Health and Fitness Blog

CHENNAI, India (Reuters) –
The prevalence of diabetes worldwide will far outstrip even the sharp increase currently projected unless rising trends of obesity are controlled, health experts said on Saturday.

Adult-onset diabetes has been linked to risk factors like aging, an inactive lifestyle, unhealthy diets, smoking, alcohol and obesity. The silent, chronic disease damages the heart, blood vessels, eyes, kidneys and nerves and was responsible for 3.8 million deaths worldwide in 2007.

The International Diabetes Foundation estimates a current prevalence of 246 million diabetes cases worldwide and projects it will hit 380 million by 2025, but experts say these figures may well be an underestimate.

“The projections are conservative because they take into account only aging and urbanization but not obesity, which if unarrested, will lead to more cases,” Gojka Roglic of the World Health Organization’s diabetes program told a regional diabetes conference in Chennai, southern India.

Roglic said not a single country in the world had shown any signs of a plateau for obesity.

“It’s the responsibility of governments to enable populations to create the conditions where (healthy) lifestyle is an easy choice rather than something that’s very difficult to achieve,” Roglic told Reuters.

“If you don’t have a park to walk in, if the traffic is too dangerous, then people won’t be encouraged to walk or ride bicycles. Or if there is crime and someone will kill you for your bike, then you won’t be encouraged to cycle.”

DOUBLE JEOPARDY

Anthony Harries, senior adviser with the London-based International Union Against Tuberculosis (TB) and Lung Diseases, warned of the increased risks of developing active tuberculosis that come with diabetes.

“It was recognized even in ancient Roman times that people with urine that was sweet had increased risk of tuberculosis,” he told the conference, adding that a diabetic was three times more likely to develop active TB than a non-diabetic.

One in every three people in the world is infected with TB bacilli. But not everyone who is infected with TB gets sick. Chances of developing active TB rise when one’s immune system is weak, for example when compromised by a chronic illness.

India carries the highest diabetes burden in the world, with 41 million cases in 2007, projected to hit 70 million by 2025.

The problem is worsening in rural India, which now has a prevalence of 9.2 percent among people aged 20 years and older, up from 2.2 percent in 1983. The rate in urban areas is 18.6 percent, compared with 11.2 percent in 1998.

Apart from a more sedentary lifestyle, experts say the propensity for diabetes among Indians may also be due to a switch, linked to rising affluence, to eating polished rice which has much more sugar than crude, unpolished rice.

Genetics may also play a part.

“Years ago, people had famines and then they had plenty. During times of plenty, food will be stored, so when there is little food in the next three months, they burn off all that,” said Viswanathan Mohan, a diabetes specialist who runs a program to reduce diabetes and its harms in the countryside.

“Now the famines are gone, it is feasting all the time but the genes have not changed because this has just happened over 30 years. So when you overeat and reduce physical activity and when you have ‘thrifty genes’ (geared toward storing energy), you are heading toward diabetes,” Mohan said.

(Editing by Mark Trevelyan)

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WEDNESDAY, Nov. 26 (HealthDay News) — As you push your chair
back from the Thanksgiving table this year, a molecule produced in the
small intestine will be swarming through your bloodstream, ready to
register on your brain the impact of the fat you’ve just consumed.

For now, the signal might keep you feeling full for a while. But,
researchers are hoping that one day variations of this family of
hormones — known as N-acylphosphatidylethanolamines, or NAPEs — can be
used to control appetite and therefore obesity.

“We’re excited but we have to be cautious,” said Dr. Gerald Shulman,
senior author of a study in rats that’s published in the Nov. 26 issue of
the journal Cell. “We would love to be able to take this to man
tomorrow because we need effective ways to treat obesity and, right now,
we have very few agents that work effectively. But we have much work to
do.”

Shulman is an investigator at the Howard Hughes Medical Institute and a
professor of internal medicine and of cellular and molecular physiology at
Yale University School of Medicine.

Shulman’s research team had been looking for a new, fat-derived signal
that might regulate food intake. A sensitive blood-screening test —
called LC tandem mass spectrometry — turned up the NAPE group of
molecules.

Levels of NAPEs increased consistently in rats and mice that had just
eaten a fatty meal. And when synthesized and re-injected into the lab
rodents, NAPEs shut down the rodent’s food intake, with one dose lasting
12 hours or longer. NAPEs also entered the brain, appearing to concentrate
in the hypothalamus, an area with a high concentration of neurons involved
in the regulation of food intake, the researchers said.

Rats receiving NAPEs chronically (through a catheter in the jugular)
ate less and lost weight.

“That’s what we have, a gut-derived fat that works centrally to inhibit
food intake,” Shulman said.

Shulman and his colleagues believe that aberrations in how NAPEs are
secreted in people who eat lots of high-fat foods may contribute to
obesity. “Some of our animal data suggests that NAPE secretion is
dysregulated in our animal models of diet-induced obesity,” Shulman said.

“We’re moving up the species ladder to see if chronic NAPEs reduces
food intake and is well-tolerated in non-human primates,” Shulman said.
“If everything there looks good, that would give us a lot of motivation to
actually do trials in humans.”

David Earnest, professor of neuroscience and experimental therapeutics
at Texas A&M Health Science Center College of Medicine, said, “The
NAPEs work to suppress appetite or decrease food intake, [but] feeding is
a complex behavior. There are a lot of factors that figure into eating
disorders. The findings are very interesting and exciting, basically
because we have identified these NAPEs which are synthesized by the gut
and presumably can be used in supplementary fashion to treat obesity in
humans.”

“Unfortunately, things don’t always work out according to plan,” he
added. “Not to say that NAPEs don’t offer hope. These are some
encouraging observations.”

More information

The U.S. Centers for Disease Control and Prevention has more
on obesity and overweight.

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WASHINGTON (Reuters) –
Scientists have identified a fatty substance made in the gut that signals the brain when it’s time to stop eating — a discovery that could inspire new approaches to fighting obesity.

Writing in the journal Cell on Wednesday, U.S. researchers said experiments with mice and rats showed that a naturally occurring fat-derived chemical messenger called NAPE regulated how much the animals ate. It is present in people and may do the same thing, they said.

Gerald Shulman of Yale University and the Howard Hughes Medical Institute and colleagues said that when the rodents were fed a fatty meal, their small intestine made a lot of NAPE and put it into the bloodstream. It then traveled to the brain and shut down hunger signals, they said.

NAPE levels shot up after the rodents ate a fatty meal, but not when they ate only protein or carbohydrates, they said.

The researchers then synthesized NAPE and injected it into the abdomen of the animals, whose appetites diminished greatly. When NAPE was delivered in much smaller amounts directly to the brain, it had the same effect on appetite as a larger dose injected into the bloodstream.

NAPE concentrated in the hypothalamus, an important brain structure known to regulate hunger, and inhibited neurons that stimulate appetite, they said.

When the rodents were given extra NAPE for five days, they animals ate less and lost weight, the researchers said.

With obesity on the rise in many parts of the world as people eat fattier diets and get less exercise, scientists are eager to find new ways to combat the problem. These findings could help guide efforts to create better drugs to suppress appetite and reduce obesity, the researchers said.

“Clearly what we have in mind is trying to find new approaches that regulate food intake. And this may be a new pathway that one could target to treat obesity,” Shulman said in a telephone interview.

“We’re now doing the fat-feeding studies in humans to see if we get a similar increase in plasma (blood) NAPE concentrations following a fatty meal,” Shulman added.

Scientists are working toward a greater understanding of how the body tells the brain to control food intake. Hormones such as leptin that help regulate this system have proven disappointing when examined as human weight-loss treatments.

(Editing by David Wiessler)

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NEW YORK (Reuters Health) –
Study findings suggest less than one quarter of asthmatic adults meet national exercise guidelines and, among this group, obesity may be a greater exercise deterrent actual asthma symptoms.

People with asthma may get caught in a vicious cycle, note Dr. Carol A. Mancuso and colleagues from Weill Cornell Medical College and the Hospital for Special Surgery in New York City.

“Obesity leads to worse asthma, which can be associated with less exercise, which predisposes to obesity and long-term (worsening) asthma,” Mancuso told Reuters Health.

Since the high prevalence of obesity among people with asthma makes the relationship between body mass and exercise particularly important, Mancuso’s team assessed exercise habits of 258 patients (75 percent women) who were 42 years old. The patients had mild-to-moderate asthma for 21 years on average and, in 37 percent, asthma was well controlled.

Overall, 40 percent of the patients were obese, 29 percent were overweight, and 31 percent were of normal weight, the researchers report.

Their findings, published in Annals of Allergy, Asthma and Immunology, show that of the obese group only 25 percent reported any exercise and just 14 percent met national guidelines of 20 to 30 minutes of exercise on 3 to 5 days each week.

By contrast, 46 and 20 percent of overweight asthmatics reported any exercise and meeting guidelines, respectively, while the corresponding percentages for the normal-weight asthmatics were 67 and 33 percent.

After factoring for age, gender, education, and asthma status, Mancuso’s group found obesity most consistently and strongly associated with exercise habits. They report no association between short-term control or long-term severity of asthma symptoms and the exercise habits of the study participants.

Partaking in short bouts of different types of exercise may help people with asthma reach current exercise guidelines, the investigators suggest.

Mancuso further recommends physicians and patients “work together to manage obesity, select prudent exercise regimens, and use medications correctly to prevent symptoms induced by exercise.”

SOURCE: Annals of Allergy, Asthma and Immunology, November 2008.

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NEW YORK (Reuters Health) –
Overweight and obese women are at increased risk of breast cancer and of being diagnosed with advanced disease, according to results of a large study published Wednesday in the Journal of the National Cancer Institute.

And it’s not because overweight and obese women get fewer mammograms than normal-weight women. “Even after taking into account how often women were screened for breast cancer, overweight women had a 10 percent increased risk of advanced disease and obese women a 56 percent to 82 percent increased risk of advanced disease compared to normal-weight women,” Dr. Karla Kerlikowske told Reuters Health.

It’s also not because mammograms are less accurate in heavy women. “We were able to show that breast tumors are easy to detect in overweight and obese women, so the increase in advanced disease among overweight and obese women is not because more tumors are missed on mammography in these women,” Kerlikowske said.

“The message to women is to get routine mammography and to maintain ideal body weight — two factors that decrease the chance of being diagnosed with advanced-stage breast cancer,” added Kerlikoswke, a physician at San Francisco VA Medical Center and a professor of medicine, epidemiology, and biostatistics at the University of California, San Francisco.

From 1996 to 2005, Kerlikoswke and colleagues collected mammography data on 287,115 postmenopausal women not using hormone therapy who underwent a total of 614,562 mammograms. A total of 4,446 of these women were diagnosed with breast cancer within 12 months of a mammography exam.

The researchers found that the overall breast cancer rates rose in tandem with weight, as did rates of advanced tumors.

As mentioned, differences in mammography use and accuracy did not explain the higher rates of breast cancer among overweight and obese postmenopausal women not taking hormone therapy.

“The reason may be that being overweight increases circulating estrogen, which in turn promotes tumor growth,” Kerlikowske suggested.

Fortunately, she added, “this is a modifiable risk factor. There are very few breast cancer risk factors that can be modified. Not taking postmenopausal hormones is one. Maintaining a healthy weight is another.”

SOURCE: Journal of the National Cancer Institute, November 26, 2008.

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NEW YORK (Reuters Health) –
Higher-protein meals may help overweight and obese people burn more fat, the results of a small study suggest.

Research has shown that overweight people are less efficient at burning fat after a meal than thinner people are. In the new study, Australian researchers looked at whether the protein composition of a meal affects that weight-related gap.

They found that overweight men and women burned more post-meal fat when they ate a high-protein breakfast and lunch than when they had lower-protein meals. That is, the added protein seemed to modify the fat-burning deficit seen in heavy individuals.

“Our research suggests that people with higher body fat burn fat better after a high-protein meal than people with lower levels of body fat,” lead researcher Dr. Marijka Batterham, of the University of Wollongong in New South Wales told Reuters Health.

A number of studies have suggested that high-protein diets may help people shed weight more easily — possibly, in part, because protein suppresses appetite better than fat or carbohydrates do.

The current study did not look at weight loss, so it’s not possible to tell whether the increased fat-burning seen in overweight participants would translate into fewer pounds over time, Batterham said.

But answering that question, she said, will be the next step.

The findings, published in the journal Nutrition & Dietetics, are based on 18 adults whose post-meal metabolism was tested on 3 separate days. The average age was 40 years, eight subjects were overweight, six subjects had a normal weight, and four were obese.

On day one, they were given a “control” breakfast and lunch composed of 58 percent carbohydrates and 14 percent protein. On the other 2 days, their meals were more balanced, with about one third of calories coming from protein and another third from carbohydrates.

In the 8 hours after the control meal, the investigators found that overweight and obese participants burned less fat than their thinner counterparts did. But that gap was closed when participants ate the higher-protein meals.

The protein-rich meals contained low-fat dairy, lean meat and eggs, along with bread and vegetables as carbohydrate sources. Batterham said she and her colleagues are now testing whether vegetarian sources of protein have similar effects on overweight adults’ fat metabolism.

In general, experts recommend that people looking to bulk up the protein in their diets choose their sources carefully — eschewing bacon and butter in favor of foods like fish, poultry, low-fat dairy, beans and nuts.

SOURCE: Nutrition & Dietetics, December 2008.

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OTTAWA (Reuters) –
Obese people have the right to two seats for the price of one on flights within Canada, the Supreme Court of Canada ruled on Thursday.

The high court declined to hear an appeal by Canadian airlines of a decision by the Canadian Transportation Agency that people who are “functionally disabled by obesity” deserve to have two seats for one fare.

The airlines had lost an appeal at the Federal Court of Appeal in May and had sought to launch a fresh appeal at the Supreme Court. The court’s decision not to hear a new appeal means the one-person-one-fare policy stands.

The appeal had been launched by Air Canada, Air Canada Jazz and WestJet.

(Reporting by Randall Palmer)

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ATLANTA – A little less “I’m Lovin’ It” could put a significant dent in the problem of childhood obesity, suggests a new study that attempts to measure the effect of TV fast-food ads.

A ban on such commercials would reduce the number of obese young children by 18 percent, and the number of obese older kids by 14 percent, researchers found.

They also suggested that ending an advertising expense tax deduction for fast-food restaurants could mean a slight reduction in childhood obesity.

Some experts say it’s the first national study to show fast-food TV commercials have such a large effect on childhood obesity. A 2006 Institute of Medicine report suggested a link, but concluded proof was lacking.

“Our study provides evidence of that link,” said study co-author Michael Grossman, an economics professor at City University of New York.

The study has important implications for the effectiveness of regulating TV advertising, said Lisa Powell, a researcher at the University of Illinois at Chicago’s Institute for Health Research and Policy. She was not involved in the research but was familiar with it.

The percentage of U.S. children who are overweight or obese rose steadily from the 1980s until recently, when it leveled off. About a third of American kids are overweight or obese, according to Centers for Disease Control and Prevention estimates.

The causes of childhood obesity are complicated, but for years researchers have been pondering the effects of TV advertising. Powell, for example, found fast-food commercials account for as much as 23 percent of the food-related ads kids see on TV. Others have estimated children see fast-food commercials tens of thousands of times a year.

The new study is based in part on several years of government survey data from the late 1990s that involved in-person interviews with thousands of U.S. families. The researchers also looked at information about local stations in the 75 largest TV markets, including locally seen fast-food commercials and the size of viewing audiences.

The researchers used a statistical test that presumes TV ads lead to obesity but made calculations to address other influences such as income and the number of nearby fast-food restaurants. They also took steps to account for the possibility that some children may already have been overweight and inactive regardless of their TV-watching habits.

The study is being published this month in the Journal of Law & Economics. The authors, funded by a federal grant, included Grossman and researchers from Lehigh University and Georgia State University.

The authors stopped short of advocating an advertising ban or eliminating the advertising tax deduction.

Grossman said it’s possible that some families benefit from advertising by finding out what restaurants are nearby and what they’re serving. “A lot of people consume fast food in moderate amounts and it doesn’t harm their health,” he said.

McDonald’s Corp., the giant fast-food chain responsible for the widely seen “I’m Lovin’ It” ad campaign, referred questions about the study to the National Council of Chain Restaurants. Officials with that organization could not be reached Wednesday evening.

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On the Net:

The Journal of Law & Economics: http://www.journals.uchicago.edu/toc/jle/current

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WASHINGTON (Reuters) –
Banning fast-food advertising on television in the United States could reduce the number of overweight children by as much as 18 percent, researchers said on Wednesday.

But the team at the National Bureau of Economic Research questioned whether it would be practical to impose that kind of government regulation — something only Sweden, Norway and Finland have done.

“We have known for some time that childhood obesity has gripped our culture, but little empirical research has been done that identifies television advertising as a possible cause,” said economist Shin-Yi Chou of Lehigh University in Pennsylvania.

“Hopefully, this line of research can lead to a serious discussion about the type of policies that can curb America’s obesity epidemic.”

For their study, funded in part by the federal government, Chou and colleagues used data on nearly 13,000 children from the 1979 Child-Young Adult National Longitudinal Survey of Youth and the 1997 National Longitudinal Survey of Youth, both issued by the U.S. Department of Labor.

“The advertising measure used is the number of hours of spot television fast-food restaurant advertising messages seen per week,” they wrote in the Journal of Law and Economics.

“Our results indicate that a ban on these advertisements would reduce the number of overweight children ages 3-11 in a fixed population by 18 percent and would reduce the number of overweight adolescents ages 12-18 by 14 percent.”

The U.S. Centers for Disease Control and Prevention estimates that 13.9 percent of children aged 2 to 5 are overweight, 18.8 percent of those aged 6 to 11 are and more than 17 percent of those 12 to 19.

The percentages have been steadily rising.

Television watching is also known to raise obesity rates, both because children exercise less and because it can interfere with sleep.

The Institute of Medicine reported in 2006 that there was compelling evidence linking food advertising on television and increased childhood obesity.

One study suggested that children viewed an average of about 20,000 commercials aired on television per year in the late 1970s, rising to 30,000 per year in the late 1980s and more than 40,000 per year in the late 1990s.

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

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NEW YORK (Reuters) –
Medicare, the U.S. government’s largest payer of health care, said on Monday it does not plan to cover weight-loss surgery in diabetic patients who are not dangerously overweight, saying there is not enough evidence to show it can improve their health.

Medicare and some private insurers already pay for the surgery, which ranges from $15,000 to $35,000 for more complicated gastric bypass, for severely obese people.

But the agency said it will evaluate whether to expand the coverage after a small study earlier this year found the surgery can completely reverse type 2 diabetes, a metabolic condition spurred by weight gain and suffered by millions of Americans.

Expanding payments for such surgeries to people who are not overweight but have diabetes could boost device makers such as Johnson & Johnson and Allergan Inc that make bands surgically placed around the stomach to help patients feel fuller. Other surgical procedures reduce the size of the stomach itself.

The agency, which provides health insurance for the nation’s roughly 44 million elderly and disabled, said its own review of available data found no overwhelming benefit.

“While recent medical reports claimed that bariatric surgery may be helpful for these patients, CMS (the Centers for Medicare and Medicaid Services) did not find convincing medical evidence that bariatric surgery improved health outcomes for non-morbidly obese individuals,” it said in a proposal.

To be considered for Medicare coverage, patients must have a body mass index — a measure of weight in relation to height — of 35 or higher and have other complications, such as heart problems or arthritis, the agency said.

The agency said it will review public comments on the draft ruling before making a final decision, which is likely to weighed by many private insurers in setting their own policies.

(Reporting by Susan Heavey; editing by Richard Chang/Jeffrey Benkoe)

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