We often read about the benefits of fiber in the digestive system. These days, it’s prominently featured in food staples as a natural attribute or as an additive. Likewise, a plethora of supplemental fiber products are available online, stocked in grocery stores and on drug store shelves, to give us that added fiber we may be missing in our less than complete diet. But what does fiber really do for us and how much should we be taking in? It’s a well-known fact we need dietary fiber for our bodies to function properly.

Some vegetarians get their share of daily fiber through natural foods, leaving the additives and supplements for those of us more fiber-challenged from our normal dietary habits. Whatever the source, fiber is important for digestive health in people of any age and it’s helpful in the prevention of many conditions, including acid reflux (or GERD), inflammatory bowel syndrome (IBS), obesity and diverticulitis.  Fiber is essential in maintaining “regularity”. Regularity is a “nice” word to use, in an effort to avoid any unpleasant sounding terms to describe proper digestion and elimination of our waste. No one really wants to utter the words, “constipation”, “diarrhea”, “irritable bowel syndrome” or other such colorful words or phrases, but everyone goes through a period of discomfort and no one is immune. We just need to do our best to limit the times when we do have issues, principally by making sure we get our daily fiber.

What’s the difference between soluble and insoluble fiber and do we need both? Insoluble fiber is the most important component in moving food through the digestive track. This type of fiber is largely indigestible, helping to bulk up stools and reduce constipation. Insoluble fiber is found in whole fruits and vegetables, seeds and whole grains.

Soluble fiber plays a different but still important role. Rather than passing through the digestive tract intact, as does insoluble fiber, soluble fiber is digested into a gel-type substance, absorbing water and slowing down digestion but also providing a prebiotic effect. Prebiotics, like those found in some soluble fiber sources, promote the growth of healthy digestive bacteria in the intestinal tract, allowing foods to be broken down more easily and aiding absorption of vital nutrients. So, as with most check and balance systems, the two types of dietary fiber work together but with separate functions, to aid in healthy digestion.

We now understand a little better how the process works. The next question is, how much do we need and are we typically getting enough fiber in our diet?
The answer to the latter part of the question is that many of us do not ingest enough healthy fiber in our diets. The typical American gets about half of the daily recommended supply of dietary fiber each day. Daily fiber needs differ with age and gender, so it’s not a one-size-fits-all recipe. The following are guidelines for recommended daily fiber needs:

• Women and Adolescent Girls—25 grams
• Women age 50 and over—21 grams
• Men and Teenage Boys—38 grams
• Men age 50 and over—30 grams
• Children age 4 to 8—25 grams
• Toddlers age 1 to 3—19 grams
• Women and Adolescent Girls—25 grams

*All figures represent daily recommended total fiber (including soluble and insoluble combined)

We have the numbers. Now for the best sources of fiber in the foods we love to eat and in dietary supplements:

You can never go wrong with eating more fruits and vegetables! Whether for the rich sources of essential vitamins often lost in prepared fruits and vegetables or for fiber needs, the fresh stuff is always the better choice at meals or at snack times. Then there are whole grains. Whole grain cereals and breads retain those all-important sources of insoluble fiber, providing better digestion and even contributing to heart health! Stay away from refined grains. They may be a little tastier going down but your body will prefer the whole grains to the refined flours any day!

Supplements offer a great way to take in that fiber we just can’t seem to get in our daily diet. Many choices are out there, including fully dissolving powders, whole food supplements and additives like flax seed that we can sprinkle over our foods for an extra boost of fiber. No longer are we left with the old standards of prunes or gritty mixes for our fruit juices in the mornings. With all the advances in fiber delivery these days, there’s really no excuse for not getting our fiber needs from our foods or from fiber supplements.

Make a friend with fiber, and incorporate dietary fiber into your routine daily for better health.

It seems like every day, we see more “pink” in our daily lives. More pink ribbons, more pink signs, bumper stickers, T-shirts, cups, etc., urging us to acknowledge and contribute to the cure for breast cancer. The Susan G. Komen for the Cure organization is perhaps the most ubiquitous foundation in cancer research and support, and its directors and supporters have done a masterful job in marketing the cause to the public. According to the American Cancer Society, 1 of every 8 women in the U.S. will be diagnosed with breast cancer in her lifetime. It’s a statistic that’s scary, for sure, but one that should also raise awareness and turn our attention to early detection and prevention.

Breast cancer can be a killer. Currently, breast cancer is second only to lung cancer, among all cancer deaths in women, in the U.S. Worldwide, breast cancer leads all cancer diagnoses and cancer deaths in women. Of course, smoking makes a huge impact in the cancer statistics here at home. Obviously, lung cancer is attributable to smoking but smoking plays a significant role in the development of breast cancer. But what else drives the numbers and what can we do to prevent or decrease our risks of breast cancer?

It must be understood that there are certain risk factors associated with breast cancer that we can do nothing about. If you are a woman, have a history of breast cancer in your family, have a genetic predisposition for breast cancer or have certain physical characteristics in breast tissue, you’re going to be at a higher risk. Likewise, as a woman ages, the risk of developing breast cancer increases. There are prevention methods that every woman can implement in her daily lifestyle and they include:

1. Maintain a healthy weight. Women who are overweight are subject to many health concerns, including cardiovascular diseases and many types of cancer.
2. Exercise. A sedentary lifestyle may contribute to the likelihood of developing breast cancer, especially in those women age 50 and older. Studies have shown a reduction in risk for women exercising just 4 to 7 hours per week. Maintaining a healthy weight and exercising can cut breast cancer risk and it’s something that we can control.
3. Eating nutritious foods. As with all cancers, a diet rich in whole grains, lean meats and fresh fruits and vegetables can help to reduce risks.
4. Smoking cessation. If there’s one risk reducing factor that trumps them all, it’s quitting smoking. Smoking causes numerous health risks, including heart disease and various forms of cancer. It’s not easy to kick the habit but if you do smoke, there’s no better way to reduce health risks and improve your overall health than to quit now.
5. Vitamin D. Women lacking sufficient vitamin D in their bodies are at higher risk for developing breast cancer. Research has shown that vitamin D plays an important role in healthy breast cell growth and this vitamin may also prohibit cancer cells from growing.
6. Limiting chemical exposure. Frequent and continued exposure to toxic chemicals may contribute to cancer growth in the breasts. Whether it be from seemingly innocuous sources such as ingredients in some cosmetics, sunscreens, certain plastics, lawn and garden chemicals or harmful components in foods and drinks, it’s important to consider your exposure to carcinogenic compounds.
7. Alcohol. Studies have shown that the risk of developing breast cancer increases by as much as 10% for women consuming more than one alcoholic drink per day. While this statistic may sound dramatic, it is considered factual that increasing alcohol consumption presents a significant risk in the development of breast cancer.

Breast cancer research continues to advance every day. Causes associated with this disease and new risk factors are constantly being reviewed and updated, in accordance with the latest research. Already, researchers have identified genetic markers for those men and women who carry mutant genes which predispose one to breast cancer. One day, we may even find a cure for this killer. Until that day we must be vigilant in taking steps to significantly reduce our risks and urge our friends and families to follow our lead. So, “think pink” and make healthy changes in your lifestyle.

The World Health Organization has published their leading causes of death from killer diseases and conditions worldwide, while breaking down results of surveys from the 193 member countries by income level. Not surprising, lower income countries face enormous threats from communicable diseases. But somewhat surprisingly, most of the top diseases on every list are preventable.

The top causes of death worldwide are attributable to noncommunicable diseases such as various types of heart disease, cancers, lung diseases and diabetes. More than 36 million deaths were caused by these conditions in 2008, according to the WHO report. Specifically, 48% of these deaths were attributable to heart disease, 21% to some form of cancer, 12% caused by lung disease and about 3% being the result of diabetes.

As we’re all aware, many of these conditions can be mitigated or eliminated altogether, by reduction of certain health risks and risky behaviors such as smoking, lack of exercise and poor eating habits. From a worldwide perspective, infectious and communicable diseases like those associated with diarrheal diseases and HIV/AIDS, follow the above leading causes of death. Of course, many of these deaths can also be prevented by clean drinking water, better nutrition and hygiene, as well as safe-sex strategies.

As a reaction to the statistics revealed by the WHO report, the United Nation’s General Assembly will convene this month to develop an international plan to fight noncommunicable diseases facing the world’s population. No one expects the UN to save the world, as its members may suggest. But as is the case with communicating information, the task of adequately educating populations with regard to healthy lifestyle choices, is always something we can and should make a concerted effort to do.

The WHO has in the past, attempted to confront poor lifestyle choices by addressing the hazards of smoking. In 2008, the WHO issued recommendations to member countries which included smoking cessation programs, higher taxes on tobacco products, and publishing warnings on tobacco products and restrictions on tobacco advertising. These policy suggestions mimic those already in place in the U.S. and are beneficial in other areas of the world.

As for the higher income countries, 87% of all deaths are caused by noncommunicable diseases. Heart disease accounts for 35% of all deaths, with cancers at 23%, lung disease coming in at 7% and followed by diabetes at 3%.  In the WHO report, it’s noted that nearly 70% of Americans are either overweight or obese. We’re all going to go by some means. There’s no way around it. What we can do is increase our longevity by living healthier and happier lives. The plan is as simple as eating right, exercising, drinking more water and taking vitamins and supplements. Just follow the path and live longer.

Duke and the Doctor (Health Headline News) – Video-

In this video Dr. McBarron shares  her thoughts on a study published in the medical journal Pediatrics regarding childhood obesity. 

Weigh loss and obesity is a topic that is close to Dr. McBarron as her full time medical practice “Georgia Bariatrics” is devoted to the non-surgical medical treatment of obesity.

By watching this video you will find out what both Dr. McBarron and the researchers beleive is the real key to preventing childhood obesity.

Over 100 condition specific recommendations from Jan McBarron M.D., N.D. : Dr. McBarron’s Natural Remedies

Let’s start by talking about what Omega 3 and Omega 6 fatty acids are. Both of these fatty acids are what they call essential fatty acids. They are called essential because it is essential that we consume them because our body is unable to make them. What’s more is that our body cannot function properly without them. Both types are important.

 Let’s talk now about foods that contain Omega 3 and 6 fatty acids. Omega 3 fatty acids are found in deepwater fish (salmon, mackerel, anchovies, sardines, and herring), fish oil, flaxseed and flaxseed oil, and walnut oil. Nuts are also a good source of omega 3’s. Hazelnuts, almonds, pecans, cashews, walnuts, and macadamia nuts are particularly high in omegs3’s. Omega 6 fatty acids, on the other hand, are found in some nuts and seeds, as well as in many vegetable oils (borage, grape seed, primrose, sesame and soybean oil).

 Now that we know what Omega 3 and 6 fatty acids are, let’s talk about what a recent study has uncovered about them. This study suggests that a deficiency in dietary alpha-linolenic acid (Omega-3) paired with too much of dietary linoleic acid (Omega-6) could cause what the researchers call “inherited obesity”. Researchers think it is the ratio of the two (or the amount of one compared to the amount of the other) that makes the difference. This study looked at several generations of mice who were all fed a diet that consisted of high levels of Omega-6’s and low levels of omega-3’s. The results of this study showed that as the generations went on, the diet triggered a steady increase in inflammation and fat mass in the mice.

 At this point you may be wondering, what does this mean to me? Well, the recommended ratio for humans is 5-to-1, meaning we should consume 5 parts of omega-6’s to every 1 part of omega-3’s. However, the kicker is that the actual ratio in the United States is, in some cases, as high as 40-to-1.

 Dr. McBarron’s Natural Remedy

 I am often asked “What should I take an Omega 3 supplement or an essential fatty acid supplement that contains Omega 3 and Omega 6?”.  The answer depends on what balance of fatty acids you are currently consuming.  If your diet is one that is close to the 5-to-1 ratio of omega 6-to-3′s I would recommend a blend of fatty acids sauch as Vita Logic’s EFA Formula.  On the other hand if your intake contains a higher percentage of Omegs 6-to-3′s then VitaLogic’s Fish Oil would be my supplement of choice.

 Although this study refers to “inherited obesity” don’t be fooled into thinking that fatty acids in your diet leads to obesity.  These are the good fats and studies have shown that in the proper balance they can actually help you loose weight.

 In the following short video I cover some of the nuts that are high in essential fatty acids and Omega 3 in particular.  Nuts often are neglected because people think they are too high in fat. Of course moderation is the key as far as calories and keeping the proper balance of Omega 6-to-3′s is also very important

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With children going back to school, parents are concerned that their youngsters are staying fit and eating right, especially those who dine in a school cafeteria.

New research funded by the U.S. Department of Agriculture finds that children who eat school lunches that are part of the federal government’s National School Lunch Program are more likely to become overweight.

The same research study found, however, that children who eat both the breakfast and lunch sponsored by the federal government are less heavy than children who don’t participate in either, and than children who eat only the lunch, says economist Daniel L. Millimet at Southern Methodist University in Dallas.

Millimet authored the study with economists Rusty Tchernis, Georgia State University, and Muna S. Hussain, Kuwait University.

“The fact that federally funded school lunches contribute to the childhood obesity epidemic is disconcerting, although not altogether surprising,” said Millimet, whose research expertise is the economics of children, specifically topics related to schooling and health.

The new study was published in the Summer issue of The Journal of Human Resources. It is titled “School Nutrition Programs and the Incidence of Childhood Obesity.”

The U.S. Department of Agriculture oversees the federal lunch and breakfast programs. Through USDA the federal government reimburses schools for a portion of school lunch costs and also donates surplus agricultural food items. While USDA does require that the meals meet certain nutritional standards, schools choose the specific foods.

A la carte items outside the guidelines

Schools also can serve individual food items a la carte, which fall outside the scope of the federal guidelines and allow students to choose additional foods.

For their study, the researchers analyzed data on more than 13,500 elementary school students. Students were interviewed in kindergarten, first and third grades, and then again in later grades.

“First, it is very difficult to plan healthy but inviting school lunches at a low price,” Millimet said. “Second, given the tight budgets faced by many school districts, funding from the sales of a la carte lunch items receives high priority. That said, it’s comforting to know that the U.S. Department of Agriculture, which oversees the federal school nutrition programs, takes the issue very seriously. The USDA sponsors not only my research, but that of others as well, to investigate the issues and possible solutions.”

The USDA is partnering with First Lady Michelle Obama to fight what experts say is a childhood obesity epidemic among America’s school children. The First Lady on May 18 released the results and recommendations of The White House Task Force on Childhood Obesity report, which said that more than 30 percent of American children ages 2 to 19 are overweight or obese. The report recommends serving healthier foods in schools.

Lunches may not be in compliance

Judging from the results of the study, Millimet said, the food being served in school lunches may not maintain a healthy weight in children. The food in school breakfasts appears to be healthier, however.

“Technically what is going on is that the federal government establishes nutrition guidelines for lunches and breakfasts if schools wish to receive federal funding,” Millimet said. “But there’s evidence that school lunches are less in compliance with these guidelines than breakfasts. The other possible issue is that these days schools try to make money from a la carte items at lunch. And it’s possible that even if the school lunch is healthy, kids buying lunch are more likely to tack on extra items that are not healthy.”

Nutritionists strongly advocate eating breakfast for a healthy lifestyle, Millimet said, noting that — up to a point — any breakfast is better than no breakfast.

The National Student Lunch Program supplies meals to about 30 million children in 100,000 public and nonprofit private schools, according to the USDA.

The School Breakfast Program gives cash assistance to more than 80,000 schools for about 10 million children.

Obesity among students takes jump

The study cites data from the National Health and Nutrition Examination Survey taken between 1971 and 1974 and again from 2003 to 2004 that found the prevalence of overweight preschool children ages 2-5 jumped from 5 percent to 13.9 percent. Among school-aged children, it jumped from 4 percent to 18.8 percent for children 6-11; and 6.1 percent to 17.4 percent for those 12-19.

Provided by Southern Methodist University

People who sleep either more or fewer than seven hours a day, including naps, have an increased risk for cardiovascular disease, according to a new study.

Sleeping fewer than five hours a day more than doubles your risk of being diagnosed with angina, coronary heart disease, heart attack or stroke.  And sleeping more than seven hours also increases your risk of cardiovascular disease; more than nine hours of sleep results in a 50 percent increase in risk.

The Daily Telegraph reports:

“The most at-risk group was adults under 60 years of age who slept five hours or fewer a night. They increased their risk of developing cardiovascular disease more than threefold … Women who skimped on sleep … were more than two-and-a-half times as likely to develop cardiovascular disease.”

In related news, researchers have also found that sleeping in after a few days of missed sleep can help restore you after missed sleep, nearly erasing any lingering sense of fatigue and mental fuzziness.

How much recovery sleep you need to feel recharged depends on how much sleep you’ve lost.

In the study, volunteers deprived of about three hours of sleep a night for five nights felt nearly, but not quite, back to normal after ten hours of sleep.

To help you get the optimal amount of sleep each night, U.S. News & World Report suggests:

“… [T]ry removing all electronic media devices — BlackBerry, TV, computer — from your bedroom. These distractions … are a prime reason many of us turn out the lights an hour or two later than we originally intended.”

(Reuters Health) – Teenagers who are overweight, get little exercise, or smoke may be more likely than their peers to have recurrent headaches, researchers reported Wednesday.

Norwegian researchers found that among nearly 6,000 13- to 18-year-olds they assessed, those who were overweight, sedentary or who smoked were more likely to report suffering recurrent headaches in the past year — including both migraines and common tension-type headaches.

The findings, published in the journal Neurology, do not show whether those lifestyle factors may raise teenagers’ risk of developing frequent headaches in the first place.

But they raise the possibility that addressing kids’ weight, smoking or exercise levels could help prevent or manage headache problems, senior researcher Dr. John-Anker Zwart, of Oslo University Hospital in Norway, told Reuters Health in an email.

The results mirror those that have been seen in adults with recurrent headaches; but the role of lifestyle in teenagers’ headaches has rarely been studied, Zwart said.

The study “is an important step in clarifying the effects of lifestyle factors on headache,” according to the authors of an editorial published with the report.

And it “sets the stage” for looking at the effects of treatments focused on weight, smoking and exercise, write Dr. Andrew D. Hershey, of Cincinnati Children’s Hospital Medical Center, and Dr. Richard B. Lipton, of Albert Einstein College of Medicine in New York.

For the study, Zwart’s team interviewed 5,847 teenagers about a number of health and lifestyle factors, including any headaches they’d suffered in the past year not related to a cold or other acute illness.

Overall, 36 percent of girls and 21 percent of boys said they’d had recurrent headaches in the previous year. Tension-type headaches were most common, but one-quarter of girls with recurrent headaches reported migraines, as did a similar percentage of boys.

In general, rates of smoking, overweight and low physical activity — defined as exercising less than twice per week — were higher among teens with recurrent headaches compared with their peers.

Among boys, 19 percent of those with headaches were overweight, versus 15 percent of those who were headache-free; 31 percent versus 25 percent reported low exercise levels; and 20 percent versus 15 percent said they currently smoked.

Among girls, 20 percent of those with recurrent headache were overweight, compared with 14 percent of their headache-free peers; 37 percent versus 32 percent had low activity levels; and 27 percent versus 18 percent smoked.

The researchers found that each of the three factors was linked to an increased risk of headache problems, after controlling for the effects of the other two lifestyle factors, as well as age and gender.

Overweight teens were 40 percent more likely to have recurrent headaches than their peers with none of the three negative lifestyle factors. Those with low activity levels had a 20 percent increase in their risk, and smokers had a 50 percent increase.

Moreover, teenagers with all three unhealthy lifestyle factors showed the highest risk of recurrent headaches. Nearly 55 percent reported headache problems, compared with 24 percent of teenagers who were normal weight, non-smokers and exercised at least twice per week.

The findings leave open the question of whether excess pounds, smoking or inactivity are risk factors for recurrent headaches, or whether they may exacerbate existing headaches — making them more frequent or intense, according to Hershey and Lipton.

Large studies that follow participants over time are needed to answer those questions, they point out.

With smoking, for example, it is plausible that tobacco could act as a headache trigger. On the other hand, people with frequent headaches may be more prone to depression or anxiety, for instance — which could, in turn, have some of them reaching for cigarettes.

Zwart’s team agrees that mental health and other factors, like families’ socioeconomic status, may help explain the relationships among smoking, weight, exercise and recurrent headaches.

However, positive lifestyle changes are bound to bring teenagers health benefits.

“The take-home message,” Zwart said, “is that it is worthwhile to try preventive measures and encourage positive lifestyle changes in adolescents with recurrent headaches, which includes stopping smoking, better and healthy dietary habits, as well as regular exercise.”

August 9, 2010

Individuals with a large waist circumference appear to have a greater risk of dying from any cause over a nine-year period, according to a report in the August 9/23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Having a large waist circumference has previously been associated with inflammation, insulin resistance, type 2 diabetes, abnormal cholesterol levels and heart disease, according to background information in the article. This may be because waist circumference is strongly correlated with fat tissue in the viscera—surrounding the organs in the abdomen—which is thought to be more dangerous than fat tissue under the skin.

Eric J. Jacobs, Ph.D., and colleagues at the American Cancer Society, Atlanta, examined the association between waist circumference and risk of death among 48,500 men and 56,343 women age 50 and older (median or midpoint age, 69 years in men and 67 years in women). All had participated in the Cancer Prevention Study II Nutrition Cohort, for which they completed a mailed questionnaire about demographic, medical and behavioral factors in 1992 or 1993 and provided information about weight and waist circumference in 1997. Deaths and their causes were tracked through the National Death Index until Dec. 31, 2006; a total of 9,315 men and 5,332 women died during this timeframe.

After adjusting for body mass index (BMI) and other risk factors, very large waists (120 centimeters or 47 inches or larger in men, and 110 centimeters or 42 inches or larger in women) were associated with approximately twice the risk of death during the study period. A larger waist was associated with higher risk of death across all categories of BMI, including normal weight, overweight and obese; however, among women, the association was strongest for those at a normal weight.

“The reason for the stronger association between waist circumference and mortality among women with low BMI in our study is unclear,” the authors write. “Future detailed analyses of the relationship between waist circumference and visceral adipose tissue or measures of insulin resistance within categories of BMI could identify biological reasons for potential differences in the strength of the association between waist circumference and mortality.”

The results may affect the development of future guidelines for obesity, the authors suggest. “Currently available clinical guidelines from the National Institutes of Health are based on evidence from the 1990s,” they write. “These guidelines recommend that waist circumference be used to identify increased disease risk only among individuals in the overweight and obese categories of BMI. In addition, the NIH guidelines recommend weight loss goals for all patients in the obese category of BMI (30 or greater), but they do not specifically recommend weight loss goals for abdominally obese patients (waist circumference of 88 centimeters or larger in women or 102 centimeters or larger in men) who are in the normal or overweight BMI category unless they also have two or more cardiovascular risk factors or a desire to lose weight.”

Americans are continuing to get fatter and fatter, with obesity rates reaching 30 percent or more in nine states last year, as opposed to only three states in 2007, health officials reported on Tuesday.

The increases mean that 2.4 million more people became obese from 2007 to 2009, bringing the total to 72.5 million, or 26.7 percent of the population. The numbers are part of a continuing and ominous trend.

But the rates are probably underestimates because they are based on a phone survey in which 400,000 participants were asked their weight and height instead of having it measured by someone else, and people have a notorious tendency to describe themselves as taller and lighter than they really are.

“Over the past several decades, obesity has increased faster than anyone could have imagined it would,” said Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention, which issued a report on the prevalence of obesity. Obesity rates have doubled in adults and tripled in children in recent decades, Dr. Frieden said.

If the numbers keep going up, he added, “more people will get sick and die from the complications of obesity, such as heart disease, stroke, diabetes and cancer.”

The report estimates the medical costs of obesity to be as high as $147 billion a year, and notes that “past efforts and investments to prevent and control obesity have not been adequate.”

Researchers blame the usual suspects: too little exercise and too much of the wrong kind of food, which means not enough fruits and vegetables and too many high-calorie meals full of sugar and fat, like French fries, soda and other sweet drinks. Children do not get enough exercise during the school day; Dr. Frieden noted that even in gym classes, students are active for only about a third of the time.

A 5-foot-4-inch woman is obese if she weighs 174 pounds, as is a 5-foot-10-inch man who weights 209 or more, according to the disease centers. Both would have a body-mass index, or BMI, of 30; that index is calculated from height and weight, and scores of 30 or over are defined as obese.

The nine states with obesity rates of 30 percent or more are Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and West Virginia. The highest rate, 34.4 percent, was in Mississippi.

People over 50 had higher rates of obesity than those who were younger. The aging of the population may account for some of the general increase in obesity, but not all of it, said Dr. Heidi Blanck, chief of the disease centers’ obesity branch of the division of nutrition, physical activity and obesity.

Non-Hispanic black women had the highest obesity rate, 41.9 percent. Over all, blacks and Hispanics were more likely than whites to be obese, and the more education people had, the less likely they were to be heavy.

Only Colorado and Washington, D.C., had obesity rates under 20 percent. Researchers are not sure why. Dr. William Dietz, director of the nutrition, physical activity and obesity division, said that Colorado had spent money from a state lottery on biking and walking trails and that many people were using them. The state seems to have “a culture of physical activity,” he said.

Dr. Dietz said the relatively low prevalence of obesity in Washington was harder to explain, particularly because the area has a large black population.

He said one explanation may be that many residents ride the subway; studies have shown that compared with people who drive, those who use public transportation tend to be thinner because it involves more walking. In addition, Dr. Dietz said, there is evidence of above-average fruit and vegetable consumption, and higher rates of breast-feeding, both of which are linked to lower rates of obesity.

Although the prevalence of obesity and obesity-attributable deaths has steadily increased, the resultant burden of disease associated with obesity has not been well understood. A new study published in the September issue of the American Journal of Preventive Medicine indicates that Quality-Adjusted Life Years (QALYs) lost to U.S. adults due to morbidity and mortality from obesity have more than doubled from 1993-2008 and the prevalence of obesity has increased 89.9% during the same period.

Using data from the 1993-2008 Behavioral Risk Factor Surveillance System, the largest ongoing state- based health survey of U.S. adults, Haomiao Jia, PhD, Columbia University, and Erica I. Lubetkin, MD, MPH, The City College of New York, examined trends in the burden of obesity by estimating the obesity-related QALYs lost, defined as the sum of QALYs lost due to morbidity and future QALYs lost in expected life years due to premature deaths, among U.S. adults. They found the overall health burden of obesity has significantly increased since 1993 and such increases were observed in all gender and race/ethnicity subgroups and across all 50 states and the District of Columbia.

“The ability to collect data at the state and local levels is essential for designing and implementing interventions, such as promoting physical activity, that target the relevant at-risk populations,” according to Dr. Lubetkin. “Although the prevalence of obesity has been well documented in the general population, less is known about the impact on QALYs both in the general population and at the state and local levels….Our analysis enables the impact of obesity on morbidity and mortality to be examined using a single value to measure the Healthy People 2020 objectives and goals at the national, state, and local levels and for population subgroups.”

From 1993 to 2008, the obesity prevalence for U.S. adults increased from 14.1% to 26.7% (89.9%). Black women had the most QALYs lost due to obesity, at 0.0676 per person in 2008, which was 31% higher than QALYs lost in black men and about 50% higher than QALYs lost in white women and white men. A direct correlation between obesity- related QALYs lost and the percentage of the population reporting no leisure-time physical activity at the state level also was found.

The prevalence of obesity increased over time for all states, while obesity-related QALYs lost tended to follow a similar pattern. However, disparities among states lessened over time, with less obese states “catching up” to more obese states and producing a greater percentage change of QALYs lost.

“Collaborative efforts among groups at the national, state, and community (local) levels are needed in order to establish and sustain effective programs to reduce the prevalence of obesity, “commented Dr. Jia. “Although the impact of current and future interventions on curtailing the burden of disease might not be available for a number of years, this method can provide an additional tool for the Healthy People 2020 toolbox by providing a means to measure objectives and goals. The availability of timely data would enable the impact of evidence-based interventions to be assessed on targeted populations and subgroups, promote continuous quality improvement through monitoring trends, and facilitate head-to-head comparisons with other modifiable health behaviors/risk factors and diseases.”

MONDAY, July 26 (HealthDay News) — Obesity and chronic pain are both linked with family history and mood disorders, a new study suggests.

Previous research has shown that overweight people are at greater risk for chronic pain, mainly due to excessive weight placed on the joints. The most common pain disorders related to overweight and obesity are low back pain and osteoarthritis.

In this new study, Lisa Johnson Wright, of the University of California, San Diego, along with colleagues there and at the University of Washington in Seattle and the Veterans Affairs San Diego Healthcare System, examined data from 3,471 people in the University of Washington Twin Registry in order to determine how family history and psychological factors influence the relationship between obesity and chronic pain.

“Overall, overweight and obese twins were more likely to report low back pain, tension-type or migraine headache, fibromyalgia, abdominal pain, and chronic widespread pain than normal-weight twins after adjustment for age, gender and depression,” Wright and colleagues wrote in the July issue of the Journal of Pain.

The study authors also concluded that depression and family history play a significant role linking obesity and pain.

In terms of depression, behavioral factors play a role in obesity and pain. Depressed people are often sedentary, which can lead to obesity and contribute to acute pain becoming chronic pain, the researchers explained in a news release from the American Pain Society.

Chronic pain and obesity are significant problems in the United States, the researchers noted, with costs related to obesity estimated at $118 billion annually. For chronic pain the estimate is $70 billion a year in health-care expenses and lost productivity.

A review of more than 100 studies found overweight girls tend to reach puberty earlier than their peers do.

While some researchers have argued hitting puberty early in life makes a person at higher risk for metabolic syndrome and diabetes, Emily Walvoord, M.D., pediatric endocrinologist and review author, found such diseases are not linked to early puberty, but obesity.

The review appears online in the Journal of Adolescent Health.

“Early puberty is one of the many outcomes of obesity,” said Walvoord, a professor at the Indiana University School of Medicine. “There are clearly other factors we don’t understand that have affected the timing.”

While childhood obesity is a growing epidemic, she suggested other factors include a possible increase in hormone-disrupting chemicals in the environment and more chronic stress in children’s homes.

Mounds of research on the topic exist, but each study parses data differently, leading to scattered results. “It’s very hard really to scientifically scrutinize the timing of puberty just by looking at these studies,” she said.

Despite the wealth of attention the early start of puberty has received in the last 15 years, Walvoord said many unanswered questions exist, none more troubling than that of the psychological impact. The long-term effect on adolescents is still unclear.

Girls who reach puberty early are more likely to experience negative body image, depression and other mental disorders. However, those mental health issues also link closely to obesity, so it is difficult to untangle cause and effect.

Jane Mendle, psychology professor at the University of Oregon, said those in her field know the psychological effects of early puberty well. “Whether or not that knowledge has been translated in the way it could or should be to the general population, I’m not sure.”

Mendle said girls who mature earlier tend to land in social situations they are not psychologically prepared to handle. Because of that, they might develop psychological issues during puberty.

While research on boys and puberty is thin compared to girls, Mendle said her recent work suggests the deciding factor for the emotional influence on boys might be the duration of puberty, while it is timing for girls.

“It could be that with boys by trying to focus on timing we’re sort of barking up the wrong tree,” she said.

Provided by Health Behavior News Service

Research to be presented at the Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB), the foremost society for research into all aspects of eating and drinking behavior, finds that that feelings of hunger have less influence on how the brain responds to the smell and taste of food in overweight than healthy weight individuals.

The research team scanned the brains of healthy and overweight participants and found that the overweight participants had greater activity in many key brain regions that respond to the smell and taste of food. An important new finding was that the brain responses of healthy weight participants were associated with their feelings of hunger, whereas the responses of overweight participants did not depend on whether the participants felt hungry or full. Dana Small from The John B Pierce Laboratory and Yale University says, “We are all guilty of mindlessly reaching for a handful of peanuts or chips. The amygdala is a region of the brain important for orchestrating this behavior. Our findings show that feelings of fullness are effective in reducing amygdala responses in healthy but not overweight people”.

In an environment that is rich in sights and smells of food, one factor that may contribute to overeating is whether eating serves to dampen the brain’s responses to food cues that usually encourage eating. The team also reports that activation of the amygdala predicted weight gain by participants one year after the scanning session. “For some people feelings of fullness may provide a good brake on eating behavior. For others, the brake may be less effective, resulting in more eating in the absence of hunger, with subsequent weight gain”, says Small.

Provided by Society for the Study of Ingestive Behavior

June 30, 2010

(PhysOrg.com) — While organic food may contain fewer, if any, pesticides and additives, consumers mistakenly believe it also has fewer calories, say researchers at the University of Michigan.

“As Americans’ waistlines have grown, so has their appetite for organic food,” said Norbert Schwarz, professor of marketing at the U-M Ross School of Business. “Labeling food as ‘organic’ entails a claim about its production, but is silent on its calorie content. Nevertheless, people struggling to cut calories may turn to organics and possibly consume more calories than they otherwise would.”

In an article this month in the journal Judgment and Decision Making, Schwarz and U-M colleague Jonathon Schuldt found that Americans believe that organic food contains fewer calories and is, therefore, more appropriate to eat more often than nonorganic food. This is true even when the nutrition labels for organic and conventional foods list the same amount of calories.

The researchers showed more than 100 study participants nutrition information for a regular Oreo cookie and for one that was made with organic flour and sugar. The nutritional label clearly showed a serving size (two cookies) of 160 calories for both Oreos. Nevertheless, 38 percent of the participants thought that the organic cookie had fewer calories than competing brands, whereas only 12 percent did so without the organic claim.

“Presumably, participants inferred that if organic cookies contain 160 calories, then the calorie content of conventional cookies—whatever the precise amount—is likely to be higher,” said Schwarz, who also is a professor of psychology and research professor at U-M’s Institute for Social Research. “In addition, participants considered it appropriate to consume Oreo cookies more frequently when they were organic than when they were not.”

Schuldt and Schwarz also examined whether the influence of organic claims extend beyond judgments about the food itself to judgments about the need for physical exercise—another major factor in America’s obesity crisis.

They asked more than 200 study participants whether a female college student trying to lose weight could forgo her daily post-dinner, three-mile run if she ate an organic dessert or a conventional nonorganic dessert (in both cases, a small bowl of ice cream or a chocolate chip cookie) or skipped the dessert altogether.

The researchers found that taking a day off from running seemed less of a problem to study participants if the college student ate the organic dessert or no dessert at all compared to if she ate the conventional dessert.

“Despite the student’s goal of losing weight through regular exercise, participants were more lenient toward her forgoing planned exercise when she had chosen organic over conventional dessert,” said Schuldt, a doctoral student in psychology at U-M. “Even more surprising was the fact that leniency toward forgoing exercise was slightly greater when the student chose organic dessert than when she chose no dessert at all.”

In all, the U-M study shows that the popularity of organic food is not without its down side.

“As millions of Americans attempt to lose weight, eating organic foods—even desserts—may be viewed as a substitute for actual weight-loss-promoting behaviors,” Schuldt said. “Our findings suggest that organic claims may not only foster lower calorie estimates and higher consumption intentions, but they may also convey that one has already made progress toward one’s weight-loss goal, thus undermining subsequent action.”

(HealthDay News) — Americans are continuing to get fat, with obesity rates nudging upwards in 28 states over the past year, a new report shows.

“More than two-thirds of states now have adult obesity rates above 25 percent,” Jeff Levi, executive director of the Trust for America’s Health, said during a Tuesday news conference. “Back in 1991, not that long ago, not a single state had an obesity rate above 20 percent. There’s been a dramatic change in a relatively short period.”

“Obesity is one of the biggest public health crises in the country,” Levi added. “Rising rates of obesity over past decades is one of the major factors behind skyrocketing health care costs in the U.S., one-quarter of which are related to obesity.”

Mississippi weighed in for the sixth year in a row as the fattest state, with 33.8 percent of its adults obese, while Alabama and Tennessee tied for second (31.6 percent). The other top 10, also concentrated in the south, were West Virginia, Louisiana, Oklahoma, Kentucky, Arkansas, South Carolina and Michigan tying with North Carolina for 10th place (29.4 percent).

Michigan was the only state in the top 11 not in the South, an anomaly perhaps explained by the state’s economy.

“Michigan certainly has been very hard hit, not just in the recent recession, but in the last decade or so,” Levi explained.

And, as the report also shows, income is a major driver of the obesity epidemic. More than 35 percent of adults bringing in less than $15,000 a year were obese, vs. only 24.5 percent in the over-$50,000 income bracket.

The healthiest states in terms of weight were congregated in the Northeast and West. Colorado (19.1 percent) came in first, followed by Connecticut, the District of Columbia, Massachusetts, Hawaii, Vermont, Rhode Island, Utah, Montana and New Jersey. The District of Columbia was the only region to experience a decline in obesity rates.

In addition to geographic and economic differences, this year’s report also focused on racial and ethnic disparities, finding that blacks and Latinos bear the brunt of the obesity problem. Blacks and Latinos outweighed whites in at least 40 states plus D.C.

“Just over 30 percent of African-Americans and nearly 40 percent of Latino children are overweight versus 29 percent of white children,” Angela Glover Blackwell, founder and chief executive officer of PolicyLink, said during the teleconference.

As with adults, this puts them at higher risk of developing diabetes, high blood pressure and other risk factors for heart disease.

Racial/ethnic differences are closely intertwined with economic inequalities.

“The link between poverty, race and obesity is undeniable,” Glover Blackwell said. “For example, Mississippi, the poorest state in nation with an African-American population of more than 37 percent, has the highest obesity rate of any state and highest proportion of obese children.”

Poor and minority neighborhoods lack safe streets and parks in which to exercise and many are also so-called “food deserts.”

“Twenty-three million African-Americans do not have access to a grocery store within a mile of where they live, and only 8 percent of African-Americans live in a census tract with a grocery store,” Glover Blackwell said.

A poll on childhood obesity included in this year’s report found that 16.4 percent of children aged 10 to 17 are obese and 18.2 percent are overweight. Although the rates are troubling, the trend may have stabilized, the report said.

But the issue is at least getting on the radar, with 80 percent of Americans saying they believe “childhood obesity is a significant and growing challenge for the country.”

Some glimmers of hope have also appeared on the horizon, including “three major developments at the federal level,” Dr. James Marks, senior vice president of the Robert Wood Johnson Foundation, said during the teleconference. “This includes First Lady Michelle Obama’s ‘Let’s Move’ program; health care legislation that includes support for obesity-related projects; and many states and communities have mandated nutritional standards for school meals and snacks as well as foods sold in schools.”

“In the last few years, promising programs and policies have increased exponentially, but our response as a nation has yet to fully match magnitude of problem,” Levi said.

June 15, 2010

Parents are more likely to underestimate their preschool children’s weight when pediatricians do not tell them their children are overweight or gaining weight too fast, a study by the University of South Florida and Johns Hopkins University reports.

The study, published online earlier this month in Clinical Pediatrics, suggests pediatricians should not hesitate to wield their influence in helping parents identify overweight children. These children are at risk of developing serious and costly health problems once reserved for adults, like Type II diabetes and heart disease.

“When it comes to younger children, pediatricians tend to shy away from discussing and making recommendations about weight,” said lead author Raquel Hernandez, MD, MPH, assistant professor of pediatrics at USF Health.

“That’s unfortunate, because even a child as young as 2 years old with a body mass index indicative of obesity is at high risk of becoming an obese adult,” said Dr. Hernandez, who initiated the study while she was a fellow in general academic pediatrics at Johns Hopkins. “As much as we’d like to think that chubby, smiling toddler will outgrow the excess weight, it’s just not likely to happen with today’s overabundance of food and societal influences toward heavier size.”

The American Academy of Pediatrics recommends using body mass index (BMI), an indicator of body fatness calculated from height and weight, to screen for overweight and obesity in children, beginning at age 2.

Children are considered overweight if they fall in the 85th to 94th percentiles of the BMI growth charts, and deemed obese if they are in the 95th percentile or higher.

This USF-Johns Hopkins study was the first to look at parents’ perception of an ideal or healthy-weigh image in preschoolers – children ages 2 to 5. From July 2008 to April 2009, the researchers interviewed 150 parents of preschoolers during well-child visits to an academic-based clinic. Among their findings:

* The absence of a pediatrician’s comment was the strongest predictor that a parent of an overweight or obese child would misclassify their child’s body image. These parents reported that their own child’s current weight was the same or lighter than that of a healthy-weight preschooler.
* Among all respondents, less than 8 percent recalled ever being told by their pediatrician that their child was gaining weight too fast or overweight. A larger proportion of parents with overweight or obese children reported hearing this from a pediatrician – 10 percent and 30 percent, respectively.
* While nearly one in three preschoolers in the study was overweight or obese, 83 percent of all parents reported their children as “about the right weight.” More than half the parents of obese children cited their child was “about the right weight.”
* Parents of overweight preschoolers were much more likely to underestimate their children’s weight (89.6 percent) than parents of obese children (45.5 percent). In fact, 20 percent of these parents indicated that an image heavier than their child’s reflected a healthy preschooler.

Dr. Hernandez said physicians may hesitate to bring up a young child’s weight because they don’t want to risk offending the parent. Adding to their reluctance may be the lack of specific clinical testing recommendations (blood sugar, cholesterol, etc.) and practical lifestyle guidelines for overweight and obese children ages 2 to 5, she said. “As a pediatrician, you may ask yourself. ‘Do I really want to get into talking about a child’s weight with the parent who hasn’t asked about it, and if I do, what do I have to offer?’”

Yet, the advice of pediatricians matters more than they may think. Parents in the study overwhelmingly reported that they would value a pediatrician’s advice about a child’s weight problem over that of family members or friends.

Pediatricians have an important opportunity to make a difference in preventing obesity by intervening early, Dr. Hernandez said, before children’s nutritional and exercise habits are set and when it’s easier for them to lose weight.

“Weight is part of early childhood growth and development that should be on a parent’s radar screen,” Dr. Hernandez said. “Even when it’s an uncomfortable subject, pediatricians need to raise the issues of long-term health risk, nutrition and behavioral changes with parents whose children are overweight or obese – because clearly they will listen to us.”

NEW YORK (Reuters Health) – A new study confirms a link between obesity and asthma.

A number of studies have shown an association between obesity and asthma, both of which have become much more common over the past three decades, Dr. Jun Ma of the Palo Alto Medical Research Institute in California note in the medical journal Allergy.

Ma and her team looked at about 4,500 men and women from the National Health and Nutrition Examination Survey for 2005-2006. About a third were overweight, and another third were obese.

Forty-one percent had some type of allergy, while 8 percent had asthma. The researchers wanted to tease out those rates because allergy and asthma are related in some people.

Twelve percent of the obese individuals had asthma, compared to six percent of the normal-weight study participants. And the likelihood of asthma rose as the body mass index — BMI, a relation of weight and height used to gauge obesity — increased and waist circumferences expanded.

The risk of asthma was more than tripled for the most obese individuals compared to normal weight people.

But the reason why the two might be related is still not clear. Some researchers have suggested the system-wide, low-grade inflammation that occurs with obesity may be a factor, while others have argued that resistance to the key blood-sugar-regulating hormone insulin — which rises with excess weight — is the reason for the link. That resistance often foretells the onset of diabetes.

Thirty-seven percent were either diabetic or had insulin resistance. The study did not find any evidence, however, that insulin resistance was responsible for the relationship, and allergy was not related to either weight or insulin resistance.

The findings don’t rule out the possibility that insulin may be a link between obesity and asthma, Ma told Reuters Health by e-mail. There are a host of other potential reasons for the association, which seems complex, she added.

May 24, 2010

Ensuring access to healthy, affordable foods is a top priority in tackling the obesity epidemic in the United States. Over the course of the last six months, the Institute of Medicine, United States Department of Agriculture, The White House and First Lady Michelle Obama have taken an interest in improving access to affordable and nutritious foods.

Here in Seattle, Adam Drewnowski, UW professor of epidemiology, and his team are tackling the same issue. Remember the “fat zip codes” that predicted obesity rates from a few years ago? Drewnowski and his team were the brains behind that, as well as last summer’s study which showed that grocery prices in Seattle varied greatly between one supermarket chain and another.

Now, researchers at the UW Center for Public Health Nutrition, UW Urban Form Lab and the Nutritional Sciences Program in the School of Public Health are asking: “Who buys what foods, why, where, and for how much?”

The answers might surprise you. Most studies have used distance to the nearest supermarket as the best predictor of whether people have good diets and better health. But Drewnowski and team say that’s not true. “Six out of seven people shopped for food outside their immediate neighborhood,” he said “The closest supermarket for most people was less than a mile away, but people chose the market that was more than three miles away.” Driving further to save money on groceries is common. For that reason, physical proximity to a supermarket may not, by itself, assure a healthy diet. “Money does matter,” Drewnowski said.

Areas where access to healthy affordable foods is scarce have become known as “food deserts.” Seattle, however, is well-supplied with supermarkets, grocery stores, farmers markets and other vendors, said Drewnowski. “We do not see evidence of significant food deserts,” he said. In comparison with other areas in the state, public transportation is also prevalent and accessible, so people can take a bus to a supermarket or grocery store with relative ease.

Researchers combined a telephone survey, modeled on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factors Surveillance System, with new geo-coding techniques and methods of spatial analysis for the new study.

Economic access has also become a primary research focus in public health nutrition, including the work by Drewnowski and team. Supermarket chains have specific demographics–consumers differ by age, education, income, health, and even obesity rates. “The county-wide obesity rate in 2007 was 19.8 percent, but our research found that the obesity rate was only four percent among Whole Foods and PCC shoppers,” said Drewnowski. “Consumers who shop at most area supermarket chains have obesity rates at 25 percent and higher. Clearly, not all supermarkets are the same and economic access is determined by price.”

UW researchers recently discussed the Seattle Obesity Study results at “Shopping for Health” conference, which brought together public health agencies, academicians, supermarket representatives and policymakers from Seattle, King County and Washington state. Additional findings include:

* New ways to identify underserved areas (“food deserts”) in Washington state that are most in need of resources
* New ways to identify healthy, affordable and sustainable foods
* The Seattle Atlas, or SEATTLAS, of all food sources, including supermarkets, grocery stores, and fast food restaurants
* Food purchases and expenditures, diet quality and weight/ obesity
* Insights from similar studies conducted in New York City.

“We plan to explore how local data can best be used in new initiatives to improve access to healthy, affordable foods in Seattle, King County and throughout Washington state,” said Drewnowski. “As part of the dialogue, it is extremely important that the food industry be part of the solution and we welcomed their presence at this recent gathering,” he said. “We hope to provide the local answer to the question that the federal government is trying to address. And we want to make sure our public health initiatives and programs are backed by research and science.”

By Jenifer Goodwin
May 7, 2010

(HealthDay News) — At the age of 5, Lauren Ashley began complaining that “her eyes hurt.”

An ophthalmologist who examined her suspected a brain tumor because of swelling of the optic nerve, which sends information from the retina to the brain.

“Looking back, we were so devastated by the news,” said her mother, Diane Ashley. “What we didn’t know then was that what was in store was, in some ways, worse. And I am in no way making light of brain tumors.”

Lauren, now 15 and living in Gahanna, Ohio, was later diagnosed with a severe case of pseudotumor cerebri, a painful condition in which pressure inside the head builds for no apparent reason, potentially causing blindness.

Once found mostly among adults, pseudotumor cerebri seems to be rising among children — and doctors say rising rates of obesity may be to blame. About two-thirds of children diagnosed with the condition are overweight or obese, although one-third, like Lauren, are of normal weight when diagnosed.

“There are no good data on how many children have it, but we believe the reason we seem to see so much of it these days is the increase in obesity among children,” said Dr. E. Steve Roach, chief of neurology and vice chair of pediatrics at Nationwide Children’s Hospital in Columbus, Ohio.

Nationwide is currently treating about 80 children with the disorder, Roach said. The spike in children with the condition led Roach and his colleagues to establish what’s believed to be the nation’s first pseudotumor cerebri clinic geared toward children. The clinic, which just opened, will have an ophthalmologist, neurologist and endocrinologist or weight-loss specialist to provide comprehensive treatment.

Pseudotumor cerebri, sometimes called “phantom tumor,” got its name decades ago. Patients would come to the doctor with headaches and swelling of the optic nerve, Roach said. Pressure would be elevated inside the head, leading doctors to conclude it must be a tumor, only to operate and find nothing.

Diagnosis got easier in the late 70s and 80s with the advent of brain scans such as CT and MRIs, but the name stuck. The condition is also sometimes referred to as idiopathic intercranial hypertension, meaning elevated pressure within the skull with no known cause.

Normally, the brain makes cerebrospinal fluid in the ventricles, or spaces within the brain, which then circulates where it’s needed. Some of the fluid ends up on the outside of the brain, providing a cushion between it and the skull, while some flows to the spinal cord.

In a normal head, the fluid is constantly being made and reabsorbed to maintain the proper pressure inside a closed space, Roach explained.

Pseudotumor cerebri is believed to be tied to a deficiency in the brain’s ability to absorb the fluid. This causes pressure to build and in some people this brings intense, unrelenting pain.

In some, the condition gets better with medications or by losing weight, Roach said. More serious cases can be treated with surgery — either a shunt placed in the lumbar region of the spine to drain excess fluid into the abdominal cavity and relieve the pressure or, if that doesn’t work, neurosurgeons may implant a shunt in the brain to drain excess fluid.

Vision loss occurs when fluid gets pushed into the optic nerve, causing it to swell and damage the axons (nerve branches). To save the eyesight, opthalmologists can cut a “window” in the optic nerve to relieve pressure.

“The loss of vision is very gradual. It shows up first in the peripheral vision,” Roach said. “Kids don’t always recognize they are losing vision until it’s almost gone. We have a nice treatment for this, but one of the things you have to do is treat it early.”

Lauren still faces almost constant pain, even though she takes seven prescriptions a day, has undergone more than 30 surgeries to replace shunts that have stopped working, and been admitted to the hospital more than 50 times.

“I’ve never had a normal life,” Lauren said. “For as long as I can remember, I’ve had these awful headaches that feel like somebody is sticking a knife through my head.”

Because she doesn’t look sick, sometimes friends and even medical professionals don’t understand the seriousness of the condition. “They say, ‘You’re not bald. You’re not in a wheelchair. What’s wrong with you? You look perfectly fine,’” Lauren said.

She goes to school for two classes and completes the rest with the help of an at-home tutor. She enjoys going to youth group at her church when she’s feeling up to it, and keeping in touch with other teens with her condition on Facebook.

Diane Ashley, along with other families of children with the condition, have started a foundation, I.H. Gray Matters (ihgraymatters.org) to raise awareness and money to help families travel to the new clinic.

“The more people get to know what this is and the more doctors know what it is, the more research will get done,” Diane Ashley said. “Maybe one day other kids won’t have to suffer like Lauren does.”

(HealthDay News) — Obese children are much more likely to snore than normal weight children, a new study finds.

Italian researchers compared 44 children with habitual snoring, 138 children with occasional snoring, and 627 children who did not snore. Of those children, 64 were obese, 121 were overweight, and 624 were normal weight.

The incidence of snoring among obese children was 12.5 percent, more than two times higher than that of overweight children (5.8 percent) and three times higher than that of normal weight children (4.6 percent).

The researchers also found that obese children were nearly twice as likely to have obstructive sleep apnea, a breathing-related sleep disorder, as overweight or normal weight children.

The study is published in the May issue of the journal Chest.

By Amanda Gardner
HealthDay Reporter
April 27, 2010T

Children who are overweight or obese appear to metabolize over-the-counter drugs differently than normal-weight children, a new study finds.

This could result in complications at both ends of the spectrum, whether kids’ bodies end up with more drug than they need or less.

“There could be severe implications,” said L’Aurelle Johnson, senior author of the research, which was to be presented Tuesday in Anaheim, Calif., at a meeting of the American Society for Pharmacology and Experimental Therapeutics, part of the Experimental Biology 2010 conference.

“There could be adverse effects if the therapeutic agent is metabolized into an active form,” she explained. “They could have higher systemic circulation of this particular agent, and they might have adverse events due to [overly] high concentrations in the system.”

On the contrary, if the therapeutic agent is metabolized into an inactive form, therapeutic thresholds might not be met, meaning the child would not benefit from the drug, she explained.

Though it’s long been known that adults who are overweight metabolize drugs differently than their normal-weight counterparts, there has been little similar research done in kids, according to the researchers.

“Because of the increase in obesity in the pediatric population, we need to know how being overweight or obese affects how drugs are metabolized in the system,” Johnson said.

Johnson and a co-author looked at how both dextromethorphan (the active ingredient in over-the-counter Robitussin DM) and caffeine (delivered via a cola drink) were metabolized by 16 normal-weight and nine obese children, 6 to 10 years old. All of the children were black.

Specifically, the authors measured activity levels of two key enzymes involved in drug metabolism.

They found higher enzyme activity among the obese children who were given caffeine, but not among those who took dextromethorphan.

“This means that there is variability in enzyme activity, which has implications for furthering personalized medicine,” said Johnson, who is an assistant professor of experimental and clinical pharmacology at the University of Minnesota College of Pharmacy. “We might need to take into account a child’s physiological condition — whether they’re obese or non-obese — when determining dosing.”

Johnson also plans to look at how the activities of additional enzymes might be altered in obese children.

By Anne Harding

NEW YORK (Reuters Health) – Excess weight increases stroke risk, a new study including nearly 2.3 million people confirms. And the heavier a person is, the greater their risk.

“Being obese (but indeed even just overweight) puts an individual at significantly higher risk of ischemic stroke, with a serious possibility of permanent disability and reduced life expectancy,” Dr. Pasquale Strazzullo of Frederico II University of Naples Medical School in Naples, Italy, one of the study’s authors, told Reuters Health.

Ischemic strokes occur when blood vessels supplying the brain are blocked. Hemorrhagic strokes, caused by bleeding in the brain, are less common.

While being overweight increases a person’s likelihood of having stroke risk factors such as high blood pressure, the question of whether being overweight or obese directly ups stroke risk has not been answered adequately; evidence from past research has been “controversial,” Strazzullo noted.

To investigate, he and his colleagues searched the medical literature for studies with at least four years of follow-up that looked at stroke risk based on body mass index, or BMI, a standard measure of weight in relation to height used to gauge how fat or thin a person is. They found 25 studies including 2,274,961 people, who had a total of 30,757 strokes.

People who were overweight were 22 percent more likely to suffer an ischemic stroke than normal weight people, while the risk for obese people was 64 percent higher, the researchers found. Hemorrhagic stroke risk wasn’t higher for overweight people, but it was 24 percent higher for obese people.

A person’s risk of having a stroke within the next 10 years can be estimated based on their gender, blood pressure, whether or not they smoke, and whether or not they have diabetes, Strazullo explained.

For example, a 62-year-old man whose systolic blood pressure (the top number) is 125, doesn’t smoke, and does not have diabetes or other cardiovascular problems, would have a 4 percent risk of stroke over the following decade; if the same man had a systolic blood pressure of 160 (140 and above is too high) and wasn’t receiving treatment for high blood pressure, his risk of stroke within the next 10 years would be 15 percent.

Therefore, obesity would raise the risk of stroke to nearly 6 percent for the man with normal blood pressure, and to 25 percent for the man with untreated high blood pressure.

Strazzullo and his team also found that once they accounted for lifestyle risk factors like smoking, age, and cardiovascular risk factors, overweight and obesity independently affected stroke risk. One possible reason for this, the researcher noted, is that fat cells secrete several substances that have “unfavorable effects” on the body, for example promoting inflammation, hardening of the arteries, or blood clotting.

Given the difficulty of treating obesity, the researcher said, the best approach to preventing related complications like stroke is for people to avoid packing on the pounds in the first place.

“All of us should keep tight control of our weight and take immediate action in case of weight gain, reducing calories and increasing physical exercise,” he advised.

SOURCE: Stroke, April 2010.

(Reuters Health) – Pudgy babies may be adorable, but being overweight may delay a baby’s ability to roll over, crawl, or conquer other important physical skills, researchers report.

Meghan Slining, a doctoral student in nutrition epidemiology at the University of North Carolina at Chapel Hill, and colleagues evaluated 215 infants at various times up to 18 months.

Of the 152 infants found to be overweight during any of these evaluations, 20 percent – 31 infants — had delayed motor skills, Slining said in an email to Reuters Health.

During these observations Slining’s team also found 75 babies with high average measures of belly, upper-arm, and upper-back skin fat. Of these, 23 percent — 17 infants — had delayed motor skills, Slining added.

Over all observations, motor skill delays such as an inability to sit steadily for 30 seconds were about twice as likely in overweight and overly pudgy infants than in those with “normal” weight and fat.

The group’s report in the Journal of Pediatrics is the first to “suggest overweight infants and those with excessive body fat may be at greater risk for delayed motor development than infants without extra weight and fat,” she said.

During home visits with the low-income African-American mothers and babies, the researchers documented each infant’s ability to perform 14 to 21 different age-appropriate skills. At each visit they also measured pudginess and weight for length of the infants.

Initially, 62 babies were overweight by U.S. Centers for Disease Control weight-for-length standards for 3-month-old infants. At 6 months 30 were overweight, and by 18 months 14 remained so.

Twenty of the 3-month-olds had higher skin fat averages than the rest of the study group at that age. By 18 months, 12 remained overly pudgy compared with the others.

Generally, 3-month-olds balance their head, sit with support, and roll over, and 6-month-olds sit alone and show signs of crawling. But 6-month-olds with low motor skills might not sit steadily for 30 seconds without support or roll from their backs to their stomachs, Slining said.

Eighteen-month-olds with low motor skills might not have enough balance to walk backwards or sideways, or stand on one foot for two seconds, she noted. Normally, walking skills develop between 9 and 12 months, and 18-month-olds walk backwards and up stairs.

It is important for parents to provide a safe space where infants can and are encouraged to explore, but overweight infants may limit age-appropriate exploration beyond their arm’s reach, Slining and colleagues surmise.

Still, without examining other groups of infants for months and years, researchers won’t know whether excessive weight or body fat causes delayed motor skills in older children, they note.

A new study led by researchers from the Harvard School of Public Health (HSPH) in collaboration with researchers from the Institute for Health Metrics and Evaluation at the University of Washington estimates that smoking, high blood pressure, elevated blood glucose and overweight and obesity currently reduce life expectancy in the U.S. by 4.9 years in men and 4.1 years in women. It is the first study to look at the effects of those four preventable risk factors on life expectancy in the whole nation.

The researchers also estimated the effects of these risk factors on eight subgroups of the U.S. population, called the “Eight Americas.” The Eight Americas are defined by race, county location and the socioeconomic features of each county. They found that these four risk factors account for a substantial proportion of differentials in life expectancy among these groups. Southern rural blacks had the largest reduction in life expectancy due to these risk factors (6.7 years for men and 5.7 years for women) and Asians the smallest (4.1 years for men and 3.6 years for women).

The study appears in the March 23, 2010 issue of the open-access journal PLoS Medicine.

“This study demonstrates the potential of disease prevention to not only improve health outcomes in the entire nation but also to reduce the enormous disparities in life expectancy that we see in the U.S.,” said Majid Ezzati, associate professor of international health at HSPH and senior author of the study.

Smoking, high blood pressure, elevated blood glucose and obesity are responsible for hundreds of thousands of deaths from chronic diseases such as cardiovascular diseases, cancers and diabetes, in the U.S. each year. By studying how these risk factors affect mortality and life expectancy, public health officials can better address how to improve the nation’s health and to reduce health disparities.

For their study, the researchers used 2005 data from the National Center for Health Statistics, the National Health and Nutrition Examination Survey, the Behavioral Risk Factor Surveillance System, and an extensive review of epidemiologic studies on the effects of these factors. They estimated the number of deaths that would have been prevented in 2005 if exposure to the four risk factors had been reduced to their optimal levels or commonly used guidelines. They also assessed the benefits for life expectancy, a measure of longevity.

The Eight Americas were defined by the authors in an earlier study as Asians; Northland low-income rural whites; middle America; low-income whites in Appalachia and Mississippi Valley; Western Native Americans; Black middle America; high-risk urban blacks and Southern low-income rural blacks.

The researchers found that a person’s ethnicity and where they live is a predictor of life expectancy and how healthy a person is. Some of the findings include:

* Asian American men and women had the lowest body mass index (BMI), blood glucose levels and prevalence of smoking
* Blacks, especially those in the rural South, had the highest blood pressure
* Whites had the lowest blood pressure
* Western Native American men and Southern low-income rural black women had the highest BMI
* Western Native American and low-income whites in the Appalachia and Mississippi Valley had the highest prevalence of smoking

As a result of these patterns, smoking, high blood pressure, elevated blood glucose and overweight and obesity account for almost 20% of disparities in life expectancy across the U.S. These four factors also accounted for three quarters of disparities in cardiovascular mortality and up to half of disparities in cancer mortality.

Below is the number of years that would be gained in life expectancy in the U.S. if each individual risk factor was reduced to its optimal level:

* Blood pressure: 1.5 years (men), 1.6 years (women)
* Obesity (measured by body mass index): 1.3 years (men), 1.3 years (women)
* Blood glucose: 0.5 years (men), 0.3 years (women)
* Smoking: 2.5 years (men), 1.8 years (women)

“It’s important that public health policy makers understand that these behavioral and metabolic risk factors are not just personal choices or the responsibility of doctors,” said Goodarz Danaei, a postdoctoral research fellow at HSPH and the lead author of the study. “To improve the nation’s overall health and reduce health disparities, both population-based and personal interventions that reduce these preventable risk factors must be identified, implemented, and rigorously evaluated.”

Provided by Harvard School of Public Health

March 11, 2010

Obesity plus daily drinking boosts the risk of liver disease in men and women, researchers report in two new studies.

In one study, scientists at the University of Oxford examined the medical records of 1.2 million middle-aged British women. They followed them for an average of about six years and found that overweight or obese women faced a higher risk of cirrhosis of the liver, and the risk increased if they also reported drinking an average of a third to half a drink a day.

Still the overall numbers were small: Of those who drank that much, only 0.8 or 1 in 1,000 was admitted to the hospital with cirrhosis of the liver or died of the disease over five years.

But among those who reported drinking an average of 2.5 drinks a day, the rate was 2.7 in 1,000 among those with healthy weight and five in 1,000 among those who were obese.

In another study, teams at the universities of Glasgow and Bristol tracked more than 9,000 men in Scotland for an average of 29 years. They found that a combination of higher alcohol consumption and obesity boosted the levels of liver disease beyond what would be expected.

Both reports appear online March 12 in the BMJ.

February 22, 2010

Obesity in general nearly doubles the risk of developing kidney stones, but the degree of obesity doesn’t appear to increase or decrease the risk one way or the other, a new study from Johns Hopkins shows.

“The common thinking was that as weight rises, kidney stone risk rises as well, but our study refutes that,” says study leader Brian R. Matlaga, assistant professor of urology at the Johns Hopkins University School of Medicine and director of stone diseases and ambulatory care at Hopkins’ James Buchanan Brady Urological Institute. “Whether someone is mildly obese or morbidly obese, the risk for getting kidney stones is the same.” The findings are published in the February Journal of Urology.

Over the last decade, several epidemiological studies have shown a strong connection between obesity and kidney stone disease. However, as obesity continues to rise worldwide, Matlaga and his colleagues wondered whether different subcategories of obesity, ranging from mildly to morbidly obese, presented different risks.

To answer the question, the researchers used a national insurance claims database to identify 95,598 people who had completed a “health risk assessment” form with information about their body mass index (BMI), a measure of body fat calculated by dividing weight by height, and a general indicator of underweight, healthy weight, or overweight. The database, which spanned over a five-year period from 2002 to 2006, also had encoded information indicating whether these individuals had been diagnosed with kidney stone disease.

Using a definition of obesity as having a BMI greater than 30 kg/m2 (which, in English measurements, corresponds to a 5 foot tall person who weighs 153 pounds, or a 6 foot tall person who weighs 221 pounds), the researchers calculated the incidence of kidney stones in people who were non-obese and in those who were obese. Among the non-obese individuals, 2.6 percent were diagnosed during the study period with kidney stones, compared to 4.9 percent of the obese individuals. When the investigators arranged those in the obese group by their BMIs, ranging from above 30 kg/m2 to more than 50 kg/m2, they found that the increased risk remained constant, regardless of how heavy the individuals were.

Matlaga says that he and his colleagues aren’t sure why obese people are more at risk for kidney stones, though metabolic or endocrine factors unique to obesity are likely reasons, along with dietary factors such as a high-salt diet. The researchers plan to study these potential risk factors in subsequent studies.

Other researchers who participated in this study include Michelle J. Semins, M.D., Andrew D. Shore, Ph.D., Martin A. Makary, M.D., M.P.H., Thomas Magnuson, M.D., and Roger Johns, M.D., M.P.H., all of the Johns Hopkins University School of Medicine.

February 12th, 2010
in Medicine & Health / Diseases

Diet, exercise and genes are not the only factors which determine if someone can become obese. The composition of the intestinal bacteria may also account for a person’s obesity. This is the contention of Wageningen microbiologists and colleagues from the University of Amsterdam end January in the scientific journal Diabetologia.

The authors base their viewpoint on tens of experimental studies carried out mostly on laboratory animals. These studies apparently show that the intestines of mice which suffer from obesity contain more bacteria types which efficiently convert indigestible food into manageable fatty acids. When researchers transplanted the gut flora of obese mice into mice without such gut flora, the fat percentage increased significantly in these so-called germ-free mice. It is suspected that the gut flora (known as gut microbiota) of these obese mice also affects hormones involved in fat storage.

Humans suffering from obesity also have such efficient gut bacteria, the authors surmise. They would therefore derive more energy from food and become fat easier. Various studies also point to this view, although the results are not always conclusive. Professor Willem de Vos, one of the authors of the publication, says: ‘The study of gut bacteria in humans is rather complex. Every human being has a unique composition of microbiota, which makes research difficult. We want to use this review article as a first step into a territory which is abandoned by and large. Research into the relationship between microbiota and obesity in humans can only begin afterwards.’

It is therefore unclear as to how far efficient gut bacteria can increase the risk of obesity. Is their influence bigger or smaller than diet, exercise or a person’s genetic profile? The Wageningen microbiologists will research into this in a big European study. In another project, they are examining, together with Amsterdam researchers, the extent to which the composition of the microbiota of obese patients can be influenced in favour of less efficient bacteria. They will introduce the gut bacteria of non-obese people into that of obese people. This experiment is in full swing.

Provided by Wageningen University

Obesity linked to higher risk of kidney stones

January 18, 2010

(Reuters Health) – Obese people are more likely to develop kidney stones than normal weight individuals, but severe obesity doesn’t seem to further increase risk, research in the Journal of Urology shows.

Kidney stones are solidified deposits of minerals and acid salts. “Passing” the stones in the urine can be extremely painful. Rarely, a person will require surgery or other types of treatment if they are unable to pass the stone on their own.

Studies have shown a rise in kidney stone disease paralleling the increase in obesity, Dr. Brian R. Matlaga of Johns Hopkins University in Baltimore and his colleagues write. It’s unclear why weight would affect kidney stone rates, although researchers have a number of theories involving different levels of substances in the blood among the obese.

Matlaga’s team analyzed 2002-2006 records for more than 95,000 people included in a national private insurance database.

The researchers identified 3,257 people with kidney stones. Men were twice as likely as women to have kidney stones, while the risk of stones increased with age.

They used the body mass index (BMI) – a standard measure used to gauge how fat or thin a person is – to classify patients’ weight. (You can use http://www.nhlbisupport.com/bmi/ to calculate your own BMI.)

Among people classified as either normal weight (BMI 18.5-24.9) or overweight (BMI 25-29.9) but not obese, about one in 40 had been diagnosed with kidney stones, compared to about one in 20 of those classified as obese (BMI above 30). But there was no significant difference in risk among obese individuals, no matter how heavy they were.

Those who were obese were more likely than the non-obese to undergo kidney stone removal, but those who were severely obese were no more likely to undergo these procedures than their normal weight peers.

It’s possible, the researchers note, that the heaviest people were more likely to have their kidney stones treated with medication than surgery.

“Dietary modification and weight loss should be encouraged in the obese population for a multitude of reasons but also to reduce stone risk,” they conclude.

FRIDAY, Sept. 10 (HealthDayNews) — Four common supplements — chromium, vitamin B-6, vitamin B-12 and multivitamins — may help slow weight gain in middle-age adults, claims a study by researchers at the Fred Hutchinson Cancer Research Center in Seattle.

Researchers reviewed questionnaire responses from about 15,000 people, average age 55, in Washington state. They provided information about their vitamin, mineral and herbal supplement use over the previous 10 years, along with details about diet, physical activity and medical history.

The researchers focused on 14 supplements.

The study concluded that the people who had taken multivitamins, vitamin B-6, vitamin B-12 and chromium had less weight gain over the previous 10 years than other respondents. That slowed weight gain was most evident among people who’d been categorized as overweight or obese at the start of the 10-year period.

The findings were to be presented this week at the annual meeting of the American Association of Naturopathic Physicians in Seattle.