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."

Obesity, smoking cuts many US women's life expectancy: study

WASHINGTON (AFP) -
Life expectancy has declined for many women in the United States, largely due to smoking-related diseases and obesity, a study published Tuesday showed.

Nearly one in five US women saw the number of years they are expected
to live decline or hold steady, starting in the 1980s, showed the joint
study by the Harvard School of Public Health and the University of Washington.

The study looked at data from more than 2,000 county "units" between 1959 and 2001.

In around 1,000 of those counties -- mainly poor, rural areas -- life
expectancy for women dropped starting in the 1980s, "primarily because
of chronic diseases related to smoking, overweight and obesity, and high blood pressure," according to the study.

In the United States as a whole, in contrast, life expectancy for women
rose by more than six years and for men by more than seven years during
the same period, it showed.

"There is now evidence that there are large parts of the population in
the United States whose health has been getting worse for about two
decades," Majid Ezzati, associate professor of international health at
the Harvard School of Public Health, and lead author of the study, said
in a statement.

Worst affected by the downturn in longevity were the south -- the region hardest hit by poverty, according to the US Census Bureau -- the Appalachians, southern parts of the Midwest and areas of Texas.

Men in the same areas also saw a drop in life expectancy, but numbers
were less alarming than among women -- only four percent -- and the
fall was attributed to different causes, mainly HIV/AIDS and homicide.

"Life expectancy decline is something that has traditionally been
considered a sign that the health and social systems have failed, as
has been the case in parts of Africa and Eastern Europe," said the
study's co-author Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.

"The fact that this is happening to a large number of Americans should be a sign that the US health system needs serious rethinking," he added.

Obesity, low birthweight mar health of kids

CHICAGO (Reuters) -
Rising obesity rates and a large
percentage of children born with low birthweight are dragging
down the overall health of American children in their first
decade of life, according to a report tracking the health and
well-being of young children in the United States.

While U.S. children overall have seen improvements in their
well-being in recent years, American children aged 6 to 11 are
four times more likely to be obese than similarly aged children
in the 1960s, the report found.

The report, led by researchers at Duke University in North
Carolina and the Foundation for Child Development, a private
advocacy group, looked at the well-being of children in early
childhood, those from birth to age five, and middle childhood,
or those aged 6 to 11, from 1994 to 2006.

The researchers found obesity among children in middle
childhood is nearly four times more common than in children of
the same age in a national survey in 1960s. For children aged 2
to 5, it is three times higher.

"These are dramatic increases in the prevalence of
overweight children in American society from one generation to
the next," the researchers wrote. "The importance of this trend
for the health and well-being of children is difficult to
exaggerate."

They said overweight children have greater risks of type 2
diabetes, and often have elevated risk factors associated with
heart disease, such as high cholesterol and high blood
pressure.

They also found that the percentage of babies born with low
birthweight rose 12.3 percent from 1994 to 2005, an increase
they said was likely tied to delayed childbearing among working
mothers and an increased use of fertility drugs.

Low birthweight has been linked in large studies to a
higher risk of developmental and learning problems and to lower
academic achievement. It also has been linked with higher rates
of chronic health conditions.

Other trends were more positive.

The researchers found significant improvements in the
mortality rates of children, with the most dramatic improvement
for children aged 1 to 4. Death rates among these children fell
to 29.4 deaths in 100,000 in 2005, compared with 42.9 deaths
per 100,000 in 1994.

For those aged 5 to 9, rates of death fell 27 percent to
14.5 deaths per 100,000 in 2005.

The researchers cite a host of contributing factors,
ranging from better health care and nutrition to car safety
seats.

The report also noted a dramatic 84 percent drop in the
rates of lead poisoning among children aged 0 to 6. Lead
poisoning can result in physical, neurological and cognitive
problems.

Still, many children remain at risk for moderate levels of
lead in their blood should continue to be monitored, they said.

Obesity and low birthweight mar health of kids

While U.S. children overall have seen improvements in their
well-being in recent years, American children aged 6 to 11 are
four times more likely to be obese than similarly aged children
in the 1960s, the report found.

The report, led by researchers at Duke University in North
Carolina and the Foundation for Child Development, a private
advocacy group, looked at the well-being of children in early
childhood, those from birth to age five, and middle childhood,
or those aged 6 to 11, from 1994 to 2006.

The researchers found obesity among children in middle
childhood is nearly four times more common than in children of
the same age in a national survey in 1960s. For children aged 2
to 5, it is three times higher.

"These are dramatic increases in the prevalence of
overweight children in American society from one generation to
the next," the researchers wrote. "The importance of this trend
for the health and well-being of children is difficult to
exaggerate."

They said overweight children have greater risks of type-2
diabetes, and often have elevated risk factors associated with
heart disease, such as high cholesterol and high blood
pressure.

They also found that the percentage of babies born with low
birthweights rose 12.3 percent from 1994 to 2005, an increase
they said was likely tied to delayed childbearing among working
mothers and an increased use of fertility drugs.

Low birthweight has been linked in large studies to a
higher risk of developmental and learning problems and to lower
academic achievement. It also has been linked with higher rates
of chronic health conditions.

Other trends were more positive.

The researchers found significant improvements in the
mortality rates of children, with the most dramatic improvement
for children aged 1 to 4. Death rates among these children fell
to 29.4 deaths in 100,000 in 2005, compared with 42.9 deaths
per 100,000 in 1994.

For those aged 5 to 9, rates of death fell 27 percent to
14.5 deaths per 100,000 in 2005.

The researchers cite a host of contributing factors,
ranging from better health care and nutrition to car safety
seats.

The report also noted a dramatic 84 percent drop in the
rates of lead poisoning among children aged 0 to 6. Lead
poisoning can result in physical, neurological and cognitive
problems.

Still, many children remain at risk for moderate levels of
lead in their blood should continue to be monitored, they said.

(Reporting by Julie Steenhuysen, Editing by Maggie Fox and
Cynthia Osterman)

Overweight warning: More than exercise needed

"Even high quantities of physical activity are unlikely to
fully reverse the risk of coronary heart disease in overweight
and obese women without concurrent weight loss," Dr. Amy
Weinstein and colleagues at Boston's Beth Israel Deaconess
Medical Center reported.

"Regardless of body weight, (the findings) highlight the
importance of counseling all women to participate in increasing
amounts of regular physical activity and maintaining a healthy
weight to reduce the risk of coronary heart disease," they
concluded.

The study, appearing in the Archives of Internal Medicine,
was based on information from a study of nearly 39,000 women
that began in 1992 and traced a number of health issues.

The researchers said 34 percent of the women in the study
were physically active based on government guidelines, 31
percent were overweight and 18 percent were obese.

In the end, 948 women were diagnosed with heart disease.
Active women with normal weight had the lowest risk of
developing heart problems while there was a slightly higher
risk for those with normal weight who were not active.

The risk was next highest for active women who were either
overweight or obese, and highest for similar women who were
inactive.

Fat cells produce chemicals that can speed up hardening of
the arteries and increase inflammation, the researchers said,
harming blood vessels, while physical activity makes for
healthier blood vessels and reduces the risk of blood clots.

(Reporting by Michael Conlon; editing by Maggie Fox and
Bill Trott)

source:news.yahoo.com

Gastric Bypass May Also Relieve Low Back Pain

(HealthDay News) -- Obese people who underwent surgery
that reduced the amount of food they could ingest not only lost weight,
they also lost some of their lower back pain, according to a new report.

Thirty-eight morbidly obese patients with low back pain who underwent
gastric bypass surgery reported that their pain decreased by an average of
about 44 percent six months after surgery, according to researchers at the
University of Southern California. The average amount of individual
weight loss among the group of 30 women and eight men was about 85 pounds.

"This study provides evidence that substantial weight reduction
following bariatric surgery results in moderate reductions in pre-existing
back pain within six months of weight loss. While this initial research
is promising, larger long-term trials are needed to prove the efficacy of
this treatment," Dr. Paul Khoueir said in a prepared statement.

Khoueir was expected to present the findings in Chicago April 29 at the
annual meeting of the American Association of Neurological Surgeons.

According to recent statistics, more than one-third of U.S. adults --
more than 72 million people -- were obese in 2005-2006. An estimated 75
percent to 85 percent of all Americans will experience some form of back
pain during their lifetime.

Obese people are known to have a higher rate of hip and knee arthritis,
but little is known about the extra weight's effect on lumbar spinal
degeneration. While obese patients with back pain are frequently advised
to lose weight, the association between these medical conditions remains
unproven.

source:news.yahoo.com

Asthma attacks worsened by obesity

NEW YORK (Reuters Health) -
In asthma patients, dynamic
hyperinflation, following a test measure airway
hypersensitivity, is greater in obese individuals than in their
nonobese counterparts, which helps explain why asthma is
perceived to be more severe in patients with a higher body mass
index (BMI), investigators in New Zealand report.

A BMI is the ratio between height and weight, and is used
to classify people as underweight, overweight or normal weight.

"The greater dynamic hyperinflation means that obese
individuals lose the ability to inhale as deeply or exhale as
fully as normal weight individuals," Dr. D. Robin Taylor
explains in an American Thoracic Society statement.

Taylor's team at the University of Otago in Dunedin studied
the changes in airway expansion and lung volume that occur with
acute constriction of the bronchial tubes in a group of 30
adult women with asthma. Ten women each were classified as
normal weight, overweight, or obese, and lung volumes were
measured.

The degree of bronchial constriction following the airway
sensitivity test did not vary by group, the team reports in the
American Journal of Respiratory and Critical Care Medicine. The
only significant difference among the subjects was a decrease
in vital capacity that significantly corresponded with
increasing BMI.

Lung volume measurements also showed that the volume of air
retained in the lung following exhalation was significantly
higher as BMI increased, while the amount of air that could be
inhaled was lower.

These variations "were significantly greater in relation to
BMI" after taking into account the effects of "airway
hyperresponsiveness, the severity of airflow obstruction, and
lung volume measurements, indicating the effect of BMI was an
independent one," the investigators note, meaning that BMI
alone was associated with the severity of asthma.

This puts obese individuals at greater disadvantage due to
enhanced gas trapping, they point out, a significant
contributor to difficulty in breathing.

Taylor and his associates also noted that conventional lung
function tests "may have limitations when used to evaluate
symptoms in obese patients with asthma, with the potential for
misinterpretation" in the absence of lung volume measurements.

source:news.yahoo.com

Special Diet Can Ease Epileptic Seizures in Kids

(HealthDay News) -- The "ketogenic" diet, which
features high levels of fat, low levels of carbohydrates and controlled
protein intake, helps control and prevent seizures in children with
drug-resistant epilepsy, a new study finds.

The trial is the first randomized controlled study to confirm that the
ketogenic diet -- widely used since the 1920s -- is effective against
epilepsy, the British researchers said.

Experts believe that the regimen's high fat and restricted carbohydrate
content mimics the biochemical response to starvation, when compounds
called ketone bodies (rather than sugar) provide the main source of energy
for the brain.

Ketone bodies are byproducts produced when fatty acids are broken down
for energy in the liver and kidneys. They are used as energy sources in
the heart and brain. In the brain, ketone bodies are a crucial source of
energy when a person fasts.

This University College London study included 145 children, aged 2 to
16, who suffered seizures at least once a day or more than seven seizures
per week. These patients hadn't responded to treatment with at least two
epileptic drugs, and hadn't previously been placed on the ketogenic
diet.

Baseline information about the children's seizures was first recorded.
Seventy-three of the children started the ketogenic diet immediately,
while the other 72 started it after a three-month delay. The delay group
acted as a control group during the study. Complete data was obtained from
54 children in the diet group and 49 children in the control group.

The overall number of seizures in the diet group declined by more than
38 percent, while seizures in the control group increased by 36.9 percent,
the researchers report. The study found that 28 of the 54 children who
completed three months in the diet group had a greater than 50 percent
reduction in seizures, compared to four of 49 children in the control
group. Five children in the diet group had more than 90 percent fewer
seizures. None of the children in the control group experienced that kind
of improvement.

The study appears in the current online edition of The Lancet
Neurology and will appear in the June print issue.

"We have shown that the diet has efficacy and should be included in the
management of children who have drug-resistant epilepsy. However, the diet
is not without possible side effects, which should be considered alongside
the risk-benefit of other treatments when planning the management of such
children," the study authors wrote.

More information is needed about the long-term effects of the ketogenic
diet, such as changes in blood fat concentrations and ketosis, Dr. Max
Wiznitzer, of Rainbow Babies and Children's Hospital in Cleveland, wrote
in an accompanying comment article.

"Better identification of epilepsies that benefit from starting early
on the ketogenic diet and comparisons between the choices of ketogenic
diet are needed," he wrote.

news.yahoo.com

Obesity May Worsen Impact of Asthma

(HealthDay News) -- A study of women with a wide
range of body-mass indexes (BMIs) found that obesity may worsen the impact
of asthma and also mask its severity in standard tests.

"We have demonstrated significant differences in the changes in
respiratory function that occur with asthmatic bronchoconstriction in
relation to obesity," principal investigator Dr. D. Robin Taylor, of the
University of Otago in New Zealand, said in a prepared statement.

The study also found that simple spirometry couldn't determine the
level of pulmonary dysfunction in obese people with asthma.

The findings were published in the first issue for May of the
American Journal of Respiratory and Critical Care Medicine. It's
the first prospective study to find a significant comparative difference
between obese and non-obese people in how the lungs and airways respond to
a simulated asthma attack.

The researchers said it establishes a direct link between obesity and
the development of dynamic hyperinflation -- air breathed into the lungs
can't be expelled. This often occurs with acute asthma, but is more
frequent in obese people.

The study included 30 asthmatic women who were divided into three
groups based on their BMI: normal weight, overweight and obese. All the
women breathed nebulized methacholine to induce an asthma-like attack and
were then assessed for changes in lung function, including functional
residual capacity (FRC -- how much air remained in the lungs after
exhalation) and inspiratory capacity (IC -- how much air could be inhaled
on the next breath).

"After the methacholine challenge, the amount of bronchoconstriction
was identical for each of the three groups, but the changes in FRC and IC
were greatest in the obese group. This indicated to us that greater
dynamic hyperinflation was occurring among obese individuals," Taylor
said.

The greater a woman's BMI, the higher her FRC and the lower her IC.

"This means that among women with greater BMI, an asthma-like episode
has the potential to cause greater breathing difficulties than in
non-obese women. The greater dynamic hyperinflation means that obese
individuals lose the ability to inhale as deeply or exhale as fully as
normal weight individuals," Taylor said.

The findings suggest fundamental differences in the way that obese
people with asthma may experience shortness of breath.

"We know that asthma in obese subjects is more likely to persist and is
more likely to be perceived to be severe. These individuals often require
more treatment to achieve asthma control. Our study provides an insight
into why this might be happening -- the same asthma trigger produces a
greater effect in obese individuals," Taylor said.

More research is needed to "confirm that the differences in dynamic
hyperinflation between obese and non-obese asthmatics are sufficient to
explain the differences in symptoms between the two groups. Our study was
not large enough to do this," Taylor said.

source:news.yahoo.com

High-fat, low-carb diet helps kids with epilepsy

NEW YORK (Reuters Health) -
The results of a study provide
strong evidence that a diet high in fat and low in
carbohydrates -- a so-called "ketogenic diet" -- can help
control seizures in children with stubborn epilepsy that does
not respond well to drug therapy.

Epilepsy is a common neurological disorder characterized by
recurrent seizures when the normal working of the brain is
interrupted. A ketogenic diet has been widely used since the
1920s to help control hard-to-treat seizures in children.

In their study, Dr. Elizabeth G. Neal, from University
College London, and colleagues randomly assigned a group of
children who were having at least seven epileptic fits per week
despite anti-epileptic drug therapy, to a standard diet or a
ketogenic one, which is typically high in fats and very low in
carbohydrates.

After three months, children on the ketogenic diet had more
than one third fewer seizures, while seizure frequency
increased in children on the standard diet, the researchers
report in the Lancet Neurology medical journal.

A greater than 50 percent drop off in seizure frequency was
noted in 38 percent of children on the ketogenic diet compared
with just 6 percent of children on the standard diet.

This study confirms that a ketogenic diet is safe and
effective in children with drug-resistant epilepsy, the
investigators conclude.

The most common side effects with the ketogenic diet were
constipation, vomiting, lack of energy, and hunger, Neal and
colleagues note.

In a written commentary, Dr. Max Wiznitzer, from the
Rainbow Babies and Children's Hospital in Cleveland, notes that
some questions still remain regarding ketogenic diets for
childhood epilepsy. Among these are the long-term effects, the
identification of epilepsies that benefit from early initiation
of such a diet, and the mechanism by which the diet produces
its anti-seizure effect.

SOURCE: Lancet Neurology, online May 3, 2008.

Obese moms-to-be have longer pregnancies

NEW YORK (Reuters Health) -
Pregnant women who are
overweight or obese in the first trimester of pregnancy and
those who have a greater change in body weight during pregnancy
are more apt to have lengthier pregnancies and more
complications, according to results of a new study.

Dr. Fiona C. Denison, of the University of Edinburgh, UK,
and colleagues analyzed data from the Swedish Medical Birth
Register on women who gave birth between 1998 and 2002.

Out of 143,519 pregnancies, 6.8 percent were delivered
"postdate" -- defined as longer than 42 weeks. A normal
pregnancy lasts 40 weeks.

Compared with women with normal body mass indexes (BMIs),
more women with higher BMIs during the first trimester, as well
as those with greater weight gain during pregnancy, had
longer-than-normal pregnancies.

Being overweight or obese during the first trimester was
also associated with a lower chance of spontaneous delivery at
term and being obese was associated with a higher risk of
stillbirth, pregnancy-related (gestational) diabetes and need
for cesarean delivery.

"Maternal obesity poses a significant risk to maternal and
fetal health during pregnancy, and our study confirms the
findings of others that obesity is associated with significant
complications including stillbirth, gestational diabetes,
pregnancy-induced hypertension and cesarean section," Denison's
team concludes.

"If a healthy lifestyle including physical activity and
healthy eating, which are more common in underweight women,
were advocated more strongly for the obese obstetric
population," they suggest, "then obstetric outcomes might be
improved."

source:news.yahoo.com

Calling all carbs: Dietitian hired to arrest officer obesity

LOS ANGELES - Rana Parker tells pudgy police they have the right to
remain chubby, but it can and will be used against them on the streets
of Los Angeles.
The dietitian lays down the law for recruits, veterans and top brass,
letting them know that eating right can help them do a better job and
could even save their lives.

"I joke with them that I'm not the food police, that I'm just here
to give them information, education and hopefully give them motivation
to help themselves," she said.

While overweight officers aren't unique to Los Angeles, the police
department believes it's the first to hire a full-time diet coach.
Parker joined in July, leaving behind decidedly less macho clients at
Head Start, the federal aid program for children.

Faced with a need for more officers in recent years, the LAPD
briefly relaxed body fat limits from a maximum of 22 percent for men
and 30 percent for women, drawing recruits who mirrored a plumper
American public.

By targeting recruits, Parker is trying to instill good eating
habits before the rigors of the field make it difficult to find time
for balanced meals. She's provided one-on-one counseling to about 90
recruits, taught a nutrition course to about 500 others and made
presentations to more than 400 officers.

Though Parker's met some resistance to her belt-tightening measures, she's also found followers.

Recruit Ashley Goodroe has dropped four dress sizes since they
started working together in September. Goodroe said the lessons she's
learned include giving up sugary fruit punch and regularly eating
breakfast. The hardest part was cutting back on the fat-laden weekly
meal that takes her home to Georgia: fried pork chops, collard greens and corn bread.

"I feel skinny," Goodroe, 23, said with a laugh. "I actually had to get my uniforms fitted again."

Doughnuts may be the punch line for many cop jokes, but they're not
the problem, Parker said. Long hours and the on-the-go nature of police
work make it hard to find time to eat well and stay in shape, she said.

"They may be sitting in their car and all of a sudden they need to
go for a sprint, which might end in a fight as well," Parker said.
"They need to be in good shape so their body can handle that kind of stress."

But officers who don't plan their meals are reduced to nutritional
bottom-feeding: drive-thru burgers, microwave burritos and greasy
slices of pizza.

Parker believes officers can better take a bite out of crime if they
aren't hungry on their shifts. She encourages stashing energy bars,
fruit and peanut butter sandwiches in squad cars and desks, to stave
off hunger when getting a full meal is hard.

Fit officers are more confident, project strength and give the
department a good image, she added. A suspect may think twice about
trying to outrun a physically fit officer.

Kevin Sommers, national chairman of safety and technology for the
Fraternal Order of Police, applauded the LAPD for recognizing diet as
an important issue.

"For the longest time in law enforcement we trained our people in
policing, but we didn't teach our people about how to maintain their
mental and physical well-being," he said.

Francisco Rubio Jr., a 30-year-old recruit, said diabetes and high
cholesterol run in his family. But it was the recent death of a
40-year-old friend, an officer who had a heart attack on the job, that
really drove home the need to get fit.

With Parker's guidance and a regimen that replaces sweets with fresh
oranges and strawberries, Rubio has dropped from 195 to 175 pounds. He
vows to be wary of the fatty food that lurks around every corner.

"What catches our eyes unless we discipline ourselves is pizza,
hamburgers — all the food that's out there that's easy-access," Rubio
said. "Now I tend to look at it as a heart attack waiting to happen."

Source:news.yahoo.com

Obesity-Related Inflammation Boosts Heart Risks

(HealthDay News) -- Obesity causes prolonged
inflammation of heart tissue that in turn boosts heart failure risk,
according to a U.S. study of almost 7,000 people.

The latest findings from the Multiethnic Study of Atherosclerosis
(MESA) are believed to provide the first large scale of evidence of such a
link and give the estimated 72 million obese American adults another
reason to change their lifestyle.

"The biological effects of obesity on the heart are profound. Even if
obese people feel otherwise healthy, there are measurable and early
chemical signs of damage to their heart, beyond the well-known
implications for diabetes and high blood pressure," senior study
investigator Dr. Joao Lima, a professor of medicine and radiology at the
Johns Hopkins University School of Medicine and its Heart Institute, said
in a prepared statement.

There is "now even more reason for (obese people) to lose weight,
increase their physical activity and improve their eating habits," Lima
said.

He and his colleagues tracked the development of heart failure in an
ethnically diverse group of nearly 7,000 people, ages 45 to 84, who
enrolled in the MESA study, starting in 2000. Of the 79 participants
who've developed congestive heart failure so far, 35 (44 percent) were
physically obese (body mass index of 30 or greater).

On average, obese participants were found to have higher blood levels
of key immune system proteins involved in inflammation (interleukin 6,
C-reactive protein, and fibrinogen) than non-obese participants. A near
doubling of average interleukin 6 levels alone was associated with an 84
percent increased risk of heart failure.

"Our results showed that when the effects of other known disease risk
factors -- including race, age, sex, diabetes, high blood pressure,
smoking, family history and blood cholesterol levels -- were statistically
removed from the analysis, inflammatory chemicals in the blood of obese
participants stood out as key predictors of who got heart failure," Lima
said.

He added that doctors "need to monitor their obese patients for early
signs of inflammation in the heart and to use this information in
determining how aggressively to treat the condition."

Lima and colleagues also found a link between inflammation and
metabolic syndrome, which doubles a person's chances of developing heart
failure. Metabolic syndrome is a collection of risk factors -- obesity,
high blood pressure, elevated blood glucose levels, excess abdominal fat,
and abnormal cholesterol levels -- that increase the risk of heart disease
and diabetes.

The study was published in the May 6 issue of the Journal of the
American College of Cardiology. The MESA study was expected to
continue tracking patients through 2012.

source:news.yahoo.com

Common gene variants linked to obesity

NEW YORK (Reuters Health) -
Researchers have identified new
genetic variants that influence the risk of obesity and insulin
resistance, a precursor to diabetes, according to findings from
two studies published online this week.

In the first of the two genome-wide association studies, a
research team headed by Dr. Ruth J. F. Loos, from Addenbrooke's
Hospital in Cambridge UK, analyzed data from 16,876 people of
European descent.

The investigators not only confirmed prior research linking
variants in the FTO gene with obesity, but they also identified
a strong association with genetic variants near the MC4R gene.
The MC4R gene regulates energy levels in the body by
influencing how much we eat and how much energy we expend or
conserve. Mutations in this gene are the most common genetic
cause of severe obesity that runs in families.

The findings by Loos and colleagues, which were later
confirmed in 60,352 adults and 5988 children, showed that the
presence of the MC4R risk variant increased the odds that a
child would be obese by up to 30 percent. An analysis of data
from 660 families revealed that "over transmission" of the risk
variant was common among obese offspring.

"Several groups had shown that rare, highly disruptive
variants in the MC4R gene were responsible for very severe,
genetic forms of obesity: this collaboration (by many
international groups) has uncovered more common variants that
affect more people," Loos said in a statement.

In the second study, an investigation of 318,237 single
letter changes, or SNPs, in the DNA of over 14,000 subjects of
Indian Asian and European descent, Dr. Jaspal S. Kooner, from
Imperial College London, and colleagues linked a gene sequence
variant near the MC4R gene with increased waist circumference
and a tendency to become insulin resistant, which can lead to
type 2 diabetes.

Two copies of the risk variant added roughly 2 cm to waist
circumference and increased insulin resistance by about 10
percent, the results show.

"A better understanding of the genes behind problems such
as diabetes and cardiovascular disease means that we will be in
a good position to identify people whose genetic inheritance
makes them most susceptible," Kooner said in a written
statement.

"We can't change their genetic inheritance. But we can
focus on preventative measures, including life-style factors
such as diet and exercise, and identifying new drug targets to
help reduce the burden of disease," Kooner added.

source:news.yahoo.com

;

Weight-loss drugs may harm developing brain: study

CHICAGO (Reuters) -
A drug from a new class of weight-loss
treatments disrupted wiring needed for brain development in
young mice, U.S. researchers said on Wednesday, raising
concerns about using such medications in children.

Mark Bear and colleagues at the Massachusetts Institute of
Technology studied the effects of a chemical that suppresses
appetite by blocking cannabinoid receptors in the brain, the
same brain mechanisms that make people hungry when they smoke
marijuana.

"I think that the cautionary note is that these mechanisms
play an important role in ... brain development," said Bear,
whose study appears in the journal Neuron.

Sanofi-Aventis' weight-loss pill rimonabant, also known as
Zimulti and sold under the brand name Acomplia in Europe, is
the first in this new class of drugs. A U.S. expert panel
rejected it last June because of fears it might trigger
suicidal thoughts.

Other drugmakers, including Merck & Co Inc, are working on
similar drugs.

Bear's team at MIT was hoping to gain insight into how the
brain adapts and rewires itself through learned experiences.
This so-called plasticity is central to the development of
neurons in the brain of children and young animals.

Bear said these cannabinoid receptors are known to regulate
signals between neurons, and his team wanted to see if they
would have an effect on plasticity in these young mice.

They were specifically testing learning in the visual
cortex of the mouse, a part of the brain that processes
information gathered from what they see.

ADAPTING TO CHANGE

Their experiments tested how well the animals adapted if
one eye was closed.

The researchers did not use rimonabant in the study.
Instead, they used a chemical analog or copy -- in this case a
drug available for laboratory use known as AM 251.

When they gave the mice AM 251 to block their cannabinoid
receptors, the animals still behaved as if both eyes were open.
This suggested the visual cortex was not adapting as it should.

"Our finding of a profound disruption of cortical
plasticity in juvenile mice treated with AM 251 suggests
caution is advised in the use of such compounds in children,"
the researchers wrote.

Bear said the finding is similar to the situation with many
drugs.

"You have to weigh the benefits against the risks. If the
benefit is related more to vanity than morbidity, I don't think
the risks are tolerable," he said.

Sanofi-Aventis spokeswoman Julissa Viana said rimonabant is
not approved for use in children.

"At this point in time it is approved for use in adults who
are overweight and obese with cardiovascular risk factors," she
said. "We don't encourage its use in children and it has not
been studied nor is it indicated for use in children."

The finding is the latest blow for rimonabant, which once
was predicted to be a multibillion-dollar seller.

A study last month of the drug in obese heart patients
found more than 40 percent of patients who took the drug
developed psychiatric problems.

But last month the drugmaker Sanofi said it still believes
Acomplia can be a winner and reiterated plans to submit the
drug worldwide as a treatment for type 2 diabetes in 2009.