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
Showing posts with label risk. Show all posts
Showing posts with label risk. Show all posts
Wednesday, 19 October 2011
Wednesday, 20 April 2011
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
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
Saturday, 9 April 2011
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.
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.
Tuesday, 25 January 2011
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
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
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