly everyone with diabetes is able to become more active through walking," Trenell said.

The Newcastle team paired 10 Type 2 diabetes patients with people without the condition of similar height, weight and age and asked everybody to walk more than 10,000 steps each day.

Magnetic resonance imaging or MRI scans showed that people who walked 45 minutes more each day burned about 20 percent more fat -- increasing the ability of the muscles to store sugar and help control diabetes, the researchers said.

"What is exciting about this study is that it provides an immediate way to help control diabetes without any additional drugs," Trenell said.

Diabetes affects an estimated 246 million adults worldwide and accounts for 6 percent of all global deaths. Type 2 diabetes accounts for about 90 percent of all diabetes cases and is closely linked to obesity and physical inactivity.

Obesity and diabetes both are growing problems as more developing nations adopt a Western lifestyle, something the International Diabetes Federation estimates will propel the number of people with diabetes to 380 million by 2025.

But current exercise guidelines calling for people to get 150 minutes -- 2.5 hours -- each week may not be enough to help the obese keep weight off, John Jakicic of the University of Pittsburgh and colleagues wrote in the Archives of Internal Medicine.

To determine an optimal amount of exercise, the U.S. team enrolled 201 overweight and obese women in a weight loss programme between 1999 and 2003 and assigned them to one of four exercise groups.

After six months, women in all four groups had lost an average of 8 to 10 percent of their weight but many gained it back.

Women assigned to exercise for about an extra hour each day did not gain the weight back, the researchers said. These women were also more likely to stick to healthy diets.

Jakicic recommended that people who want to lose weight and keep it off get at least 4-1/2 hours of exercise a week.

"There is a growing consensus that more exercise may be necessary to enhance long-term weight loss," Jakicic and colleagues wrote.

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.

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.

All U.S. adults could be overweight in 40 years

If the trends of the past three decades continue, it's possible that every American adult could be overweight 40 years from now, a government-funded study projects.The figure might sound alarming, or impossible, but researchers say that even if the actual rate never reaches the 100-percent mark, any upward movement is worrying; two-thirds of the population is already overweight.

"Genetically and physiologically, it should be impossible" for all U.S. adults to become overweight, said Dr. Lan Liang of the federal government's Agency for Healthcare Research and Quality, one of the researchers on the study.

However, she told Reuters Health, the data suggest that if the trends of the past 30 years persist, "that is the direction we're going."

Already, she and her colleagues point out, some groups of U.S. adults have extremely high rates of overweight and obesity; among African- American women, for instance, 78 percent are currently overweight or obese.

The new projections, published in the journal Obesity, are based on government survey data collected between the 1970s and 2004.

If the trends of those years continue, the researchers estimate that 86 percent of American adults will be overweight by 2030, with an obesity rate of 51 percent. By 2048, all U.S. adults could be at least mildly overweight.

Weight problems will be most acute among African-Americans and Mexican- Americans, the study projects. All black women could be overweight by 2034, according to the researchers, as could more than 90 percent of Mexican-American men.

All of this rests on the "big assumption" that the trends of recent decades will march on unabated, Liang acknowledged.

"This is really intended as a wake-up call to show what could happen if nothing changes," she said.

Waistlines aren't the only thing poised to balloon in the future, according to Liang and her colleagues. They estimate that the healthcare costs directly related to excess pounds will double each decade, reaching $957 billion in 2030 -- accounting for one of every six healthcare dollars spent in the

U.S.

Those financial projections are based on Census data and published estimates of the current healthcare costs attributed to excess weight -- and they are probably a "huge underestimate" of what the actual costs will be, Liang said.

The findings highlight a need for widespread efforts to improve Americans' lifestyles and keep their weight in check, according to the researchers. Simply telling people to eat less and exercise more is not enough, Liang noted.

Broader social changes are needed as well, she said -- such as making communities more pedestrian-friendly so that people can walk regularly, or getting the food industry to offer healthier, calorie-conscious choices.

"It really needs to be more than an individual effort," Liang said. "It needs to be a societal effort."

SOURCE: Obesity, online July 24, 2008.

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.

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.

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

Eating Habits Not Sole Cause of Thinness or Obesity

WEDNESDAY, June 4 (HealthDay News) -- Your nerves, rather than your eating habits, may have a more direct role in whether you are fat or thin, according to new research.

A study on worms shows that serotonin levels in the nervous system influence feeding and fat. Serotonin, a neurotransmitter, also acts independently to control eating and what your body does with those calories once they've been consumed, the study said.

"It says that the nervous system is a key regulator coordinating all energy-related processes through distinct molecular pathways," Kaveh Ashrafi, of the University of California, San Francisco, said in a prepared statement. "The nervous system makes a decision about its state leading to effects on behavior, reproduction, growth and metabolism. These outputs are related, but they are not consequences of each other. It's not that feeding isn't important, but the neural control of fat is distinct from feeding."

Ashrafi said that given serotonin's ancient evolutionary origins, you can apply what's learned from the worms to humans.

"From a clinical perspective, this may mean you could develop therapeutic strategies to manipulate fat metabolism independently of what you eat," he said. "Now, the focus is primarily on feeding behavior. As important as that is, it's only part of the story. If the logic of the system is conserved across species, a strategy that focuses solely on behavior can only go so far. It may be one reason diets fail."

The findings were published in the June issue of Cell Metabolism.

At its most basic level, fat regulation is the balance between energy intake and expenditure; however, Ashrafi said the physiology is very complicated.

In the worms, serotonin affected feeding by involving nerve receptors not normally required for fat control. The byproducts of the signaling process ended up affecting the control of feeding behavior, Ashrafi said.

In the worms and in mammals, high serotonin levels are associated with fat reduction, while low serotonin levels lead to fat accumulation, the researchers noted. However, in the worms, when serotonin goes up, the worms desire to eat increases even as fat melts away. But in humans, high serotonin leads people to eat less and shed fat.

Serotonin's effects on fat and eating habits in the worms fit the nerve messenger's role as a sensory gauge of nutrient availability, the researchers said. When resources are scarce, worms build up their fat reserves and switch metabolic gears to save energy and direct nutrients to fat stores.

Ashrafi said serotonin's role in balancing energy across species leads him to believe that "human counterparts of feeding-independent fat regulatory genes identified in our study may similarly regulate energy balance."

'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.

Lifestyle change key for obesity surgery success

NEW YORK (Reuters Health) -
Anyone thinking about having
weight loss surgery should be sure to do their homework
beforehand, and must understand they need to dramatically
change the way they eat for the surgery to be successful,
advises the head of the U.S. government agency responsible for
research on health care quality and patient safety.

"People who succeed and lose weight and keep it off eat
very, very differently," Dr. Carolyn Clancy, director of the
Agency for Healthcare Research and Quality (AHRQ) in Rockville,
Maryland, told Reuters Health. "Essentially, you've got to eat
a whole lot less."

Clancy has written about the realities of operations to
promote weight loss, known as bariatric surgery, in the latest
issues of Nursing for Women's Health and Health for Women, both
published by the Association of Women's Health, Obstetric and
Neonatal Nurses.

Bariatric surgery has skyrocketed in popularity, Clancy
noted in an interview, but just a fraction of people who could
benefit most from the surgery have gotten it. According to
AHRQ, evidence for the procedure's benefits is strongest for
people with body mass indexes (BMIs) of 40 or higher, or
individuals with BMIs of 35 or greater who have a serious
medical condition, such as diabetes or severe sleep apnea.

Nevertheless, she added, the surgery "is not risk free, and
I think it's really important for all people, women and men, to
know about the risks and to be very clear about what they're
getting into."

For example, Clancy said, 7 percent of people who undergo
the surgery need to be rehospitalized for complications. Four
out of 10 will develop complications within 6 months of the
surgery. These complications include nausea, cramps and
vomiting due to overeating.

People should also seek out a surgeon and health care team
they can communicate with effectively, because post-surgical
follow-up care is just as important as the procedure itself,
Clancy added. If you don't "click," or you feel your surgeon
isn't hearing your concerns, she advised, look elsewhere.

People may want to seek out bariatric surgery programs
designated as Centers of Excellence by the American Society for
Metabolic and Bariatric Surgery (http://www.asbs.org/), Clancy
suggested.

Finally, she said, people need to find out before having
the surgery whether or not their insurer covers it. Some will
require documentation that a person has made a serious effort
to lose weight by other means before they will pay for the
procedure.

SOURCE: Nursing for Women's Health, February/March 2008.

School nutrition policy can prevent obesity

NEW YORK (Reuters Health) -
Philadelphia schools that cut
out soda, revamped snack selections and took other measures to
prevent childhood obesity were able to halve the odds of
students becoming overweight by sixth grade, a study has found.

Among fourth-graders at five schools that instituted the
new nutrition policy, 7.5 percent became overweight over the
next 2 years, compared with 15 percent of students at five city
schools that did not make the changes, researchers report in
the journal Pediatrics.

The findings show that a comprehensive approach to battling
childhood obesity in schools can make a significant difference,
according to lead researcher Dr. Gary D. Foster of Temple
University.

Schools have been at the center of the controversy over
what to do about U.S. children's rising rates of overweight and
obesity. Critics have pointed to vending machines, sugary "a la
carte" items in school cafeterias, and reductions in gym class
as part of the problem.

At the same time, schools are considered the ideal place
for children to learn healthy eating and exercise habits, and
various school-based programs have been developed with that
aim. The results have been mixed, however.

For their study, Foster and his colleagues evaluated a
program developed by a non-profit community group called the
Food Trust. Ten schools enrolled in the study; half were
randomly assigned to adopt the nutrition program, while the
other half served as a comparison group.

Schools in the program made an array of changes. They
replaced soda with water, low-fat milk and 100-percent fruit
juice, and rid vending machines and cafeterias of snacks that
did not meet certain nutrition criteria. They educated students
on how diet and exercise affect their health, and gave them
raffle tickets for bikes and other prizes to reward them for
choosing healthy snacks.

The schools also got parents involved through meetings and
nutrition workshops that encouraged them to give their kids
more fruits, vegetables and other healthy foods.

Among the 1,349 students Foster's team followed from fourth
to sixth grade. As mentioned, there was about a 50 percent
reduction in the incidence (new cases) of overweight at the end
of 2 years among the children attending the program schools,
while no changes were seen among the children attending the
schools without a program.

The prevalence (total number) of overweight children also
declined during the study period in the program group. However,
no differences in the prevalence of obesity were seen between
the program group and the comparison group.

The results, Foster told Reuters Health, underscore the
benefits of schools having a comprehensive nutrition program,
rather than taking only individual measures -- like removing
vending machines, for instance.

He and his colleagues also stress that the urban schools in
this study had largely low-income, minority student populations
-- children who are at particularly high risk of obesity. Black
children appeared to particularly benefit from the nutrition
policy.

In the sixth grade, the study found, African-American
children in these schools were 41 percent less likely to be
overweight than African Americans in the comparison schools.

Despite the success, Foster's team writes, the fact that
7.5 percent of children in the program schools still became
overweight shows that even more needs to be done.

They say that obesity-prevention programs should start
before fourth grade, and possibly include a broader range of
measures -- such as devoting more time to gym class and
enlisting the corner stores near schools to offer healthier
snack options.

SOURCE: Pediatrics, April 2008.

Dad's early obesity tied to liver disease in kids

NEW YORK (Reuters Health) -
Having a father who becomes
obese at a relatively young age may increase a person's risk of
developing serious liver problems, a new study shows.

Individuals whose fathers were obese before age 45 were
more likely than those whose parents were not obese to have
high levels of alanine aminotransferase (ALT) in their blood,
an enzyme that signals liver injury, Dr. Rohit Loomba of the
National Institutes of Health in Bethesda, Maryland and
colleagues found.

High ALT levels in the general population can be associated
with non-alcoholic fatty liver disease, an obesity-related
condition, Loomba and his team say. One severe, progressive
form of non-alcoholic fatty liver disease is nonalcoholic
steatohepatitis, which can lead to cirrhosis and even liver
cancer, they note in the medical journal Gastroenterology.

To investigate whether parental obesity might be related to
high ALT levels, as well as levels of another enzyme related to
liver damage, aspartate aminotransferase (AST), the researchers
looked at measurements of both enzymes in 1,732 men and women
participating in the Framingham Heart Study.

The researchers divided study participants into three
groups: people whose parents became obese unusually early
(before age 41 for women and before age 45 for men), those with
parents who became obese later on, and those with parents who
were never obese.

Having a father with early-onset obesity increased a
person's likelihood of having elevated ALT levels, regardless
of their own weight, the researchers found. But there was no
link between maternal obesity and ALT levels, and no
relationship at all between parental obesity and AST levels.

Developing a condition like obesity early can indicate
genetic susceptibility to that condition, the researchers note
in their report. The findings suggest that genes that promote
early-onset obesity could also influence ALT levels, they add.

"These results support the need for further studies to
establish whether individuals with early-onset parental obesity
and elevated serum ALT levels are at a higher risk for
developing progressive liver disease such as nonalcoholic
steatohepatitis," the researchers conclude.

SOURCE: Gastroenterology, April 2008.

Metabolic Syndrome Triggered by Overeating, Not Obesity

(HealthDay News) -- Overeating, not the obesity
it causes, is the actual cause of metabolic syndrome, suggests a study
with mice by researchers at the University of Texas Southwestern Medical
Center at Dallas.

Metabolic syndrome is a collection of health factors that increase the
risk of developing insulin resistance, fatty liver, heart disease and type
2 diabetes.

This study was among the first to propose that weight gain is an early
symptom, not a direct cause, of metabolic syndrome, the researchers
said.

"Most people today think that obesity itself causes metabolic
syndrome," senior author Dr. Roger Unger, professor of internal medicine,
said in a prepared statement. "We're ingrained to think obesity is the
cause of all health problems, when, in fact, it is the spillover of fat
into organs other than fat cells that damages these organs, such as the
heart and the liver. Depositing fatty molecules in fat cells where they
belong actually delays that harmful spillover."

In this study, Under and his colleagues compared normal mice to mice
that were genetically altered to prevent their fat cells from expanding.
Both groups of mice were overfed.

The normal mice got fat but didn't develop signs of metabolic syndrome
until after about seven weeks of overeating. The genetically altered mice
stayed slim but became seriously ill within a few weeks and displayed
evidence of severe heart problems and major increases in blood sugar
levels eight weeks before minimal heart problems developed in the normal
mice, the researchers said.

The genetically altered mice showed significant damage to heart cells
and to the insulin-secreting cells in the pancreas. They also got sick
quicker, because the extra calories they consumed weren't stored in fat
cells, but rather in other tissues, the researchers said.

The study was published online in the journal Proceedings of the
National Academy of Sciences.

Canadian cancer survivors obese and inactive

WASHINGTON (Reuters) -
Cancer survivors in Canada are more
likely to be obese and less likely to exercise than the rest of
the population -- putting themselves at risk of having their
cancers come back, researchers said on Monday.

The trends, likely to be seen in cancer survivors around
the world, suggest patients need help and support in staying
active and keeping the weight off, said Kerry Courneya of the
University of Alberta in Edmonton, who led the study.

"It's a challenge for all of us to eat properly and
exercise, and it may be especially challenging for cancer
survivors who have been through difficult treatments and may
have lingering health issues," Courneya said in a statement.

"But eating well and exercising are two of the best things
we can do for our mental and physical health, even in trying
times. Rest is rarely the best medicine for any health
condition."

Courneya and colleagues analyzed data from a 2005 survey of
more than 114,000 adults.

Fewer than 22 percent of former cancer patients described
themselves as physically active. This compares with 25 percent
of the general Canadian population, they reported in the
journal Cancer.

They also found that 18 percent of cancer survivors were
medically obese, compared to 15 percent of the general
population, and 34 percent were overweight.

Many cancers are linked with obesity and a lack of
exercise.

"These findings tell us that we need to look at ways to
better support cancer survivors to become more active and to
maintain a healthy body weight," Courneya said.

"We know that physical inactivity and obesity are risk
factors for developing cancer. These are also risk factors for
the recurrence of cancer. Lifestyle is just as important after
diagnosis."

The researchers defined someone as physically active if
they walked at least an hour a day or did the equivalent in
swimming, cycling or some other activity. Inactive people
walked or exercised less than 30 minutes a day.

(Reporting by Maggie Fox, editing by Todd Eastham)

Many Cancer Survivors Are Overweight and Sedentary

(HealthDay News) -- A healthy lifestyle may help
cancer survivors prevent recurrence of the disease and live longer, yet
cancer survivors have rates of obesity and physical inactivity similar to
those of the general population, according to new research.

The study, published in the June 1 issue of Cancer, found that
less than one-quarter of cancer survivors were regularly physically
active, and more than 18 percent were obese.

"We thought this might be a time when people would be particularly
motivated to exercise and control weight. But, a cancer diagnosis and
treatment didn't seem to stimulate behavior change," said the study's lead
author, Kerry Courneya, a professor and Canada Research Chair at the
University of Alberta in Edmonton, Canada.

What's troubling is that maintaining a healthy weight and getting
regular physical exercise may be even more crucial for cancer survivors
than it is for the general public. Some studies have suggested that
physical activity and losing weight may help prevent cancer recurrence and
improve survival odds.

Additionally, some research suggests that exercise can help reduce
fatigue, improve physical functioning and improve quality of life for some
cancer survivors.

For the study, Courneya and his colleagues gathered data from the
Canadian Community Health Survey. This survey contains information based
on interviews of more than 114,000 people in Canada. Details of cancer
history, weight, height and physical activity were all supplied by the
respondents.

General population statistics for Canada find that 37 percent of people
are overweight, and 22 percent are obese, according to background
information in the study.

Fewer than 22 percent of cancer survivors reported being physically
active. The lowest rates of physical activity were found among colorectal
cancer survivors, breast cancer survivors and female survivors of
melanoma.

Thirty-four percent of cancer survivors were overweight, and almost one
in five was obese.

Obese breast cancer survivors were only about half as likely to be
physically active as obese women who hadn't had cancer, a finding that's
particularly worrisome, because poor outcomes in breast cancer have been
associated with obesity and the often accompanying sedentary lifestyle.

"We really didn't know which way the research would go. Cancer
survivors may be more motivated at the time of their diagnosis to make
changes, but others point out that it's a very stressful time that can
take a toll and lead to the opposite effect," Courneya said.

Kevin Stein, director of Quality of Life Research at the American
Cancer Society, said, "This is an important finding to underscore the fact
that cancer survivors need to pay attention to their health. You've
dodged a bullet for the time being, but cancer survivors are actually at
an increased risk for a number of health conditions, including cancer
recurrence.

"There is a teachable moment when someone is diagnosed. It's the
perfect opportunity to say, 'We all need to eat healthy and exercise, but
it's even more important for you as a cancer survivor,' " he said.

Courneya added: "This is something they can do for themselves to help
beat cancer and improve quality of life. The cancer community needs to get
more involved in the promotion of healthy lifestyles in cancer patients.
Maybe a program something like cardiac rehabilitation. The cancer
community's been slower to realize the importance of lifestyle changes
after cancer diagnosis."