Obesity also a threat in developing countries

Sadly, we are getting accustomed to see emaciated people in poor countries and extremely fat people in rich countries. However, as countries develop this is getting far form reality as both starvation and obesity are closely linked with poverty, and as such they are both symptoms of malnutrition.

The negative effects of unhealthy processed fat and sugar-rich diets in combination with low physical activity began to be recognized in the early 1990s, but they did not become clearly acknowledged until diabetes, hypertension, and obesity began to dominate the world.

As well as in countries with high income levels, rates of obesity and overweight are widely documented in the poorest countries of sub-Saharan Africa and South Asia. In these countries, higher incomes imply access to unhealthy fattening food, and consequently, higher prevalences of obesity. Healthy food is usually either not available or not affordable. While in the developed world, obesity is already considered a pandemic, this is also now true for the developing countries. Obesity is affecting both rich and poor countries and causing more deaths than undernourishment, according to the World Economic Forum, which is actually bankrupting economies and short-changing future generations in a major way.

Governments from the richest countries have stated to implement policies to fight the pandemic, with an array of large-scale programmatic and policy measures. However, few developing countries are engaged in serious efforts to prevent the serious dietary challenges being faced.

Weight-loss drug obtains FDA approval

After 13 suspenseful years, the US Food and Drug Administration (FDA) has approved a pill that could help to fight the US obesity epidemic.

According to the FDA, Belviq (lorcaserin) can help people to lose about 3–4% of their body weight when combined with a healthy diet and exercise. The drug has been approved for use by obese people with a body mass index (BMI) greater than 30, and for a subset of overweight people (with a BMI of more than 27) who have health conditions such as high blood pressure, elevated cholesterol and type 2 diabetes.

The FDA had already rejected Arena’s first application for approval of Belviq in September 2010 because the compound seemed to produce tumours in rats and because the company could not statistically rule out an increase in the risk of heart-valve problems. Similar to fenfluramine, Belviq suppresses food cravings by mimicking the effects of serotonin in the brain, making people eat less and feel full. However, Belviq seems to activate only the serotonin 2C receptor in the brain, not the serotonin 2B receptor that is present in heart muscle.

The FDA’s turnaround this week came after Arena performed echocardiograms in nearly 8,000 people to measure heart-valve function, which revealed that there was no increase in heart-valve abnormalities among those taking the drug. The firm has agreed to run six post-marketing studies, including a long-term cardiovascular trial, and patients with congestive heart failure are advised not to take the drug.

Source: Nature (doi:10.1038/nature.2012.10923) http://www.nature.com/news/weight-loss-drug-wins-us-approval-1.10923

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...

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

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

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

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 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. 

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.

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