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    28
    Nov
    2012
    5:48pm, EST

    Simple formula predicts child obesity at birth

    By Kate Kelland

    A simple assessment can predict at birth a baby's likelihood of becoming obese during childhood, scientists said on Wednesday.

    The formula, available as an online calculator, estimates the child's obesity risk based on its birth weight, the body mass index of the parents, the number of people in the household, the mother's professional status and whether she smoked during pregnancy.

    Researchers who published a study of the test in the journal PLOS ONE say they hope it will be used to identify babies at high risk and help families take steps to stop them putting on too much weight before it's too late.

    Childhood obesity is a leading cause of early type 2 diabetes, as well as various types of cardiovascular disease, and is becoming increasingly common in developed countries.

    According to data from the American Heart Association, almost 18 percent of boys and almost 16 percent of girls aged between two and 19 in the United States are obese. In England, 17 percent of boys and 15 percent of girls aged between two and 15 are obese, according to National Health Service (NHS) data.

    "Once a young child becomes obese, it's difficult for them to lose weight - so prevention is the best strategy and it has to begin as early as possible," said Philippe Froguel of Imperial College London, who led the study.

    "Unfortunately, public prevention campaigns have been rather ineffective at preventing obesity in school-age children. Teaching parents about the dangers of over-feeding and bad nutritional habits at a young age would be much more effective."

    Froguel's team developed the formula using data from a study set up in 1986 following 4,000 children born in Finland.

    They were initially investigating whether obesity risk could be assessed using genetic profiles, but the test they developed based on common genetic variations failed to make accurate predictions. Instead, they found that non-genetic information available at the time of birth was enough to predict which children would become obese.

    The formula proved accurate not just in the Finnish children they studied, but also in further tests using data from studies in Italy and the United States.

    "This test takes very little time, it doesn't require any lab tests and it doesn't cost anything," Froguel said. The calculator is available here.

    Although the team's work using common genetic variants did not prove to be helpful for predicting childhood obesity, they said about one in 10 cases of obesity are caused by rare mutations that seriously affect appetite regulation.

    The researchers said tests for these types of mutations could become available to doctors in the next few years as the cost of DNA sequencing technology falls.

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  • 18
    Sep
    2012
    10:03am, EDT

    If you think we're fat now, wait till 2030

    Image Source / Getty Images file

    In the 13 heaviest states, 60 percent of residents will be obese in less than two decades if current trends continue, finds a new report.

    By Maggie Fox, Senior Writer, NBC News

    Think Americans are fat now? After all, a third of us are overweight and another 35 percent are obese. But a report out Tuesday projects 44 percent of Americans will be obese by 2030.

    In the 13 worst states, 60 percent of the residents will be obese in less than two decades if current trends continue, the report from the Trust for America’s Health projects. That’s not chubby or a little plump – that’s clinically obese, bringing a higher risk of heart attacks, strokes, diabetes, several forms of cancer and arthritis.

    “The initial reaction is to say, ‘Oh it couldn’t be that bad’,” says Jeff Levi, executive director of the Trust for America’s Health. “But we have maps from 1991 and you see almost all the states below 10 percent.” By 2011 every single state was above 20 percent obesity, as measured by body mass index (BMI), the accepted medical way to calculate obesity. Those with a BMI or 30 or above are considered obese.

    In August, the Centers for Disease Control and Prevention reported that 12 states have an adult obesity rate over 30 percent. Mississippi had the highest rate of obesity at 34.9 percent. On the low end, 20.7 percent of Colorado residents are obese. CDC projections for obesity resemble those in Tuesday's report - it projects 42 percent of adults will be obese by 2030.

    The problem isn’t just cosmetic. “The number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could increase 10 times between 2010 and 2020 — and then double again by 2030,” the report projects.  “Obesity-related health care costs could increase by more than 10 percent in 43 states and by more than 20 percent in nine states.”

    That’s bad news when states are already strapped to pay for public health programs such as Medicaid and the federal government is struggling to fund Medicare.

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    Over the next 20 years, more than 6 million patients will be able to blame obesity for their diabetes, 5 million will be diagnosed with heart disease and 400,000 will get cancer caused by obesity.

    And some of them are frighteningly young.

    "Now I am seeing 25-year-olds weighing 350 pounds who present with chest pain or shortness of breath," says Dr. Sheldon Litwin, a cardiologist at Georgia Health Sciences University. “Everything from the heart disease process to its diagnosis and treatment are affected by obesity. We see it every day. This really is the number-one issue facing us," added Litwin, who worked on one of a series of obesity studies published in this week’s issue of the Journal of the American Medical Association.

    The trend is not inevitable, according to the report, entitled “F as in Fat.” Some programs are beginning to make a dent in the rising rates.  “We certainly see, in some communities, the beginning of some changes,” says Levi. “We know what some of the answers are.”

    Convicted killer: I'm too obese to be executed

    For instance, making it easier for people to exercise day in and day out, and making it easier to get healthy food. “A large-scale study of New York City adults found that increasing the density of healthy food outlets, such as supermarkets, fruit and vegetable markets, and natural food stores is associated with lower BMIs and lower prevalence of obesity," the report reads.

    What about initiatives like New York’s controversial ban on the largest sodas? “Every community is going to experiment with different approaches. It is going to be very interesting to see what happens in New York and whether this makes a difference,” Levi said.

    New York’s health commissioner, Dr. Thomas Farley, defends the move in the medical journal’s obesity issue. "How should government address the health problems caused by this successful marketing of food? To do nothing is to invite even higher rates of obesity, diabetes, and related mortality,” he wrote.

    Trust for America's Health

    Many studies have also shown that people who live in big, walkable cities such as New York and Washington D.C. are thinner than their rural and suburban counterparts, and it’s almost certainly because they walk more and use public transportation instead of sitting in cars.

    If everyone lost just a little weight, the savings would be enormous, the study predicts.

    “If we could lower obesity trends by reducing body mass indices (BMIs) by only 5 percent in each state, we could spare millions of Americans from serious health problems and save billions of dollars in health spending —between 6.5 percent and 7.8 percent in costs in almost every state,” the report says.

    Education can’t hurt, either. The more educated people are, the less likely they are to be obese. Higher-earners are also thinner. “More than 33 percent of adults who earn less than $15,000 per year were obese, compared with 24.6 percent of those who earned at least $50,000 per year,” the report notes. And several studies have shown that people who eat more fruits and vegetables are thinner, as well as healthier. “Seven of the 10 states with the highest rates of obesity were also in the bottom 10 for fruit and vegetable consumption,” the report says.

    Levi believes it’s worthwhile targeting kids the hardest. New nutritional guidelines for schools will help, he said, as will initiatives to restore recess and physical education classes. Beverage makers have agreed to replace sugary sodas in vending machines with water and other low-calorie drinks. “It is as simple as an hour a day less of screen time and one less sugar beverage,” Levi says.  “Just 120 calories can make a big difference as to whether a kid crosses over from being normal weight into overweight and obesity.”

    Another study in the Journal of the American Medical Association showed that kids who exercised 20 minutes a day lowered an important measure of diabetes risk by 18 percent. Exercising 40 minutes a day cut the risk by 22 percent. The researchers also noted it’s important to make exercise fun for kids

    "Regulation sports tend to have kids standing around a lot waiting for the ball. We had enough balls so everyone was moving all the time," said Dr. Catherine Davis of Georgia Health Sciences University. "It had to be fun or they would not keep coming.”

    For some people, drastic measures remain an option. One study in the Journal shows that gastric bypass surgery is a viable option. And two doctors present opposing views over whether the Food and Drug Administration holds obesity drugs to an unreasonably high standard. On Tuesday, one of the newest obesity drugs hits the market - Qsymia, made by Vivus.

    Are you obese? The National Institutes of Health has a BMI calculator here. http://www.nhlbisupport.com/bmi/

    If you’re 5 feet 6 inches tall, you become overweight at 160 pounds (a BMI of 25.1) and obese at 192 pounds, when your BMI grows to 30.1.

    Trust for America's Health

     

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  • 8
    May
    2012
    8:24am, EDT

    Beep! Beep! That creeping commute is hurting your health

    A new study finds that long commutes could have a negative impact on your health. WCAU's Dawn Timmeney reports.

    By Bill Briggs

    Sure, speed kills. But new science suggests your sluggish slog from home to work (and back again) is slowly sucking the life out of you -- exit by excruciating exit. 

    Commuters who log 16 or more miles each way on their daily haul to the job tend to pack plumper paunches and post higher blood pressure when compared to those with shorter excursions, according to the first research exploring the intersection of travel distances and health impacts.

    Clogged roads seem to clog arteries, in part, by eating into potential gym minutes. Among folks who drive 16-plus miles to earn a paycheck, the prevalence of obesity is almost 9 percent higher while the rate of fitness is nearly 9 percent lower versus those who journey six to 10 miles, according to a study published today in the American Journal of Preventive Medicine. (Those numbers are not adjusted for age or gender).

     


    “Part of it is that people with longer commutes aren’t exercising as much. But there could be other factors like they’re eating (fast food) while driving or they’re getting less sleep because they don’t have as much discretionary time,” said Christine M. Hoehner, the study’s lead investigator and an assistant professor in the department of surgery at Washington University in St. Louis, Mo.

    By mapping the daily drives and dissecting the health scores of 4,297 residents from two Texas metro areas, Dallas and Austin, Hoehner and her colleagues distilled the mile-by-mile health hazards linked to sitting behind the wheel.

    Take, for example, Body Mass Index -- a calculation of stored fat based on height and weight. (A BMI between 18.5 and 24.9 is considered normal). For every 10-mile increase in your driving distance, your BMI rises by .17 units, Hoehner said. So if you’re already on the cusp of an unhealthy BMI -- say at 24.5 -- adding 15 miles to your foray -- each way -- will nudge you into the danger zone.

    The daily drive has taken a toll on Sharon Binford, part of the marketing and development team at an online office supply retailer. She has a roughly 30-mile commute to and from her home in White Plains, N.Y., and her office in Manhattan, spanning 1 hour and 20 minutes each way.

    “I am more tired, so I think my mood and activity level have been affected” by the daily trek, said Binford, 25. Before she got her current job, she didn’t drive to work.

    “Before, I would have avocados and tomato, or strawberry and yogurt, or eggs-and-bacon breakfasts. Now, I eat cereal in the mornings -- Special K Red Berries, but it’s still all carbs instead of almost none,” Binford said. “I used to spend about an hour running three times a week. Now, I try to occasionally squeeze in a half-hour run during my hour lunch break.”

    Americans are, indeed, spending slightly more time collectively navigating to and from their jobs. In 2010, 8 percent of U.S. workers had one-way commutes of one hour or more -- up from 7.8 percent in 2009, said Brian McKenzie, a commuting analyst at the U.S. Census Bureau.

    But the true traffic terrors are, of course, found on the local levels, especially in cities where far-flung suburbs offer more affordable housing. According to INRIX, a traffic information provider that ranks the worst municipal commutes, the most congested cities in 2010 were, in order, Los Angeles, New York, Chicago, Washington, D.C. then Dallas/Fort Worth -- where Hoehner conducted much of her study.

    And, hardly shocking to any fuming driver who routinely winces at an agonizing line of brake lights, Hoehner found that longer commutes are more likely to fuel stress levels.

    “It’s about the chronic stress: daily exposure to traffic, the hassles of not being able to predict when you’ll arrive, and having no control over your time because of that traffic,” Hoehner said.

    About one-third of the commuters Hoehner analyzed notched 16 or more miles getting to work. The prevalence of elevated blood pressure in that group was about 52 percent. Meanwhile, slightly more than half the drivers studied needed 10 miles or less to reach their jobsite or office. The rate of high blood pressure in that portion: about 45 percent.

    So, honk if you hate the guy driving one car ahead -- and the other 500 beyond. They’re killing you.

    Related stories: 

    Working moms are happier, study finds

    Working moms multitask way more than dads

    Daily serving of red meat raises risk of heart disease

    A Siberian husky named Shiro and her owner have a bonding ritual of hand-and-paw holding during their daily commute; in fact, Shiro whimpers when she's not holding his hand. TODAY's Natalie Morales takes a look at the adorable video.

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  • 3
    Apr
    2012
    8:51pm, EDT

    The surprising new face of obesity

    The obesity epidemic could be far worse than previously thought. BMI, an estimate of body fat, often isn't accurate enough to categorize people as being at-risk. NBC's Dr. Nancy Snyderman reports.

    By Joyce Ho and Dr. Nancy Snyderman
    NBC News

    Follow @nbcnightlynews

    The nation’s ever-growing obesity epidemic may be far worse than originally thought. New research demonstrates that even people with a healthy Body Mass Index, a commonly used scale to measure body fat, could actually be obese and at risk for a host of complications.

    A study published Monday in the journal PloS One found that using BMI as an indicator of obesity actually misclassifies 39 percent of Americans as “overweight” rather than “obese.” And because BMI doesn’t distinguish between fat and muscle, some people with normal BMIs may have dangerously high amounts of fat in their bodies.

    Without an accurate measurement of body fat, the researchers say, millions of people don’t know they are at high risk for a number of obesity-related diseases.

    “The fat is what causes heart disease, cancer, menstrual problems, depression, anxiety, and a host of medical problems,” said Dr. Eric Braverman, a professor at Weill Cornell Medical School and co-author of the study. “So if you want to save society from a lot of illnesses …  you have to identify how much fat they have.”

    More than one in three adults in the U.S. are obese, as defined by a BMI of 30 or higher, according to the Centers for Disease Control. Obesity measurement, however, has been a controversial topic for years, and the widely-used BMI calculation has been called outdated by experts.

    BMI is calculated through a simple formula: weight divided by height squared. The ease of calculation made this formula popular, even though it’s nearly 200 years old. In Braverman’s study, researchers compared the BMI with a different measurement, the Dual Energy X-ray Absorptiometry (DXA) scan. DXA scans, commonly done in women to check for osteoporosis, measure percentage of body fat, muscle mass, and bone density.

    Of the 1,393 people studied, 26 percent were classified as obese when body fat was measured with BMI, whereas 64 percent of them were considered obese when measured with DXA. The misclassification was observed more often in women and increased with advancing age: 48 percent more women between the ages of 50 to 59 were classified as obese when measured with DXA instead of BMI, and among women ages 70 and above, 59 percent more were considered obese after getting a DXA scan. 

    According to the authors, BMI is an inaccurate measure for obesity – but especially in this demographic, because as women age they lose more muscle to fat than men. BMI, which does not distinguish between muscle or fat, does not reflect this bodily change. 

    “BMI doesn't tell you how much fat … you have,” said Braverman. “So without knowing how much fat you have, you can't really save people from illness. It is the number one predictor of who's going to live or die.”

    Researchers also tracked blood levels of leptin, a hormone produced by fat cells that regulates hunger and energy expenditure. Increased blood leptin levels correlated well with DXA scan results, highlighting the potential for a simple leptin blood test to be a measurement for obesity.

    Based on these findings, Braverman and his co-author Dr. Nirav Shah, the current New York state health commissioner, suggest lowering the BMI definition of obesity from 30 to 24 in women and down to 28 in males. Under these suggested guidelines, a woman who is 5’ 6” and 150 pounds would be considered obese. Under the current BMI standards, the same woman would be considered healthy.

    “Fat is costing the country a fortune, by not measuring it,” said Braverman. “A dollar blood test and doing our bone density scans with body fat scans at the same time is going to save us an enormous medical cost in the end.”

    NBC’s Stacey Naggiar, Chiara Sottile and Joo Lee contributed to this report.


    Read more from msnbc.com:

    • America’s fattest cities
    • Size matters for obese cancer patients’ drug dose
    • U.S. advisers back obesity pill

     

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  • 26
    Oct
    2011
    9:44am, EDT

    Desperate to qualify for weight loss surgery, some pile on the pounds

    A woman who was desperate for lap band weight-loss surgery had to gain weight to meet qualifications for the procedure that would ultimately help her shed the extra pounds. NBC's Kristen Dahlgren reports.

    By JoNel Aleccia, Senior Writer, NBC News

    At 202 pounds, Steffany Sears knew she was fat, but not fat enough to qualify for traditional weight-loss surgery.

    Desperate for help, the Gold Bar, Wash., woman did what seemed the only logical thing:  She gorged herself on chips and cookies, pizza and fried chicken so she’d gain at least eight pounds more.

    Courtesy Steffany Sears

    Steffany Sears, 34, of Gold Bar, Wash., lost nearly 70 pounds after receiving the Lap-Band stomach-shrinking device as part of a clinical trial in 2008. The trial led the Food and Drug Administration to lower the limit for obese patients eligible for the device last spring.

    “I would have eaten myself stupid,” recalled Sears, 34, who was turned down by her insurance company for the $20,000 procedure. “I know friends who would have done that, too.”

    In the end, she actually qualified to participate in a clinical trial that led the federal Food and Drug Administration this spring to lower the bar for obesity in people eligible for one form of weight-loss surgery, Allergan’s Lap-Band stomach-shrinking device. Because she had a body mass index, or BMI, of between 30 and 35, the target range of the new rule, she even got the treatment for free, instead of having to take out a second mortgage on her house.

    Today, at 5-foot-6, she weighs 143 pounds. "I felt like I'd won the lottery, really, with my life," said Sears, a native of England.

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    But Sears’ experience highlights what dieters and doctors alike say is a growing dilemma. Spurred by strict insurance policies that limit surgery to high BMIs of 35 or 40, some obese people are actually striving to gain weight -- in order to lose it.

    Web sites devoted to weight-loss surgery are full of advice and anecdotes from would-be losers who claim they ate piles of bananas, chowed down on burgers and curly fries or swilled gallons of water to nudge the scale to the correct heights.

    “That happens all the time,” said Dr. Robert Michaelson of Northwest Weight Loss Surgery in Everett, Wash., who was a clinical investigator for the FDA trial. “I’ve seen people come in with ankle weights on.”

    Sometimes, it works. Elizabeth Marks, 32, of San Diego, Calif., was turned down for surgery once by her insurance company for being less than 100 pounds overweight, but accepted after she gained more.

    “I just had two weeks of eating all the junk I could,” Mark said.


    In general, a person who is 5-foot-6 and weighs 220 pounds has a BMI of 35. At 250, the BMI climbs to 40.

    Weight-loss doctors definitely discourage patients from gaining more and instead urge them to pursue non-surgical options, or to find other ways to pay for the surgery. One good reason? Some insurers regard the practice as fraud.

    “I tell them go home. You don’t qualify,” said Dr. Namir Katkhouda, a bariatric surgeon at the University of Southern California who has performed 2,000 procedures. “They come back six months later and their problems are much worse.”

    Weigh in on this story on the Vitals Facebook page

    The dilemma has been exacerbated by the recent FDA decision, which approved the use of Lap-Band in patients with BMIs as low as 30 with at least one weight-related disease, such as high blood pressure or diabetes. The agency left the BMI level at 40 for heavy but otherwise healthy people.

    The move opened the door to an additional 27 million people eligible to access surgery and prompted experts to predict a sudden rush toward lower BMI procedures. So far, despite great interest, that hasn’t happened, said Dr. Robin Blackstone, president of the American Society for Metabolic and Bariatric Surgery.

    “The insurance hasn’t expanded to embrace that indication,” she said, noting that less than 1 percent of those eligible for bariatric surgery actually get it. In 2009, nearly 63,000 Lap-Band devices were implanted in the U.S., according to estimates from the Agency for Healthcare Research and Quality.

    Insurers prefer that people try other less-drastic weight-loss options, including medically supervised programs, said Susan Pisano, a spokeswoman for America’s Health Insurance Plans.

    “Many, if not most, insurers look to less invasive, less-risky approaches before they move on to the more invasive, more life-threatening approaches,” Pisano said.

    As far as Sears is concerned, the January 2008 surgery changed her life; she says she doesn’t regret gaining a little to lose a lot.

    “I would do it again, now that I’ve tasted what it feels like to be normal and not overweight,” said Sears.  

    Read on:

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