Health and Fitness Blog

FRIDAY, Oct. 31 (HealthDay News) — An antibody that breaks down
and suppresses an appetite stimulant produced by the human body has been
discovered.

Scientists with The Scripps Research Institute say the antibody
catalyst, GHR-11E11, increased the metabolic rate in fasting mice and
curbed their eating even after the rodents went 24 hours without food.

The antibody counteracts ghrelin, a gastric hormone that promotes
weight gain and fat storage through metabolic actions that decrease the
breakdown of stored fat for energy as well as energy expenditure itself.
The body releases the substance to encourage eating during periods of
calorie restriction.
The findings were published in this week’s online issue of the
Proceedings of the National Academy of Sciences.

“Our study showed that this novel catalytic ghrelin antibody could
specifically seek out and degrade ghrelin,” co-lead investigator Kim
Janda, a professor of chemistry, said in a news release from the
institute. “While this antibody lacks a high level of catalytic
efficiency, our study clearly demonstrates that even a basal level of
catalysis can effectively modulate feeding behavior. These findings not
only validate antibody-based therapeutics, but strongly suggest that
catalytic anti-ghrelin antibodies might help patients reach and maintain
their weight-loss goals.”

Because obesity has a complex nature, any antibody-based treatment
would likely be combined with other weight-loss strategies, including
medicinal, nutritional, exercise, educational and psychosocial components,
Janda said. However, he added, more research is needed to better
understand the effect of the antibodies over the long-term and other
issues.

According to recent reports from the World Health Organization, about 1
billion people worldwide are overweight or obese, with most of these in
the developed world.

More information

The U.S. government has more about weight management.

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ATLANTA – The nation’s obesity epidemic is exacting a heavy toll: The rate of new diabetes cases nearly doubled in the United States in the past 10 years, the government said Thursday. The highest rates were in the South, according to the first state-by-state review of new diagnoses. The worst was in West Virginia, where about 13 in 1,000 adults were diagnosed with the disease in 2005-07. The lowest was in Minnesota, where the rate was 5 in 1,000.

Nationally, the rate of new cases climbed from about 5 per 1,000 in the mid-1990s to 9 per 1,000 in the middle of this decade.

Roughly 90 percent of cases are Type 2 diabetes, the form linked to obesity.

The findings dovetail with trends seen in obesity and lack of exercise — two health measures where Southern states also rank at the bottom.

“It isn’t surprising the problem is heaviest in the South — no pun intended,” agreed Matt Petersen, who oversees data and statistics for the American Diabetes Association.

The study, led by Karen Kirtland of the Centers for Disease Control and Prevention, provides an up-to-date picture of where the disease is exploding. The information should be a big help as the government and health insurance companies decide where to focus prevention campaigns, Petersen said.

Diabetes was the nation’s seventh-leading cause of death in 2006, according to the CDC. More than 23 million Americans have diabetes, and the number is rapidly growing. About 1.6 million new cases were diagnosed among adults last year.

In Type 2 diabetes, cells do not properly use insulin, a hormone needed to convert sugar into energy, and the pancreas gradually loses its ability to produce it. The illness can cause sugar to build up in the body, leading to complications such as heart disease, blindness, kidney failure and poor circulation that leads to foot amputations.

The study involved a random-digit-dialed survey of more than 260,000 adults. Participants were asked if they had ever been told by a doctor that they have diabetes, and when the diagnosis was made. The comparisons between 1995-97 and 2005-07 covered only the 33 states for which the CDC had complete data for both time periods.

The researchers had data for 40 states for the years 2005-07.

West Virginia, South Carolina, Alabama, Georgia, Texas and Tennessee had the highest rates, all at 11 cases per 1,000 or higher. Puerto Rico was about as high as West Virginia. Minnesota, Hawaii and Wyoming had the lowest rates.

It is not entirely clear why some states were worse than others. Older people, blacks and Hispanics tend to have higher rates of Type 2 diabetes, and the South has large concentrations of all three groups. However, West Virginia is overwhelmingly white.

The report asked about diagnosed diabetes only. Because an estimated one in four diabetics have not been diagnosed, the findings probably underestimate the problem, said Angela Liese, a diabetes researcher at the University of South Carolina.

The underestimates may be particularly bad in the rural South and other areas where patients have trouble getting health care, she noted.

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On the Net:

State-by-state rates: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5743a2.htm

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CHICAGO (Reuters) –
Women who gain more than 40 pounds (18 kg ) during pregnancy have nearly twice the risk of delivering a heavy baby as those who gain less, U.S. researchers said on Friday.

The study of more than 40,000 U.S. women and their babies found as many as one in five women gains too much weight during pregnancy, doubling the chances her baby will weigh 9 pounds (4 kg) or more.

And they found women who gain more than 40 pounds during pregnancy are more likely to have a heavy baby even if they do not have gestational diabetes, a short-term form of diabetes linked with pregnancy that is known to increase the risk of having a big baby.

“Because there are so many women who are gaining more than 40 pounds during pregnancy, it’s an important health message for most women to avoid excessive weight during pregnancy,” Dr. Teresa Hillier of Kaiser Permanente Center for Health Research in Portland, Oregon, whose study appears in the journal Obstetrics & Gynecology, said in a telephone interview.

Hillier said gaining extra weight during pregnancy increases the risk for having heavy babies, and studies suggest these babies are programed to become overweight or obese later in life.

According to the American College of Obstetricians and Gynecologists, babies who weigh more than 9 pounds at birth are considered heavy.

A large baby can pose risks for a difficult delivery — increasing the chances of vaginal tearing, bleeding, and Caesarian-sections for the mother and the risk of stuck shoulders and broken collar bones for the baby.

In the study, Hillier and colleagues examined the medical records of 41,540 women who gave birth in Washington, Oregon and Hawaii from 1995-2003. All had been tested for gestational diabetes and 5.4 percent were treated for it with a program of diet, exercise and insulin, if needed, to control blood sugar.

Overall, 20 percent of the women in the study who gained more than 40 pounds — the upper limit of pregnancy weight gain recommendations in the United States — gave birth to heavy babies.

Fewer than 12 percent of women in the study with normal weight gain delivered heavy babies, she said.

The group at greatest risk were those who gained more than 40 pounds and had gestational diabetes. Nearly 30 percent of these women had heavy babies, compared with 13.5 percent of women with gestational diabetes who had normal weight gains during pregnancy.

The researchers said the findings suggest all women should avoid excessive weight gain during pregnancy. And women who are being treated for gestational diabetes should also strive to keep weight gain below 40 pounds.

“You can’t treat the glucose and ignore the weight gain issue,” Hillier said.

Weight gain during pregnancy has been rising over the past two decades, and some researchers suspect this may be fueling an epidemic of childhood obesity.

(Editing by Maggie Fox)

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NEW YORK (Reuters Health) –
Certain white adults who say they’ve been discriminated against in their daily lives are more likely to be obese than their peers who haven’t perceived personal discrimination, a new study finds.

The study of U.S. adults, reported in the American Journal of Public Health, found that perceived unfair treatment was associated with increased abdominal girth. Weight was not, however, clearly related to feelings of discrimination among black and Hispanic adults.

For the study, researchers led by Dr. Haslyn Hunte of Purdue University in Indiana analyzed data on 3,025 adults who had taken part in a Chicago-area health study.

Participants were weighed and interviewed about their health habits and demographics. They were also asked about perceived discrimination — including how often they believed they’d been treated disrespectfully, received poorer service than other people or felt threatened or harassed.

Overall, the researchers found, one-quarter of study participants said they’d been discriminated against based on race or ethnicity, while 40 percent believed they’d been treated unfairly based on other reasons.

The association between perceived discrimination and weight among Whites was stronger in certain groups. “Compared with Irish, Jewish, Polish and Italian Whites who did not experience perceived chronic discrimination, Irish, Jewish, Polish and Italian Whites who perceived chronic discrimination were 2 to 6 times more likely to have a high-risk waist circumference,” the investigators report.

White ethnic groups “have historically been discriminated against,” the researchers point out. They may experience higher levels of perceived discrimination than do other Whites, and this experience “may adversely affect their health.”

In contrast, there was no clear evidence that weight was related to perceived bias among black and Hispanic adults.

Hunte’s team speculates that this may be because of expectations; African- and Hispanic Americans are more likely to be accustomed to bias and may have an easier time putting discrimination aside. Bias may be less expected, and therefore more difficult to deal with, among whites.

SOURCE: American Journal of Public Health, December 2008.

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PARIS (AFP) –
EU authorities suspended sales of pharmaceutical giant Sanofi-Aventis‘ anti-obesity drug Acomplia across the continent Thursday, the firm announced, adding that it had not ruled out a worldwide halt.

“Sales have been halted in all the pharmacies in the 18 countries of the European Union where it is distributed,” a company spokesman told AFP.

Sanofi-Aventis said the European Medicines Agency (EMEA) had warned that patients taking the drug ran almost double the normal risk of psychiatric problems.

“The risks of taking Acomplia are now greater than the benefits that the drug can bring the patient according to its current guidelines,” the company said, citing the EMEA.

Europe has allowed sales of Acomplia since 2006, but it has not been authorised in the United States where authorities believe it encourages suicidal thoughts, even in patients with no history of depression.

The company said it had not ruled out withdrawing the drug in the 14 non-EU countries where it is sold. It said users of the drug should consult a doctor or pharmacist.

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WEDNESDAY, Oct. 22 (HealthDay News) — People who eat quickly and until
they’re full are three times more likely to be overweight than others, a
Japanese study says.

For the research, 1,122 men and 2,165 women, ages 30 to 69, filled out
a diet history questionnaire about their eating habits, which revealed
that 50.9 percent of men and 58.4 percent of women said they ate until
they were full, while 45.6 percent of men and 36 percent of women said
they ate quickly.

Those who said they ate quickly and until they were full had a higher
body mass index (BMI) and total energy intake, and were three times more
likely to be overweight than those who didn’t eat until they were full and
didn’t eat quickly.

The study, published online Oct. 22 in the British Medical
Journal, shows that eating quickly and until full has “a
supra-additive effect on overweight,” concluded Professor Hiroyasu Iso, of
Osaka University, and colleagues.

Until recently, most adults didn’t have the opportunity to consume
enough energy to enable the body to store fat, according to background
information in the study. But eating behaviors have changed due to
increased availability of inexpensive food in larger portions, fast food,
fewer families eating together, and eating while distracted (such as
watching TV).

The study findings illustrate how current eating patterns in many
nations may play a role in the epidemic of obesity, Elizabeth
Denney-Wilson, of the University of New South Wales, and Karen Campbell,
of Deakin University, both in Australia, wrote in an accompanying
editorial.

They said doctors need to work with parents to encourage healthy eating
habits in children, such as eating slowly, serving appropriate portion
sizes, and eating as a family in a non-distracting environment.

More information

The U.S. Centers for Disease Control and Prevention has more about factors that contribute to overweight and obesity.

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LONDON (Reuters) –
People taking NeuroSearch A/S’s obesity pill tesofensine lost twice as much weight as men and women using approved weight loss drugs, Danish researchers said on Thursday.

The study suggest the experimental drug is safe because it had no effect on blood pressure and only raised heart rate slightly, said Arne Astrup of the University of Copenhagen, who led the study published in the journal Lancet.

“It is quite solid from this study that it seems to produce a weight loss that is twice … what we see from existing compounds on the market,” Astrup said in a telephone interview.

The company hopes to take tesofensine to Phase III clinical trials early next year — the last stage of human testing before a company can seek regulatory approval for a drug.

Obesity, which raises the risk of diseases like type 2 diabetes and heart problems, is increasingly a problem as more people adopt a Western lifestyle.

The World Health Organization classifies around 400 million people around the world as obese, representing an increasingly lucrative market for drug makers.

Astrup and his team compared tesofensine against the Sanofi-Aventis SA obesity-fighting drug Acomplia and Abbott Laboratories’ Reductil, known as Meridia in the United States.

The 203 obese volunteers at five Danish obesity centers were given different doses of tesofensine or placebo. The drug worked twice as well as previously published data on Acomplia and Reductil, known generically as sibutramine, the study showed.

SIDE EFFECTS

After the study ended, the men and women on tesofensine had lost 10 kilograms more than people on placebo, compared with studies which have shown weight loss of 3 kilograms for Reductil and about 5 kilograms for Acomplia over a similar six month period, Astrup said.

Side effects included dry mouth, constipation and insomnia, but importantly the volunteers did not exhibit the suicidal thoughts that have plagued Acomplia, known generically as rimonabant, Astrup said.

Acomplia took a hit last year when a U.S. expert panel recommended against its approval in the world’s biggest market after it was linked to rare cases of suicide ideation — a psychological problem not shown to raise the risk of suicide but one that worries doctors.

“So far there have been no warnings about problematic side effects,” Astrup said. “It seems clean so far.”

Other researchers not involved in the study cautioned that the results are from a single trial in a relatively small number of patients.

“We should therefore be a little circumspect about accepting these claims as to efficacy and await the results of the more relevant Phase III studies, which the author does say at the end of the paper,” Ian Broom, a researcher at Robert Gordon University in Britain said in a statement.

Tesofensine works by interfering with three brain chemicals — noradrenline, serotonin and dopamine — involved in regulating hunger. People who take the pill are less hungry and feel full more quickly.

The next step are Phase III trials in which doctors will also try to regulate diet, something that Astrup said could lead to the kind of weight loss associated with gastric-bypass surgery.

“Most clinicians are always saying we need more effective drugs that can make surgery not necessary,” Astrup said. “This is the first opening we have seen.”

(Reporting by Michael Kahn; Editing by Maggie Fox and David Holmes)

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LONDON (Reuters) –
People who eat quickly until full are three times more likely to be overweight, a problem exacerbated by the availability of fast food and the decline of orderly dining habits, Japanese researchers said on Wednesday.

The findings, published in the British Medical Journal, highlight how eating styles, and not just what or how much is eaten, can contribute to an obesity epidemic fueled by the spread of Western-style affluence in many parts of the world.

The World Health Organization classifies around 400 million people as obese, 20 million of them under the age of five. The condition raises the risk of diseases like type 2 diabetes and heart problems.

For their study, Hiroyasu Iso and colleagues at Osaka University asked more 3,000 Japanese volunteers aged 30 to 69 about their eating. About half of the men and a little more than half of the women said they ate until full. About 45 percent of the men and 36 percent of the women said they ate quickly.

Those who said they ate until full and ate quickly were three times more likely to be fat than people in the “not eating until full and not eating quickly” group, the researchers found.

They cited as causes both the availability of cheap food in big portions and habits like watching television while eating.

To counteract the “supra-additive effect” of speedy or glut eating among children prone to obesity, parents should encourage them to eat slowly and in calm surroundings, the study found.

(Reporting by Michael Kahn; Editing by Dan Williams)

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NEW YORK (Reuters Health) –
The risk faced by obese people of having a heart attack or other cardiovascular “events” is reduced substantially after they undergo gastric bypass surgery to lose weight, according to a recent study.

The take-home message is that “bariatric surgery can be considered as a means to reduce cardiovascular risk (in obese patients) after conservative treatment options have failed,” Dr. John A. Batsis told Reuters Health.

Batsis, at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire and his colleagues identified six studies that looked at cardiovascular risk after bariatric surgery for obesity. The risk was estimated from standard tables that assigned a score for factors such as weight, blood pressure and cholesterol levels.

Depending on how the patients’ risk was assessed, the researchers found that gastric bypass reduced the risk for a future cardiovascular event anywhere from 8 percent to 79 percent, compared to not having the procedure, the team reports in the American Journal of Cardiology.

Looked at another way, the predicted chance of having a heart attack or needing heart surgery or dying of heart disease over 10 years fell from 7.0 percent to 3.5 percent after undergoing bariatric surgery. For people who did not have surgery, the probability fell from 7.1 percent to 6.5 percent.

These figures were estimates. As Batsis noted, “Further studies are required to better understand the long-term impact of bariatric surgery on predicted cardiovascular risk in obese patients by determining the actual number of cardiac events.”

SOURCE: American Journal of Cardiology, October 1, 2008.

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NEW YORK (Reuters Health) –
Older African-American, Native American and non-white Hispanic women are more likely to develop arthritis than their white counterparts, and the larger prevalence of obesity among these ethnic groups may help explain why, new research shows.

Among 146,494 women participating in the Women’s Health Initiative — an ongoing study of an ethnically diverse group of healthy postmenopausal women — 44 percent had been diagnosed with osteoarthritis (degeneration of the joints), the most common form of arthritis.

These women were older and less active than their arthritis-free peers, and were also less educated, poorer, and heavier, Nicole C. Wright and colleagues from the University of Arizona in Tucson Wright report in the Journal of the American Geriatrics Society.

As expected, women in their 70s were at greater risk of osteoarthritis than women in their 50s, while the risk for women in their 60s fell in between.

Overall, the researchers found, osteoarthritis risk was slightly increased for Native American and African American women compared to non-Hispanic white women, while Asian women were at lower risk than whites.

Risk factors for osteoarthritis were more common among black, Native American and Hispanic women than whites; 57.9 percent of African Americans were obese, for example, compared to 51 percent of American Indian women, 41.9 percent of Hispanic women, and 32.9 percent of non-Hispanic whites.

Prevalence of physical inactivity followed the same pattern, with 30.1 percent of black women falling into the lowest activity group, compared to 19.5 percent of whites.

Osteoarthritis prevalence among the youngest women participating in the study also varied by ethnicity, with 39.3 percent of Hispanic women in their 50s reporting arthritis, 36.4 percent of Native Americans, 33.8 percent of black women, 25.8 percent of Asians and 22.6 percent of whites.

The researchers hypothesize that excess weight could contribute to arthritis in two ways: by increasing physical stress on joints, and also by increasing bone mineral density, which may increase bone stiffness and thus contribute to the breakdown of cartilage.

The findings, along with other studies showing that black and Hispanic women suffer more pain and disability from osteoarthritis than do whites, offer “strong evidence that body weight and BMI may be large contributing factor to the number and severity of osteoarthritis symptoms, further elaborating the importance of postmenopausal women, especially African-American, Hispanic, and American-Indian women, maintaining a healthy weight,” Wright and her team wrote.

SOURCE: Journal of the American Geriatrics Society, 2008.

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