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.