All Posts tagged obese

Craving for alcohol linked to obesity

Addiction researchers at Washington University School of Medicine in St. Louis have found that a risk for alcoholism also may put individuals at risk for obesity. The researchers noted that the association between a family history of alcoholism and obesity risk has become more pronounced in recent years. Both men and women with such a family history were more likely to be obese in 2002 than members of that same high-risk group had been in 1992. “In addiction research, we often look at what we call cross-heritability, which addresses the question of whether the predisposition to one condition also might contribute to other conditions,” says first author Richard A. Grucza, PhD. “For example, alcoholism and drug abuse are cross-heritable. This new study demonstrates a cross-heritability between alcoholism and obesity, but it also says — and this is very important — that some of the risks must be a function of the environment. The environment is what changed between the 1990s and the 2000s. It wasn’t people’s genes.”

Obesity in the United States has doubled in recent decades from 15 percent of the population in the late 1970s to 33 percent in 2004. Obese people – those with a body mass index (BMI) of 30 or more – have an elevated risk for high blood pressure, diabetes, heart disease, stroke and certain cancers.

Reporting in the Archives of General Psychiatry, Grucza and his team say individuals with a family history of alcoholism, particularly women, have an elevated obesity risk. In addition, that risk seems to be growing. He speculates that may result from changes in the food we eat and the availability of more foods that interact with the same brain areas as addictive drugs. “Much of what we eat nowadays contains more calories than the food we ate in the 1970s and 1980s, but it also contains the sorts of calories — particularly a combination of sugar, salt and fat — that appeal to what are commonly called the reward centers in the brain,” says Grucza, an assistant professor of psychiatry. “Alcohol and drugs affect those same parts of the brain, and our thinking was that because the same brain structures are being stimulated, overconsumption of those foods might be greater in people with a predisposition to addiction.”

Grucza hypothesized that as Americans consumed more high-calorie, hyper-palatable foods, those with a genetic risk for addiction would face an elevated risk from because of the effects of those foods on the reward centers in the brain. His team analyzed data from two large alcoholism surveys from the last two decades. The National Longitudinal Alcohol Epidemiologic Survey was conducted in 1991 and 1992. The National Epidemiologic Survey on Alcohol and Related Conditions was conducted in 2001 and 2002. Almost 80,000 people took part in the two surveys.

“We looked particularly at family history of alcoholism as a marker of risk,” Grucza explains. “And we found that in 2001 and 2002, women with that history were 49 percent more likely to be obese than those without a family history of alcoholism. We also noticed a relationship in men, but it was not as striking in men as in women.” Grucza says a possible explanation for obesity in those with a family history of alcoholism is that some individuals may substitute one addiction for another. After seeing a close relative deal with alcohol problems, a person may shy away from drinking, but high-calorie, hyper-palatable foods also can stimulate the reward centers in their brains and give them effects similar to what they might experience from alcohol.

“Ironically, people with alcoholism tend not to be obese,” Grucza says. “They tend to be malnourished, or at least under-nourished because many replace their food intake with alcohol. One might think that the excess calories associated with alcohol consumption could, in theory, contribute to obesity, but that’s not what we saw in these individuals.” Grucza says other variables, from smoking, to alcohol intake, to demographic factors like age and education levels don’t seem to explain the association between alcoholism risk and obesity. “It really does appear to be a change in the environment,” he says. “I would speculate, although I can’t really prove this, that a change in the food environment brought this association about. There is a whole slew of literature out there suggesting these hyper-palatable foods appeal to people with addictive tendencies, and I would guess that’s what we’re seeing in our study.” The results, he says, suggest there should be more cross-talk between alcohol and addiction researchers and those who study obesity. He says there may be some people for whom treating one of those disorders also might aid the other.

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Infant obesity widespread in the USA

A study led by Brian Moss of Wayne State University’s School of Social Work reveals that one third of infants in the U.S. are obese or at risk of obesity. In addition, of the 8,000 infants studied, those found to be obese at 9 months had a higher risk of being obese at 2 years. Other studies have revealed that Infant obesity increases the risk for later childhood obesity and could lead to other obesity-related health problems like heart disease, asthma, high blood pressure and cancer. According to the U.S. Centers for Disease Control and Prevention, childhood and infant obesity has more than tripled in the past 30 years.

Moss, in collaboration with William H. Yeaton from the Institute for Social Research at the University of Michigan in Ann Arbor, published their analysis, “Young Children’s Weight Trajectories and Associated Risk Factors: Results from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B),” in the January/February 2011 issue of the American Journal of Health Promotion. The ECLS-B draws from a representative sample of American children born in 2001 with diverse socioeconomic and racial/ethnic backgrounds. It is one of the first studies to monitor weight status changes of a nationally representative sample of very young children.

For their study, Moss and Yeaton used results from ECLS-B to follow the trajectory of the infants’ weight status at 9 months and 2 years, then performed statistical analyses to examine whether weight persistence, loss or gain was linked to demographic characteristics such as sex, race/ethnicity, geographic region or socioeconomic status. Children above the 95th percentile on standard growth charts were considered to have infant obesity, children in the 85th to 95th percentile were considered at risk for obesity.

Some of their results show that:
• 31.9 percent of 9-month-olds were at risk or obese;
• 34.3 percent of 2-year-olds were obese or at risk for obesity;
• 17 percent of the infants were obese at 9 months, rising to 20 percent at 2 years;
• 44 percent of the infants who were obese at 9 months remained obese at 2 years;
• Hispanic and low-income children were at greater risk for weight status gain;
• Females and Asian/Pacific Islanders were at lower risk for undesirable weight changes;
• 40 percent of 2-year-olds from the lowest income homes were at risk or obese compared to 27 percent of those from the highest income homes.

“This study shows that a significant proportion of very young children in the United States is at risk or is obese,” said Moss. The team notes a consistent pattern of obesity starting early in life. “As obesity becomes an increasing public health concern, these findings will help guide health practitioners by targeting high risk populations and foster culturally sensitive interventions aimed at prevention and treatment of obesity,” Moss said.

“We are not saying that overweight babies are doomed to be obese adults. However, we have found evidence that being overweight at 9 months puts you on track for being overweight or obese later in childhood.”

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More risk factors linked with overweight

The link between obesity and cardiac disease is not merely anecdotal, there is proof for that. Now, there is further proof that even overweight causes a clustering of risk factors for cardio vascular abnormalities. A recent publication in Heart Asia, a British Medical Journal, has showed that there is not much difference between the cardio vascular risk factors in obese and overweight people. “The clutch of risk factors – glucose intolerance, hyper tension, high cholesterol – are all significantly higher among overweight and obese subjects than among normal subjects,” Vijay Viswanathan, MV Hospital for Diabetes and Prof. M.Viswanthan Diabetes Research Center said. He co-authored the article with Shabana Tharkar, also from the Indian hospital.

The study, conducted among two groups – 2021 subjects aged over 20 years, and 1289 subjects aged 8-19 years – indicated that even among overweight, 'non-obese' people, the presence of major cardiovascular risk factors was not significantly different. While the total diabetes prevalence among the obese population is 28.4 per cent, among the overweight population is 25 per cent. Again, with hypertension, the value for the obese group is 34.2 per cent, while for the overweight population it is 27.6 per cent. In contrast, the corresponding values are 16.2 per cent (diabetes) and 20.2 (hypertension).

Similarly, the study showed higher values for triglycerides and high HDL cholesterol for both these groups.

Overweight was defined as a Body Mass Index, equal to, or in excess of 25 kg/m2 and obesity, a BMI of 30 kg/m2 or above. Further worrisome is the increasing rate of overweight and obesity among both men and women from 1995 to 2008, across all age groups. Dr. Viswanathan added that this is the result of rapid urbanisation. “Obesity has already hit the Western world and it is time for Indians to wake up to the alarm bells,” according to the article. Results from previous studies show a lower risk of developing diabetes with just a five per cent initial reduction in weight, Dr. Viswanathan said.

The findings highlight the urgent need for framing direct and indirect strategies to control the rising levels of obesity in the population, in order to substantially reduce the country's non communicable diseases burden, he added. Regulating the diet, reducing intake of fast foods and high-calorie meals, and upping physical activity and exercise on a regular basis would go a long way in keeping weight under control, diabetologists advise.

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Obesity may interfere with Vitamin D absorption

The more obese a person is, the poorer his or her vitamin D status, a new study by a team of Norwegian researchers suggests. The study found an inverse relationship between excess pounds and an insufficient amount of vitamin D, which is critical to cell health, calcium absorption and proper immune function. Vitamin D deficiency can raise the risk for bone deterioration and certain types of cancer. The researchers also suggest that overweight and obese people may have problems processing the vitamin properly.

The team noted that after the so-called “sunshine vitamin” is initially absorbed (through either sun exposure or the consumption of such foods as oily fish and fortified milk), the body must then convert it into a usable form, called 1,25-dihydroxyvitamin D. This conversion process, however, seems to be short-circuited among obese people, complicating efforts to gauge their true vitamin D health.

The findings are published in the January issue of the Journal of Nutrition.

To investigate the impact of obesity on vitamin D absorption, the team spent six years tracking 1,464 women and 315 men, with an average age of 49. Based on the participants' body mass index (BMI), an indicator of body fatness calculated from a persons weight and height, the average participant was deemed to be obese. About 11 percent were categorized as “morbidly obese.”

From the outset, overall vitamin D levels were found to be below the healthy range, the authors noted. By the end of the study, overall levels of vitamin D were found to have dropped off “significantly” while BMI readings rose by 5 percent. The research team concluded that having a higher-than-normal weight, body fat and BMI was linked to a poorer vitamin D profile. For example, people with the lowest BMI readings had 14 percent higher vitamin D levels than those with the highest BMI readings. Because vitamin D levels did not correlate properly with 1,25-dihydroxyvitamin D levels (and in fact appeared to have an abnormal inverse relationship), the authors suggested that future efforts to explore vitamin D status among obese people should test for both measures of vitamin D health.

They also suggested that people who are overweight and obese might benefit from vitamin D supplementation and more exposure to sunlight.

SOURCE: Journal of Nutrition, news release, Dec. 14, 2010

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Vitamin D reduces obesity-induced uterine cancer

Georgetown University researchers suggest obese women can reduce their risk of endometrial cancer by taking vitamin D supplements.Scientists from Georgetown's Lombardi Comprehensive Cancer Center recently showed that 67 percent of obese mice fed a regular diet developed this cancer, versus only 25 percent of obese mice fed a vitamin D-supplemented diet. “In the obese mice, vitamin D offered a very strong, very significant protective effect,” says the study's lead investigator, professor of oncology Leena Hilakivi-Clarke. The findings, published in Cancer Prevention Research, also reported that vitamin D offers no protective effects for mice of normal weight. About 60 percent of mice predisposed to endometrial cancer developed it no matter what diet they were fed.

All of the mice in the study were genetically predisposed to develop endometrial cancer because they lacked one of two tumor suppressor genes. People without one of these genes are strongly predisposed to the cancer, and obesity adds a strong risk factor for the disease, researchers say. “Vitamin D has been shown to be helpful in a number of cancers, but for endometrial cancer, our study suggests it protects only against cancer that develops due to obesity,” Hilakivi-Clarke says. “Still, if these results are confirmed in women, use of vitamin D may be a wonderfully simple way to reduce endometrial cancer risk.”

Until further studies are conducted, she says women concerned about their risk of this disease may wish to take vitamin D supplements or spend a few more minutes each week in the sun, They also should strive to lose weight if they are carrying around too many pounds. The National Cancer Institute and the Department of Defense funded the research, which also included investigators from the National Cancer Institute, Northwestern University, Wake Forest University School of Medicine and Walter Reed Hospital. 

“But we really don't know why dietary vitamin D works so well in our obese mice,” Hilakivi-Clarke says. “We are currently investigating the mechanisms, and we are hopeful that we can find an answer.”

 

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Meal replacements may not help teens keep weight off

A new study at the Children's Hospital of Philadelphia found that meal replacements like shakes, bars and prepackaged entrees aren't a good long-term solution for obese teens. For the new study, researchers randomly assigned 113 obese teens and their families to different diets for a year. One group of teens ate self-selected low-calorie meals not exceeding 1,300 to 1,500 total calories per day. The other group ate meal replacements (three SlimFast shakes and one prepackaged entree), along with five servings of fruits and vegetables. Four months into the study, participants in second group were randomized to a second-phase diet: some were put on the low-calorie self-selected diet, while the rest stayed on meal replacements.

At the four-month mark, all participants had lost weight, but the teens on meal replacements lost more — a 6.3% reduction in body mass index (BMI) versus 3.8% for the low-calorie group. But by the end of the one-year study, many participants had regained much of the weight they had lost, resulting in no significant differences in weight loss between the groups: on average, the teens had reduced their BMI 3.4% since the beginning of the study.

The results underscore one of the many difficulties of dieting: keeping the weight off long term. Many dieters regain weight because they can't stick to rigid eating programs for long: one-third of the participants in the current study dropped out before its conclusion. The monotony of the meal-replacement diet couldn't have helped either: teens in the meal-replacement group started out drinking SlimFasts 5.6 days a week (in Month 2); by the end of the study, they were only able to tolerate the shakes 1.6 days each week.

“The potential benefit of (meal replacement) in maintaining weight loss was not supported,” the researchers concluded. So for those of you who are gearing up to begin a weight-loss program in the New Year, it helps to remember that austerity isn't the best strategy long-term. Focus on variety — both with your diet and your exercise regimen — and manageability instead. A regular visit with Nastaran can ensure that you stay on track and keep the weight off long term.

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Obesity may interfere with Vitamin D absorption

The more obese a person is, the poorer his or her vitamin D status, a new study by a team of Norwegian researchers suggests. The study found an inverse relationship between excess pounds and an insufficient amount of vitamin D, which is critical to cell health, calcium absorption and proper immune function. Vitamin D deficiency can raise the risk for bone deterioration and certain types of cancer.

The researchers also suggest that overweight and obese people may have problems processing the vitamin properly.

The team noted that after the so-called “sunshine vitamin” is initially absorbed (through either sun exposure or the consumption of such foods as oily fish and fortified milk), the body must then convert it into a usable form, called 1,25-dihydroxyvitamin D. This conversion process, however, seems to be short-circuited among obese people, complicating efforts to gauge their true vitamin D health.

The findings are published in the January issue of the Journal of Nutrition.

To investigate the impact of obesity on vitamin D absorption, the team spent six years tracking 1,464 women and 315 men, with an average age of 49. Based on the participants' body mass index (BMI), an indicator of body fatness calculated from a persons weight and height, the average participant was deemed to be obese. About 11 percent were categorized as “morbidly obese.”

From the outset, overall vitamin D levels were found to be below the healthy range, the authors noted. By the end of the study, overall levels of vitamin D were found to have dropped off “significantly” while BMI readings rose by 5 percent.

The research team concluded that having a higher-than-normal weight, body fat and BMI was linked to a poorer vitamin D profile. For example, people with the lowest BMI readings had 14 percent higher vitamin D levels than those with the highest BMI readings. Because vitamin D levels did not correlate properly with 1,25-dihydroxyvitamin D levels (and in fact appeared to have an abnormal inverse relationship), the authors suggested that future efforts to explore vitamin D status among obese people should test for both measures of vitamin D health.

They also suggested that people who are overweight and obese might benefit from vitamin D supplementation and more exposure to sunlight.

SOURCE: Journal of Nutrition, news release, Dec. 14, 2010

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As womens depression drops so does the excess weight

Treating obese women's depression may help them lose weight, a new study suggests. Although researchers couldn't determine which condition may cause the other, obesity and depression frequently strike together. Obese women who saw their depression lessened in a treatment program also lost more weight than women whose depression didn't improve or worsened, researchers said.

“I expect that the relationship between depression and physical activity goes in both directions,” said study researcher Dr. Gregory Simon, a senior investigator and psychiatrist at Group Health Research Institute in Seattle. “Increased physical activity leads to improvement in depression, and improvement in depression leads to increased physical activity.” “You can't prove which came first.”

The researchers evaluated 203 women, ages 40 to 65, who had an average body mass index of 38.3 at the study's start, and found that obesity increased a woman's risk of depression by 50 percent to 150 percent.

Participants were then split into two groups: one focused only on helping the women lose weight, and the other also treating the women's depression. The researchers held 26 group treatment sessions over 12 months, and checked in on the women six, 12 and 24 months after the study began.

Of those whose depression had loosened its grip — as measured by a small drop on a test called the Hopkins Symptom Checklist depression score — 38 percent had lost at least 5 percent of their body weight. Of those whose depression scores stayed the same or increased, 21 percent lost that much weight.

While the study's purpose wasn't to make recommendations about exercise, Simon said, it's advisable for people suffering from depression to seek more opportunities for physical activity. “There certainly is evidence that exercise alone is an effective treatment for depression, whether you're overweight or obese or not, or even if you're a normal weight,” he said.

The study was unusual because it focused on the sometimes-overlooked link between depression and obesity, without focusing solely on the role of weight loss, said Robert E. Thayer, a psychology professor at California State University in Long Beach who has researched how people regulate their moods with food and exercise.

“These findings suggest that, like other negative moods that motivate eating as a kind of self-medication, depression is no exception,” said Thayer, who was not involved with the study. “It's a useful addition to the scientific literature.”

Simon said future studies could focus on learning which antidepressants — many of which can bring on weight gain as a side effect — contribute most to that situation. “Losing weight can certainly have a positive effect on people's moods,” he said.

The research was published in the November/December issue of the journal General Hospital Psychiatry.

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Poor Diet Metabolism, Lack of Exercise Increases Asthma Risk in Kids

Metabolic syndrome is a cluster of risk factors which can result in heart disease and diabetes. Researchers have now found that poor diet and lack of exercise that lead to an imbalance in metabolism may also increase a child's risk of developing asthma.

Dr. Giovanni Piedimonte and researchers from West Virginia University School of Medicine analyzed data from nearly 18,000 children aged 4 to 12 years who were taking part in the Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) project. Factors considered included triglyceride levels and evidence of acanthosis nigricans, which are raised patches of brown skin that are often biomarkers for insulin resistance.

The team also considered body mass index or BMI, and almost 21% of the children were considered obese. Fourteen percent of the children had asthma.

The researchers found that asthma prevalence among the children was strongly associated with certain symptoms of metabolic syndrome including dyslipidemia and abnormal glucose metabolism, but not weight status. Although those who were obese were more likely to have asthma, even children of a healthy weight who had imbalanced metabolism were at increased risk.

Certain metabolic factors participate in the asthma disease process by contributing to inflammation of the airways in the lungs and hyperreactivity (contraction of smooth muscle in the bronchial walls), says Dr. Piedimonte. He says that strict monitoring and control of triglyceride and glucose levels early in life may play a role in the management of chronic asthma in children.

Dr. Piedimonte would like to see the findings used as further support for universal lipid screening in children. “The rationale is that by using selective screening, we would have missed over a third of children with significant genetic dyslipidemia,” he said.

Both poor diet – one lacking in antioxidants but high in fat – and inadequate exercise play a role in the metabolic syndrome, a group of risk factors that increase the risk for coronary artery disease, stroke, and type 2 diabetes. The goal of treatment is often weight loss (if overweight), a minimum of 30 minutes of daily moderate intensity exercise, and a lowering of cholesterol, blood pressure and blood sugar through diet or medication.

Source reference:
Cottrell L, et al “Metabolic abnormalities in children with asthma” Am J Respir Crit Care Med 2010; DOI: 10.1164/rccm.201004-0603OC.

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Cigarette Smoking and Fructose Exacerbate Liver Disease

NAFLD is the most common cause of liver disease worldwide and research suggests the number of cases will climb given an increasing trend toward higher fat diets, obesity, decreased physical activity, and a rise in diabetes. Past studies indicate that more than 30 million Americans have NAFLD and approximately 8 million may have nonalcoholic steatohepatitis (NASH).

In the first study, Ramón Bataller, M.D., and colleagues from the Hospital Clínic in Barcelona, Spain investigated the effects of cigarette smoking (CS) in obese rats. Rats were divided into 4 groups (n=12 per group): obese smokers, obese non-smokers, control smokers and control non-smokers. Smoker rats were exposed to 2 cigarettes/day, 5 days/week for 4 weeks. Researchers found that obese rats exposed to CS showed a significant increase in ALT serum levels (indicating liver disease), while this effect was not observed in control rats.

“Our results show that CS causes oxidative stress and worsens the severity of NAFLD in obese rats,” said Dr. Bataller. “Further studies should investigate longer exposures to CS, and assess whether this finding also occurs in patients with obesity and NAFLD.”

In her editorial, also published in Hepatology this month, Claudia Zein, M.D., from the Cleveland Clinic, noted that “the importance of these results is that taken together with other experimental and clinical data, they support that cigarette smoking appears to aggravate liver injury in patients with liver disease.” Dr. Zein added, “Studies characterizing the effects of cigarette smoking in human NAFLD will be crucial because of the vast number of patients that may benefit from modification of this risk factor.”

Additionally, prior studies suggest an over consumption of high fructose corn syrup (HFCS), primarily in the form of soft-drinks, have contributed to weight gain and the rise in obesity, particularly in children and adolescents. Table sugar (sucrose) and HFCS are the two major dietary sources of fructose. Over the past 40 years, consumption of dietary fructose has increased 1,000% according to Bray et al, and doctors believe it to be a major cause of NAFLD.

Researchers from Duke University studied 341 adults enrolled in the NASH Clinical Research Network who responded to a Block food questionnaire within 3 months of a liver biopsy. Fructose consumption was estimated conservatively by including that found in beverages, which accounts for 50% of dietary fructose intake. Results showed that 27.9% of participants consumed at least 1 fructose-containing beverage per day, 52.5% had 1 to 6 beverages with fructose per week, and 19.7% drank no beverages with fructose.

“In patients with NAFLD, daily fructose ingestion was associated with reduced fatty liver (steatosis), but we found increased fibrosis,” noted Manal Abdelmalek, M.D., M.P.H, and lead author of the study. “Further dietary intervention studies are needed to evaluate whether a low-fructose diet improves metabolic disturbances associated with NAFLD and improves patient outcomes for those at risk of disease progression,” concluded Dr. Abdelmalek.

A second fructose study led by Ling-Dong Kong, M.D., from Nanjing University in China investigated the effects of curcumin on fructose-induced hypertriglyceridemia and fatty liver in rats. Curcumin, a compound derived from turmeric (curcuma root), is sold as an herbal supplement and is believed to have anti-inflammatory, anti-tumor, and anti-viral properties. Researchers observed a hyperactivity of hepatic protein tyrosine phosphatase 1B (PTP1B), which is associated with defective insulin and leptin signaling, in fructose-fed rats.

For the first time this study demonstrated that curcumin inhibited hepatic PTP1B expression and activity in fructose-fed rats. “Our results provide novel insights into the potential therapeutic mechanisms of curcumin on fructose-induced hepatic steatosis associated with insulin and leptin resistance,” said Dr. Kong.

These studies indicate modifying risks such as smoking and fructose consumption offer potential benefits for those with liver diseases. Further studies are needed to explore these benefits in preventing the progression of liver disease.

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