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2011年6月25日星期六

Industry role in child obesity less prominent on TV (Reuters)

在 ServiceModel 客户端配置部分中，找不到引用协定“TranslatorService.LanguageService”的默认终结点元素。这可能是因为未找到应用程序的配置文件，或者是因为客户端元素中找不到与此协定匹配的终结点元素。
在 ServiceModel 客户端配置部分中，找不到引用协定“TranslatorService.LanguageService”的默认终结点元素。这可能是因为未找到应用程序的配置文件，或者是因为客户端元素中找不到与此协定匹配的终结点元素。

NEW YORK (Reuters Health) – Television coverage of childhood obesity is less likely than print media to focus on the role of the food and beverage industry, according to a new report in the journal Pediatrics.

On the other hand, TV networks more often mention solutions on the personal level, like exercising and eating healthy foods.

That is concerning, researchers say, because spotlighting individual ways to combat obesity instead of focusing on underlying societal issues can pull the public's attention away from needed changes.

"If we think the answer to solving the problem is all about individuals changing their behavior, then there is no role for policy changes," said Colleen Barry of Johns Hopkins Bloomberg School of Public Health in Baltimore, who worked on the study.

According to the U.S. Centers for Disease Control and Prevention, childhood obesity has more than tripled over the past three decades, reaching close to 20 percent in 2008.

With her colleagues, Barry analyzed a sample of 806 of the news stories that ran in U.S. magazines and newspapers and on TV networks between 2000 and 2009.

The team found that nearly all stories mentioned some sort of solution to the obesity problem. About two-thirds of TV news stories mentioned diet or exercise changes, while newspapers did so 52 percent of the time and magazines 58 percent of the time.

By contrast, TV networks mentioned system-level solutions -- like creating playgrounds or making sure that healthy foods are available in poor neighborhoods -- less frequently than print media.

Specifically, networks pointed to potential changes in the food and beverage industry only 18 percent of the time, compared to more than 30 percent in newspapers and magazines.

Barry said the reasons for this are unclear, but said industry ads on TV might play a role.

"TV news relies more heavily on advertising dollars from the food and beverage industry, so I think that could provide some influence," she told Reuters Health.

According to data from the Nielsen Company, about 15 percent of ads on TV were paid for by the food industry in 2008, compared to only two percent of the ads in newspapers.

Another possible explanation for the different coverage is that systems-based solutions may be too abstract and therefore harder to address in a visual medium, Barry said.

The researchers also found that childhood obesity coverage had dropped markedly since 2007, although the extra weight is still plaguing our society.

"It's a serious public health problem, and despite efforts to change people's behavior, childhood obesity shows no signs of abating," Barry said.

SOURCE: http://bit.ly/iidweQ Pediatrics, online June 20, 2011.

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Obesity Surgery Yields Clues to Weight-Loss Mysteries (LiveScience.com)

Surgery for obesity began with a simple premise: if you make the stomach smaller, people will eat less, so they will lose weight.

But in recent years the results of obesity surgery have been so outstanding, researchers went back to the drawing boards to figure out what was going on.

Their findings are beginning to present a far more complicated picture of weight — and of how much diet and exercise can really do to change it. Turns out, a slew of hormones from the gut, and their communication with the brain, play a role in the way the body maintains and loses weight.

Chasing down the answer to exactly how obesity surgery works is providing new insights into human weight loss and appetite regulation, researchers say.

"As a result of weight loss surgery, we finally are beginning to understand the physiology of weight loss better than we've ever understood it before," said Dr. Sunil Bhoyrul, a weight-loss surgeon at Olde Del Mar Surgical in La Jolla, Calif.

Their investigations may reveal how to replicate the results of the surgery without requiring patients to go under the knife.

Ghrelin from the gut

There are several different types of weight-loss surgery (also called bariatric surgery), including gastric bypass and gastric banding, but all involve making the stomach smaller. [Infographic: Types of Weight Loss Surgery].

Patients can lose up to 60 to 80 percent of their excess weight in one to four years after surgery, and many have an easier time keeping it off than they did through dieting, Bhoyrul said. However, up to a third can end up back at their pre-surgical weight seven to 10 years later, he noted.

But researchers are realizing that weight loss after surgery is fundamentally different from weight loss achieved by dieting.

A key player in this difference is the hormone ghrelin, which stimulates appetite. When we diet, our ghrelin levels rise, making us hungry. We may lose weight, but our ghrelin levels stay high, and we continue to feel hungry even after eating. Ghrelin levels come down only if we regain the weight, said Dr. Robin Blackstone, a bariatric surgeon at Scottsdale Bariatric Center in Arizona.

"People who are trying to lose weight are being fought tooth and nail by the body to keep that weight on," said Dr. Miguel Burch, associate director of general surgery and minimally invasive surgery at Cedars-Sinai Medical Center in Los Angeles.

But after gastric bypass surgery, ghrelin levels go down significantly, Burch said.

"They're losing more weight than they ever had before and not only are not hungry, they have to force themselves to eat," Burch said. This may be why surgery patients can keep their weight off, he said.

And ghrelin is likely just the tip of the iceberg in terms of hormonal changes that occur. There are likely many more hormones we don't know about that aid in weight loss after surgery, Burch said.

Mind over stomach

Results from the surgery have also highlighted the role of the brain in weight loss and weight gain. Your mind, not just your stomach, manages your waistline.

"We never realized that the brain was so important," Bhoyrul said. "We thought it was just as simple as getting people to eat less. That turns out to be the least of the issues," he said.

The brain is the body's energy thermostat, Bhoyrul said, controlling how quickly you use energy, and when to store and expend it. There is an ongoing conversation between the gut and the brain that takes place via hormones, he said.

Deciphering this conversation could help researchers understand how to best instigate weight loss, Bhoyrul said.

A recent finding underscores how much there is to learn about the stomach-brain connection. Unlike the drop in ghrelin seen after gastric bypass, those who undergo gastric banding experience a drop in their hunger, but not in ghrelin, said Dr. Emma Patterson, a bariatric surgeon in Portland, Ore. This may be because ghrelin communicates with the brain differently after this surgery, Patterson said.

Surgery without the surgery

It might be possible to replicate the results of the surgery using drugs.

"If we can understand how these surgeries work…we can put whatever that thing is in a pill," Patterson said.

One possible target may be an enzyme involved in the production of ghrelin, Burch said.

Indeed, one approach taken by researchers seeking to develop an obesity vaccine has been to block the hormone's production.

However, some have argued that, because many hormones are involved in weight loss, targeting one is unlikely to help people lose weight.

"Most of us are skeptical that 'turning off the ghrelin switch' is the universal answer to all obesity," Bhoyrul said.

Pass it on: The success of obesity surgery is yielding a better understanding of how gut hormones and the brain regulate weight and controls appetite.

This story was provided by MyHealthNewsDaily, a sister site to LiveScience. Follow MyHealthNewsDaily staff writer Rachael Rettner on Twitter @RachaelRettner.

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Obesity and lack of exercise linked to chronic pain (Reuters)

NEW YORK (Reuters Health) – It may not be surprising, but people who exercise at least one hour per week have a lower risk of troublesome back, neck, and shoulder pain, a new study shows.

The new evidence supports the possibility that obesity and physical inactivity play a role in a person's risk of developing chronic pain in those areas, said study co-author Dr. Paul Mork, of Norwegian University of Science and Technology in an email to Reuters Health.

Mork and colleagues followed more than 30,000 adults who participated in a large Norwegian health study. They recorded participants' body mass index (BMI) - a measure of weight related to height - at the start of the study, as well as how often they exercised, and then tracked them over the next 11 years.

The authors divided the participants into four categories based on how often they exercised, and four categories based on their BMI. They also looked at how many people in each category developed chronic neck, shoulder, and lower back pain.

Overall, 1 of every 10 people in the study developed lower back pain, and nearly 2 of every 10 developed shoulder or neck pain.

After taking into account participants' age, BMI, whether or not they smoked, and whether they did manual labor at work,

the research team found that men who were exercising 2 hours or more per week at the start of the study were 25 percent less likely to have lower back pain 11 years later, and 20 percent less like to have neck or shoulder pain, compared men who didn't exercise at all. And women who exercised at least 2 hours per week were 8 percent less likely to develop lower back pain than women who were inactive, and 9 percent less likely to develop neck and shoulder pain.

Weight, not surprisingly, also affected the risk of chronic pain later on. Obese men were almost 21 percent more likely to develop chronic lower back pain than men of normal weight, and 22 percent more likely to develop neck or shoulder pain. Obese women were also 21 percent more likely to develop lower back pain than women of normal weight, and 19 percent more likely to develop neck and shoulder pain.

Based on the results, Mork believes that even moderate physical exercise - just one hour or more per week - "can, to some extent, compensate for the adverse effect of being overweight and obese on future risk of chronic pain."

"Chronic neck and back pain are important to public health due to their substantial influence on quality of life, disability, and health care resources," Dr. Adam Goode from Duke University in Durham, North Carolina told Reuters Health by email. Goode, a physical therapist, was not involved in the study by Mork's group.

Back in the mid-1990s, a study from the Netherlands estimated that low back pain cost that country nearly 2 percent of its gross national product. In their new paper Mork and colleagues write that "just a small reduction in the incidence of chronic lower back pain would have a profound economic impact."

Because of the way it was designed, the Norwegian study can't prove that lack of exercise and being overweight actually caused people's chronic pain, or that regular exercise and a more healthy weight prevented it. It could be that the people who did or didn't have chronic pain are different in ways the study did not measure.

However, given the known benefits of exercise and maintaining a healthy weight, Mork believes that "community based measures aimed at reducing the incidence of chronic pain...should aim at promoting regular physical exercise and the maintenance of normal body weight."

SOURCE: http://bit.ly/jaoix5, online June 11, 2011

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TV and soda: small habits cause weight creep (Reuters)

CHICAGO (Reuters) – Just a few bad habits -- watching TV, eating potato chips, having a sugary soda at lunch or staying up too late at night -- can add up to a steady creep of pounds over the years, U.S. researchers said on Wednesday.

While most studies on diet focus on changes needed to help obese people lose weight, the study by the Harvard team showed tiny changes in diet and lifestyle can make a big impact.

The study focuses on specific lifestyle choices -- foods, activity, sleep habits -- that slowly pack on the pounds. The researchers stressed that the quality of food choices, and not just calories, are key to maintaining a healthy weight.

"These small choices add up," said Dr. Dariush Mozaffarian of the Harvard School of Public Health and Brigham and Women's Hospital, whose study appears in the New England Journal of Medicine.

"Because the weight gain is so gradual and occurs over many years, it has been difficult for scientists and for individuals themselves to understand the specific factors that may be responsible," Mozaffarian, who led the effort, said in a statement.

To get at this, the team analyzed data on 120,877 U.S. women and men from three large studies of health professionals that tracked changes in lifestyle factors and weight every four years over a 20-year period.

All study participants were normal-weight and healthy when they started. Over time, they gained an average of 3.35 pounds (1.59 kg) during each 4-year period for a total average weight gain of 16.8 pounds (7.6 kg) at the end of the 20-year study.

Foods that added most to weight gain over a four-year period included daily consumption of potato chips (1.69 lbs or 0.76 kg), potatoes (1.28 lbs or 0.58 kg), sugar-sweetened beverages (1 lb or 0.45 kg), unprocessed red meats (0.95 lbs or 0.43 kg) and processed meats (0.93 lbs or 0.42 kg).

More than a third of adults and nearly 17 percent of children in the United States are obese, increasing their chances of developing health problems including type 2 diabetes, heart disease, high blood pressure, fatty liver disease and some cancers.

Obesity-related diseases account for nearly 10 percent of U.S. medical spending, or an estimated $147 billion a year.

FOOD THAT SHOULD BE CALLED BAD

Mozaffarian said understanding ways to keep people from becoming obese may be more effective than getting people to lose weight as U.S. policymakers attempt to turn the tide.

Those in the study who lost or maintained their weight over time tended to eat minimally processed foods.

"Fruits, vegetables, whole grains and nuts -- if you increase their intake, you had relative weight loss, presumably because you are replacing other foods in the diet," Mozaffarian said.

The study contradicts the notion that all foods are good for you in moderation.

"The idea that there are no 'good' or 'bad' foods is a myth that needs to be debunked," said Frank Hu of Harvard, who worked on the research.

Mozaffarian said different foods have a different effect on the body. "You can't just say a calorie is a calorie. It doesn't address your feelings of fullness, your blood glucose levels, your blood insulin levels and the other biological responses in your body," he said.

In the study, dietary changes appeared to have the biggest impact on weight gain over time, but other lifestyle changes also were a factor.

For example, watching one hour of TV per day added 0.31 pounds (0.14 kg) over a four-year period.

Sleep also played a role. People in the study who got between six and eight hours of sleep were less likely to gain weight over the study period. But people who got less than six hours or more than eight hours tended to gain weight.

And when people increased their physical activity, they tended to gain less weight during the study period.

SOURCE: http://bit.ly/myrd12 New England Journal of Medicine, June 23, 2011.

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Rushed Discharge After Weight-Loss Surgery May Raise Risks (HealthDay)

WEDNESDAY, June 15 (HealthDay News) -- Weight loss surgery patients who are discharged from the hospital too soon after undergoing gastric bypass have an increased risk of complications and death, a new study has found.

After analyzing data from nearly 52,000 gastric bypass patients, researchers found that those released from the hospital the day of surgery were 12 times more likely to have serious complications (1.9 percent versus 0.16 percent) and 13 times more likely to die than patients who left the hospital after the U.S. average of a two-day stay.

The death rate within 30 days of discharge was 0.1 percent for those who stayed in the hospital for two or more days, versus 0.8 percent for those who left the day of surgery.

Patients who were discharged from the hospital less than 24 hours after an overnight stay were two times more likely to die within 30 days than those who remained in hospital for two days after their surgery, the investigators found.

Like all surgeries, bariatric surgery carries surgical risks, including serious infections, internal bleeding, blood clots, and death, according to the American Society for Metabolic & Bariatric Surgery (ASMBA).

Length of stay appeared to be a greater risk factor than age, gender, race, body mass index and obesity-related conditions, the researchers noted.

The study was scheduled for presentation Wednesday at the annual meeting of the American Society for Metabolic & Bariatric Surgery, in Orlando, Fla. Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"This study shows what a difference a day makes," co-author Dr. John Morton, an associate professor of surgery and director of bariatric surgery at Stanford Hospital & Clinics at Stanford University, said in an ASMBS news release.

"A two-day length of stay appears reasonable for most people and results in a safety profile that rivals gallbladder or hip replacement surgery. To reduce it further may put patients at an increased chance of unnecessary risk," said Morton, who is chair of the ASMBS Access to Care Committee. "A patient should be discharged based on his or her individual risk profile. We counsel our patients to avoid drive-thru fast food, and also advise against drive-thru gastric bypass."

"Bariatric surgery is safer than ever, but discharging patients too soon after surgery may be pushing the envelope too far and may have serious consequences," he added.

More information

The U.S. National Library of Medicine has more about gastric bypass surgery.

View the original article here

For Many, Weight-Loss Surgery Also Eases Migraines (HealthDay)

WEDNESDAY, June 15 (HealthDay News) -- Severely obese patients who suffer from migraines may see them fade or become less frequent after having weight-reducing gastric bypass surgery, University of Iowa researchers say.

In the three years following surgery, 70 percent of the patients reported being migraine-free and more than 18 percent saw their migraines reduced from five to two a month, the researchers found.

"The association between migraine and obesity is controversial," said lead researcher Dr. Isaac Samuel, director of the University of Iowa Obesity Surgery Program. "Some people say the risk for migraine is higher in obese people; others say the symptoms are worse," he said.

There could be a number of reasons why migraine is relieved by gastric bypass surgery, including hormonal changes that occur after the procedure or certain proteins produced by fat cells, Samuel said.

"Severely obese patients with migraine should be encouraged to have gastric bypass if they want relief of the symptoms," Samuel said. "In addition, people who are obese, but not severely obese, should be encouraged to lose weight if they have migraine."

The findings of the study were due to be presented Wednesday at the 28th Annual Meeting of the American Society for Metabolic & Bariatric Surgery in Orlando, Fla. Since the study is small and it has not appeared in a peer-reviewed journal, its findings should be considered preliminary.

Like all other operations, bariatric surgery carries some medical risks, including. serious infections, internal bleeding, blood clots, and death, according to the American Society for Metabolic & Bariatric Surgery (ASMBA). The organization reports that the overall risk of serious complications is about 4 percent and the risk of dying is one in 1,000.

Weight-loss surgery is also expensive, costing from $17,000 to $35,000 or more, depending on the type of procedure performed.

For the study, Samuel's team reviewed the medical records of 702 patients who underwent gastric bypass surgery between March 2000 and September 2009. In addition to being obese, the patients also suffered from migraines. Of these patients, 81 were selected for the current study.

The researchers found that gastric bypass surgery improved or completely alleviated migraines in most patients. The most pronounced effect was among those patients whose headaches started after they became obese, the researchers note.

Of those who had their first migraine before becoming obese, 46 percent became migraine-free and 29 percent experienced some improvement, Samuel's group says.

These findings were independent of problems associated with migraine such as depression, anxiety or sleep apnea, the researchers added.

Other causes of headache in obese people include pseudotumor cerebri, or idiopathic intracranial hypertension, which is an increase in pressure around the brain that can feel like a migraine and may be caused by obesity. This type of headache also responds well to gastric bypass surgery, the researchers noted.

Commenting on the study, Dr. Elizabeth Loder, chief of the Division of Headache and Pain at Brigham and Women's Hospital in Boston said that "this is an interesting observation but the data seem quite preliminary."

In the absence of a control group, it is not possible to say whether the surgery and ensuing weight loss really "caused" the improvement in migraine, she said.

"Migraine is a condition that naturally waxes and wanes," Loder said. "Some of the improvement might simply reflect this variable disease activity. It is also the case that people who undergo surgery of any kind often report temporary improvement in headaches," she said.

Without a similar group of patients who did not undergo surgery, it is not possible to distinguish among these possibilities, Loder explained.

"In addition, it is unclear what is meant by complete, partial and no resolution, Loder said. "It would be very, very unusual for any treatment to cause complete resolution of migraine," she said.

Another expert, Dr. Richard B. Lipton, vice chairman of neurology, and director of the Montefiore Headache Center at the Albert Einstein College of Medicine in New York City, felt that the findings underscored the need for further research.

"These data are compatible with the epidemiologic studies showing that obesity is a risk factor for migraine progression," he said. "In addition, there is another published observational study showing that migraine improves after bariatric surgery in proportion to the extent of weight loss. Randomized trials are badly needed."

More information

For more information on diabetes, visit the U.S. National Library of Medicine.

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How Overweight Pregnant Women Can Limit Weight Gain (LiveScience.com)

Overweight pregnant women who weighed themselves weekly and received text-message reminders about weight early in their pregnancy gained less weight than women who didn't, a new study shows.

Gaining too much weight during pregnancy can bring on diabetes and may pose risks for babies.

"There is not a lot being done in early pregnancy to avoid weight gain and the complications," said study author Catherine Lombard, of the Monash University School of Public Health and Preventive Medicine in Melbourne, Australia.

The preliminary results from the ongoing study will be presented Sunday (June 12) at the annual meeting of the Endocrine Society in Boston.

The women in the study were overweight, not obese, but were considered at high risk for gestational diabetes due to their weight, age and ethnic background. Further results from the study will determine whether the healthy lifestyle program in which the women participated also reduced gestational diabetes, a serious condition that can cause complications for both the mother and child during the pregnancy.

Overweight and pregnant

Among pregnant women in the United States, about half are overweight or obese, said Dr. Raul Artal, chairman of the Department of Obstetrics/Gynecology and Women's Health at Saint Louis University. Artal conducts research on weight gain during pregnancy but was not involved in the study.

“I and many of my colleagues believe excessive weight gain in pregnancy is a major reason for the obesity epidemic in our country,” Artal said.

The Institute of Medicine guidelines on pregnancy weight gain, which were released in 2009, suggest a gain of 25 to 35 pounds for women of normal weight, 15 to 25 pounds for women who are overweight and 11 to 20 pounds for women who are obese.

Artal said the recommendations "have done a disservice to women." "It is allowing too much weight gain" for women who are already obese or overweight, he said.

Complications from being overweight or obese during pregnancy include higher rates of birth defects and higher risk of gestational diabetes. Women with gestational diabetes are at seven times the risk of getting diabetes later in life than women who do not have the condition, Artal said.

Babies born to mothers with gestational diabetes have their own complications. “These babies have a tendency to be very large and therefore have traumatic deliveries, and more complications in delivery and in the first few days of life,” Artal said. These infants are at higher risk for obesity as children and adults.

Text messages and weekly weigh-in

Lombard’s study included 200 pregnant women who were at risk for gestational diabetes. The participants were divided into two groups, one that underwent the educational program and a control group.

At 14 weeks of pregnancy, researchers gave both groups information that emphasized making small, healthy changes to eating and physical activity, such as walking and eating more fruits and vegetables. One group also received information about how much weight they should gain during pregnancy, an instruction to weigh themselves and frequent reminders by text messaging.

At 28 weeks, the women who had received the extra information had gained, on average, about two pounds less than those in the control group.

This difference might seem small, but it is important at that stage of pregnancy, Lombard said.

Further results will measure weight gain during the entire pregnancy, as well as the rates of gestational diabetes in the two groups. The study is following patients through delivery and the first six weeks of each baby’s life.

Pass it on: A healthy lifestyle program conducted early in a pregnancy can help overweight women avoid excessive weight gain.

This story was provided by MyHealthNewsDaily, sister site to LiveScience.

View the original article here

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