3 Keys to Cutting Your Risk of Heart Failure

MONDAY, Nov. 28, 2016 (HealthDay News) -- Middle-aged adults who've avoided obesity, high blood pressure and diabetes are far less likely than others to experience heart failure in their later years, new research reports.

Investigators found that a 45-year-old without those three key risk factors has as much as an 86 percent lower risk for heart failure compared with someone with poor control of weight, blood pressure and blood sugar.

"This paper provides more evidence to demonstrate the importance of a heart-healthy lifestyle," said study co-author Dr. John Wilkins. He's a cardiologist and assistant professor of medicine and preventive medicine at the Northwestern University Feinberg School of Medicine in Chicago.

Good lifestyle habits can help prevent obesity, high blood pressure and diabetes in many people, "which will substantially reduce their chances of developing cardiovascular disease later in life," Wilkins said.

According to another heart specialist, Dr. Gregg Fonarow, "This means doing everything necessary to maintain a healthy body weight -- including eating a heart-healthy diet and remaining physically active, and having regular monitoring to ensure healthy blood pressure and blood sugar levels."

The new report indicates that "while there are therapies available once heart failure develops, the most effective strategy is to prevent heart failure in the first place," said Fonarow. He is a professor of cardiology at the University of California, Los Angeles.

Heart failure affects an estimated 5.7 million adults in the United States. The disabling condition occurs when the heart can no longer pump enough blood and oxygen throughout the body.

The U.S. Centers for Disease Control and Prevention says that about half of those who develop heart failure will die within five years.

For this study, Wilkins and his associates analyzed data from four heart studies launched across the United States between 1948 and 1987.

Through 2007-2008, the researchers tracked outcomes for over 19,000 men and women whose heart health was assessed at age 45. The investigators followed another 24,000 whose heart status was determined at age 55.

Heart failure developed in nearly 1,700 participants tested at 45, and in almost 3,000 of those examined at 55, the findings showed.

But men who were free of high blood pressure, diabetes and obesity at 45 went on to live free of heart failure almost 11 years longer than men who had all three conditions. For women, the advantage was about 15 years, the study found.

On average, men and women without any of those three heart risks lived 35 years and 38 years longer, respectively, without developing heart failure.

Similar trends were seen among those assessed at 55, the researchers said.

Of the three heart-failure risk factors cited, diabetes appeared to have the greatest effect. Those without diabetes at 45 lived about nine to 11 years longer without heart failure, compared with those who did have the blood-sugar disease.

According to Fonarow, "this study quantifies the degree to which preventing the onset of high blood pressure, obesity, and diabetes can pay huge dividends in terms of lifelong health free from heart failure, cardiovascular disability, large health care expenditures, and premature cardiovascular death."

Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, noted that to enjoy these benefits, many Americans may first need to adjust their behavior.

"We need to make some pretty intense changes to our eating habits and physical activity," she said.

"The majority of us still come up short on key foods known to support health: fruits, vegetables, whole grains," Sandon said. "Few come anywhere near the recommended amount."

Physical activity is no different, Sandon added. "Many of us spend way too much time in sedentary environments. The 30 to 60 minutes you might squeeze in at the gym a few times a week barely scratches the surface to help support a healthy weight, blood pressure and reduce diabetes risk," she said.

The findings were published online Nov. 28 in JACC: Heart Failure.

More information

There's more on heart failure at the American Heart Association.

SOURCES: John T. Wilkins, M.D., M.S., cardiologist, and assistant professor of medicine, department of preventive medicine, Northwestern University Feinberg School of Medicine, Chicago; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Lona Sandon, Ph.D., RDN, LD, assistant professor, department of clinical nutrition, school of health professions, University of Texas Southwestern Medical Center at Dallas; Nov. 12, 2016, JACC: Heart Failure

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Fast-Food Calorie Labeling Not Working, Study Finds

MONDAY, Nov. 28, 2016 (HealthDay News) -- Does it help to know that a double quarter-pounder with cheese delivers 740 calories? Probably not, a new study suggests.

Starting next May, fast-food chains with more than 20 locations in the United States must display calorie counts on menus. But this study questions whether the well-intended regulations will actually steer customers to less-fattening foods.

Research in Philadelphia, where such rules already exist, indicate as few as 8 percent of fast-food eaters make healthy choices based on menu calorie counts, the study found.

"I believe menu labeling has been an important policy effort to combat a public health problem for which we have few solutions," said study author Andrew Breck.

"The success of such a calorie-labeling campaign, however, requires that target consumers simultaneously see the calorie labels, are motivated to __eat healthfully, and understand how many calories they should be eating," said Breck. He is a doctoral candidate at NYU Wagner Graduate School of Public Service in New York City.

Simply presenting calorie information is not enough, he and his colleagues stressed.

To be effective, nutrition labeling must be clearer and larger. It must also reach regular fast-food eaters -- people who expressed more concern with cost and convenience than nutrition, Breck and his colleagues found.

The trend toward nutrition labeling on fast-food menus began in response to the U.S. obesity epidemic. About 38 percent of adults and 17 percent of teenagers are obese, according to the U.S. Centers for Disease Control and Prevention. Obesity has been linked to a greater risk of high blood pressure, stroke, diabetes, cancer, and other health issues.

Philadelphia in 2010 required fast-food restaurants to post the caloric, fat and sodium content of meals. New York City and Seattle already had similar rules.

But based on interviews with 1,400 people in Philadelphia, Breck's team concluded that significant labeling improvements are needed for such laws to have an impact.

The researchers analyzed responses from about 700 customers at 15 fast-food eateries in Philadelphia and another 700 people interviewed by phone.

Nutrition postings went unnoticed by nearly two-thirds surveyed at the restaurants and one-third questioned by phone, the investigators found.

To increase visibility of calorie content, the study authors recommended increasing the type size or color contrast of calorie information on menus and menu boards.

Making these numbers more apparent could have another effect as well, the researchers suggested.

"We are hopeful that highly visible posting of calorie content on menus may also cause some restaurants to add new, more healthful options to their menus," Breck said.

But customers must first know what their recommended caloric intake should be -- and many don't, the study found.

Less than half of those surveyed at the restaurants correctly estimated the number of calories they should consume daily, Breck said.

To put calorie content into perspective, Breck would like to see statements like this on fast-food menu boards: "2,000 calories a day is used for general nutrition advice, but calorie needs vary."

"Traffic-light or stop-sign type labeling indicating the healthfulness of food items is another example of a policy that has proven successful in laboratory settings in improving consumer choice," Breck said. But whether it would work in real-world settings isn't yet known.

Finally, Breck said, successful nutrition labeling must provide information that differs from consumers' expectations of how many calories foods contain.

Connie Diekman, director of university nutrition at Washington University in St. Louis, said calorie posts are just a start in improving the nation's eating behaviors.

"Awareness is the first step in the change process, so if consumers begin to see the numbers, eventual change is possible," Diekman said.

Motivation is also critical, she said, "and achieving that requires time, education, a desire to change, and an environment that supports the changed behaviors."

As a society, Diekman added, "we have a ways to go to provide an environment that encourages and supports healthy eating."

The study was published online recently in the Journal of Public Policy & Marketing.

More information

For more on health problems related to obesity, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Andrew Breck, Ph.D. candidate, Wagner Graduate School of Public Service, New York University, New York City; Connie Diekman, M.Ed, R.D., director of university nutrition, Washington University in St. Louis; October 2016, Journal of Public Policy & Marketing, online

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Don't Get Stuffed on Thanksgiving

WEDNESDAY, Nov. 23, 2016 (HealthDay News) -- Weight gain is a common problem during the holiday season, but it can be avoided if you have a plan and a bit of self-discipline, a nutrition specialist says.

"Lack of sleep, an abundance of decadent food and the stress of the holidays are the perfect storm for weight gain," Kristen Kizer, a registered dietitian at Houston Methodist Hospital, said in a hospital news release.

"Remind yourself how it feels to overeat and implement a personal wellness plan to get you through the holiday season without adding to your waistline," she advised.

Reduce the amount of food you prepare. Instead of 14 dishes, limit it to seven or eight dishes. Doing so will save time and money and spare you from eating leftovers for the next several days, she added.

"Holiday meals are typically heavy in carbohydrates, so try reducing your carb consumption for the day by replacing mashed potatoes with mashed cauliflower. Your guests probably won't even notice the difference," Kizer said.

Don't add marshmallows or brown sugar to sweet potatoes. Replace unhealthy green bean casserole with fresh steamed green beans with low-fat cheese sprinkled on top or roasted green beans with a little olive oil and fresh garlic.

"Substitute natural applesauce for oil or butter in your dessert recipes. This simple ingredient swap not only adds moisture and flavor to baked goods, but fiber and nutrients," Kizer said.

At parties, choose either alcohol or dessert, but not both.

"Get plenty of sleep. Getting less than six hours of sleep a night causes cravings for starchy, sugary foods and dissolves your resolve to make healthy food decisions. Most health experts recommend at least seven hours of sleep a night to feel fully rested," Kizer said.

Exercise is another important factor in preventing weight gain during the holidays, she noted.

More information

The U.S. Centers for Disease Control and Prevention has more on healthy weight.

SOURCE: Houston Methodist Hospital, news release, Nov. 10, 2016

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TV Snack Ads Make Preschoolers Snack More: Study

MONDAY, Nov. 21, 2016 (HealthDay News) -- Preschoolers who watched "Sesame Street" interrupted by TV ads for a salty snack food ended up eating more of that food soon after, a new study found.

The finding suggests that "young children remain highly exposed to TV advertisements for foods that may contribute to unhealthy dietary patterns," said a team led by Jennifer Emond. She's an assistant professor of pediatrics at Dartmouth College, in Hanover, N.H.

Obesity remains a threat to the health of many American children. And Emond's team pointed out that "energy-dense, nutritionally poor foods" continue to be aggressively marketed to very young children.

Indeed, the average preschooler is exposed to more than three hours of television each day, and "preschoolers viewed 18 percent more TV snack food advertisements from 2010 to 2014," the researchers said.

Does such advertising "work" to get these youngsters to __eat more unhealthy snacks?

To find out, Emond's team monitored 60 kids aged 2 to 5, from New Hampshire and Vermont, as they watched a 14-minute segment of "Sesame Street."

The preschoolers got a filling snack before the show -- so they were not hungry -- and then had unlimited access to snacks during it.

Some of the children watched the "Sesame Street" segment without food commercials, while others watched the show with commercials for a popular salty snack. The ads depicted kids happily playing and eating the snack.

The result: Children who watched the snack commercial "consumed, on average, 29.5 kilocalories more" food afterwards, and "the main effect was driven by a greater consumption of the advertised food," Emond's team wrote.

The researchers believe this shows that food ads prompt kids to eat, even when they're not hungry. Limiting food commercials targeted to children could help kids __eat more healthily and consume fewer unneeded calories, the study authors contended.

Dr. Allison Stakovsky is a pediatrician at Cohen Children's Medical Center in New Hyde Park, N.Y. She said the new findings mirror previous research.

"We already know that television viewing is an important environmental influence on the development of obesity," she said. "Kids who watch more television are more likely to be overweight. Kids who have a television in their bedroom are more likely to be overweight.

"This study shows that food advertising affects preschoolers snacking habits," Stakovsky added, and "these findings further support the American Academy of Pediatrics' recommendation to limit preschoolers media use to no more than one hour a day."

One nutritionist agreed, and said it's up to parents to help steer children towards healthier eating habits.

"Efforts should be made towards eating as a family and focusing on conversation instead of the distraction of TV," said Dana Angelo-White. She's a dietitian and clinical assistant professor at Quinnipiac Univerity in Hamden, Conn.

"Screen time should be limited during meal and snack times, regardless of what type of programming they could be exposed to," White added.

The study appears online Nov. 21 in the journal Pediatrics.

More information

There's more on healhy nutrition for preschoolers at the U.S. Department of Agriculture.

SOURCES: Allison Stakofsky, M.D., attending pediatrician, Cohen Children's Medical Center, New Hyde Park, N.Y.; Dana Angelo-White, RD, clinical assistant professor, Quinnipiac University, Hamden, Conn.; Pediatrics, Nov. 21, 2016

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Choose the Healthy Foods Options This Holiday Season

SUNDAY, Nov. 20, 2016 (HealthDay News) -- Even the best intentions to make healthy food choices during the holidays can be derailed, the American Heart Association cautions.

Eating a diet consisting of fruits, vegetables, lean protein and healthy grains is one of the most important ways to reduce the risk for heart disease and stroke, the association points out.

Fortunately, there are ways to avoid moments of weakness when dining out or going to gatherings, said Rachel Johnson. She is a nutrition professor at the University of Vermont and past chair of the association's nutrition committee.

When dining at a restaurant, the first step is to look at the menu with blinders on.

"Don't even let yourself look at that [unhealthy] section of the menu," Johnson said in an association news release. It's a lot easier to order a salad when menu options loaded with fat and calories aren't up for consideration, she added.

At home, it's also important to anticipate unhealthy cravings. Many people make unwise snack choices when they are relaxing after dinner, said Johnson. Instead of giving in to those cravings, take a walk or call a friend on the phone, she suggested.

It's also a good idea to plan ahead and anticipate food temptations. To increase the chances of making healthy choices, Johnson offers the following tips:

• Store unhealthy foods out of sight. Put these foods away in a cabinet or container that's not transparent. Keep a bowl of fruit on the kitchen counter instead of a cookie jar.

• Buy smaller or individually wrapped portions. Instead of buying a half-gallon of ice cream, choose individually packaged low-calorie frozen treats.

• Brush your teeth right after you eat. Having minty fresh breath will make sneaking another treat less tempting.

• Stock up on sugarless gum. The sweetness of chewing gum can calm cravings for treats with sugar and more calories.

• Don't overdo it. If you do give in to temptation, do so in moderation. Have a small portion and share the rest, or put it away.

More information

The American Academy of Nutrition and Dietetics provides more tips for healthy dining.

SOURCE: American Heart Association, news release

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'Yo-Yo Dieting' Hard on Older Women's Hearts: Study

THURSDAY, Nov. 17, 2016 (HealthDay News) -- Millions of Americans have a lifelong struggle with their waistlines -- dieting, losing weight, but then gaining it back again.

It's a pattern known as "yo-yo dieting," and a new study suggests it does no favors for older women's hearts.

"Women with a normal [weight] who experience yo-yo dieting throughout their adult life are at increased risk of sudden cardiac death and coronary heart disease death," said study leader Dr. Somwail Rasla.

The risk of sudden cardiac death was nearly 3.5 times higher, and the risk for death linked to coronary heart disease was 66 percent higher, according to Rasla. He's an internal medicine resident at Memorial Hospital of Rhode Island in Pawtucket.

Experts have long known that being overweight at midlife is linked with a higher risk of death from heart disease. It can also boost the chances for sudden cardiac death, a condition where the heart's electrical system abruptly stops working.

However, less has been known about how repeatedly gaining and losing weight might affect a person's heart disease death risk.

For the new study, Rasla's team tracked self-reported weight histories from more than 158,000 older, postmenopausal women. The researchers put the women into four categories -- stable weight, steady weight gain, weight loss that was maintained, or the "yo-yo dieting" pattern.

Stable weight was defined as no more than a 10-pound gain or loss over the adult life span, Rasla said.

The women's health was then tracked for more than 11 years.

Over the follow-up, slightly more than 2,500 women died of coronary heart disease and 83 died from sudden cardiac death, a much rarer condition, the study showed.

The women who began the study with a healthy weight -- and then repeatedly gained and lost weight over the years -- had the strongest risk of death from coronary heart disease or sudden cardiac death, the researchers found.

Keeping your weight stable seemed key. For example, the study found no increase in death risk for women who said they gained weight but did not lose it, or for those who lost weight and didn't gain it back.

It should be noted that the study only found an association between yo-yo dieting and heart trouble, not a cause-and-effect connection.

And why would an "up-and-down" weight history be potentially dangerous to the heart? Rasla said that right now he can't explain the findings and that more research is needed.

Also, the study included only women, so he couldn't speculate about how weight cycling might affect men's heart disease risk.

For now, Rasla said, the message seems to be that "maintaining a stable body weight is best for overall health."

One dietitian who reviewed the new findings urged caution in interpreting the study, however.

Connie Diekman is director of university nutrition at Washington University in St. Louis. She believes more research is needed to determine if the connection with sudden cardiac death and coronary artery disease death and yo-yo dieting is, in fact, related or linked with other variables not identified in the study.

"The value that this study provides is the important reminder that 'weight cycling' -- losing, gaining, losing, gaining -- is not a good way to achieve a healthy weight," Diekman said.

For those who want to achieve a healthy weight, she advises focusing on overall lifestyle changes, not crash diets or other quick fixes.

The key: "Learn to balance what you __eat with your activity in a way in which you can maintain it for life," Diekman said.

Rasla was scheduled to present his findings Tuesday at the American Heart Association annual meeting, in New Orleans. Studies presented at medical meetings are viewed as preliminary until published in a peer-reviewed journal.

More information

To learn more about yo-yo dieting and disordered eating, visit the Academy of Nutrition and Dietetics.

SOURCES: Somwail Rasla, M.D., internal medicine resident, Memorial Hospital of Rhode Island, Pawtucket, and Alpert Medical School, Brown University, Providence, R.I.; Connie Diekman, R.D., M.Ed., director, university nutrition, Washington University, St. Louis; Nov. 15, 2016, American Heart Association Scientific Sessions, New Orleans

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Weight-Loss Surgery Tied to Lower Heart Risks

MONDAY, Nov. 14, 2016 (HealthDay News) -- Weight-loss surgery may significantly reduce obese people's risk of heart failure, a new study indicates.

Researchers compared more than 25,800 obese people who had weight-loss (bariatric) surgery with more than 13,700 obese people who tried to lose weight through a program of major lifestyle changes. Both groups had no history of heart failure.

Four years after the start of treatment, the weight-loss surgery group had lost more weight, had a nearly 50 percent lower risk of heart failure, and had lower rates of heart rhythm problems, diabetes and high blood pressure than the lifestyle-changes group, the findings showed.

Both groups had similar rates of heart attack and death, according to the study, which was scheduled for presentation Monday at the American Heart Association (AHA) annual meeting, in New Orleans.

"Our study shows an association between obesity and heart failure, and offers support for efforts to prevent and treat obesity aggressively, including the use of bariatric surgery," senior author Dr. Johan Sundstrom said in an AHA news release.

"Bariatric surgery might affect the incidence of atrial fibrillation, diabetes and hypertension -- known risk factors of heart failure -- explaining the lower risk of heart failure we observed," added Sundstrom, who is a professor of epidemiology at Uppsala University in Sweden.

Sundstrom noted that while the study found that heart failure risk was lower in patients who lost more weight, it does not prove that obesity causes heart failure.

In addition, because the study participants were all from a Scandinavian population, it is unclear whether the findings would relate to a U.S. population, the authors noted in the news release.

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on weight-loss surgery.

SOURCE: American Heart Association, news release, Nov. 14, 2016

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DNA Isn't Destiny: Healthy Living Can Overcome Genes Linked to Heart Disease

SUNDAY, Nov. 13, 2016 (HealthDay News) -- If your parent or sibling died young from cardiovascular disease, take heart: There are ways you can counter any genetic predisposition to the illness.

New research shows that people can minimize an inherited risk for heart attack by living right -- exercising, eating healthy, staying slim and quitting smoking.

Even with a little effort in these areas, people can cut their high genetic risk of heart disease by more than half, said senior researcher Dr. Sekar Kathiresan, director of the Center for Human Genetic Research at Massachusetts General Hospital in Boston.

But the opposite also is true, Kathiresan warned. People born with a genetic advantage protecting them against heart disease can ruin their good luck through unhealthy lifestyle choices.

"For heart attack at least, DNA is not destiny," Kathiresan said. "You have control over your risk for heart attack, even if you've been dealt a bad hand."

Kathiresan presented his findings Sunday at the American Heart Association's annual meeting, in New Orleans. The study was published simultaneously in the New England Journal of Medicine.

For their research, Kathiresan and his colleagues pooled data on more than 55,000 participants in four large-scale health studies.

The researchers analyzed each person's genetic risk for heart disease using a panel of 50 gene variants previously associated with elevated heart attack risk.

They also judged each person's lifestyle based on four factors: smoking, body weight, diet and exercise.

The requirements to have a good lifestyle were not rigorous, Kathiresan said. The person essentially had to not smoke, not be obese, get physical activity at least one day a week, and regularly meet at least half of the American Heart Association's recommendations for a healthy diet.

"It's safe to say we're not being that aggressive in terms of the lifestyle score," Kathiresan said.

For example, a person could be overweight, but not obese, and still meet the criteria for a healthy lifestyle in this study, he said. People also didn't need to meet current U.S. physical activity guidelines, which call for two and a half hours of moderate physical activity or one and a half hours of vigorous physical activity.

Even these minimal lifestyle changes mattered greatly for people at high genetic risk of heart disease.

The study looked at the risk for a "coronary event" -- heart attack, cardiac arrest or the need for angioplasty or other procedures to open a blocked artery.

A person with high genetic risk and a bad lifestyle had a nearly 11 percent chance of having a coronary event within the next 10 years, the study found. However, a person at high risk who lived well cut the 10-year risk of such a health crisis down to 5 percent, Kathiresan reported.

Lifestyle also mattered for people who won the genetic lottery.

Those with low genetic risk and a good lifestyle had a 3 percent risk of a coronary event over the next 10 years, but a bad lifestyle would drive their risk up to 5.8 percent, Kathiresan said.

"If you've been dealt a good hand, you could really harm yourself by having an unfavorable lifestyle," he said. "You basically take your heart attack rate up into the ranges of the people with the highest genetic risk."

Patients often ask cardiologists whether they should get genetic testing for their heart health risks, and the doctors usually aren't keen on it, said Dr. Martha Gulati, division chief of cardiology at the University of Arizona-Phoenix.

"Once you get those test results, it becomes, 'what do you do with them?' Often you hear from patients, 'Now I'm doomed to this disease,' " said Gulati, who also serves as editor-in-chief of CardioSmart, an online patient education program of the American College of Cardiology. "Their genetics make them feel very negative and helpless."

But this new study shows there is cause for optimism even for those facing the roughest road.

"We can change this with lifestyle," Gulati said. "We always say 80 percent of heart disease is preventable with lifestyle changes. This just gives more evidence; where people at the highest risk of heart disease, there were still things that were modifiable."

Gulati noted that the study does not prove a direct cause-and-effect link between lifestyle and heart health risk, however. She hopes a follow-up clinical trial will be conducted where people are directed in their lifestyle changes, to see how that affects their heart risk.

"That would be, to me, the next study," Gulati said.

More information

For more on a heart-healthy lifestyle, visit the American Heart Association.

SOURCES: Sekar Kathiresan, M.D., director, Center for Human Genetic Research, Massachusetts General Hospital, Boston; Martha Gulati, M.D.; division chief, cardiology, University of Arizona-Phoenix; Nov. 13, 2016, presentation, American Heart Association annual meeting, New Orleans; Nov. 13, 2016, New England Journal of Medicine

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Could C-Section Birth Raise Child's Risk of Obesity?

SUNDAY, Nov. 13, 2016 (HealthDay News) -- Babies delivered via C-section might be at increased risk for childhood obesity, researchers contend.

Compared to vaginally delivered children, cesarean-delivered children seem to have a 40 percent greater risk of becoming overweight or obese by the time they turn 7, the study found.

The risk was even stronger in children born by C-section to overweight and obese mothers, ranging from 70 to 80 percent, said lead researcher Noel Mueller, an assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore.

"We also found that the protective association conferred by vaginal delivery was as strong, if not stronger, among mothers that were overweight or obese, suggesting that vaginal delivery among overweight or obese mothers may help to mitigate the intergenerational transmission of obesity," Mueller said.

Babies pick up beneficial microbes from their mother as they pass through the birth canal, and Mueller and colleagues believe these microbes might help protect a child against obesity.

"There's been consistent evidence which shows vaginally delivered babies have different gut microbiota than C-section-delivered babies," Mueller said. "The different functions of these bacteria may relate to metabolic processes that may either predispose or protect one from obesity."

Childhood obesity has more than doubled over the past 30 years in the United States, according to the Centers for Disease Control and Prevention. The percentage of kids between the ages of 6 and 11 who are obese increased from 7 percent in 1980 to nearly 18 percent in 2012.

For this study, the researchers analyzed data on more than 1,400 full-term deliveries in Boston. About 57 percent of the women who gave birth by cesarean were obese, and 53 percent of those who delivered vaginally were obese.

The researchers checked to see if there were any differences in weight between children born either vaginally or by C-section, following the kids until they were 7 years old on average, Mueller said.

Kids born by C-section were found to have an increased risk of excess weight, the researchers report.

The findings were to be presented Sunday at the American Heart Association annual meeting, in New Orleans. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

One expert said the findings made sense.

"It's certainly reasonable. We know babies born by C-section have differences in their flora compared to those who are born vaginally, and there has been some suggestion that the microbiome [the variety of microorganisms in the body or part of the body] may play a role in the development of obesity," said Dr. Stephen Daniels. He is chair of pediatrics at the University of Colorado School of Medicine and pediatrician-in-chief at Children's Hospital Colorado.

Mueller said the research team is now looking into clinical trials that would expose C-section babies to healthy bacteria from their mother's vagina. These trials could confirm that the association found in this study is actually a cause-and-effect relationship.

"What we would like to do is see if administration of vaginal microbiota to C-section delivered babies could potentially have health benefits," Mueller said.

Another way of testing this association would be to look at children born by emergency C-section following a difficult labor, said Dr. Aaron Caughey, chair of obstetrics and gynecology at Oregon Health & Science University in Portland.

"One would think that children born to women via cesarean after a long labor with ruptured membranes, who should be getting colonized by bacteria, would have a lower risk of obesity than those born to women with a scheduled cesarean and no labor," Caughey said. "I haven't seen such a study done cleanly, and it would help answer this question."

In the meantime, parents of children delivered by C-section should not assume their child is doomed to a life of obesity, Mueller and Daniels said.

"I don't think this is a predetermination in any way," Daniels said. "A risk factor suggests it may increase risk, but it's not creating a certainty."

Breast-feeding has also been shown to help reduce risk of obesity in children, Mueller said. In addition, parents could focus on diet and exercise as a way to help prevent obesity in their offspring, Daniels said.

"Women who deliver by C-section should certainly not feel hopeless, because there are many ways to mitigate any potential increased risk of obesity," Mueller concluded.

More information

For more on childhood obesity, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Noel Mueller, Ph.D., M.P.H., assistant professor, epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore; Stephen Daniels, M.D., Ph.D., chair, pediatrics, University of Colorado School of Medicine, and pediatrician-in-chief, Children's Hospital Colorado, Aurora; Aaron Caughey, M.D., Ph.D., chair, obstetrics and gynecology, Oregon Health & Science University, Portland; Nov. 13, 2016, presentation, American Heart Association annual meeting, New Orleans

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Craving Salt? Your Genes May Be the Reason, Study Suggests

SUNDAY, Nov. 13, 2016 (HealthDay News) -- Some people carry a genetically driven "salt tooth" that could affect how heavily they season their food, potentially endangering their heart, a new study suggests.

Genetic variations cause some people to be more keenly aware of bitter flavors, said lead researcher Jennifer Smith, a doctoral student at the University of Kentucky College of Nursing.

These people are about twice as likely to exceed the daily limit of salt recommended by heart health specialists, according to study findings presented Sunday at the American Heart Association annual meeting in New Orleans.

The research centers on a gene called TAS2R38. Variations of this gene have been shown to enhance a person's perception of bitter flavors.

"We were looking at a gene that codes for taste receptors," Smith said. "People with one genotype will taste bitter more keenly than people who have the other genotype."

Previous studies have shown that people carrying those genetic variations of TAS2R38 are more likely to avoid heart-healthy foods that can taste bitter, like broccoli or dark leafy greens, the researchers said.

Smith decided to test whether this gene would lead people to use more salt in their daily diet. Eating too much salt can lead to high blood pressure, which increases a person's risk for heart attack and stroke.

Her team analyzed the diets of 407 people in rural Kentucky who had two or more heart disease risk factors. The researchers also did genetic testing to see whether participants carried the gene variation that enhances bitter taste.

"We found people who tasted bitter more keenly were in fact 1.9 times more likely to be non-adherent to the sodium guidelines," she said.

U.S dietary guidelines recommend no more than 2.3 grams of salt per day.

The researchers have different theories about why people with these genetic variants seem to __eat more salt.

It could be that they taste salt more intensely and enjoy it more, causing them to prefer heavily salted foods, Smith said.

Or it could be that people use salt to mask the bitter taste of some foods, she added.

"There are alternatives you can use to flavor foods, and we need to begin investigating those," Smith said. "We can start to look if there are different types of spices or seasonings we can add instead of salt to offset the bitter taste. For example, with bitter vegetables, you can use a little bit of sugar rather than salt to offset the bitter."

The findings are fascinating but "very preliminary," said Dr. Lawrence Appel. He's a professor of medicine and director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins Medical Institutions in Baltimore.

"Because bitterness is amplified, these people may need some other flavor alternative to mitigate the gene-induced bitterness," said Appel, a spokesman for the American Heart Association. "But you always need replication [studies], because there are always a lot of chance findings in genetic research. It's definitely what I like to call preliminary science."

Another study presented at the AHA meeting found that most U.S. adults consume too much salt, based on 24-hour urinary tests.

Overall, adults excreted more than 3.6 grams of sodium in their urine on a given day, far higher than the 2.3-gram dietary limit, researchers found. Men excreted about 4.2 grams a day on average; women, 3.1 grams, according to the study.

"We still consume vastly more sodium than we need to, and it does adversely affect blood pressure. Especially as we age, it becomes increasingly important to cut back," Appel said. "Whether or not you have this gene, sodium reduction is good for you."

Research presented at medical meetings is typically considered preliminary, because it has not had the same scrutiny as studies in peer-reviewed journals.

More information

For more on sodium and heart health, visit the American Heart Association.

SOURCES: Jennifer Smith, Ph.D. student, University of Kentucky College of Nursing; Lawrence Appel, M.D., M.P.H., professor, medicine, and director, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore

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5 tips for winter running

Don't let the darker days and colder weather hold you back from reaching your PB this winter. 

You’ve been pounding the pavements all year long to keep fit, train for a big race or lose weight, when suddenly winter sneaks up on you and messes everything up. But it doesn't __have to. Summer might seem like a lifetime away, but these tips we've put together with the help of Winter Run Series ambassador, Tom Craggs, are just what you need to leave the excuses behind you as you jog, run or sprint closer to your goals. 

Buddy Up

While running alone can be blissful, if you're struggling to find motivation sometimes accountability is just the kick you need. Running with a friend or in a group is not only a great way of challenging yourself through being competitive and learning from each other, but also a way of forcing yourself to stay consistent - plus, we're far less likely to bail if it means letting a friend down. As winter weather conditions make outdoor running a cautious activity, working out with a partner is also safer than running alone. 

Milestones

If running is your go-to when it comes to keeping fit but you're doing so without a specific goal in mind, it can be difficult not to make compromises. It’s important to track changes in your body even if you aren’t training for a particular purpose as a long-term way of staying motivated. Setting a mixture of short-term and long-term goals can also help to give you direction and to accept running as a consistent part of a healthy lifestyle rather than just another way to work out. For a long-term goal, Tom Craggs suggests signing up to the 10km London Winter Run which takes place 5 February 2017. The Central London route is breath-taking, while the flat route is perfect for those on the lookout for a PB.

Warm up 

For most of us it’s the thought of leaving the warmth of our cosy beds that discourages us from our usual outdoor runs come winter. While layering up may initially help, becoming uncomfortably sweaty halfway through our run is also pretty irritating. Layering is always a good option, choosing gear that can be easily removed and tied around the waist, but the best way to overcome this struggle is by warming up indoors before you start your run. This can be as simple as running on the spot and going through dynamic stretching, if you don’t __have the space or time for something more intense. 'In the cold weather, capillaries will stay constricted for longer and synovial fluid, which helps reduce friction in your joints, is more viscous. Warm up well and you’ll perform better,' advises Tom in discussing the risks of sprinting in winter without preparation.

Switch it up 

According to Tom, conditioning sessions outside of your runs can highly benefit your performance to give you improved posture and stability and a lesser chance of picking up a pesky injury. Resistance exercises, yoga and Pilates can help to strengthen the muscles used during a run and increase their range of motion while also refreshing your regime.

Hydrate

Running in colder weather masks the amount you’re sweating, so it’s easy to forget the importance of staying hydrated. If you are heading out for a winter run though, make sure your fluid intake still increases accordingly. Stay away from sugary energy drinks and opt for natural electrolyte mixes instead.

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Follow-Up Appointments Boost Weight-Loss Surgery Success

SATURDAY, Nov. 5, 2016 (HealthDay News) -- Regular follow-up visits with a doctor translated into greater health improvements for weight-loss surgery patients, new research indicates.

"This study shows there is great value in seeing patients at routine intervals after surgery in terms of health outcomes," said study co-author Dr. Andrea Schwoerer. She was at the Brody School of Medicine at East Carolina University at the time of the study.

"Unfortunately, many patients, reportedly as many as 50 percent, are lost to follow-up and therefore may not benefit as much as they can from weight-loss surgery, no matter how well it was performed," she added.

In the study, the researchers compared outcomes for more than 51,000 patients. Some had three follow-up visits. These visits occurred at 3, 6 and 12 months after the weight-loss surgery (complete follow-up). Others had only one or two follow-up visits (incomplete follow-up).

After one year, type 2 diabetes remission rates were 62 percent in the complete follow-up group, while the incomplete follow-up group had a remission rate of 57.5 percent. Rates of improvement in type 2 diabetes were 75 percent for the complete group. For the incomplete group, diabetes improvement was 69 percent, the study found.

The complete follow-up group also had greater improvements in high blood pressure and high cholesterol, the researchers said.

The study was to be presented Saturday in New Orleans at ObesityWeek, a meeting hosted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and The Obesity Society.

"We cannot stress enough the importance of follow-up visits and post-operative care," said Dr. Stacy Brethauer, president-elect of ASMBS and a bariatric surgeon at the Cleveland Clinic.

"It could mean the difference between a good and a great result. The most committed patients do best, and we need to find ways to keep all patients engaged for the long-term," she said.

Findings presented at meetings are generally considered preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on weight-loss surgery.

SOURCE: American Society for Metabolic and Bariatric Surgery, news release, Nov. 5, 2016

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Healthy Diet as Teen, Less Weight Gain as Adult

FRIDAY, Sept. 23, 2016 (HealthDay News) -- Teens who __eat right may gain less weight later on, researchers report.

Encouraging more young people to __eat a variety of fruits and vegetables as well as lean proteins and whole grains while limiting sugar, red meat and processed foods could have a positive long-term effect on obesity rates, investigators found.

The University of Minnesota researchers tracked the diet and weight of more than 2,500 teens, starting at age 15, over a decade.

"People with a healthier diet at 15 gained less weight over the next five and 10 years," lead author David Jacobs said in a university news release. Jacobs is a professor of epidemiology and community health.

A separate study of middle school and high school students showed similar results. It found that healthy eaters were not thinner at 15, but were slimmer at ages 20 and 25.

And that held true regardless of their food intake, physical activity and smoking habits, according to the report published recently in The Journal of Pediatrics.

"Food preferences and attitudes may be established as early as age 15," Jacobs said. "The choices adolescents make during that stage establish a lifetime diet pattern, which could influence weight gain over time."

The study authors suggested that parents and health care professionals help young people develop healthy eating habits and recognize that tastes may change.

More information

The American Academy of Pediatrics has more about teen nutrition.

SOURCE: University of Minnesota School of Public Health, news release, Sept. 15, 2016

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Balloon-in-a-Pill Helped Obese Patients Lose Weight

FRIDAY, Nov. 4, 2016 (HealthDay News) -- Obese patients who swallowed balloon capsules that helped them __eat less lost an average of 15 pounds, roughly two times more weight than patients who just dieted and exercised, researchers report.

The capsule was inflated with gas via a catheter when it reached the stomach. As many as three balloons were placed over three months, and all of the balloons were removed after six months. The balloons made patients feel full, the researchers explained.

In addition to the balloons, patients followed a moderate diet and behavior modification program. Whether the weight loss will last over the long term isn't known, said lead researcher Dr. Aurora Pryor, director of the Bariatric and Metabolic Weight Loss Center at Stony Brook University in New York.

The study lasted a year, but "we don't know what happens after that," Pryor said.

"If they are able to stick to their newfound lifestyle with their diet and exercise program, they could maintain their weight loss," she said. "The long-term results are dependent on patients keeping their motivation to stay with their diet and exercise programs."

The balloon treatment will be available starting in January, but the cost hasn't been announced, Pryor said. The device, called the Obalon Balloon System, was approved in September by the U.S. Food and Drug Administration.

An advantage of the balloons is that patients have no downtime and can go back to work the same day, the researchers said.

"There is no sedation or recovery time when the balloons are placed, but there is sedation when the balloons are removed, so you wouldn't want to go back to work after that," Pryor added.

Pryor believes balloons are a better option for patients who are candidates for weight loss surgery but don't want surgery. "For people who want to lose some weight but don't feel they are heavy enough for surgery or they're afraid of surgery, this is a really good next step to help them jump start their weight loss," she suggested.

The findings were to be presented Friday at the annual meeting of the American Society for Metabolic and Bariatric Surgery and the Obesity Society in New Orleans. Research presented at meeting is considered preliminary until published in a peer-reviewed journal.

One weight-loss expert expressed some doubts about the findings.

"I still question the efficacy of balloons," said Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City. "While there is potentially easier insertion that does not require sedation, I still doubt after removal there will be weight loss," he said.

Roslin said patients who have other treatments that restrict their ability to __eat -- such as bands and bypass operations that reduce the size of the stomach -- often regain lost weight over time. "As time goes on, weight loss will be about lifestyle changes," he said.

The only argument for the balloon is that it starts the lifestyle changes, Roslin said. "It may make it easier to become motivated," he said. "But I believe that few will maintain weight loss two years after any balloon."

For the study, Pryor and her colleagues randomly assigned nearly 400 obese patients to receive a real or sham device. All patients also had 25 minutes of lifestyle therapy every three weeks. After six months, patients with the Obalon balloons had them removed.

During the time patients had the balloons, and for six months after, the researchers monitored their weight loss. The investigators also followed those who had not received the balloon therapy.

People treated with the balloons lost an average of 7 percent of their weight, compared to less than 4 percent for those who received the sham device, the researchers found. Six months after the balloons were removed, nearly 90 percent maintained the weight loss they achieved during treatment, Pryor said.

As for side effects, one patient had a bleeding stomach ulcer while taking high doses of pain pills after a knee replacement. Most patients (91 percent) suffered from stomach cramps and nausea, which nearly 100 percent said were mild or moderate.

The results were also presented at a medical meeting in May.

One health and nutrition expert noted that a balloon does not equal a lifestyle change.

"A gastric balloon may help with weight loss, but will do nothing to improve diet quality and overall health," said Dr. David Katz. He is director of the Yale-Griffin Prevention Research Center in Derby, Conn., and president of the American College of Lifestyle Medicine.

The role for such technology-based approaches to weight control should be a small one, he said.

"Such devices may be alternatives to bariatric surgery in some cases. But they should not distract us from the far better solution at the population level: practices, programs and policies that make eating well and being active a cultural norm," Katz said.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on obesity.

SOURCES: Aurora Pryor, M.D., professor, surgery, and director, Bariatric and Metabolic Weight Loss Center, Stony Brook University, N.Y.; Mitchell Roslin, M.D., chief, obesity surgery, Lenox Hill Hospital, New York City; David Katz, M.D., M.P.H., director, Yale-Griffin Prevention Research Center, Derby, Conn., and president, American College of Lifestyle Medicine; Nov. 4, 2016, presentation, Obesity Week, New Orleans

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9 of 10 U.S. Teens Don't Get Enough Exercise

MONDAY, Sept. 26, 2016 (HealthDay News) -- Over 90 percent of U.S. high school students don't get enough exercise to stay fit and healthy, and the pattern persists after they graduate, a new study finds.

The researchers followed students at 44 high schools for four years, and found that only 9 percent met current exercise recommendations throughout that time. For the most part, those habits held steady after high school -- though college students were more active than non-students.

There was also some variation among college kids, the study found: Those who lived on campus exercised more than those who lived at home.

It's not clear why those students were more active. They might have been more involved in sports, for example, or simply walked more -- running from classes to dorms and other campus buildings, said lead researcher Kaigang Li.

"The walkability of your environment is important," said Li, an assistant professor of health and exercise science at Colorado State University, in Fort Collins.

The study is far from the first to show that most U.S. teenagers need to move more.

According to Peter Katzmarzyk, a professor at Louisiana State University's Pennington Biomedical Research Center, in Baton Rouge, "This study really confirms the low levels of physical activity in adolescents, which appear to be maintained over time as they transition into young adulthood."

A strength of this study, he said, is that it objectively measured teens' activity levels: They wore devices called accelerometers, which tracked how much they moved over the course of a week.

Katzmarzyk, who was not involved in the study, conducts research on child exercise patterns, obesity and health.

The U.S. Centers for Disease Control and Prevention has long recommended that children and teenagers get at least an hour of physical activity each day. That mainly means exercise that boosts the heart rate, such as running. But, kids should also try some strength-building activities -- for example, push-ups or lifting light weights.

Studies have shown that few young people are heeding that advice, however, according to the CDC.

That may be partly related to a lack of physical education in schools: Only 29 percent of U.S. high school students have gym class every day, the CDC says.

The evidence from this new research and other studies makes a good argument for more physical education, according to Katzmarzyk.

"Any way that we can increase physical activity levels in adolescence might translate into maintaining higher levels of physical activity in young adulthood," he said. "So physical education in high school is certainly an important outlet for this."

Still, Li said, there are probably numerous reasons for teenagers' low exercise levels.

He noted that in elementary school, most U.S. kids do get enough physical activity. But there is a steep drop-off after that. According to Li, that could be related to many factors -- including heavier homework loads starting in middle school, and more time on cellphones and computers.

The new findings are based on 561 students who were followed for four years, starting in 10th grade. Over 90 percent fell short of getting an hour of exercise each day over the study period, Li's team found.

What's more, the study participants' activity levels typically declined in the year after high school graduation -- especially if they did not go to college. Those who went to a four-year college got a little more exercise, particularly if they lived on campus.

According to Li, that suggests that college life -- possibly by giving students access to gyms and other facilities -- helps young people be more active.

Still, he said, colleges can do a better job of promoting exercise. The same goes for communities, so that all young people have opportunities to move every day, he added.

"Communities could create more walkable environments, public parks, bike trails, or low-cost or free exercise programs," Li said.

However, gyms and bike paths "aren't enough." Kids also need to learn, early on, how to build healthy habits into their day, he stressed.

"Especially as kids become independent," Li said, "it's important that they have the skills to manage their time and make good choices."

The study findings were published online Sept. 26 in the journal Pediatrics.

More information

The CDC offers exercise advice for kids and teenagers.

SOURCES: Kaigang Li, Ph.D., assistant professor, health and exercise science, Colorado State University, Fort Collins, Colo.; Peter Katzmarzyk, Ph.D., professor and chair, pediatric obesity and diabetes, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge; Sept. 26, 2016, Pediatrics, online

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Health Tip: Health Risks of Childhood Obesity

(HealthDay News) -- Obesity among children can lead to numerous health problems now and for many years to come.

The U.S. Centers for Disease Control and Prevention says obese children are at greater risk of developing:

• High blood pressure and high cholesterol.

• Type 2 diabetes, insulin resistance and impaired fasting glucose.

• Asthma, sleep apnea and other breathing problems.

• Pain and discomfort of the joints and musculoskeletal system.

• Gallstones, heartburn and fatty liver disease.

• Behavioral problems, depression, poor self-esteem, poor quality of life and poor school performance.

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It May Be Time to Punt on Your Favorite Football Fare

FRIDAY, Sept. 30, 2016 (HealthDay News) -- Fried foods and free-flowing beer may be the norm at many football or tailgate parties, but the American Heart Association (AHA) says there are many healthier options.

When it comes to meats for the grill, they recommend choosing lean or extra-lean beef burgers and keeping the patties to the size of a deck of cards. Or try turkey or salmon burgers. Instead of fried chicken wings, grill chicken breast strips coated in a small amount of your favorite sauce.

Watch how you season your meats, the AHA says. Instead of lots of salt, use chopped onions or extra pepper to boost flavor. With burgers, use 100-percent whole wheat buns or make a lettuce wrap.

"Have vegetables for dipping rather than chips. Serve plenty of salsa and bean-based dips rather than other high-calorie dips," said Rachel Johnson in an AHA news release. She is a professor of nutrition at the University of Vermont and a volunteer for the AHA.

Vegetable skewers are another great way to snack. Pack them with onions and peppers, or grill corn on the cob or zucchini, the AHA suggests.

Johnson also recommends only eating if you're truly hungry.

If you drink alcohol, do so in moderation. "Try not to overindulge on alcoholic beverages. Too much beer, wine or liquor impairs judgment and can cause us to __eat more," Johnson said.

Choose no-calorie sodas over those packed with sugar. Water is the best choice of beverage, and you can add some fresh fruit to give it a refreshing taste, the association says.

More information

The U.S. National Heart, Lung, and Blood Institute has more on healthy eating.

SOURCE: American Heart Association, news release

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'Mindfulness'-Based Approach Could Help You Stay Slim

FRIDAY, Sept. 30, 2016 (HealthDay News) -- A weight-loss therapy that focuses on personal values and "mindful" decision-making may help people shed more pounds, a new clinical trial suggests.

Over one year, people who received the therapy lost more than 13 percent of their initial weight, on average.

To put that into perspective, current behavioral therapies typically help people drop 5 percent to 8 percent of their starting weight, the study authors said.

Researchers call the new approach acceptance-based behavioral therapy, or ABT.

The study authors said ABT addresses some of the biggest obstacles in keeping extra pounds off -- including the difficulty of resisting temptation.

"The standard advice on weight loss only works if people are able to stick with it," said Evan Forman, who helped develop ABT. He's a professor of psychology at Drexel University in Philadelphia.

There is nothing new about using behavioral therapy to help people lose weight.

But, Forman said, the standard approaches don't address the "main issue."

"People are biologically driven to eat, especially foods that are rewarding and taste good," he said.

Through most of human history, when food was scarce, that was an asset, Forman pointed out. Now, when so many people are surrounded by calorie-laden temptations every day, the biological drive to __eat can be a problem.

"It takes special skills to resist those temptations," Forman said. "It's hard to turn down pleasure and reward. But those skills can be learned."

ABT aims to teach people those skills.

The new clinical trial put the approach to the test by comparing it with standard behavioral therapy, which only encourages reducing calories and increasing exercise.

Forman's team recruited 190 overweight or obese adults and randomly assigned them to either ABT or standard treatment. People in both groups went to 25 group sessions over one year, meeting with therapists with expertise in weight loss.

Both groups received help with diet changes and exercise, "problem solving," and dealing with food cravings.

But ABT had added components.

For one, Forman said, people chose a goal based on their "personal values" -- rather than aiming for a certain number on the bathroom scale.

A person might, for example, choose the goal of being a healthy, active grandmother.

"We emphasize the point, 'Why does this matter?' " Forman said. "We get at the bigger idea of what people want in life, and how is weight related to that?"

Beyond that, ABT encourages people to accept the fact that weight loss is hard and they will inevitably feel deprived, have cravings, or find it unpleasant to opt for an apple over a brownie.

"They can say, 'Of course, that's how my brain is working,' " Forman said. Then, rather than trying to fix their thinking, they can focus on what they can change: their behavior.

How do you learn to choose the apple when your brain really wants the brownie? Patience and practice, according to Forman.

"It sounds weird, but you can literally practice tossing a piece of brownie in the trash and eating the apple instead," he said.

Another aspect of the therapy is training in "mindful" decision-making.

"So many of the decisions we make around eating have no explicit thought process behind them," Forman said.

During ABT, people learn to notice how "cues" from their environment -- from TV to the presence of tempting food to sheer boredom -- influence their decisions to eat.

In this new trial, the approach appeared to work better than standard therapy: After a year, ABT patients had lost a little over 13 percent of their starting weight, compared to just under 10 percent for people in the comparison group.

The ABT group also fared better when it came to keeping the pounds off: 64 percent had maintained at least a 10 percent weight loss at the one-year mark, compared with 49 percent of the standard-therapy group.

Dr. Steven Heymsfield is a spokesman for the Obesity Society and a professor at Pennington Biomedical Research Center, in Baton Rouge, La.

He had praise for the ABT approach.

"It recognizes the underlying biological drive to eat, and provides people with a powerful counterweight to that," said Heymsfield, who wasn't involved in the research.

Losing weight is not just about "willpower," Heymsfield said. People have to overcome strong biological impulses -- and that takes strong motivation, he said.

It makes sense that focusing on important personal values (such as being a healthy grandma) can work better than a "superficial goal" of fitting into smaller jeans, Heymsfield said.

Still, he pointed to some big remaining questions about ABT: Does the weight loss hold up over time? And does the therapy have to be ongoing?

Practically speaking, it's not clear whether ABT can be disseminated widely.

In this study, it was given by Ph.D.-level professionals, Heymsfield pointed out.

"So can this program 'transport' well?" he asked. "Can it be incorporated into a Watch Watchers or Jenny Craig program?"

Forman agreed that practical barriers have to be addressed. He also said it's possible that after the initial therapy sessions, people could have once-a-year "booster" sessions -- or even get help through mobile apps -- to make the approach more feasible.

The study is published in the October issue of the journal Obesity.

More information

The U.S. National Institutes of Health has advice on healthy weight loss.

SOURCES: Evan Forman, Ph.D., professor, psychology, Drexel University, Philadelphia; Steven Heymsfield, M.D., professor, Pennington Biomedical Research Center, Baton Rouge, La.; October 2016, Obesity

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Lack of Sleep May Stretch Your Waistline

THURSDAY, Nov. 3, 2016 (HealthDay News) -- Too little sleep may contribute to a larger waistline, researchers say.

The new research included 11 studies with a total of 172 participants. Compared to those who got enough sleep, those who were sleep-deprived consumed an average of 385 more calories a day. That's equal to the calories in about four and a half slices of bread.

Sleep deprivation didn't have a significant effect on how many calories people burned. That means those with sleep deprivation had a net gain of 385 calories a day, the researchers said.

People with too little sleep had higher fat and lower protein intake than those who got enough sleep, but both groups had similar carbohydrate intake.

The paper was published Nov. 2 in the European Journal of Clinical Nutrition.

"The main cause of obesity is an imbalance between calorie intake and expenditure and this study adds to accumulating evidence that sleep deprivation could contribute to this imbalance. So there may be some truth in the saying 'early to bed, early to rise, makes a man healthy and wise,' " said senior study author Gerda Pot. She's with the diabetes & nutritional sciences division at King's College London and Vrije University in Amsterdam.

If sleep deprivation lasts long-term, an extra 385 calories a day would likely contribute to weight gain, Pot added.

"Reduced sleep is one of the most common and potentially modifiable health risks in today's society in which chronic sleep loss is becoming more common. More research is needed to investigate the importance of long-term, partial sleep deprivation as a risk factor for obesity and whether sleep extension could play a role in obesity prevention," Pot concluded.

A previous study found that partial sleep deprivation led to greater activation of brain areas associated with reward when people were exposed to food.

More information

The U.S. National Heart, Lung, and Blood Institute has more on sleep deprivation.

SOURCE: King's College London, news release, Nov. 2, 2016

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Skip Dinner and Maybe Boost Your Metabolism

THURSDAY, Nov. 3, 2016 (HealthDay News) -- Overweight people who __eat during a much smaller window of time each day than is typical report fewer hunger swings and burn slightly more fat at certain times during the night, according to a new study.

But the study was small and it's not yet clear what effect, if any, this approach might have on weight.

Courtney Peterson, the study's lead author, said the researchers definitely aren't saying this is a cure for obesity.

However, the assistant professor of nutrition sciences at the University of Alabama at Birmingham thinks the idea is worth examining as a potential weight-loss approach and hopes to conduct a larger study.

The approach is called early time-restricted feeding. It's been tested in animals, where researchers have found that it reduced fat mass and the risk of chronic disease.

Peterson was scheduled to present her findings Thursday at The Obesity Society annual meeting, in New Orleans. Studies presented at medical meetings are viewed as preliminary until published in a peer-reviewed journal.

For the study, Peterson evaluated 11 men and women. Their average age was 32, and their average body mass index (BMI) was 30.

Body mass index is a rough measure of a person's body fat based on height and weight. A BMI of 30 is considered obese. Someone who is 5 feet 9 inches tall would need to weigh 203 pounds to have a BMI of 30.

All of the study participants tried each approach -- the early restricted-eating and the typical pattern. During one four-day period, participants ate between 8 a.m. and 2 p.m. only; during another four-day period they ate between 8 a.m. and 8 p.m.

The participants ate the same number of calories during each approach, Peterson said, and they ate only the food given to them by the researchers and under supervision.

Peterson's team then tested the impact of the longer fast time on calories burned, fat burned and appetite. The restricted eating time didn't change the total number of calories burned, she said.

But it did increase fat burning at some points during the night, though it didn't increase fat burning overall. The restricted time improved the body's ability to switch between burning carbohydrates and burning fat, the study authors said. Experts call this metabolic flexibility.

During the day, from 8:30 a.m. to 7:30 p.m., "fat-burning is identical between the two groups," she said.

Peterson also found that those in the restricted-eating group had fewer swings in hunger when the participants were asked to report how hungry they were at different points in the day. Peterson speculates that when people "front-load" calories, they aren't very hungry at a typical dinnertime.

The body has an internal clock, and many aspects of metabolism are working best in the morning, according to Peterson. Eating in alignment with the body's circadian clock, which means eating earlier in the day, may help with fat burning, she suggested.

It's not clear yet what the restricted eating pattern might mean in terms of long-term weight control, Peterson said.

Dale Schoeller, professor emeritus of nutritional sciences at the University of Wisconsin, Madison, pointed out that "these are very early results."

Schoeller, who is also a spokesperson for The Obesity Society, was not involved with the new research. He noted that most studies about restricted eating have been done with animals, and researchers are "only starting to look at humans."

Among the caveats, Schoeller said, were that the study was small and short-term. The effects "may not last," he added.

Even so, he said, people who are healthy without any disease might try this approach. Others should talk to their doctor first. And, as with other weight-loss approaches, Schoeller said, this may only help some people looking to get to a healthier weight.

More information

To learn more about maintaining a healthy weight, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Courtney Peterson, Ph.D., assistant professor of nutrition sciences, University of Alabama at Birmingham; Dale Schoeller, Ph.D., spokesperson, The Obesity Society and professor emeritus of nutritional sciences, University of Wisconsin, Madison; Nov. 3, 2016, presentation, The Obesity Society annual meeting, New Orleans

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Lazy Summer Days Mean Weight Gain for Young Kids

WEDNESDAY, Nov. 2, 2016 (HealthDay News) -- Summer vacation may bring unexpected weight gain for young children, a new study finds.

Researchers tracked more than 18,000 children from the start of kindergarten through the end of second grade. They found that the kids' rate of overweight increased from 23 percent to 29 percent during that time. The researchers also saw that the rate of obesity rose from 9 percent to 11.5 percent.

All of these increases occurred over the two summer periods during the study -- and not during the school years, the researchers said.

The findings were published in the journal Obesity and released Wednesday at the annual meeting of the Obesity Society, in New Orleans.

"Educators have long worried that summer break leads to knowledge loss, and now we know that it is also a time of excessive weight gain for our youngest school children," said study co-author Paul von Hippel, from the LBJ School of Public Affairs at the University of Texas, Austin.

"Our findings raise questions for parents and policymakers about how to help children adopt healthy behaviors during the long summer vacation to stop unhealthy weight gain. Our results also suggest that we cannot reverse the obesity epidemic if we focus only on what children are doing and eating while they are in school," von Hippel said in a society news release.

Obesity Society spokeswoman Amanda Staiano said, "Now that we have solid data pointing to summer vacation as a time for potential weight gain in young children, the next step is to work together to shape out-of-school behaviors."

She suggested that parents help their children stick to a school-year sleep schedule and reduce the amount of time with electronic screens -- TVs, computers, tablets and the like.

"We hope these findings galvanize efforts by parents, educators, public health advocates and officials to make sure that summer does not set back efforts made during the school year to not just teach our children, but to keep them healthy," Staiano said.

More information

The U.S. Centers for Disease Control and Prevention offers tips for keeping children at a healthy weight.

SOURCE: Obesity Society, news release, Nov. 2, 2016

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Stressed-Out Mate Bad for Your Weight

TUESDAY, Nov. 1, 2016 (HealthDay News) -- Is your spouse feeling stressed? Then you may want to watch your waistline, a new study suggests.

"We found that your partner's stress, and not your own, predicted an increased waist circumference over time," said Kira Birditt, a research associate professor at the University of Michigan Institute for Social Research.

Birditt and her university colleagues also found that quality of marriage also seemed to play a role in whether husbands and wives fattened up over the four-year study.

The study can't prove the association. But Joan Monin, of the Yale School of Public Health, said that based on this study and her own research, "stress reduction interventions should be aimed at couples rather than individuals."

Another take-home message: "It's good to be aware of your partner's stress," said Monin, an assistant professor of chronic disease epidemiology, who wasn't involved in the new study.

Waist circumference matters because it's "an indication of excess abdominal fat and a risk factor for several different illnesses," including diabetes and heart disease, Birditt said. For women, a waist circumference more than 35 inches indicates a health risk; for men, waist circumference more than 40 inches does.

For the study, Birditt's team used data from the university's Health and Retirement Study. More than 2,000 married men and women answered questions about their waist size, marriage quality and stress levels in 2006 and again in 2010. They were in their early 60s, on average, and had been married an average of 34 years.

The researchers defined chronic stress as potentially overwhelming circumstances -- such as financial problems, work difficulties or long-term caregiving -- that continued for more than a year.

At the start of the study, roughly six out of 10 participants (59 percent of husbands and 64 percent of wives) had waists in the unhealthy-size range.

Four years later, about 9 percent of participants had a 10 percent increase in waist size. That was an average increase of 4 inches or more over four years, Birditt said. "The findings aren't just about slight increases," she noted.

"Wives were 1.6 times more likely to have an increase in waist circumference when their husbands reported greater stress and greater negative marriage quality," Birditt said.

However, she added, husbands were more than twice as likely to have a 10 percent increase in waist size when their wives had greater stress but weren't complaining about marriage quality. Birditt said she couldn't explain that difference.

Marriage quality was assessed by questions such as: How often does your spouse make too many demands on you, criticize you or let you down?

The new findings are both interesting and puzzling, said Monin.

"You usually see that an individual's own stress influences weight gain," she said. "They [the study authors] didn't [find that]. You would think because spouses are so interdependent they would find both."

While Monin can't explain the findings, she suggested that if spouses see that their partner is stressed out, they may __eat more to cope.

As for marriage quality's effect, Birditt said, "research shows that people who are more distressed in their marriage do __eat more as a way to feel connected to each other to reduce their feeling of stress."

Husbands and wives under stress can take steps to minimize weight and waist gain, Birditt and Monin agreed.

"Couples who create goals together tend to be more successful than those who create them separately," Birditt said.

For instance, saying, " 'Let's go out and walk together after dinner every night' is better than one partner saying, 'I'm going to go exercise,' " she said.

The study was published online recently in the Journals of Gerontology: Social Sciences.

More information

For more about waist size and its link to health risks, visit the U.S. National Institutes of Health.

SOURCES: Kira Birditt, Ph.D., research associate professor, University of Michigan Institute for Social Research, Ann Arbor; Joan Monin, Ph.D., assistant professor, chronic disease epidemiology, Yale School of Public Health, New Haven, Conn.; Sept. 24, 2016, Journals of Gerontology: Social Sciences

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Kids 6 and Older Should Be Screened for Obesity, Task Force Reaffirms

TUESDAY, Nov. 1, 2016 (HealthDay News) -- Doctors should screen children older than 6 for obesity, and offer them behavioral therapy to help them lose weight if necessary, new guidelines reassert.

The draft recommendation, from the U.S. Preventive Services Task Force, is essentially the same as a 2010 final recommendation, but specifies teens for further clarification.

Children and teens who are found to be obese should be referred for "comprehensive, intensive behavioral interventions," the task force said.

Such interventions "last at least 26 hours and may include sessions that target both the parent and child; offer information on healthy eating and safe exercise; discuss the use of stimulus control such as limiting access to tempting foods and limiting screen time; and include supervised physical activity," the panel explained.

The draft recommendation is open for public comment through Nov. 28.

The task force is an independent, volunteer panel of medical experts that makes recommendations about preventive health services such as screenings, counseling and medications.

More information

The U.S. Centers for Disease Control and Prevention offers tips for keeping children at a healthy weight.

SOURCE: U.S. Preventive Services Task Force, news release, Nov. 1, 2016

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