Doctors need to be honest with their patients and say ‘Your kid’s overweight’

According to a study published online in Archives of Pediatrics & Adolescent Medicine, doctor should tell parents when their children are overweight as this would improve their motivation to follow healthy eating and activity.

Perrin and co-authors Asheley Cockrell Skinner, and Michael J. Steiner, performed a secondary statistical analysis of data collected from 4,985 children ages 2 to 15 years old who had a body mass index (BMI) at or above the 85th percentile based on measured height and weight. The data were collected as part of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2008.

During that time, only 22 percent of parents reported that a doctor or other health professional told them their child was overweight. This percentage increased from 19.4 percent in 1999 to 23.4 percent in 2004, and then to 29.1 percent in 2007-2008. Even among parents of very obese children, only 58 percent recall a doctor telling them.

However, as shown in the journal Pediatrics parents are reluctant to be told that their children have an unhealthy weight.

Source: http://www.sciencedaily.com/releases/2011/12/111205165122.htm

Focus on an "obesogenic" environment rather than kids behavior to battle obesity

According to researchers reviewing numerous anti-childhood obesity programs, the focus to prevent it should be on strategies that seek to change children’s environments rather than their behavior.

The researchers said that environmental approaches improving physical activity and dietary habits are the key to prevention measures.

To find which forms of intervention could have a maximum effect to help prevent obesity in children, an international team of researchers updated a previous Cochrane Review by searching for new evidence from existing studies to see which forms of intervention work best.

Researchers targeted children ages 6-12 with school-based programs that encourage healthy eating, physical activity, and positive attitudes to body image.

The researchers highlighted the key strategies that could be considered for prevention measures including healthy eating, physical activity and body image in school curricula.

The key findings are:

• Increasing physical activity and the development of fundamental movement skills during the school week.
• Improving the nutritional quality of food supplied in schools.
• Creating environments and cultural practices within schools that support children eating healthier foods and being active throughout each day.
• Professional development and capacity building activities which help to support teachers and other staff as they implement health promotion strategies and activities.
• Giving more attention to parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen-based activities.

Source: http://www.medicaldaily.com/news/20111207/8141/how-to-prevent-childhood-obesity-prevention-measures-for-child-obesitywatch-your-child%C3%A2%E2%82%AC%E2%84%A2s-dietch.htm

Are diet and exercise enough to lose weight and keep it low?

A new study, published in The New England Journal of Medicine, shows that regaining weight after a period of diet and exercise may be inevitable due to hormones.

Australian researchers found that after losing weight, hormone levels - particularly those that influence hunger - shifted in the body, leading to increase appetites and weight regain.

The study involved 50 adults with a body mass index (BMI) between 27 and 40, who were on a diet and exercise for 10 weeks. After an initial loss scientists found that the levels of appetite-regulating hormones changed, resulting in a regain of 1/3 of the lost weight over the course of a year.

The results of the Australian study corroborate findings in another paper released earlier this year, in which researchers from Spain confirmed that people with high levels of the hormone leptin and low levels of ghrelin are more likely to gain the weight they lost.

Instead of playing the diet and exercise message on repeat - an ineffective longterm weight loss strategy for some - the Spanish authors suggested that endocrinologists and nutritionists consider the possibility of hormonal imbalances when developing weight loss strategies.

Source: http://www.nydailynews.com/life-style/health/diet-exercise-fight-obesity-study-article-1.971052#ixzz1cjDgPJ3S

New drug to prevent pregnant obese women to give birth to obese babies

A UK trial will soon be under way whereby a commonly used diabetes pill will be administered to obese pregnant women in an attempt to prevent overweight mothers from delivering obese babies.

Obese women who become pregnant are generally at risk of complications such as pre-eclampsia (potentially fatal), fetal death, possible birth defects and a greater number of caesarean deliveries. Children born to obese mothers are twice as likely to be obese and to develop type 2 diabetes later in life. Obesity during pregnancy is also associated with greater use of health care services and a longer hospital stay.

Given the disturbing trend of increasing obesity among women in many developed countries, the answer is, apparently, to counter this by medicating babies while still in the womb. The trial will involve 100 obese but non-diabetic volunteers at hospitals in Liverpool and Coventry, England and Edinburgh, Scotland. Half will take the drug Metformin after the first trimester of their pregnancies and the other half will take a placebo.

Many weight loss groups and others feel that this news is most disturbing and gives the message that there is a solution to conditions such as obesity, which involve simply taking a pill as a "cure". The emphasis, they feel, should be on encouraging mothers-to-be to lose excess weight before even considering bringing a child into the world.

Studies have consistently shown that lifestyle modification that includes a healthy diet, regular exercise and weight management can prevent the many and various conditions associated with obesity, such as diabetes, gestational diabetes mellitus, and so on.

The ethics of medicating babies while in the womb, or the possible long-term effects of administering drugs of this nature, are also reasons for concern.

Source: http://www.telegraph.co.uk/health/h...

Caution bariatric surgery for adolescents

Weight-loss surgery for morbidly obese adolescents has become more popular even though many questions about safety and effectiveness remain, according to a commentary published in the New England Journal of Medicine.

Bariatric, surgery produces many benefits for most adult patients: they lose weight and can even have a complete reversal of diabetes. But less is known about the effects of the surgery on a young person who is just finished growing.

Several large and important studies are now underway to examine the risks and benefits of bariatric surgery on teens. Already, at least 1,000 teens a year are undergoing bariatric surgery in the USA despite the lack of long-term data on how the surgery affects them long-term. Until the data comes in from ongoing studies, doctors should tread cautiously in qualifying teens for surgery.

Source: http://www.latimes.com/health/boostershots/la-heb-bariatric-surgery-teens-20111012,0,4705997.story

Is there a link between air pollution and obesity?

Medical research has long supported the fact that exposure to ultrafine particulate matter increases the risk of various respiratory, cardiovascular, and pulmonary illnesses. Incidences of asthma, heart attacks, and chronic bronchitis are all higher in areas where the concentration of ultrafine particulate matter is higher. The correlation between particulate matter and these health issues is particularly pronounced in children, as well as low-income communities, which are often located closer to the sources of particulate matter (highways, factories, power plants) than their higher income neighbors.

Over the past decade, new studies have emerged that link air pollution to two of this country’s most pressing (and expensive) health epidemics: obesity and type II diabetes. Both are not only on the rise in terms of diagnoses, but also in terms of the costs associated with treatment. Even after controlling for factors such as genetics, income levels, weight, diet and exercise, Harvard researchers found a “consistent and significant” relationship between Type II diabetes prevalence and exposure to ultrafine particulate matter in a recent study published in Diabetes Care.

Results of an animal study published by Ohio State University researcher Qinghua Sun in late 2010 revealed that early exposure to ultrafine particulates led to the accumulation of abdominal fat and insulin resistance in mice even if they ate a normal diet. Exposure levels for animals in the study were similar to those found in U.S. cities.  The study compared mice fed a high-fat diet with those fed a normal, healthy diet, and exposed some members of both groups daily to ultrafine particulate matter, controlling for all other factors. In the end, all of the mice exposed to air pollution, including those fed a normal diet, had increased abdominal and subcutaneous (under the skin) fat.

These findings suggest that fine particulate pollution exposure alone, in the presence of a normal diet, may lead to an increase in fat cell size and number, and also have a proinflammatory effect.

Source: http://www.forbes.com/sites/amywestervelt/2011/10/10/two-new-reasons-to-worry-about-air-pollution-obesity-and-diabetes/

Fat cell formation may be inhibited by blueberry polyphenols

The latest research has shown that blueberry polyphenols may inhibit fat cell formation and increase lipolysis at the molecular level, suggesting the potential of polyphenols in reducing obesity risk through the reduction of adipose tissue production in the body. Plant polyphenols have shown to inhibit adipogenesis and to increase lipolysis. This action of polyphenols shows the positive effect plant based food constituents have on reducing body fat and inhibiting obesity.

The study utilized pre-adipocyte tissue to identify the effects of blueberry polyphenols on differentiation of unspecialized cells into adipocytes, or fat cells. Compared to the control tissue that received no polyphenols, the tissue exposed polyphenols showed significant reduction in lipid content (27% - 73%).

The polyphenols in blueberries and antioxidants in other fruits are showing important promise in the treatment of obesity. Research has shown an association with obesity and a decrease in the activity of antioxidants in the body. Another preliminary study shows early indications that oxidative stress can potentially lead to an increased development of fatty tissue.

Source: http://www.lef.org/newsletter/2011/0412_Blueberries-Inhibit-Fat-Cell-Formation.htm?source=eNewsLetter2011Wk15-1&key=Article&l=0

Sleep deprivation may cause weight gain

A new European study published in the American Journal of Clinical Nutrition augments existing evidence that sleep deprivation can lead to weight gain, not only by increasing appetite, but also by slowing metabolism.

The research conducted in Uppsala University in Sweden found that as little as a single night's sleep deprivation can significantly lower energy expenditure in healthy men. This indicates that sleep plays a prominent role in determining daytime energy production. Previous research has revealed an association between sleep loss and weight gain and also has found that sleep disorders affect blood levels of stress and hunger hormones. In a quest to determine the exact means by which a lack of sleep affects weight, the team of investigators induced differing degrees of sleep conditions in 14 male college students. They divided the men into three groups, consisting of no sleep, normal sleep and limited sleep. The men were then assessed in regard to alterations in factors such as metabolic rate and amount of food consumed.

The energy outlay for activities such as breathing and digestion was lessened by 5 to 20 percent. Higher levels of appetite-regulating hormones and stress hormones were also noted. Even though the appetite hormones were affected, the men did not eat more during the day.

Although research data is inadequate to prove the link between sleep loss and weight gain, evidence is quite sufficient to suggest it. Data collected over the past 50 years reveals an inverse relationship between obesity rates and average sleep time, with the highest obesity percentages found in adults getting the least amount of sleep.

Source: http://www.reuters.com/article/2011/05/16/uk-health-sleep-idUSLNE74F02320110516

A Pablo Picasso painting donated to an Australian university was sold in June for £13.5 million at auction. The proceeds will benefit obesity, diabetes and cardiovascular research at the University of Sydney.

The work depicts his lover Marie-Thérèse Walter, whom he met in 1927 when she was 17 and he 45. The painting was snatched up by art collector Walter P. Chrysler Jr., son of the automobile tycoon, before being sold to the anonymous donor. Christie's puts its value at £9 million to £12 million (US$14 million to $18 million).

It is not clear why the donor picked the University of Sydney as the beneficiary for the Picasso, or why diabetes, obesity and heart research was chosen to benefit. In a statement, the university’s vice chancellor Michael Spence said the proceeds “will create multiple endowed chairs across several disciplines within a new multidisciplinary University centre dedicated to research into obesity, diabetes and cardiovascular disease”.

Source: http://blogs.nature.com/news/2011/06/a_picasso_fetches_135_million.html

Researchers Identify Pathways Leading to Activation of 'Good' Fat

Brown fat, burns energy rather than storing it, which the more common white fat does. The study, published in the October issue of Endocrinology, sought to learn more about how to get brown fat cells to grow. It identified two molecular pathways that lead to a protein called necdin that blocks brown fat growth.

With this information, researchers can look for ways to modify the steps along the pathways, either to stimulate another protein, called CREB, which shuts down necdin, or block a different protein called FoxO1, located along the second pathway, which stimulates necdin. The study showed for the first time that the two proteins can bind directly to the necdin gene.

One pathway to necdin starts with insulin cells and runs through proteins called Ras and ERK1/2 before getting to CREB. The second also starts with insulin and runs through proteins called P13-K and Akt before getting to FoxO1.

This is the latest in a series of studies on brown fat led by Drs. Cypess and Tseng. In July, Dr. Cypess and his team showed that brown fat can be seen on imaging studies in nearly half of all children and is most active in those who are thin. The amount of the fat also increases in children up until puberty, when it begins to decline, according to that study, published in the Journal of Pediatrics.

In 2009, Dr. Cypess and his team demonstrated in the New England Journal of Medicine for the first time that brown fat is metabolically active in adult humans. Previously, it had been thought that brown fat was present only in babies and children. The 2009 study showed it was found to be active under normal living conditions in 5.4 percent of all adults, with higher rates in women.

Source: http://www.sciencedaily.com/releases/2011/09/110921075423.htm

Hypotensive diet may prevent teen obesity

A study, published in the Archives of Pediatric and Adolescent Medicine, found that girls who followed basic principles of the Dietary Approach to Stop Hypertension (DASH) diet through their teens had a smaller tendency to gain an excess amount of weight by the time they reached early adulthood than teens who didn't stick to this diet.

The DASH diet centers around high consumption of low-fat dairy products, fish, chicken, and lean cuts of beef, as well as nuts, fruits, whole grains, vegetables, and legumes. This is the diet that’s recommended by the US government in its dietary guidelines.

The research, which surveyed more than 2,300 girls on their eating habits during 10 annual visits beginning at age 9, found that those whose eating patterns were closest to the DASH diet had an average body mass index of 24 (considered a healthy weight) by age 18, compared with a BMI of 26 (considered overweight) for those who didn't follow DASH.

The diet plan boils down to eating mostly whole foods while minimizing intake of processed cakes, cookies, and chips. But it's not necessarily about reducing calories. Those in the study who followed a DASH-style diet actually ate, on average, more than 250 extra calories a day compared with those who consumed a lot more high-fat meats, cheeses, and junk food.

On the other hand, the girls who were better eaters were more physically active and watched less TV -- two factors that also help protect against obesity.

Source: http://www.boston.com/lifestyle/health/blog/dailydose/2011/06/study_suggest_d.html

Naringenin, a compound from grapefruit, helping to reduce insulin resistance

A complex of naringenin and cyclodextrin may help to substantially reduce the absorption of fat and sugar in the body, according to study published in PLoS One.

The research team, from Harvard and the Hebrew University of Jerusalem, found their complex increases the absorption of naringenin by 11 times. They reported that a single dose given to rats before a meal reduced the generation of very low density lipoprotein (VLDL) by 42 per cent, whilst insulin sensitivity was boosted by 64 per cent. The authors claim that their research is the first demonstration that a dietary supplement can change the way our body can react beneficially to a meal.

In recent years, polyphenols, and flavonoids in particular, have emerged as a class of natural products shown to have anti-oxidant, anti-atherogenic, and normolipidemic effects. One of the most abundant flavonoids is the citrus flavonoid-glycoside naringin, which is broken down into naringenin.

Previous research has previously shown that naringenin, responsible for the bitter taste in grapefruits, could potentially be used in the treatment of diabetes, arteriosclerosis and hyper-metabolism. However,  the absorption of naringenin in its natural form is usually very low, reducing its bioavailability. The solubility and transport through the intestinal epithelium of naringenin can be enhanced by forming a complex with a chyclodextrin.

When the complex was administered to rats just prior to a meal it caused a decrease in VLDL levels by 42% and increased the rate of glucose clearance by 64% compared to naringenin alone.

Source: PLoS ONE
Published online ahead of print, doi:10.1371/journal.pone.0018033
“Enhancement of Naringenin Bioavailability by Complexation with Hydroxypropoyl-β-Cyclodextrin”
Authors: M. Shulman, M. Cohen, A. Soto-Gutierrez, H. Yagi, H. Wang, et al

Obesity: Do you really chose your lifestyle?

The sociopsychobiology of ingestive behaviour is perhaps the most complex of all human behaviours, given its importance for survival of the species, and the physiological, neuroendocrine and biochemical pathways that determine energy metabolism and activity thermogenesis are clearly no simpler.

It is perhaps, therefore, not all that unexpected when study after study (let alone your own experience) shows that the simplistic formula: “eat less – move more” is so disappointingly ineffective in either preventing or treating excess weight.

Yet, health professionals, decision makers and the general public continue to believe that obesity is simply a matter of “choice”, or in other words, people struggling with excess weight are simply making the wrong choices.

Let us for a minute assume that “lifestyle” truly is a major determinant of weight gain (and let us simply ignore the vast body of research on genetics, imprinting, fetal programming, environmental toxins, gut bugs, adipogenic adenoviruses, activated hypothalamic-pituitary adrenal axes, mood and anxiety disorders, addictions, attention deficit, abuse, emotional neglect, poor body image, obesogenic medications and the many other well-documented causes of obesity), then the question remains how much of lifestyle is truly simply a matter of “choice”.

How many of us simply chose sedentary jobs that keep us in front of a computer all day, simply chose to live in neighbourhoods with no sidewalks, simply chose to work in jobs where we earn so little that the only food we can afford to feed our family is crap, simply chose to live so far from work that we face daily hour-long commutes that leave little time for recreational activity (let alone enough sleep), chose to work rather than stay home so we can be around to fix a healthy meal from scratch in time for when the kids come home from school, simply chose to drive a car rather than spend our money on the 5-9 daily servings of fruits and vegetables for everyone in our family, simply chose to have a TV in the house that streams endless hours of advertising to our children, simply chose to drive our kids to school rather than let them cross those five busy intersections, simply chose to live in a country where the government subsidizes corn and meat producers rather than fruit and vegetables growers, etc, etc, etc?

We should demand new policies to fight against this obesgenic environment that we do not chose if we really want to cease the increase of the obese epidemic.

Source: Arya M. Sharma, MD

http://www.drsharma.ca/obesity-lifestyle-choice-or-lifestyle-chance.html

BMI may not be the right tool to measure health risks

The BMI is easy to measure, cheap to compile and track, and simple to convey to patients, but it was never meant to be a predictor of an individual's health risks. It was intended as a useful metric to track changes in the health and nutrition of large populations. For patients who are very muscular, and for African Americans, BMI is often a poor gauge of body composition. For Asians and people who are sedentary but slim, a reliance on BMI can lead a physician to overlook signs of elevated disease risk. A child's BMI, which is calculated differently than that of an adult, is also an imperfect predictor of illness or early death.

The BMI continues to dominate research on obesity and guide physicians' advice to patients. But some researchers have launched a rear-guard effort to knock the measure from its place atop the public-health pedestal. To replace — or at least supplement — the BMI, they are searching for measures that might offer individual patients a better gauge of their health risks, as well as a wider range of options to better their odds of staying healthy.

They'll also need tools to do so that are as cheap and simple as the BMI. Most techniques that measure body composition, including the Bod-Pod, the dual-energy X-ray absorption test (DEXA), and hydrostatic underwater weigh-in, are costly and time-consuming. Bioelectrical Impedance Analysis, an inexpensive and reliable gauge of body composition increasingly used in weight-management programs, may be practical in some general medical practices. But researchers are increasingly looking for ways to capture such information with tools as simple and inexpensive as tape measures.

One of the easiest alternatives to the BMI is waist measurement. With growing evidence that fat girdling the waist and visceral organs disturbs metabolism, the circumference of a patient's midsection has been shown to be a better predictor of Type 2 diabetes risk than the BMI.

Finally, an increasing number of researchers cite a major gap in the BMI: its inability to reflect the health effects of an individual's exercise habits. At least seven high-profile studies in the last decade have established that even for people with high BMIs, cardiovascular risk and the likelihood of early death are driven down significantly by maintaining a high level of fitness or at least regular physical activity. The risk of Type 2 diabetes also falls, although in that case, studies suggest that whittling waist circumference is a better strategy still.

Source: L.A. Times

BMI in adolescence, a substantial risk factor for obesity-related disorders

What you weigh in your teen years can have far-reaching effects on your heart health in the future, suggests new research.

The higher your body mass index (BMI) in your late teens, even if it is well within the normal range, the greater your risk of heart disease decades later, according to a large study published in the April 7 issue of the New England Journal of Medicine.

For every one unit increase in BMI in the teen years, the study found a 12 percent increase in the risk of heart disease around 20 years later. And, for every one unit increase in BMI, the study found a nearly 10 percent increase in the risk of type 2 diabetes, though this risk may largely be related to a higher BMI in adulthood as well.

Data for the study came from a large group of young men entering the Israeli army. The researchers followed 37,674 males from the time they were first examined for military service at the age of 17, until an average of 17.4 years later, according to the study.

Overall, men with the highest BMIs in their teens were 2.76 times more likely to develop type 2 diabetes and 5.43 times more likely to have coronary heart disease later in life compared to those with the lowest BMIs, reported the study.

However, when a normal adult BMI was factored into the analysis, the increased risk of type 2 diabetes disappeared, suggesting that weight in adulthood is far more of a risk factor for the development of type 2 diabetes than weight status in your teens.

But, the researchers found that the risk of heart disease was elevated whether or not someone was heavy in their teens or heavy as an adult, suggesting that extra weight at any age affects cardiovascular health.

Education on healthy lifestyle factors should start as early as possible in schools and at home, he said. Parents should make healthy eating and exercise part of the family routine. And, he said, it's important to start as early as possible.

Source: Serena Gordon, Health Day. 

Cardiovascular Continuum (VIDEO)

Voyage into your body to see an amazing creation you're born with: the perfect cardiovascular system. A lifetime of poor health habits can destroy that system and lead to major medical problems and a shortened lifespan, but it doesn't have to be that way. You have the power to keep your body and mind healthy, strong, and alive. See how you can live longer and live better.

The Cardiovascular Continuum
The cardiovascular continuum links various risk factors, like hypertension and high cholesterol levels, with different types of heart disease that become progressively more severe throughout a person's life. By treating risk factors that occur early on in the cardiovascular continuum, like hypertension, it may be possible to prevent or slow the development of heart disease and to prolong life.

http://www.thevisualmd.com/health_centers/cardiovascular_health/cardiovascular_continuum

Post hosts summit on childhood obesity epidemic

Last week, Washington Post Live hosted a conference on the health crisis called “Weighing In on America’s Future: Childhood Obesity Summit.” Those in the auditorium and watching online heard how children have become so sedentary that they don’t even know how to jump rope, and how our “all you can eat” culture has led to an alarming rise in diabetes in children.

Celebrity TV chef Carla Hall proved you don’t need a lot of money to make tasty meals. Decked out in her chef’s apron, Hall cooked the lunchtime meal for $2.32 a plate — the amount the federal government spends on many lunches provided in school cafeterias. On that tight budget, she whipped up chicken pot pie, tossed salad and a poached pear topped with rosemary oat crumble.

Eating well affordably was also the message of Deputy Secretary of Agriculture Kathleen Merrigan. Her advice: Don’t get paralyzed in the grocery store aisles about which kind of apple or tomato to buy. Just buy fruits and vegetables (and wash them). A mom herself, Merrigan advised parents not to think in terms of “good foods and bad foods.” As she noted, “If I start making foods prohibited, then they become very attractive.”

Greg Jennings, the Green Bay Packers wide receiver who scored two touchdowns in this year’s Super Bowl, took the stage to congratulate local students who won a KidsPost contest that sought their ideas for curbing obesity. Read today’s KidsPost (on the back page of the Style section) to learn from the winners, including the 11-year-old who wrote that kids need to learn to prepare meals because “many parents grew up eating fast food so they may not even know how to cook.”

Jennings and other football players at the event urged children to join the “Fuel Up to Play 60” program, which urges children to exercise 60 minutes a day. He and just about everyone in the audience got into the spirit and exercised between panel discussions, loosening ties and kicking off high heels for jumping jacks and scissor kicks, all in the name of powering a movement to make Americans trimmer.

What follows are comments excerpted from hours of discussion of one of the most important health issues facing America today.

Source: The Washington Post

Obesity Problems Fuel Rapid Surge Of Type 2 Diabetes Among Children

Today, about 3,700 Americans under the age of 20 receive a diagnosis annually of what used to be called "adult-onset" diabetes, according to the Centers for Disease Control and Prevention. That relatively small number makes it a rare disease in children, but it represents a trend with larger ramifications.

"In a little more than 10 years, the numbers went from nothing to something," says Larry Deeb, a pediatric endocrinologist and past president of the medicine and science division of the American Diabetes Association. "And that's something to worry about."

Diabetes can cause a litany of medical woes, including heart disease, kidney failure, limb amputations and blindness. It costs the U.S. health-care system $174 billion a year, according to the National Institutes of Health.

Those statistics are grim enough when patients are in their 60s. When the diagnosis is made decades earlier, new fears are raised: Will these children suffer heart attacks in their 20s, need kidney dialysis in their 30s or go blind before they see their own children graduate from high school?

Because about 80 percent of Type 2 diabetes patients are overweight or obese, it's not surprising that patients such as Annie ask if they've done this to themselves. But there are other risk factors that no one can control: family history, ethnicity (blacks, Hispanics and American Indians have higher rates of diabetes), genetics or a mother who had diabetes during her pregnancy.

Instead of wallowing in regret, doctors suggest that young patients and their parents seize the opportunity for a crash course on how to improve their health.

"I used to wear a button that said 'Stamp Out Guilt,' " says Fran Cogen, director of the Child/Adolescent Diabetes Program at Children's National Medical Center in Washington, D.C. "I try to tell people that no one caused their diabetes. I emphasize that they can make changes now."

Alarm bells are going off among those who study diabetes in children because of what they know about the adult version of the illness. More than 25 million Americans have diabetes (more than 90 percent have Type 2), according to the National Institute of Diabetes and Digestive and Kidney Diseases -- but another 79 million have a condition called pre-diabetes, in which blood sugar levels are higher than normal but not as high as in diabetes.

Pre-diabetes isn't a disease requiring medical treatment -- it's a wake-up call. A large national study showed that adults with pre-diabetes who lost 7 percent of their body weight reduced their risk of diabetes by 58 percent.

Officials are concerned that the number of children already identified as having Type 2 diabetes is just the tip of the iceberg. In a national study of 2,000 eighth-grade students from communities at high risk for diabetes, more than half of the kids were overweight or obese. Only 1 percent had diabetes - but almost a third of them had pre-diabetes, according to Lori Laffel, chief of the Pediatric, Adolescent and Young Adult Section of the Joslin Diabetes Center in Boston and a principal investigator on the study.

It's crucial, she says, to find those children before their condition progresses to diabetes so that it can be reversed by lifestyle changes, without medication.

Making Progress

If there is any good news in childhood diabetes, it is that pediatricians are starting to look for it.

"It's in the news, and all over the medical literature," says Susan Conrad, a pediatric endocrinologist at Inova Fairfax Hospital. "Pediatricians are on top of it."


For example, sometimes children whose bodies are beginning to have problems regulating insulin develop a telltale dark, velvety rash around their necks. A decade ago, such a child might have been referred to a dermatologist.

In addition, CDC guidelines suggest that a child with a family history of diabetes, or one whose weight is above the 85th percentile for age and sex should be screened, with blood and urine tests, for diabetes.

Family experiences made John Perrone of Winchester, Va., aware of diabetes and its consequences. John's mother, who developed gestational diabetes during all three of her pregnancies, now has Type 2 diabetes. His mother's aunt had diabetes, and by the time she died in her 70s, she was on dialysis, in a wheelchair, legally blind and had suffered two strokes.

John got a diagnosis of Type 2 diabetes four years ago, and he has worked hard ever since to keep the disease under control. He says he's gone from an overweight 11-year-old to a husky but fit 15-year-old. He has progressed from needing insulin injections to keeping his glucose under control with oral medication, combined with healthful eating and a lot of exercise.

He has learned enough to want to teach other kids with the disease. As an Eagle Scout project, he has developed a PowerPoint presentation aimed at youngsters. He has translated medical terms, such as glucose and glucometer, into words they understand, such as sugar and meter. He has also wanted to simplify for kids the basics of weight loss, which is so crucial for diabetes control.

"It's all about in and out, what you eat, how much you exercise," he says. "Maybe if kids understand it better, they can do it."



Source: Kaiser Health News

Losing weight can be fun!

A new study, published in the "Applied physiology, nutrition, and metabolism" journal has shown that  interactive video game stationary cycling (GameBike) is as efficient as stationary cycling to music for losing weight.

This was observed in a group of thirty overweight or obese adolescents aged 12-17 years, who were stratified by gender and randomized to video game or music condition to complete two 60-min sessions a week for 10 weeks.

Both interventions produced significant improvements in submaximal indicators of aerobic fitness as measured by a graded cycle ergometer protocol. Also, when collapsed, the exercise modalities reduced body fat percentage and total cholesterol.

Source: Applied physiology, nutrition, and metabolism

Cannabis use and obesity. Can it be protective?

The American Journal of Drug and Alcohol Abuse has just published a follow-up study on the relationship between cannabis and obesity in young adults.

The authors, who examined the data of cannabis consumption and BMI for 21 years, found that 50.9% of young adults reported use of cannabis in the last month or year and 34.1% had BMI ≤ 25. Multivariate analysis showed that those who had used cannabis were less likely to be categorised in the BMI ≥ 25 group with the least prevalence of overweight/obesity being observed in every day cannabis users. 

Therefore, they concluded that there is a lower prevalence of overweight and obesity among young adult cannabis users. However, they also admit athat further research is needed to examine the mechanism of this association.

Exercise helps overweight children think better, do better in math

Regular exercise improves the ability of overweight, previously inactive children to think, plan and even do math, Georgia Health Sciences University researchers report.

They hope the findings in 171 overweight 7- to 11-year-olds – all sedentary when the study started – gives educators the evidence they need to ensure that regular, vigorous physical activity is a part of every school day, said Dr. Catherine Davis, clinical health psychologist at GHSU’s Georgia Prevention Institute and corresponding author on the study in Health Psychology

To measure cognition, researchers used the Cognitive Assessment System and Woodcock-Johnson Tests of Achievement III that measure abilities such as planning and academic skills such as math and reading. A subset of the children received functional magnetic resonance imaging highlighting increased or decreased areas of brain activity.

MRIs showed those who exercised experienced increased brain activity in the prefrontal cortex – an area associated with complex thinking, decision making and correct social behavior – and decreased activity in an area of the brain that sits behind it. The shift forward appears consistent with more rapidly developing cognitive skills, Davis said.

And the more they exercised, the better the result. Intelligence scores increased an average 3.8 points in those exercising 40 minutes per day after school for three months with a smaller benefit in those exercising 20 minutes daily.

Activity in the part of their brain responsible for so-called executive function also increased in children who exercised. “In kids you just don’t know what impact you are going to have when you improve their ability to control their attention, to behave better in school, to make better choices,” Davis notes. “Maybe they will be more likely to stay in school and out of trouble.”

Cognitive improvements likely resulted from the brain stimulation that came from movement rather than resulting cardiovascular improvements, such as increased blood and oxygen supplies, Davis said. “You cannot move your body without your brain.”

The researchers hypothesize that such vigorous physical activity promotes development of brain systems that underlie cognition and behavior. Animal studies have shown that aerobic activity increases growth factors so the brain gets more blood vessels, more neurons and more connections between neurons. Studies in older adults have shown exercise benefits the brain and Davis’s study extends the science to children and their ability to learn in school.

Co-authors include Dr. Jennifer E. McDowell, neuroscientist, and Dr. Phillip Dr. Tomporowski, exercise and cognition expert, at the University of Georgia.

From: Georgia Health Science University News. http://news.georgiahealth.edu/archives/3263

Are dietary patterns in childhood associated with IQ at 8 years of age?

There is evidence that a poor diet associated with high fat, sugar and processed food content in early childhood may be associated with small reductions in IQ in later childhood, while a healthy diet, associated with high intakes of nutrient rich foods described at about the time of IQ assessment may be associated with small increases in IQ.

From: Northstone et al., Are dietary patterns in childhood associated with IQ at 8 years of age? A population-based cohort study. J Epidemiol Community Health doi:10.1136

WHO calls for junk food ban in schools, playgrounds

Junk food should not be sold in schools and playgrounds, the World Health Organisation said Friday in a series of recommendations aimed at promoting a healthy diet and cutting child obesity.
However it fell short of calling for a ban on advertising directed at children for foods high in saturated fats, sugars or salt, opting instead to ask member states to "consider the most effective approach to reduce" such marketing.
The non-binding recommendations will be put to a high-level meeting on the prevention and control of non-communicable diseases during September's General Assembly in New York, WHO officials said.
"Settings where children gather should be free from all forms of marketing of foods high in saturated fats, trans-fatty acids, free sugars or salt," said the UN health agency.
"Such settings include, but are not limited to, nurseries, schools, school grounds and pre-school centres, playgrounds, family and child clinics and paediatric services and during any sporting and cultural activities that are held on these premises," it added .
Some 43 million pre-school children are obese or overweight, according to WHO data.
"Children throughout the world are exposed to marketing of foods high in fat, sugar or salt, which increases the potential of younger generations developing noncommunicable diseases during their lives," it said.
Six out of ten deaths every year are due to cardiovascular diseases, cancers, diabetes and chronic lung diseases, the WHO warned, pointing out that a common factor of the four main diseases is poor diet.

Source: Google news. http://www.google.com/hostednews/afp/article/ALeqM5jfzUeW7BjDuqLjipN5Meuy969_Ew?docId=CNG.8c7c2d37b80a7efbfd66908fa452bb99.2f1

Kids who get recommended sleep least likely to be obese

Scientists at the University of Chicago and the University of Louisville compared the sleep patterns of 308 children, ages 4-10, with their body mass index, a number that considers height and weight. The children wore special wrist-band devices for a week to track the amount they slept.

Some of the kids had blood work done to look at their glucose, insulin, triglycerides and cholesterol levels, which are markers for the risk of type 2 diabetes and future cardiovascular disease.

The study, out online today in Pediatrics, shows:

•Kids slept an average of eight hours a night. This is far less than the nine or more hours recommended for this age group.

•Kids who slept at least 9½ to 10 hours were the least likely to be obese or to have unhealthy blood work.

•The children who slept the least and had the most irregular sleep schedule (they didn't go to bed at a set time) had a substantially greater risk of being obese and having unhealthy blood work.

•Those who got caught up on sleep on the weekends somewhat reduced their risk of being obese or having unhealthy blood work.

•Obese children were less likely to get caught up on their sleep on the weekends.

"Good sleep routines and sleeping the right amount is the best healthy proposition," says lead author David Gozal, chair of the department of pediatrics at the University of Chicago.

Previous research shows that not getting enough sleep may contribute to weight gain partly because it affects hormones that control hunger and feeling full.

Source: USA today. http://www.usatoday.com/printedition/life/20110124/sleepandweight24_st.art.htm

Obese adolescents and the risk of breast cancer

According to a recent review, adolescent girls and in high risk of developing breast cancer.

Breast cancer, the second most common cause of cancer death in women, is strongly associated with obesity; this relationship is particularly true in postmenopausal breast cancer. There are many factors that many explain the relationship between adiposity and breast cancer. Obesity is related to elevated levels of insulin and leptin, and lower levels of adiponectin. Hyperinsulinemia may impact and affect tumorigenesis. Peripheral aromatization of androgens in adipose tissue is enhanced by leptin, leading to greater estrogen levels.Adipocytokines may participate as cancer promoters and regulators, and participate in regulation of sex steroids by interleukins 4 and 6 (Il-4, Il-6). Increased serum levels of leptin and resistin, and decreased levels of adiponectin, were related to tumor metastasis.

From: In-Iw and Biro. Adolescent Women and Obesity. Journal of Pediatric and Adolescent Gynecology

How to Fix the Obesity Crisis

Why are extra pounds so difficult to shed and keep off? It doesn’t seem as though it should be so hard. The basic formula for weight loss is simple and widely known: consume fewer calories than you expend. And yet if it really were easy, obesity would not be the nation’s number-one lifestyle-related health concern. For a species that evolved to consume energy-dense foods in an environment where famine was a constant threat, losing weight and staying trimmer in a modern world of plenty fueled by marketing messages and cheap empty calories is, in fact, terrifically difficult. Almost everybody who tries to diet seems to fail in the long run—a review in 2007 by the American Psychological Association of 31 diet studies found that as many as two thirds of dieters end up two years later weighing more than they did before their diet.

From:Scientific American Magazine, February 2011

Prohibition: The Wrong Way to Improve Child Nutrition - The Atlantic

Prohibition: The Wrong Way to Improve Child Nutrition - The Atlantic