Fat Near the Heart a Hazard for Postmenopausal Women

TUESDAY, Jan. 31, 2017 (HealthDay News) -- When a certain type of fat collects around the heart, it may be a sign of developing heart disease in postmenopausal women, a new study suggests.

As estrogen levels fall during menopause, deposits of "paracardial" fat increase, the researchers found. This may cause more calcium build-up in the heart's arteries, an early sign of heart disease.

Paracardial fat sits in pockets around the heart. These pockets lie between the heart and another type of fat that covers the heart called epicardial fat, the study authors explained.

Epicardial fat provides energy to the heart, but paracardial fat has no known beneficial function, the researchers said.

"We are showing for the first time that paracardial fat is associated with greater risk of calcification [calcium build-up] in postmenopausal women, more than in premenopausal women," said lead researcher Samar El Khoudary. She's an assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.

"Premenopausal women also have this type of fat, but it increases significantly as estrogen levels drop during menopause," she explained.

El Khoudary's team found that a 60 percent increase in paracardial fat was associated with a 160 percent greater risk of calcium build-up in the heart's blood vessels in postmenopausal women versus pre- or early menopausal women.

Postmenopausal women are at risk for even more calcification in their coronary artery as their levels of paracardial fat rise, El Khoudary said.

However, while the study found an association between increased paracardial fat and greater calcium build-up in postmenopausal women, it could not prove a cause-and-effect relationship.

For the study, El Khoudary and her colleagues collected data, including CT heart scans and blood samples, on 478 U.S. women who took part in the Study of Women's Health Across the Nation.

The women were in varying stages of menopause. Their average age was 51. None of the women was on hormone replacement therapy.

In an earlier study, El Khoudary's team found that an increase in paracardial fat after menopause results from a drop in the hormone estradiol, a form of estrogen. Increased levels of epicardial fat were linked to other risk factors, such as obesity, El Khoudary said.

"We know that the menopausal transition puts women at greater risk of heart disease," she said.

"For example, their cholesterol increases and they start to have more fat around their waist. We are showing that postmenopausal women have more fat around the heart, which could be more damaging to the heart than fat around the waist, because it produces inflammatory factors that could affect the heart," El Khoudary said.

It's possible to reduce paracardial fat through diet and, in obese women, by weight-loss surgery, she said.

Hormone replacement therapy -- which increases estrogen levels -- might also reduce paracardial fat deposits, but that's not known, El Khoudary said. To find out, she is planning to study the effects of hormone replacement on the heart.

Dr. Suzanne Steinbaum is director of Women's Heart Health at Lenox Hill Hospital in New York City.

She said the drop in estrogen and the increase of fat around the heart are part of the natural process of menopause.

"Knowing this, we have to understand the huge impact of our lifestyle in preventing what could be a double whammy," she said. "As soon as you start feeling changes in your hormones, this is when you need to get your risk factors for heart disease under control."

This includes controlling blood pressure, cholesterol and weight. In addition, a healthy diet and exercise can help cut the risk of heart disease, Steinbaum said.

"Menopause is the time it becomes most important to reduce all the risk factors that lead to heart disease," she said.

For now, El Khoudary suggested, a healthy diet and lots of physical activity are the best prescriptions for reducing the risks of heart disease.

The report was published Jan. 30 in the Journal of the American Heart Association.

More information

For more on women and heart disease, visit the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Samar El Khoudary, Ph.D., M.P.H., assistant professor, epidemiology, University of Pittsburgh, Graduate School of Public Health; Suzanne Steinbaum, D.O., director, women's heart health, Lenox Hill Hospital, New York City; Jan. 30, 2017, Journal of the American Heart Association, online

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The Shame of 'Fat Shaming'

TUESDAY, Jan. 31, 2017 (HealthDay News) -- Trying to shame an overweight or obese person into losing weight won't motivate them to do so, and may even raise their risk for heart disease and other health problems, a new study suggests.

The more self-blame and devalued that people said they felt when stigmatized, the more likely they were to have health problems that could lead to heart disease, said study leader Rebecca Pearl. She's an assistant professor of psychology at the University of Pennsylvania's Perelman School of Medicine in Philadelphia.

The findings suggest that weight stigma and fat shaming "go much deeper than the inappropriate remarks or hurt feelings," said Dr. Rebecca Puhl, deputy director of the University of Connecticut Rudd Center for Food Policy & Obesity. She co-wrote a commentary that accompanied the study.

The study authors said obese people are often viewed as lazy, lacking willpower, incompetent, unattractive, and to blame for their excess weight.

This leaves them feeling stigmatized. Previous research has linked feeling stigmatized about weight to weight gain and emotional distress. The new study suggests it's not just the stigmatizing, but also the level of a person's reaction to fat-shaming that can impair health.

The new research wasn't designed to prove a cause-and-effect link, however.

The study included 159 obese adults. The researchers asked them how much they devalued and blamed themselves when they were stigmatized for their weight. The researchers also looked to see how often a condition called metabolic syndrome had been diagnosed among these adults.

Metabolic syndrome is a cluster of risk factors, including high blood pressure, high triglycerides (a type of blood fat) and a large waist circumference. These risk factors are linked with higher risks of heart disease, type 2 diabetes and other health problems.

In all, 51 of the men and women met the criteria for metabolic syndrome, Pearl said. Those with higher levels of devaluation and self-blame were about 46 percent more likely to have metabolic syndrome.

When the researchers looked at those reporting the highest levels of internalizing devaluation and self-blame compared with the lowest group, the highest group had three times the risk of metabolic syndrome as those in the lowest.

The study team also found that those with the highest levels of feeling devalued were six times as likely to have high triglycerides.

The findings lend support to previous research, said commentary co-author Dr. Scott Kahan. He's director of the National Center for Weight and Wellness in Washington, D.C.

"Numerous studies have shown that experiencing weight stigma increases stress hormones, blood pressure, inflammation and ultimately increases the risk of several diseases, including diabetes and heart disease," Kahan said.

Weight stigma has also been linked with premature death, he said, as well as binge eating and weight gain.

The new research, he said, suggests that "experiencing weight stigma is bad, but worse appears to be internalizing weight stigma."

"For people who have been targets of weight stigmatization, it is important for them to not add injury to insult by further self-stigmatizing themselves," Kahan said. More needs to be learned about the complexities of obesity, he added, so people will realize it's a complex health issue, not a willpower issue.

Puhl urged people to try to avoid self-blame. "Try to view the stigmatizing encounter as the other person's problem instead of internalizing or blaming yourself," she said. Everyone deserves respect, she added.

Loved ones should avoid blaming or criticizing friends or family struggling with weight -- it does not motivate weight loss, Puhl added.

The research was published Jan. 30 in the journal Obesity.

More information

To learn more about weight stigmatization, visit the Obesity Society.

SOURCES: Rebecca Pearl, Ph.D., assistant professor, psychology, department of psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia; Rebecca Puhl, Ph.D., deputy director, Rudd Center for Food Policy & Obesity, University of Connecticut; Scott Kahan, M.D., M.P.H., director, National Center for Weight and Wellness, Washington, and faculty member, Johns Hopkins and George Washington Universities, Washington, D.C.; Jan. 30, 2017, Obesity

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Diabetes Risk May Be Higher for HIV-Positive Adults

TUESDAY, Jan. 31, 2017 (HealthDay News) -- People infected with the virus that causes AIDS may be more likely to develop diabetes, new research suggests.

In the study, the prevalence of diabetes was almost 4 percent higher among HIV-positive adults than the general population.

Researchers examined survey responses of 8,610 HIV-positive participants in the Medical Monitoring Project (MMP). They also analyzed data from about 5,600 people in the general public who took the annual National Health and Nutrition Examination Survey (NHANES).

Of the MMP participants, 75 percent were men and nearly 60 percent were aged 45 or older. About 25 percent were obese; about 20 percent also had hepatitis C (HCV); and 90 percent had received antiretroviral therapy within the past year.

Of NHANES participants, about half were men aged 45 years and older; 36 percent were obese; and fewer than 2 percent had hepatitis C.

The study found that 10 percent of MMP participants had diabetes. Of these people, nearly 4 percent had type 1 diabetes, about half had type 2, and 44 percent had an unspecified type of diabetes. In comparison, slightly more than 8 percent of the general population had diabetes.

Diabetes among the HIV-positive adults increased with age, obesity and longer HIV-positive status.

These findings don't prove a cause-and-effect relationship. But the researchers noted that better treatment has enabled people to live longer with HIV, which may increase their risk for other chronic health issues, such as diabetes.

The study was published online Jan. 30 in BMJ Open Diabetes Research & Care.

"Although obesity is a risk factor for prevalent [diabetes] among HIV-infected adults, when compared with the general U.S. adult population, [these] adults may have higher [diabetes mellitus] prevalence at younger ages, and in the absence of obesity," lead author Dr. Alfonso Hernandez-Romieu and colleagues wrote in a journal news release.

Hernandez-Romieu is affiliated with the department of epidemiology at Emory University's Rollins School of Public Health.

He said more research would be needed to determine whether diabetes screening guidelines should include HIV infection as a risk factor.

More information

The U.S. The National Institute of Diabetes and Digestive and Kidney Diseases provides more information on risk factors for type 2 diabetes.

SOURCE: BMJ, news release, Jan. 30, 2017.

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Curbing Excess Weight Gain in Pregnancy May Not Lower Risk for Complications

FRIDAY, Jan. 27, 2017 (HealthDay News) -- Excessive weight gain during pregnancy has long been tied to a higher risk for obstetric complications.

However, a new study finds that strategies to help women limit their weight gain during pregnancy don't seem to alleviate these complications. The findings were presented this week at the annual meeting of the Society for Maternal-Fetal Medicine, in Las Vegas.

"While pregnant women should still be counseled against excess weight gain, additional measures may be required to reduce the associated complications," study lead author Dr. Alan Peaceman said in an SMFM news release. He's chief of maternal-fetal medicine in the department of obstetrics and gynecology at Northwestern Medicine in Chicago.

According to guidelines from the American Congress of Obstetricians and Gynecologists (ACOG), normal-weight women who are bearing one child (not twins) should gain 25 to 35 pounds during their pregnancy. Women who are already overweight before pregnancy should gain between 15 and 25 pounds during the pregnancy, and women who are obese before pregnancy should gain 11 to 20 pounds.

Weight gain beyond those recommended amounts is thought to be unhealthy for both the mother and the fetus.

In the new study, Peaceman's team sought to determine if efforts to curb excess weight gain in pregnancy might help lower obstetric complications.

For the study, researchers from Northwestern University randomly assigned 281 pregnant women who were overweight or obese to receive either typical obstetric care, or to receive additional help to limit the amount of weight they gained during pregnancy.

This intervention included guidance from a dietitian, guidance on physical activity and internet-based self-monitoring of eating habits.

According to the researchers, the intervention did work in one respect: The women gained much less weight during their pregnancy than the women who underwent routine care.

However, this additional care was not linked to a drop in pregnancy-related complications, such as high blood pressure, gestational diabetes and overly large babies, the study found.

There was also a higher rate of C-sections among the women in the intervention group, the study showed.

One obstetrician-gynecologist who reviewed the findings said they suggest that overweight may be a problem for pregnancy long before conception.

"We know that obese and overweight women have poorer obstetric and neonatal outcomes than non-obese women," said Dr. Jill Rabin of Northwell Health in New Hyde Park, N.Y. "Again, the stage is set in many cases, before the pregnancy begins."

So while monitoring and curbing excess weight gain in pregnancy is important, obesity "may have affected the mother's cardiovascular and other vital systems long before [the woman] becomes pregnant," said Rabin. She is co-chief of the division of ambulatory care in Women's Health Programs-PCAP Services at Northwell.

However, Rabin also noted that major complications in pregnancy are relatively rare, so any benefit to the mother might not have been picked up in this relatively small study. Only a much larger trial might truly show if limiting weight gain in pregnancy helps prevent complications, she said.

Dr. Anthony Vintzileos is chair of obstetrics and gynecology at Winthrop-University Hospital in Mineola, N.Y. He agreed with Rabin that "we need to see studies with a much larger number of patients, and also studies testing additional interventions such as drug therapy," to truly determine if efforts to limit gestational weight gain can lower complication rates.

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

More information

The American Congress of Obstetricians and Gynecologists provides more information on obesity and pregnancy.

SOURCES: Jill Rabin, M.D., co-chief, division of ambulatory care, Women's Health Programs-PCAP Services, Northwell Health, New Hyde Park, N.Y.; Anthony Vintzileos, M.D., chair, department of obstetrics and gynecology, Winthrop-University Hospital, Mineola, N.Y.; Society for Maternal-Fetal Medicine, news release, Jan. 23, 2017

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Slim But Sedentary: Risk of Prediabetes May Rise

FRIDAY, Jan. 27, 2017 (HealthDay News) -- Here's yet another reason to get off the couch: Inactivity is associated with greater risk of prediabetes, even for healthy-weight adults, a new study finds.

University of Florida researchers said the finding may help explain why up to one-third of slim American adults have prediabetes -- elevated blood sugar but not full-blown diabetes.

"We have found that a lot of people who we would consider to be at healthy weight -- they're not overweight or obese -- are not metabolically healthy," said lead investigator Arch Mainous III. He's chair of health services research, management and policy in the university's College of Public Health and Health Professions.

Mainous and his colleagues analyzed data from more than 1,000 people, aged 20 and older, in England. All had a healthy weight and no diagnosis of diabetes. Those with an inactive lifestyle were more likely than active people to have a blood sugar level of 5.7 or above, which the American Diabetes Association considers prediabetes.

About one-quarter of all inactive people and more than 40 percent of inactive people 45 and older met the criteria for prediabetes or diabetes, according to the study.

The study doesn't establish a direct cause-and-effect relationship. Still, these inactive people may have unhealthy "normal-weight obesity or 'skinny fat,' " -- a high proportion of fat to lean muscle, the researchers said.

"Our findings suggest that sedentary lifestyle is overlooked when we think in terms of healthy weight. We shouldn't focus only on calorie intake, weight or [body mass index] at the expense of activity," Mainous said in a university news release.

Because prediabetes increases the risk of diabetes and other health problems, the study adds to growing evidence that inactivity poses a risk to health, the researchers explained.

"Don't focus solely on the scale and think you're OK. If you have a sedentary lifestyle, make sure you get up and move," Mainous said.

The study results were published online Jan. 19 in the American Journal of Preventive Medicine.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity.

SOURCE: University of Florida, news release, Jan. 19, 2017

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Kids' Sugary Drink Habits Start Early

THURSDAY, Jan. 26, 2017 (HealthDay News) -- Despite health messages to limit sodas and other sugary beverages, most American children drink them often, new government statistics show.

Nearly two-thirds of boys and girls ages 2 to 19 drink at least one sugar-sweetened beverage daily, according to the U.S. Centers for Disease Control and Prevention.

The national survey of dietary habits from 2011 to 2014 also found that sweetened beverages account for more than 7 percent of total calorie intake for kids.

"For children, studies have shown that consuming sugary beverages is associated with weight gain, type 2 diabetes and dyslipidemia [high cholesterol], all of which have serious negative downstream health consequences," said CDC researcher Asher Rosinger.

Consumption of sugary drinks -- including sports drinks, juices and sweetened coffee -- is also linked to heart disease and tooth decay, among other problems, the researchers said.

Intake of these drinks is highest among 12- to 19-year-olds, but it's not clear why. "Our report did not look at parental behaviors, like supervision or attitudes toward dietary guidelines, which may modify kids' behaviors," Rosinger said.

Currently, nearly 13 million U.S. children and teens are obese, putting them at risk of serious future health problems such as diabetes and heart disease.

The new report is based on results of the 2011-2014 U.S. National Health and Nutrition Examination Survey: Among the other findings:

• Boys are more likely than girls to down one or more of these drinks a day -- 65 percent versus 61 percent.

• On average, boys consume 164 calories a day from sugar-sweetened liquids, compared to 121 calories for girls.

• Among preschool boys and girls, sweet drinks account for about 4 percent of total daily calories. By the teen years, they are responsible for almost 10 percent of daily calories.

The researchers also found racial and ethnic differences, with Asians drinking fewer sugary drinks compared to other groups.

The sugar-sweetened beverages included in the study were regular soda; fruit drinks (including sweetened bottled water and fruit juices and nectars with added sugars); sports drinks; energy drinks; sweetened coffee and tea; horchata and sugar cane drinks. The researchers did not include diet drinks, 100 percent fruit juices, beverages with sweetener added by the consumer, alcohol or flavored milk.

One bright spot: Overall caloric intake from sugary drinks has declined slightly -- from 155 six years ago to 143, according to the new report.

Current dietary guidelines for Americans advise limiting added sugars from all sources to less than 10 percent of total daily calories. The guidelines also recommend avoiding beverages with added sugars.

There are plenty of reasons to shun sweetened drinks, said Dallas nutritionist Lona Sandon.

"Added sugar does not give us any nutritional value," said Sandon, program director and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center.

Soda is also likely to replace drinks that are higher in nutritional value, such as milk, she said.

Also, "some sodas are high in phosphorous, and diets high in phosphorous may have long-term effects on bone health," Sandon added.

The calories from sugary drinks are "empty," and won't keep you feeling full, Sandon explained. Instead of sugary beverages, she recommends plain or flavored water without added sugar, low-fat milk or vegetable juice.

The report was published Jan. 26 as a U.S. National Center for Health Statistics Data Brief.

In another CDC report, Rosinger and colleagues looked at sugary beverage consumption among adults for 2011 to 2014. About half drank at least one of the drinks daily, with men more likely than women to do so.

More information

For more about sugar-sweetened beverages and health, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Asher Rosinger, Ph.D., M.P.H., researcher, U.S. Centers for Disease Control and Prevention; Lona Sandon, Ph.D., R.D.N., L.D., program director and assistant professor, clinical nutrition, University of Texas Southwestern Medical Center, Dallas; U.S. National Center for Health Statistics Data Brief, Jan. 26, 2017

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Study Counters Link Between Excess Pregnancy Weight and Overweight Kids

TUESDAY, Jan. 24, 2017 (HealthDay News) -- Kids whose moms were overweight during pregnancy have increased odds of being overweight themselves -- but the connection may be largely genetic, a new study suggests.

The implication, researchers said, is that overweight women are unlikely to influence their kids' future weight by shedding pounds before pregnancy.

But they also stressed that more research is needed to confirm their findings.

And no one is suggesting that a woman's weight before and during pregnancy is unimportant.

There are plenty of reasons to go into pregnancy at the healthiest weight possible, said Rebecca Richmond, the lead researcher on the study.

A high body mass index (BMI) raises the risk of pregnancy complications such pre-eclampsia and gestational diabetes, explained Richmond, a senior research associate at the University of Bristol in England.

Plus, she said, those extra pounds boost the odds of having an abnormally large newborn -- another risk factor for complications.

The new study, being published online Jan. 24 in PLOS Medicine, tried to address a question raised by past research: Do pregnancy pounds, in and of themselves, affect a child's weight in the long run?

Pregnancy weight does affect birth size, Richmond said. But, she added, birth weight is not "deterministic," and bigger newborns are not necessarily going to become bigger kids.

Richmond and her colleagues focused on over 6,000 mother-child pairs who were taking part in two long-term health studies. The kids' body mass index (BMI) was recorded throughout childhood and adolescence. BMI is a measure that roughly estimates body fat, using weight and height, and in children, age and sex. In general, the higher someone's BMI, the more body fat they have.

The researchers found there was a correlation between moms' pre-pregnancy BMI and kids' BMI across the age span.

But it seemed to be mostly explained by genes.

Using blood samples from mothers and their children, the researchers gave each pair a "genetic risk score." That was based on 32 gene variants that have been strongly linked to BMI in past studies.

In the end, Richmond's team found, the genetic risk score largely accounted for the higher BMI among kids of overweight moms.

However, the findings shouldn't be considered the final word, said Dr. Siobhan Dolan, an obstetrician-gynecologist and medical advisor to the nonprofit March of Dimes.

"Disentangling what's genetic and what's environmental is challenging," said Dolan, who wasn't involved in the study.

For example, she said, kids can also "inherit" behaviors such as eating habits from their parents.

Dolan agreed that there are already "compelling reasons" for women to head into pregnancy at the healthiest weight possible. And those reasons go beyond curbing the risk of pregnancy complications.

In the long run, Dolan said, excess weight can raise a woman's risk of chronic conditions such as type 2 diabetes and heart disease.

Pregnancy may only compound the issue if a woman gains too much weight -- those pounds can be tough to shed after giving birth, Dolan noted. That's why, she said, it's important to try to follow guidelines on weight gain during pregnancy.

According to the Institute of Medicine, overweight and obese women should put on fewer pounds during pregnancy, compared with normal-weight and underweight women.

Obese women should gain around 11 to 20 pounds during pregnancy, says the IOM -- an expert panel that advises the U.S. federal government. Overweight women can gain a bit more, but no more than 25 pounds.

Another important point, Dolan said, is that genes are not destiny: Even if kids inherit genetic variants that raise the odds of obesity, that can still be countered with a healthy diet and regular exercise, she said.

More information

The March of Dimes has more on weight and pregnancy.

SOURCES: Rebecca Richmond, Ph.D., senior research associate, epigenetic epidemiology, University of Bristol, England; Siobhan Dolan, M.D., M.P.H., medical advisor, March of Dimes, White Plains, N.Y.; Jan. 24, 2017, PLOS Medicine, online

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Even One High-Fat Meal Can Harm Your Liver, Study Finds

TUESDAY, Jan. 24, 2017 (HealthDay News) -- Eating a high-fat meal -- say, a cheeseburger and fries or a pepperoni pizza -- disrupts liver function, a new, small study reveals.

Researchers found that the high levels of saturated fat found in such rich foods immediately alter the work of the liver, possibly setting the body up for serious disease down the line.

"The effects mimic the abnormalities seen in people with severe metabolic disease," said study co-author Dr. Michael Roden, referring to conditions like fatty liver disease and cirrhosis.

"Our findings paint the picture of the earliest changes in liver metabolism leading to fatty liver diseases and liver cirrhosis in the context of obesity and type 2 diabetes," said Roden. He's scientific director of the German Diabetes Center at Heinrich Heine University in Dusseldorf.

How long these metabolic alterations last after people indulge in a rich meal isn't clear.

The liver plays a crucial role in processing the fats and carbohydrates people eat.

In some cases when fatty foods are repeatedly eaten to excess, fats accumulate and cause a condition known as nonalcoholic fatty liver.

This condition has ballooned along with the U.S. obesity epidemic, and is thought to affect as many as 25 percent of people in the United States. It can lead to cirrhosis, a serious condition characterized by scarring of the liver.

Dr. Hannele Yki-Jarvinen is professor of medicine at the University of Helsinki in Finland. "We know diets high in saturated fat make the liver fatty," she said.

"Saturated fats such as in butter, fatty cheeses and coconut oil are thus the worst thing to __eat from the liver perspective," said Yki-Jarvinen, co-author of a commentary accompanying the new study.

For the study, the researchers assigned 14 healthy, lean young men to consume a placebo or a dose of palm oil that varied according to their weight. The palm oil provided levels of saturated fat equivalent to that from an eight-slice pepperoni pizza or a cheeseburger with large fries, the report said.

This "fat loading" caused the liver to produce 70 percent more glucose, which could boost blood sugar levels over time, Roden said. Potentially, this could contribute to insulin sensitivity -- a precursor to type 2 diabetes.

Fat loading also caused liver cells to work harder, which could stress them and contribute to liver disease, he noted.

In addition, the saturated fat lowered the liver's ability to store glucose compared to fat, "which over time might favor fatty liver diseases," Roden said.

It's possible that healthy people could easily overcome these effects while those who repeatedly __eat fat-laden foods might be less fortunate, Roden added.

Yki-Jarvinen said that while cirrhosis is difficult to reverse, most people can boost their liver health.

"If you change your diet to a more healthy one containing healthy fats, such as found in olive oil, your liver fat decreases in a few days," she said.

In addition to their work with humans, the researchers also launched a similar analysis of fat intake in mice. This provided insight into how fat affects the workings of genes, the study authors said.

Next, Roden said he hopes to learn how long the effects of one high-fat meal last and how that compares to those of other nutrients, such as proteins and carbohydrates.

The study was published Jan. 23 in the Journal of Clinical Investigation.

More information

For more about liver disease, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

SOURCES: Michael Roden, M.D., scientific director, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Dusseldorf, Germany; Hannele Yki-Jarvinen, M.D., professor, medicine, University of Helsinki, Finland; Jan. 23, 2017, Journal of Clinical Investigation

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Could Obesity Undermine Memory Training in Older Adults?

MONDAY, Jan. 23, 2017 (HealthDay News) -- Memory training is far less effective in older adults who are obese than those who aren't, a new study finds.

The research included about 2,800 people, average age 74, who were followed for more than 10 years.

Obese participants gained only one-third of the benefit of memory training compared with those who weren't obese, the study authors said.

However, the study didn't find any differences by weight in the benefits from training in reasoning and problem-solving, or in thought-processing speed.

"These findings suggest that memory training is less beneficial for older adults with obesity, but we really don't know why," said lead author Daniel Clark. He is an investigator in Indiana University's Center for Aging Research.

Although the study wasn't designed to show a cause-and-effect relationship, Clark said there is growing evidence of a link between obesity and brain function. Imaging studies have shown that obesity is associated with more rapid loss of brain volume in an area related to memory, he noted.

"So it's possible that actual capacity for memory gains is less for older adults with obesity," Clark explained in a university news release.

"Other work has shown that weight loss can lead to improvements in memory function. Unfortunately, we know from our own prior work, and that of others, that weight loss is difficult to achieve and maintain over the long term," he said.

Clark suggested that researchers need to focus on effective ways to prevent weight gain, as well as to lose weight.

"But we should also investigate programs with potential to protect memory function in the absence of weight loss for people with obesity -- a growing segment of our population," Clark said.

The study was published recently in the journal Obesity.

More information

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

SOURCE: Indiana University, news release, Jan. 10, 2017

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Childhood Asthma May Encourage Obesity, Study Suggests

FRIDAY, Jan. 20, 2017 (HealthDay News) -- A young child with asthma has a greater risk of obesity than one without the chronic respiratory condition, a new study suggests.

Among nearly 2,200 elementary school students in California, researchers found that childhood asthma was linked to a 51 percent increased risk of obesity over the next 10 years.

"I was surprised it was that substantial," said study senior author Dr. Frank Gilliland. He is a professor of preventive medicine at the University of Southern California's Keck School of Medicine in Los Angeles.

However, kids who used "rescue" inhalers were less likely to become obese compared to those who did not treat flare-ups, the investigators found.

Prevalence of obesity and asthma has increased dramatically over the past several decades, and researchers suspect there's a biological connection between the two.

Previous research has shown obese children are at an increased risk of developing asthma. "This is the other way around -- kids with asthma have a substantial increase in the risk for developing obesity," Gilliland said.

Asthma patients have inflamed, narrowed airways. They may experience chest tightness, coughing and shortness of breath in response to infections, allergens, irritants in the air, physical activity and other triggers.

This study only found an association between asthma and obesity, not a direct cause-and-effect relationship. And it doesn't suggest that all kids with asthma will become obese.

Still, Gilliland theorized about why this link might exist.

Children may play outdoors less often when their asthma symptoms flare up, he suggested.

Also, "sleep disturbances are common in asthma, and a large risk factor for obesity," Gilliland said. In addition, obesity and asthma could have common genetic underpinnings, he noted.

The researchers also pointed out that weight gain is a side effect of many asthma medications.

A pediatric asthma specialist in Miami said she has noticed the link between asthma and obesity in her young patients.

It can be a vicious cycle, said Dr. Vivian Hernandez-Trujillo, section chief of allergy and immunology at Nicklaus Children's Hospital.

"Children who don't feel well [due to asthma] can't exercise," she said. Also, "part of it is fear." They're afraid of an asthma attack. That inactivity can lead to obesity, Hernandez-Trujillo said.

Doctors usually prescribe two types of medication for asthma: a long-term control inhaler; and a quick-relief, or rescue, inhaler for use during flare-ups, according to the U.S. National Heart, Lung, and Blood Institute.

For the study, the researchers reviewed medical records of over 2,000 students, aged 5 to 8, enrolled in the large Southern California Children's Health Study. At the study start, no one was obese; 13.5 percent had asthma.

Researchers followed the students for up to 10 years. During that time, nearly 16 percent of the children developed obesity.

Having asthma was linked to a raised risk, and the association held even after accounting for factors such as health insurance and physical activity, the study authors said.

But kids who used rescue medicine, such as albuterol, during an asthma attack had a 43 percent lower risk of becoming obese, the findings showed. However, the study found no link between maintenance medications (inhaled steroids) and reduced risk.

The researchers duplicated the findings in another sample of children from the Children's Health Study.

Hernandez-Trujillo said that the take-home message from this study is that "we need to ensure patients with asthma receive proper treatment."

As long as asthma is controlled, she said, children can lead a normal life, including getting physical activity.

Gilliland agreed. Be sure your child's asthma symptoms are not limiting sports activity or other exercise, he said.

Also, seek help if a child has sleep issues because good sleep can reduce obesity risk, he added.

Hernandez-Trujillo tells her patients who are trying out for sports, "It's not about being first. It's about trying."

The study was published online Jan. 20 in the American Journal of Respiratory and Critical Care Medicine.

More information

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

SOURCES: Frank Gilliland, M.D., Ph.D., professor, preventive medicine, Keck School of Medicine, University of Southern California, Los Angeles; Vivian Hernandez-Trujillo, M.D., section chief, allergy and immunology, Nicklaus Children's Hospital, Miami, and clinical associate professor of pediatrics, Herbert Wertheim School of Medicine, Florida International University; Jan. 20, 2017, American Journal of Respiratory and Critical Care Medicine, online

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Are U.S. Med Schools Skimping on Obesity Training?

FRIDAY, Jan. 20, 2017 (HealthDay News) -- Despite being a major health threat, obesity isn't widely discussed in U.S. medical schools, a new study suggests.

Obesity is barely mentioned in U.S. medical students' licensing exams, according to the researchers at Northwestern University School of Medicine in Chicago.

With so few test items about obesity prevention and treatment, medical schools have less incentive to educate students about obesity -- and students have less incentive to learn about it, the researchers said.

"It's a trickle-down effect. If it's not being tested, it won't be taught as robustly as it should be," said study author Dr. Robert Kushner, a professor of medicine.

"Tackling this challenge will require major changes in medical education," Kushner said in a university news release.

For the study, six obesity specialists examined the obesity-related content of the three United States Medical Licensing Examinations taken by all medical students and first-year residents.

The few exam items about obesity focused on assessment and management of obesity-related illnesses such as diabetes and obstructive sleep disorder, rather than the diagnosis and management of obesity itself, the study found.

It also revealed that important concepts of obesity prevention and treatment were poorly represented.

Nearly 40 percent of U.S. adults and almost 20 percent of children aged 6 to 11 are obese, according to the U.S. Centers for Disease Control and Prevention. Obesity can lead to serious conditions such as diabetes, heart disease and some types of cancer.

The study was published recently in the journal Teaching and Learning in Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more on obesity causes and consequences.

SOURCE: Northwestern University, news release, Jan. 18, 2017

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Heavy Kids Fare Worse in One Way After Surgery

FRIDAY, Jan. 13, 2017 (HealthDay News) -- Here's yet another reason to watch your child's weight: Overweight and obese kids seem to be more likely than others to develop a wound infection after surgery, a new study suggests.

Researchers have already documented this connection in adults. But, "research on this topic among children and adolescents is scarce," said study co-author Dr. Catherine Hunter, one of the study authors.

"The information from this first-of-its-kind study can now be used in assessing and counseling preoperative pediatric surgical patients and their families," said Hunter. She's a pediatric surgeon at Ann & Robert H. Lurie Children's Hospital of Chicago.

In the United States, childhood obesity has nearly tripled since the 1970s, which suggests more children may face these infections, she and her colleagues said.

Using statistics from a U.S. surgical database, the researchers focused on 1,380 patients aged 2-18 who developed surgical site infections after major surgery in 2012 or 2013.

Noting that 40 percent were overweight or obese, the researchers determined that the overweight kids had a 23 percent higher odds for infection. Obese kids had 43 percent higher odds.

The researchers also looked at 115 patients from a single surgical center who developed wound infections. They found that 30 percent of them were overweight or obese.

"When considering children, adolescents and adults, there are several theories as to why overweight or obese patients are at higher risk for infection," Hunter said in a hospital news release.

These may include impaired wound healing due to lower oxygen pressure in the excess fat tissue surrounding the wound as well as impaired immune responsiveness, she explained.

"However, more studies need to look at this further," Hunter added.

The study results were published recently in the journal Surgical Infections.

More information

Get tips for a successful hospital stay from the American Academy of Pediatrics.

SOURCE: Ann & Robert H. Lurie Children's Hospital of Chicago, news release, Jan. 4, 2017

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Rural Americans at Higher Risk of 5 Preventable Causes of Death: CDC

THURSDAY, Jan. 12, 2017 (HealthDay News) -- Americans who live in rural areas have a higher risk of death from five leading causes than people who live in urban locations, a federal study reveals.

In 2014, there were many potentially preventable deaths among rural Americans, including 25,000 from heart disease, 19,000 from cancer, 12,000 from accidental injuries, 11,000 from chronic lower respiratory disease and 4,000 from stroke, according to the U.S. Centers for Disease Control and Prevention.

"This new study shows there is a striking gap in health between rural and urban Americans. To close this gap, we are working to better understand and address the health threats that put rural Americans at increased risk of early death," CDC Director Dr. Tom Frieden said in an agency news release.

About 46 million Americans -- 15 percent of the nation's population -- live in rural areas. Several factors -- including economics, environment and demographic and social factors -- might put rural residents at a higher risk of these preventable causes of death, the researchers said.

Compared to city dwellers, rural Americans tend to be older and sicker. In addition, rural residents have higher rates of cigarette smoking, high blood pressure and obesity. They also get less leisure-time exercise and are less likely to use seatbelts than people who live in urban regions, the study authors said.

Rural Americans also have higher rates of poverty, less access to health care and are less likely to have health insurance, the findings showed.

The study found that deaths from accidental injuries were about 50 percent higher in rural areas than in urban areas. These fatalities were, in part, due to a higher risk of death from motor vehicle crashes and opioid overdoses.

Other factors include long distances between health care facilities and trauma centers, and slower access to specialized care, according to the report.

The findings were published in the Jan. 13 issue of the CDC's Morbidity and Mortality Weekly Report.

More information

The U.S. National Library of Medicine has more about rural health concerns.

SOURCE: U.S. Centers for Disease Control and Prevention, news release, Jan. 13, 2017

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Despite Pledges, No Improvement in Chain Restaurant Kids' Menus: Study

WEDNESDAY, Jan. 11, 2017 (HealthDay News) -- U.S. chain restaurants have not followed through on promises to boost the nutritional quality of their kids' menus, a new study contends.

Under a 2011 National Restaurant Association initiative, some chain restaurants pledged to reduce calories, saturated fat and salt in their children's menu items. By 2015, more than 150 chains with 42,000 locations in the United States were participating in the program, the study authors said.

However, those companies made no significant improvements in those areas over three years, according to researchers at Harvard T.H. Chan School of Public Health in Boston.

The investigators also said that sugary drinks still accounted for 80 percent of children's beverage options -- despite restaurant promises to lower that proportion.

"Although some healthier options were available in select restaurants, there is no evidence that these voluntary pledges have had an industry-wide impact," lead author Alyssa Moran, doctoral student in the department of nutrition, said in a Harvard news release.

In 2011 and 2012, more than one in three American children and teens ate fast-food every day, the study authors noted.

One nutritionist wasn't surprised by the findings.

"It's sad but true. You aren't going to find truly healthy fare at the majority of fast-food restaurants," said Dana Angelo White. She's a registered dietitian who is a clinical assistant professor of sports medicine at Quinnipiac University, in Hamden, Conn.

"Sodium and sugar are especially hard to avoid in the types of highly processed foods these places offer," she added. "Voluntary pledges and minuscule tweaks to menus can't change the culture of fast-food."

In a statement, the National Restaurant Association responded to the findings.

"We have just received this study and are currently reviewing it. Kids Live Well was started to promote healthy eating among children, and we welcome any opportunity to encourage children to make healthy choices," said Leslie Shedd, the group's vice president of communications.

Antonella Apicella is outpatient dietitian at Lenox Hill Hospital in New York City. She agreed with White that, "to date, there are no nutrition requirements for children's meals in chain restaurants."

Apicella believes the new study "demonstrates the need to establish standardized regulations among chain restaurants, as established in school breakfast and lunch programs."

The Harvard researchers agreed, advocating partnerships between the restaurant industry, government agencies, researchers, and public health experts to improve kids' meals. Restaurant commitments to improve the nutritional quality of their kids' menus items should also be monitored, the study authors said.

The study was published online Jan. 11 in the American Journal of Preventive Medicine.

More information

The American Academy of Pediatrics has more on nutrition.

SOURCES: Dana Angelo White, M.S., R.D., registered dietitian and clinical assistant professor of athletic training and sports medicine, Quinnipiac University, Hamden, Conn; Antonella Apicella, R.D., outpatient dietitian, Lenox Hill Hospital, New York City; Jan 10, 2017, statement, National Restaurant Association; Harvard T.H. Chan School of Public Health, news release, Jan. 11, 2017

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Want to Leave Dinner Feeling Full? Bring on the Beans

WEDNESDAY, Jan. 11, 2016 (HealthDay News) -- Legumes such as beans and peas make people feel fuller after a meal than meat, a small study shows.

The study included 43 men who were served three different protein-rich meals in which patties made of beans and peas or veal and pork were a centerpiece.

Not only were the vegetable patties more filling than the meat, the men ate 12 percent fewer calories at their next meal. That suggests that beans/peas patties may help with weight control, according to the researchers at the University of Copenhagen in Denmark.

"The protein-rich meal composed of legumes contained significantly more fiber than the protein-rich meal of pork and veal, which probably contributed to the increased feeling of satiety," lead researcher Anne Raben said in a university news release.

The findings are "somewhat contrary to the widespread belief that one ought to consume a large amount of protein because it increases satiety more. Now, something suggests that one can __eat a fiber-rich meal, with less protein, and achieve the same sensation of fullness," said Raben, a professor in the Department of Nutrition, Exercise and Sports.

"While more studies are needed for a definitive proof, it appears as if vegetable-based meals -- particularly those based on beans and peas -- both can serve as a long term basis for weight loss and as a sustainable eating habit," she concluded.

The study was published recently in the journal Food & Nutrition.

More information

The U.S. Department of Agriculture outlines protein foods for vegetarians.

SOURCE: University of Copenhagen, news release, December 2016

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Brisk Walk May Help Sidestep Heart Disease

TUESDAY, Jan. 10, 2017 (HealthDay News) -- Walking at moderate intensity may lower the risk of heart disease, a small study suggests.

"We know walking is an excellent form of exercise, but research has been mixed on how successful a walking program can be in changing biological markers such as cholesterol, weight, blood pressure," said Pamela Stewart Fahs. She is associate dean, professor, and chair in rural nursing at the Binghamton University Decker School of Nursing in New York.

For the study, Fahs and a graduate student tracked 70 women in a rural area of New York state. The study participants were asked to walk briskly at least 150 minutes a week for 10 weeks. The women ranged in age from 29 to 79, and had an average age of 55.

At the start of the study, the researchers calculated the women's risk of a heart attack within the next 10 years.

Halfway through the 10 weeks, the participants were given an incentive via a raffle to increase their steps.

At the end of the 10-week period, the investigators checked the weight, blood pressure and cholesterol levels of the participants. All of these factors had improved, suggesting that walking can help lower heart disease risk in a short time, according to the report.

"I believe there is a need to test for effects of a built-in challenge within a program to see if that helps motivate participants to participate longer and/or produces more successful outcomes," Fahs said in a university news release.

Since research such as this is often done in urban or suburban settings, "work needs to be done to see how best to keep rural women engaged in meaningful exercise for longer periods of time," Fahs added.

The study was published recently in Creative Nursing.

More information

For more about walking as exercise, visit the U.S. Centers for Disease Control and Prevention.

SOURCE: Binghamton University, State University of New York, news release

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Health Tip: Protecting Your Health

(HealthDay News) -- While getting healthy is no easy chore, neither is staying that way.

The American Academy of Family Physicians recommends:

• Avoid smoking and using tobacco.

• Don't have more than one daily drink if you're a woman, or no more than two daily if you're a man.

• Follow a healthy-eating plan to protect your heart health and weight.

• Lose any excess weight through diet and regular exercise. Aim for at least 30 minutes of exercise four-to-six days per week.

• Get tested for sexually transmitted infections.

• Avoid tanning booths, and wear sunscreen daily.

• Get all recommended vaccinations, health screenings (including mammograms and Pap smears) as recommended by your doctor. Also get an annual physical.

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Weight-Loss Surgery Offers Long-Term Benefit to Very Obese Teens

FRIDAY, Jan. 6, 2017 (HealthDay News) -- Weight-loss surgery helps severely obese teens keep extra pounds off long-term, new research confirms.

However, the authors of the two new studies also found that some young people may need additional surgery to manage complications associated with their rapid post-surgery weight loss.

Some young patients may also develop nutritional deficiencies after their procedure, the researchers said.

These are the first long-term follow-up studies on teens that undergo weight-loss surgery, the researchers noted.

The findings "clearly document long-term benefits of adolescent bariatric [weight-loss] treatment, but also highlight several nutritional risks," said lead author Dr. Thomas Inge of Cincinnati Children's Hospital Medical Center.

"Now it is important to focus on delivery of the substantial health advantages of surgery while minimizing these risks," Inge said in a news release from The Lancet Diabetes & Endocrinology. The findings were published in the journal on Jan. 5.

According to background information in the study, some 4.6 million children and teens in the United States are severely obese -- defined as roughly 100 pounds or more overweight.

Severe obesity leads to poor health and quality of life, which is why many of these teens are offered the option to undergo weight-loss surgery, the researchers explained.

In one of the new studies, researchers followed 58 young Americans between 13 and 21 years old who had one type of weight-loss surgery known as gastric bypass.

Eight years after surgery, these patients had an average weight reduction of 30 percent. Nearly two-thirds of the teens remained obese, though not severely so. The study showed that only one patient dropped down to a normal weight.

Among the teens who had weight-loss surgery, the number of those with diabetes, high cholesterol or high blood pressure dropped significantly. Along with these health benefits, however, 78 percent of the teens developed low levels of vitamin D, and 16 percent were deficient in vitamin B12. Mild anemia was diagnosed in 46 percent of these young people.

These nutritional deficiencies could stem from the fact that the teens were simply eating less, or they may be absorbing nutrients less well, the researchers explained.

They noted, however, that the health benefits of weight-loss surgery far surpass these manageable nutrient issues.

For the second study, researchers tracked 81 obese teens and adults in Sweden who had weight-loss surgery and compared them to 80 teens who didn't have the procedure. They found those who had the surgery had maintained an average 28 percent weight reduction after five years, while those who didn't have surgery gained more weight.

But among the teens who had the surgery, 25 percent did require additional surgery to manage complications from the procedure or the rapid weight loss that followed, such as bowel blockage and gallstones.

This meant more time in hospitals: Teens who had weight-loss surgery were hospitalized for an average of 6.5 days, while those who didn't have surgery were in the hospital for 1.5 days on average.

Teens who'd undergone weight-loss surgeries also had an average of five extra visits to an outpatient clinic compared to those who hadn't had the operation, the study found.

The researchers noted the overall cost to treat teens who underwent weight-loss surgery was roughly equivalent to the control group. And one in every four of the young people in the control group eventually did go on to have weight-loss surgery as an adult.

It's not clear which type of weight-loss surgery works best for teens, Inge said. "Since there are currently two effective bariatric procedures, namely gastric bypass and vertical sleeve gastrectomy, we are currently examining the outcomes of both procedures to determine what is best for adolescents," he said.

Despite some dramatic weight loss, many of the teens who had weight-loss surgery were still obese (but not severely obese) afterwards.

According to the study authors, this suggests positive lifestyle changes -- such as following a healthy diet and getting regular exercise -- are still important.

Dr. Mitchell Roslin is chief of obesity surgery at Lenox Hill Hospital in New York City. He reviewed the findings and said they highlight the benefit of surgery for severely obese young patients.

He said that according to prior research, "once obesity reaches this level in teens, it adversely affects future success more than drug addiction, alcohol or poverty."

Based on that, Roslin believes that "lasting weight loss [through weight-loss surgery] should be considered 'salvage therapy' and pursued to rescue more teens."

While the side effects noted in the studies can happen, this only shows "there is no perfect solution to what is truly a chronic and very detrimental condition," Roslin said. "The reality of this situation has to be accepted and access to surgery more easily provided."

More information

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

SOURCES: Mitchell Roslin, M.D., chief, obesity surgery, Lenox Hill Hospital, New York City; The Lancet Diabetes & Endocrinology, news release, Jan. 5, 2017

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Weight Loss May Ease Psoriasis Symptoms, Study Finds

WEDNESDAY, Jan. 4, 2017 (HealthDay News) -- Could weight loss combat psoriasis?

Danish researchers are reporting that obese people with the skin condition who lose 10 percent to 15 percent of their weight may see significant and lasting improvement in their symptoms.

The study participants lost an average of 33 pounds over 16 weeks. A year later, those who were still about 22 pounds below their weight from the start of the study maintained their improvements in psoriasis symptoms and quality of life, the study authors said.

"Psoriasis is more than just a skin condition," said Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City. Increased weight can stress the heart and other organs, and that stress can trigger psoriasis, she said.

"We know that weight and psoriasis together and independently increase the risk of high blood pressure and heart disease and diabetes. Psoriasis is an inflammatory condition -- it's not just a skin condition -- it can affect any organ," Day added.

Foods that make you gain weight can also be inflammatory, and since stress can make people __eat more, that can trigger psoriasis. When you have increased weight, you also have more stress on major organs, which can also cause a cascade of effects that lead to psoriasis symptoms, Day explained.

The report was published recently in the American Journal of Clinical Nutrition.

Psoriasis is a chronic disease that is characterized by red, itchy and scaly patches of skin. The severity of the condition varies from person to person.

The study's senior researcher, Dr. Lone Skov, said, "Psoriasis is associated with obesity, but also with type 2 diabetes and cardiovascular disease." Skov is with the department of dermatology and allergy at Gentofte Hospital at the University of Copenhagen in Denmark.

Day explained that psoriasis is a genetic disease. "You can't control your genetics, but you can control other things like your diet and your weight and your activity level," she said.

"We know by affecting your overall health, you have a positive impact on psoriasis," Day added.

Day said she sees the benefits of weight loss in her own practice. "When I help patients get their psoriasis under control, they lose weight because they feel better about themselves and they want to take better care of themselves. It's really quite powerful," she said.

The new study is a continuation of a trial in which obese psoriasis patients were randomly assigned to a weight-loss diet.

Fifty-six patients participated in a 64-week weight-loss program. Skov and colleagues followed the patients for an additional 48 weeks of a weight-maintenance diet. Patients were evaluated using the Psoriasis Area and Severity Index and the Dermatology Life Quality Index.

The average weight at the start of the study was about 235 pounds. Among the 32 patients who completed the study, the average weight loss during the first 16 weeks was 33 pounds. Scores on both symptom tests improved, the findings showed.

After 46 weeks, the average weight loss was about 22 pounds. The improvement in test scores remained, the researchers found.

"Doctors should tell their patients with psoriasis about the association between obesity and psoriasis and, in obese patients, advise weight loss," Skov said.

More information

For more on psoriasis, visit the National Psoriasis Foundation.

SOURCES: Lone Skov, M.D., department of dermatology and allergy, Gentofte Hospital, University of Copenhagen, Denmark; Doris Day, M.D., dermatologist, Lenox Hill Hospital, New York City; Dec. 22, 2016, American Journal of Clinical Nutrition

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Plant-Based Diets Score Big for Healthy Weight Loss

WEDNESDAY, Jan. 4, 2017 (HealthDay News) -- If you've resolved to __eat healthy and lose weight in 2017, a new report suggests the DASH diet may be your best bet.

For the seventh year in a row, U.S. News & World Report has named the plant-based eating plan as the best choice overall, followed by the Mediterranean diet, up from fourth place last year. DASH stands for Dietary Approaches to Stop Hypertension, but its benefits go beyond preventing high blood pressure, the report found.

The DASH and the Mediterranean diets, as well as most of the other recommended diets, focus on eating whole grains, fruits, vegetables, low- or no-fat dairy, lean meats, poultry and fish. They also recommend nuts, seeds and legumes (beans).

But these diets limit or exclude most fats and sweets, and recommend modest portions, according to Dr. David Katz. He is president of the American College of Lifestyle Medicine and a member of the expert panel that came up with the rankings.

"Overall, the diets are similar, and that's what makes this reasonable, because there is really no one diet that's best. But the question is what approach to eating well is going to work for any individual, and that's the benefit of this report," he added.

"You can pick the diet that will work for you and your family. The best diet is one that you are actually able to stick to," Katz noted.

The MIND diet, which incorporates elements of the DASH and Mediterranean diets and is touted as a way to keep Alzheimer's disease at bay, was ranked third in effectiveness.

There was a four-way tie for fourth place between the Flexitarian diet, a "casual vegetarian" diet that allows some poultry and fish; the Mayo Clinic Diet, an eating plan to keep you healthy and trim; the TLC diet, a plan that cuts cholesterol and fat by eliminating meats, dairy and fried food; and Weight Watchers, which helps you shed excess pounds.

To come up with its list, U.S. News & World Report ranked 38 diet plans in nine categories. The rankings were done by an expert panel of nutritionists, dietary consultants, and doctors specializing in diabetes, heart health and weight loss.

Each panelist considered the 38 diets across a number of areas, including the likelihood of sticking to the diet, the odds of losing weight in the short- and long-term, and effectiveness against heart disease and diabetes.

One reason the DASH diet came in first is that it was developed and tested by the U.S. National Institutes of Health, Katz said.

"The evidence for DASH is stronger than it is for some of the other diets, and it includes foods that are familiar to most Americans and can work for real families in the real world," he said.

The U.S. National Institutes of Health agreed.

"DASH is not a fad diet, but a healthy eating plan that supports long-term lifestyle changes," the agency said in a statement Wednesday. "To receive top ratings, a diet has to be relatively easy to follow, nutritious, safe, effective for weight loss, and protective against diabetes and heart disease."

Following the portion size recommended in each diet will usually result in healthy weight loss, Katz explained. "Eating well will help you be leaner and healthier," he said.

In addition to a healthy diet, exercise is necessary for good health, he said.

"Food is the fuel for the body -- it's crucial for your health over a lifetime. But combining it with exercise is also crucial," Katz said. "You are never going to be as healthy as you could be if routine physical activity is not a part of your life."

One nutrition expert said the key to healthy eating and losing weight is in lifestyles and dietary patterns, not crash diets.

"It is a waste of time for people to go on a 'diet,' which is usually a temporary, restrictive, unrealistic, and even unhealthy, way to lose weight," said Samantha Heller. She is an exercise physiologist and senior clinical nutritionist at NYU Langone Medical Center in New York City, and was not a member of the expert panel.

"Think about it -- millions of people are spending millions of dollars on fad diets, products and programs, and obesity is still a crisis. The only way to reach a healthy weight and stay there is to create patterns of eating that you can maintain for a lifetime, remembering, too, that being healthy outweighs being skinny," Heller said.

The research is clear that more plant-based diets like the DASH, Mediterranean and vegetarian approaches offer health benefits, including reduced risk of heart disease, dementia, cancer, type 2 diabetes and obesity, she said.

"Skipping the newest fad diet will save you money, time and frustration," Heller said. "Take time to adopt new ideas, such as having meatless meals like a hearty vegetable and bean soup, pasta with roasted red pepper sauce, or peanut butter and apple slices. Keep a daily food record on an app or in a notebook. Seek support and guidance from qualified practitioners such as registered dietitians," she advised.

More information

Visit U.S. News & World Report for more on the rankings.

SOURCES: David Katz, M.D., M.P.H., director, Yale-Griffin Prevention Research Center, Derby, Conn., and president, American College of Lifestyle Medicine; Samantha Heller, R.D., exercise physiologist and senior clinical nutritionist, NYU Langone Medical Center, New York City; Jan. 4, 2017, statement, U.S. National Institutes of Health; Jan. 4, 2017, U.S. News & World Report

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Resolve to Reduce Your Cancer Risk This Year

TUESDAY, Jan. 3, 2017 (HealthDay News) -- More than half of cancer deaths could be prevented through healthy habits such as eating right, exercising and not smoking, according to the American Cancer Society.

Doctors at Philadelphia's Fox Chase Cancer Center offer some advice to help you settle into the new year with a new attitude toward cancer prevention:

• Get screened. "Some risk factors cannot be controlled, such as family history or getting older," said Dr. Namrata Vijayvergia, assistant professor in the center's department of hematology/oncology. "That's why getting regular recommended cancer screenings may be just as important as living a healthy lifestyle." Screening tests are available for many forms of cancer. Ask your doctor when to begin and how often to be screened.

• Follow a healthy diet. Excess weight boosts the risk of cancer in the breast, colon and rectum, the lining of the uterus, as well as the esophagus, pancreas and kidney. "I urge everyone to get to a healthy weight and stay there," Vijayvergia said. To improve your diet, watch portion sizes; limit high-calorie foods, processed meats and red meat; __eat at least 1.5 cups of fruits and vegetables per day; and limit alcohol to two drinks a day for men and one for women.

• Stay active. The American Cancer Society recommends adults get at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. "Physical activity is essential, as it also helps to reduce the risk of heart disease and diabetes, and can improve hormone levels and the immune system," Vijayvergia said in a center news release.

• Don't use tobacco. Smoking has been linked to many types of cancer, including lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon and rectum. "The longer you smoke and the more packs per day you smoke, the higher your risk," Vijayvergia said. "Quitting smoking, or not starting, is the best thing you can do to help prevent cancer -- no matter your age and even if you've smoked for years."

• Don't get too much sun. Skin cancer is the most common type of cancer, according to the American Cancer Society. To protect yourself, cover up with long-sleeved shirts, long pants, a hat and sunglasses when possible. Also, use sunscreen with an SPF of 15 or more and avoid sun exposure between 10 a.m. and 4 p.m. And don't use tanning beds or sun lamps.

More information

The U.S. Centers for Disease Control and Prevention has more about cancer.

SOURCE: Fox Chase Cancer Center, news release

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Can Parents' Weight Hinder Toddlers' Development?

TUESDAY, Jan. 3, 2017 (HealthDay News) -- Children who have obese parents may show signs of developmental delays, such as poor social skills, by the time they're 3 years old, a new study suggests.

The specific developmental problems seem to differ depending on whether the mother, father or both parents are obese, according to researchers from the U.S. National Institute of Child Health and Human Development.

"Specifically, mothers' obesity was associated with a delay in achieving fine-motor skills, and fathers' obesity in achieving personal and social skills -- that includes skills for interacting with others," said lead researcher Edwina Yeung. She's an investigator in the institute's division of intramural population health research.

"When both parents were obese, it meant longer time to develop problem-solving skills," she added.

However, one pediatric neurologist not involved with the research isn't convinced that the study authors proved their case.

And Yeung acknowledged the same. "We used observational data, which doesn't allow us to prove cause and effect, per se," she explained.

The researchers did find that, compared with children of normal-weight mothers, children of obese mothers were 67 percent more likely to fail a test of fine-motor skills (using their hands and fingers) by age 3.

In addition, children of obese fathers were about 71 percent more likely to fail tests of personal and social skills, which may indicate how well they relate to and interact with others, by age 3, the researchers said.

Children whose mother and father were both obese were nearly three times more likely to fail tests of problem-solving ability by age 3, the findings suggested.

According to Yeung, about 2 percent to 4 percent of the children failed any single test.

Yeung said she can't explain the apparent connection between parental obesity and kids' developmental problems. For maternal obesity, some animal studies have suggested that inflammation could affect the fetal brain, she said.

With paternal obesity, the effect on offspring might be due to either gene mutations or other inherited genetic factors in sperm, Yeung said.

Most research into understanding child health and development has focused on mothers and their pregnancies. "Our findings suggest that factors from fathers may also play a role and deserve attention," Yeung said.

The report was published online Jan. 2 in the journal Pediatrics.

One child health expert doesn't think obese parents should be overly concerned by this study.

"Children of obese parents are not doomed to have developmental problems," said Dr. Ian Miller. He is a pediatric neurologist and director of neuroinformatics at Nicklaus Children's Hospital in Miami.

Any medical condition that affects the brain -- such as lead-poisoning, sickle cell disease, iron-deficiency anemia, autism, epilepsy or cerebral palsy -- can cause developmental problems, Miller said. He isn't ready, however, to add obesity to that list.

No matter whether parents are obese, normal weight or underweight, every child who might have a developmental problem should be screened and given help and therapy, he suggested.

Obesity may be a marker for increased risk of these problems, Miller said. The risk for developmental problems is low among all children, including those of obese parents. "It's not a 'sky is falling' type of scenario," he said.

For the study, Yeung and her colleagues collected data on more than 5,000 women and their children who were part of the Upstate KIDS study, which sought to determine if fertility treatments could affect child development from birth through age 3.

The women were enrolled in the study about four months after giving birth in New York state (excluding New York City) between 2008 and 2010.

About one in five pregnant women in the United States is overweight or obese, Yeung said.

To check the children's development, parents completed the Ages and Stages Questionnaire after doing a series of activities with their children, Yeung said.

The test doesn't diagnose specific problems, but is a screen for potential problems, so that children can be referred for further testing, she explained.

Children were tested at 4 months of age, and six more times through age 3 years. Mothers also gave information on their health and weight, both before and after pregnancy, and the weight of their partners, Yeung said.

Yeung said more studies are needed to explore this study's findings.

More information

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

SOURCES: Edwina Yeung, Ph.D., investigator, division of intramural population health research, U.S. National Institute of Child Health and Human Development; Ian Miller, M.D., pediatric neurologist and director, neuroinformatics, Nicklaus Children's Hospital, Miami; Jan. 2, 2017, Pediatrics

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Study Ties Alcohol Abuse to Increased Heart Risks

MONDAY, Jan. 2, 2017 (HealthDay News) -- A new study suggests that people who abuse alcohol also boost their risk of three cardiac conditions: atrial fibrillation, heart attack and congestive heart failure.

The possible added risk appears to be about the same as that linked to high blood pressure, smoking, obesity and diabetes, the researchers said.

"We found that even if you have no underlying risk factors, abuse of alcohol still increases the risk of these heart conditions," lead researcher Dr. Gregory Marcus said in an American College of Cardiology news release.

Marcus is director of clinical research at the University of California, San Francisco's division of cardiology.

The study was based on a database of close to 15 million Californians aged 21 and older who had outpatient surgery, emergency room treatment or inpatient hospital care between 2005 and 2009. About 2 percent had been diagnosed with alcohol abuse.

The researchers adjusted statistics so they wouldn't be thrown off by various other risk factors. They found that alcohol abusers were twice as likely to have atrial fibrillation; 1.4 times more likely to have a heart attack; and 2.3 times more likely to have congestive heart failure than other people.

The study did not prove that alcohol abuse directly caused these risks to rise, however.

Conditions like diabetes, high blood pressure and obesity are thought to boost the risk of these cardiac conditions by similar degrees, the researchers said.

"We were somewhat surprised to find those diagnosed with some form of alcohol abuse were at significantly higher risk of a heart attack," Marcus said.

"We hope this data will temper the enthusiasm for drinking in excess and will avoid any justification for excessive drinking because people think it will be good for their heart. These data pretty clearly prove the opposite," he added.

He suggested the new research may be more reliable than previous findings.

"The great majority of previous research relied exclusively on self-reports of alcohol abuse," Marcus said. "That can be an unreliable measure, especially in those who drink heavily. In our study, alcohol abuse was documented in patients' medical records."

It's not clear, though, how much the participants in this study drank.

The findings were published Jan. 2 in the Journal of the American College of Cardiology.

More information

For more about alcohol and the heart, try the American Heart Association.

SOURCES: American College of Cardiology, press release, Jan. 2, 2017

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