April 2017 ~ Best weight loss

Sunday, April 30, 2017

Cooking at Home Means Eating Better, Spending Less

SUNDAY, April 30, 2017 (HealthDay News) -- Your best bet for healthy eating is having plenty of home-cooked meals, a new study states.

Researchers asked more than 400 Seattle-area adults about what they cooked and ate for a week. They were graded using the U.S. Department of Agriculture's Healthy Eating Index (HEI).

HEI scores range from 0 to 100. The higher the score, the better the diet. A score over 81 indicates a good diet; 51 to 80 means improvement is needed; and 50 or less is poor.

Households that had home-cooked meals three times a week had an average score of about 67, while cooking at home six times a week bumped up the average to about 74.

The results suggest that regular home-cooked meals -- which tend to be lower in calories, sugar and fat -- give you a better diet at a lower cost.

The Oregon State University study was published in the May issue of the American Journal of Preventive Medicine.

"Higher HEI scores are generally associated with higher socioeconomic status, education and income. By contrast, cooking dinner at home depends more on the number of children at home. The study showed no association between income or education and eating at home or eating out," study author Arpita Tiwari, a health systems researcher, said in a university news release.

"Traditionally better socioeconomic status -- more money -- means healthier people. That's the trend. This research goes against that; it shows a resilience to that trend. It's not spending more but how you spend that's important," Tiwari concluded.

Eight out of 10 Americans fail to meet at least some federal dietary guidelines, and about half the money spent to __eat is for food not cooked at home, the study pointed out.

More information

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

SOURCE: Oregon State University, news release

Who You Are May Affect Your Diet More Than Where You Shop

FRIDAY, April 28, 2017 (HealthDay News) -- A new study challenges the view that building supermarkets in so-called "food deserts" will help more Americans __eat healthier.

Food deserts are places -- often in poor, urban neighborhoods or rural areas -- without easy access to stores stocked with fresh fruit, vegetables and other healthy foods.

Rand Corporation researchers surveyed nearly 1,400 households in two low-income, mostly black Pittsburgh neighborhoods long regarded as food deserts.

The survey found that people who were younger, male, not college-educated and who often shopped at convenience and neighborhood stores consumed more sugar-sweetened drinks, optional fats such as butter, and added sugars. The same was true for people receiving government food assistance.

Older, college-educated men ate more fruits and vegetables, the survey found.

These social and demographic factors were nearly twice as important than where people shopped in predicting whether they ate healthy or unhealthy foods, according to the study.

"Our findings suggest that interventions that focus on modifying the food retail environment by opening more stores that sell healthy food will have relatively little impact on reducing consumption of unhealthy food," lead author Christine Vaughan said in a Rand news release. Vaughan is a behavioral scientist at the nonprofit research organization.

"Instead, strategies designed to modify the choices people make about food stand a better chance of reducing consumption of unhealthy foods," she added.

Proven strategies include imposing taxes on sugary beverages and limiting displays of unhealthy foods in all types of stores, the study authors said.

The researchers also audited 24 food stores in the neighborhoods they studied and 14 others where residents said they did major food shopping. Nearly all stores -- from convenience marts to warehouse stores and supermarkets -- emphasized unhealthy food over healthier choices, the findings showed.

Most unhealthy were convenience stores, neighborhood shops and dollar stores, the study found. Moderately unhealthy stores included discount grocers, supercenters and wholesale clubs. Healthy stores included full-service supermarkets, specialty grocers, and fruit and vegetable shops.

However, even the healthiest stores had prominent displays of unhealthy foods, the investigators found.

Study co-author Tamara Dubowitz, a Rand senior policy researcher, concluded that "this work suggests we need to do more than just trying to eliminate food deserts. We need strategies that can encourage healthy eating and discourage unhealthy eating."

The report was published online April 25 in the journal Preventive Medicine.

More information

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

SOURCES: Rand Corporation, news release, April 25, 2017

The secret swaps to being healthier and more efficient

Type 2 Diabetes May Be Bad for Brain Health

THURSDAY, April 27, 2017 (HealthDay News) -- Previous research has linked type 2 diabetes and memory loss. Now, new research may be closing in on some of the reasons why.

The study found that people with type 2 diabetes -- particularly those who are overweight or obese -- have thinner gray matter in several areas of the brain.

These brain regions are related to memory, executive function, movement generation and visual information processing, said the study's senior author, Dr. In Kyoon Lyoo. He's director of the Ewha University Brain Institute in Seoul, South Korea.

"Obesity leads to increased risk of type 2 diabetes, metabolic dysfunction and is also associated with brain alterations independently," Lyoo said. "We aimed to investigate whether overweight/obesity influenced brain structure and cognitive function in individuals with early stage of type 2 diabetes."

The study included: 50 overweight or obese people with type 2 diabetes; 50 normal-weight people with type 2 diabetes, and 50 normal-weight people without diabetes.

The Korean study volunteers were between 30 and 60 years old. Those with diabetes had it for five years or less, and they were attempting lifestyle modifications and/or taking oral medication to lower blood sugar levels. No one was taking insulin.

The normal-weight group with type 2 diabetes had slightly better blood sugar control -- a hemoglobin A1C level of 7 percent. The overweight folks with type 2 diabetes had hemoglobin A1C levels of 7.3 percent.

Hemoglobin A1C is a two- to three- month estimate of average blood sugar levels. The American Diabetes Association generally recommends an A1C of 7 percent or less.

All study participants underwent MRI brain scans and tests to measure memory and thinking skills.

"Cortical thickness was decreased in several regions of the diabetic brains. Further thinning of the temporal lobes found in overweight/obese individuals with type 2 diabetes suggests that these regions are specifically vulnerable to combined effects of obesity and type 2 diabetes," Lyoo said.

He said this study alone cannot tease out whether the effect is from excess weight or diabetes or both. But the study did find that the longer someone had diabetes, the more likely they were to have brain changes.

Lyoo said factors such as insulin resistance, inflammation and poor blood sugar management might bring about the changes.

Memory and thinking skills were decreased in people with diabetes -- regardless of weight -- compared to the normal-weight people without type 2 diabetes, the study found.

Because the study only included an Asian population, Lyoo said it isn't clear if these effects would apply to other populations, such as Americans. He also said it isn't known if these effects occur in people with type 1 diabetes, the less common form of diabetes.

Dr. Sami Saba is an attending physician in neuromuscular medicine and electromyography at Lenox Hill Hospital in New York City.

"The regions most affected were the temporal lobes, which are also most prominently affected in people with Alzheimer's," he said of the research.

"While this was not proven on this study, it does suggest that those with diabetes who are also overweight are at higher risk for developing Alzheimer's-type cognitive impairment than those with diabetes who are not overweight," Saba said.

But, he also noted that a major limitation of this study was the lack of overweight/obese people without diabetes to serve as a comparison group.

The take-home message, said Saba, is that weight control is an "important factor in preserving brain health in these patients." He said it's one more reason to work to prevent weight gain.

Lyoo said good blood-sugar management would probably help slow down or prevent these diabetes- or obesity-related brain changes.

Dr. William Cefalu is the chief scientific, medical and mission officer for the American Diabetes Association.

"The presence of overweight and obesity has been shown in other studies to be associated with early structural changes in the brain, and may contribute to cognitive issues," he said.

But, he said that diabetes may also play a role. Both Lyoo and Cefalu said that more research is needed to figure out which factor is at the root of these changes.

The study was released April 27 in the journal Diabetologia.

More information

Learn more about managing newly diagnosed type 2 diabetes from the American Diabetes Association.

SOURCES: In Kyoon Lyoo, M.D., Ph.D., director, Ewha University Brain Institute, Seoul, South Korea; Sami Saba, M.D., attending physician in neuromuscular medicine and electromyography, department of neurology, Lenox Hill Hospital, New York City; William Cefalu, M.D., chief scientific, medical and mission officer, American Diabetes Association; April 27, 2017, Diabetologia

No Excuses: Exercise Can Overcome the 'Obesity Gene'

THURSDAY, April 27, 2017 (HealthDay News) -- Even if obesity is "in your genes," regular exercise can help keep extra pounds at bay, a new study suggests.

Researchers found that when people carried a particular gene variant that raises obesity risk, regular exercise seemed to reduce the effects of their DNA -- by about one-third.

The gene in question is known as FTO. Studies show that people with a particular variant of the gene have a heightened risk of obesity.

But the gene's effects are not huge, or written in stone. Research has found that people who carry two copies of the FTO variant (one inherited from each parent) weigh about 6.5 pounds more than non-carriers, on average.

The new findings underscore one way to counter the gene's impact: Exercise.

"There are genes that appear to directly impact weight, but the effects are small," said lead researcher Mariaelisa Graff, of the University of North Carolina at Chapel Hill. "You still have a lot of choice over your behavior."

The study results are not exactly surprising, according to Dr. Timothy Church, an obesity researcher who was not involved in the work.

"This shows, once again, that genes are not your destiny," said Church. He is a professor of preventative medicine at Louisiana State University's Pennington Biomedical Research Center.

Church said regular exercise is particularly key in preventing excess weight gain in the first place -- and in keeping the pounds off after someone loses weight.

Exercise is less effective in helping obese people shed weight, Church said. Diet changes are the critical step there.

But the bottom line is that exercise matters, regardless of your genes, according to Dr. Chip Lavie, of the John Ochsner Heart and Vascular Institute, in New Orleans.

Lavie, who was not involved in the study, pointed to findings from his own research.

"[We] have published data that suggests the main cause of increasing obesity over the past five decades is the dramatic decline in physical activity," he said.

Gym memberships aside, Americans these days are less active at work, at home (through housework) and during leisure time, according to Lavie.

And the benefits of exercise go beyond weight control, he stressed. Physical activity boosts people's fitness levels -- which, Lavie said, is critical in preventing heart disease and living a longer, healthier life.

The new findings are based on over 200,000 adults, mostly of European descent, who'd taken part in previous health studies.

Graff and her colleagues analyzed information on their weight and exercise habits, and looked at how those factors "interacted" with 2.5 million gene variants.

FTO is the gene that is most strongly linked to obesity, Graff said.

And overall, her team found, active people who carried the obesity-linked FTO variant appeared more resistant to its effects than sedentary people.

On average, exercise weakened the variant's effects by about 30 percent, the researchers reported in the April 27 issue of PLOS Genetics.

There were some hints that exercise also affected some other weight-related genes. But the only clear relationship was with the FTO variant, according to Graff.

That, she noted, could be related to the broad way the study looked at exercise. The 23 percent of people who were least active were considered "inactive," while everyone else was deemed "active."

Church said he thinks research into the genetics of body weight will increasingly become useful.

If certain gene variants affect people's response to a low-carb diet or aerobic exercise, for example, that could help in "tailoring" weight-loss plans, he suggested.

"The science is rapidly evolving," Church said, "and there's still a lot to learn. But I think that's the direction this is going."

More information

The U.S. National Institutes of Health has more on weight management.

SOURCES: Mariaelisa Graff, Ph.D., research assistant professor, epidemiology, University of North Carolina at Chapel Hill; Timothy Church, M.D., Ph.D., M.P.H., professor, preventative medicine, Pennington Biomedical Research Center at Louisiana State University, Baton Rouge; Chip Lavie, M.D., medical director, cardiac rehabilitation and prevention, and director, exercise laboratories, John Ochsner Heart and Vascular Institute, New Orleans; April 27, 2017, PLOS Genetics, online

Obesity Quadruples Kids' Type 2 Diabetes Risk: Study

TUESDAY, April 25, 2017 (HealthDay News) -- Close to 13 million American children and teens are obese, and new research shows they may be four times more likely than kids with a healthy weight to develop type 2 diabetes by age 25.

Between 2002 and 2005, there were 3,600 cases a year of type 2 diabetes among U.S. kids and teens, according to the Endocrine Society's Endocrine Facts and Figures report. A large study of British children produced similar results, the researchers noted.

"As the prevalence of obesity and being overweight has rapidly risen, an increasing number of children and young adults have been diagnosed with diabetes in the United Kingdom since the early 1990s," said study co-author Ali Abbasi, a research fellow at King's College London.

For the study, published April 25 in the Journal of the Endocrine Society, the researchers reviewed health records of 375 general practices in the United Kingdom.

The team compared the diabetes status and body mass index (BMI) of about 370,000 children between the ages of 2 and 15. BMI is a measure used to determine if someone is a healthy weight for their height.

The study found that 654 youngsters were diagnosed with type 2 diabetes and 1,319 with type 1 diabetes between 1994 and 2013. Nearly half of those with type 2 diabetes were obese. There was no link, however, between obesity and rates of type 1 diabetes, an autoimmune disease, researchers noted.

"Diabetes imposes a heavy burden on society because the condition is common and costly to treat," Abbasi said in an Endocrine Society news release. "Estimates indicate one in 11 adults has type 2 diabetes, or about 415 million people worldwide. Given that diabetes and obesity are preventable from early life, our findings and other research will hopefully motivate the public and policymakers to invest and engage in diabetes prevention efforts."

More information

The U.S. Centers for Disease Control and Prevention provides more on childhood obesity.

SOURCE: The Endocrine Society, news release, April 25, 2017

Are You Raising an 'Emotional Eater'?

TUESDAY, April 25, 2017 (HealthDay News) -- Soothing your kids with food may stop the tears in the short-term. But researchers warn it can lead to unhealthy eating patterns long-term.

Parents who are "emotional feeders" can encourage "emotional eating" -- a habit linked to weight gain and eating disorders, the Norwegian-British study found.

"There is now even stronger evidence that parental feeding styles have a major influence on children's dietary habits and how children relate to foods and beverages when it comes to addressing their own emotions," said one expert, Rafael Perez-Escamilla. He's a professor of epidemiology and public health at Yale University's School of Public Health.

"Emotional feeding" is "what parents do when they provide foods or beverages to their children to calm them down, such as when a child is having a tantrum," added Perez-Escamilla, who wasn't involved with the study.

Relying on junk food, desserts and sugary foods for comfort can lead to overeating, and later problems such as bulimia and binge-eating, said study lead author Silje Steinsbekk and colleagues.

"You don't feel like having a carrot if you're sad," said Steinsbekk, an associate professor of psychology at the Norwegian University of Science and Technology in Trondheim.

For the new study, the researchers looked at the feeding and eating habits of more than 800 children in Norway, starting at age 4. They checked in on the kids at ages 6, 8 and 10.

About two-thirds of the children at all those ages showed signs of eating to make themselves feel better, judging by questionnaires answered by their parents.

Kids offered food for comfort at ages 4 and 6 displayed more emotional eating at ages 8 and 10, the study found.

Also, the researchers also found signs that kids who felt more easily comforted by food were fed more by parents for that purpose.

"Emotional feeding increases emotional eating and vice versa," Steinsbekk said.

The researchers spotted another trend: Children who became angry or upset more easily at age 4 were more likely to __eat to feel better and to be fed by parents for that purpose.

"This makes total sense as parents get very stressed out when their children are having a fit or crying non-stop," said Perez-Escamilla.

But there are better ways of dealing with discomfort, said Melissa Cunningham Kay, a research assistant with the University of North Carolina's Gillings School of Global Public Health.

"Feeling sad or angry are normal emotions. Rather than using food as a distraction from them, children should be taught to tolerate them and find other ways to cope," said Kay, who was not part of the study.

"Sometimes that may involve positive discipline and a few tears or even a full-on tantrum," said Kay. "Parents should not fear this. It is a normal and a necessary part of development."

Perez-Escamilla said parents should soothe upset kids by understanding and responding to their problems -- say, a wet diaper -- instead of offering food as a first response, he said.

He praised the new research, noting that the eating habits of kids and their parents are closely intertwined.

"Young children develop their eating habits by observing how their caregivers eat," he said. "If they see their caregivers drinking soda and eating junk food and desserts when the caregiver is stressed or upset, then that's what the children will do when they are experiencing similar emotions."

"Emotional eating should be avoided at all costs," he added.

Study lead author Steinsbekk added: "There's no reason to worry if you have a chocolate to feel better now and then. The problem is if this is your typical way of handling negative emotions."

The same goes for dealing with kids, he said. "Parents are not supposed to be perfect, but good enough. Randomly using food to soothe your child is no big deal as long as you usually rely on other strategies," he said.

The study authors cautioned that their review relied on questionnaires answered by parents, not direct observation by the scientists. And they noted that it took place in Norway with a population that's well-educated and not very diverse, so the findings may not apply elsewhere.

The study appears April 25 in the journal Child Development.

More information

For more about children's nutrition, see nutrition.gov.

SOURCES: Rafael Perez-Escamilla, Ph.D., professor, epidemiology and public health and director, Office of Public Health Practice, Yale School of Public Health, New Haven, Conn.; Silje Steinsbekk, Ph.D., associate professor, Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Melissa Cunningham Kay, research assistant, Gillings School of Global Public Health, University of North Carolina, Chapel Hill; April 25, 2017, Child Development

The Top 5 Conditions That Shorten Americans' Lives -- And Are Preventable

MONDAY, April 24, 2017 (HealthDay News) -- More bad news for plus-sized Americans: Obesity is the leading cause of preventable life-years lost in the nation, a new study finds.

Obesity steals more years than diabetes, tobacco, high blood pressure and high cholesterol -- the other top preventable health problems that cut Americans' lives short, according to researchers who analyzed 2014 data.

"Modifiable behavioral risk factors pose a substantial mortality burden in the U.S.," said study lead author Glen Taksler, an internal medicine researcher at the Cleveland Clinic.

"These preliminary results continue to highlight the importance of weight loss, diabetes management and healthy eating in the U.S. population," Taksler said in a clinic news release.

Obesity was linked with as much as 47 percent more life-years lost than tobacco, his team said.

Tobacco, meanwhile, had the same effect on life span as high blood pressure, the researchers found.

The researchers noted that three of the top five causes of life-years lost -- diabetes, high blood pressure and high cholesterol -- can be treated. And helping patients understand treatment methods, options and approaches can have a significant effect, the study authors said.

The findings also emphasize the importance of preventive care, and why it should be a priority for physicians, Taksler's team said.

However, the researchers acknowledged that some people's situations may be different than those of the general population. For example, for someone with obesity and alcoholism, drinking may be a more important risk factor than obesity, even though obesity is more significant in the general population.

"The reality is, while we may know the proximate cause of a patient's death -- for example, breast cancer or heart attack -- we don't always know the contributing factor(s), such as tobacco use, obesity, alcohol and family history," Taksler said. "For each major cause of death, we identified a root cause to understand whether there was a way a person could have lived longer."

The findings were scheduled for presentation Saturday at the annual meeting of the Society of General Internal Medicine, in Washington, D.C. Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Library of Medicine offers healthy living resources.

SOURCE: Cleveland Clinic, news release, April 22, 2017

Exercise Benefits Aging Hearts, Even Those of the Obese

MONDAY, April 24, 2017 (HealthDay News) -- Exercise can reduce the risk of heart damage in middle-aged adults and seniors -- even in those who are obese, according to a new study.

"The protective association of physical activity against [heart] damage may have implications for heart failure risk reduction, particularly among the high-risk group of individuals with excess weight," study lead author Dr. Roberta Florido said in an American College of Cardiology news release.

Florido is a cardiology fellow at Johns Hopkins University School of Medicine in Baltimore.

"Promoting physical activity," she added, "may be a particularly important strategy for heart failure risk reductions among high risk groups such as those with obesity."

To gauge the influence of physical activity on heart health, the researchers looked at the experience of more than 9,400 people between 45 and 64 years of age.

The participants were grouped according to how much exercise they got. Current guidelines recommend at least 75 minutes a week of vigorous activity, or 150 or more minutes of moderate to vigorous activity.

A lower level of activity, called "intermediate," was defined as up to 74 minutes a week of vigorous activity or up to 149 minutes of moderate to vigorous activity.

According to the researchers, those who did no exercise were 39 percent more likely to have heart damage than those who followed the guidelines.

Those who followed intermediate level routines had 34 percent more heart damage than their fully active peers.

The researchers found indications that obese individuals who engaged in "recommended" levels of activity had lower blood levels of troponin -- a key indicator of heart damage -- compared with those who did no exercise at all.

Florido and her colleagues described their findings in the April 24 issue of JACC: Heart Failure.

An accompanying editorial urged heart specialists to promote healthy habits rather than simply treat heart problems once they develop.

More information

There's more on exercise and heart health at the American Heart Association.

SOURCE: American College of Cardiology, news release, April 24, 2017

Waist Size, Not Weight, May be Key to Life Span

MONDAY, April 24, 2017 (HealthDay News) -- That spare tire you're toting around could be increasing your risk of an early death, a new study suggests.

What's more, the increased risk associated with having a larger waistline occurs even if a person's body-mass index (BMI) indicates a healthy weight, said lead researcher Emmanuel Stamatakis. He's an associate professor with the University of Sydney in Australia.

People who carry extra weight around the middle -- also called "central obesity" -- but have a normal BMI have a 22 percent higher risk of death than people whose fat is stored elsewhere in their bodies, the study found. In folks with a BMI that indicates obesity, the risk of early death was 13 percent higher for those with central obesity.

The study also found that a large gut poses an even greater hazard for heart health. The risk of heart-related death is 25 percent higher for someone with central obesity and a normal BMI. It's 26 percent greater for those with an overweight BMI and extra abdominal girth, and 56 higher percent for an obese BMI and central obesity, the study found.

BMI is a rough estimate of a person's body fat based on height and weight measurements. Normal BMI is 18.5 to 24.9, according to the U.S. Centers for Disease Control and Prevention. Overweight is 25 to 29.9, and obese is 30 and over. Someone who's 5 feet, 9 inches tall is considered normal when weight is between 125 and 168 pounds. Overweight is 169 to 202 pounds. Obese is 203 pounds or higher.

Waist-to-hip ratio is a measurement used to determine if there is excess belly fat. Stamatakis said waist-to-hip ratio is calculated by dividing your waist measurement by your hip measurement.

"If a person's waist-to-hip ratio is over 0.85 if they are female, or over 0.90 if they are male, then they should be concerned and look into ways to alter their lifestyle to lose or reduce the 'paunch,'" Stamatakis said.

Ruth Loos is director of the genetics of obesity and related metabolic traits program at the Charles Bronfman Institute of Personalized Medicine at Mount Sinai in New York City.

She said these findings jibe with previous studies indicating that belly fat may be more detrimental to a person's health than fat stored elsewhere in the body.

"Studies have been fairly consistent in showing that waist-to-hip ratio contributes to disease," Loos said.

For this latest study, researchers looked at almost 43,000 participants in the Health Survey for England and the Scottish Health Survey. Each person's BMI and waist-to-hip ratio was compared against their health history during 10 years of follow-up.

The study participants' average age was 58. And, just over half had central obesity. Forty four percent were overweight. One quarter were obese. Folks who were overweight and obese were much more likely to have central obesity than people with a normal BMI.

Researchers found that the risk posed by a big belly was the same for men and women, Stamatakis noted.

However, men are more likely to store fat around their middle, which could mean they are more likely to develop this risk, Loos said. Women tend to store fat in their hips and buttocks.

"It is indeed true that men have more of the one type of body shape, and women the other," Loos said.

Excessive fat around the waist has been linked to insulin resistance, high cholesterol and increased inflammation, Stamatakis said. These all are risk factors for heart disease.

A high waist-to-hip ratio also can indicate less muscle mass in the legs, which also increases heart disease risk, Stamatakis added.

"In fact, people who have high BMI often have larger amounts of fat stored in the hips and the legs, and this appears to be better for metabolic and cardiovascular health for reasons we cannot fully understand," he said.

Loos said belly fat might be more harmful than fat stored in the hips because it more directly affects the central organs of the body.

"If you store fat around your belly and around your organs, it's going to affect your liver function, it's going to affect your heart function," Loos said.

Both Stamatakis and Loos said people with belly fat should take steps to improve their health, by eating right, exercising and cutting out other risk factors like smoking or drinking.

Unfortunately, weight loss efforts will not necessarily eliminate your spare tire. Weight loss tends to occur evenly across the entire body, and cannot be directed toward any exact store of fat, Loos noted.

"There's no way of specifically targeting that belly fat," Loos said. "Even exercises like doing sit ups are not going to specifically help you lose fat in your belly."

The new study was published April 24 online in the Annals of Internal Medicine.

More information

For more on abdominal obesity and health, visit the Harvard Medical School.

SOURCES: Emmanuel Stamatakis, Ph.D., associate professor, University of Sydney, Australia; Ruth Loos, Ph.D., director, genetics of obesity and related metabolic traits program, Charles R. Bronfman Institute of Personalized Medicine, Mount Sinai, New York City; April 24, 2017, Annals of Internal Medicine

Counting Your Way to Weight Loss

MONDAY, April 24, 2017 (HealthDay News) -- The concept of counting calories to lose weight is based on a pound of fat being equal to 3,500 calories, so that cutting 500 calories a day means you should lose about one pound a week.

That's not always true, however.

Many diets limit daily calories to 1,200, but this may not be the magic number for everyone. It could be too low for a very active man or too high for a sedentary woman to net a pound-a-week loss.

To determine the right calorie cap for you, it helps to know how many calories you're currently eating. That's your baseline number. Many people underestimate how much they __eat each day, and dieters tend to underestimate this even more.

To find your baseline number, keep a food journal for a week, recording the calories in everything you __eat and drink. This will also make you more aware of just how much you're taking in. Calculate your daily average to get your baseline number.

For a faster estimate, use an online "daily calorie needs" calculator. You'll type in your age, sex, height, weight and activity level, and the site will do the calculations. You can also see how many calories you'll be able to eat once you reach your ideal weight. To start your diet, cut 500 calories a day from your baseline.

As you lose weight, you'll need to progressively decrease calories to continue losing at the same rate because your baseline number gets a little smaller with every pound lost.

More information

The U.S. Department of Agriculture has more on calculating calories.

Love Chocolate? Potato Chips? Your Genes Might Be to Blame

SUNDAY, April 23, 2017 (HealthDay News) -- Your tendency to indulge in chocolate, go heavy on salt, or __eat veggies may be tied to certain gene variants, a new study suggests.

The study, of more than 800 adults, found links between several genes and people's food likes and dislikes.

The gene variants were already known. One, for example, is linked to obesity risk; others are involved in hormone regulation.

It's not yet clear what the new findings mean, the researchers said.

And they stressed that aversion to broccoli is not genetically determined: You might just need a better way of cooking it.

But the findings add to evidence that food preferences are partly related to genetic variation.

"Research is really beginning to look at the role of genes in food intake and nutrient use," said Lauri Wright, a registered dietitian in Florida who was not involved in the study.

Some researchers believe that understanding the genetics behind food preferences will lead to more individualized diet advice. In fact, there's a burgeoning field known as "nutrigenomics," Wright noted.

For now, though, you are unlikely to have your DNA analyzed when you see a dietitian.

Nor do you need to, added Wright. She said dietitians already ask people about their food preferences -- and a slew of other information -- to help craft personalized diet plans.

Wright is a spokesperson for the Academy of Nutrition and Dietetics, and director of the doctorate in clinical nutrition program at the University of North Florida.

Past studies have found correlations between gene variations and people's tastes for certain foods.

For the most part, they have looked at genes related to taste receptors, said Silvia Berciano, who led the current study.

Berciano said her team focused on certain genes that have been connected to behavioral and psychological traits (such as depression or addiction), to see if any are also related to eating habits.

To do that, the researchers analyzed variations in those genes, along with self-reported diet habits, among 818 white U.S. adults.

In general, the study found, there were associations between several genes and food preferences. Variations in a gene called FTO, which is related to obesity, were tied to vegetable and fiber consumption, for instance.

It's possible that the FTO gene influences both obesity risk and people's desire for veggies, said Berciano, a researcher at Tufts University in Boston.

Could the link exist simply because people prone to obesity are less likely to be vegetable lovers? Berciano said that's unlikely: The FTO variation tied to vegetable/fiber intake is in a different place on the gene than the variant related to obesity.

In other findings, a gene called SLC6A2, which helps regulate hormones like norepinephrine, was related to fat intake.

Meanwhile, variations in a gene that helps regulate oxytocin -- the so-called "love hormone" involved in bonding, mood and other behaviors -- were related to chocolate intake, as well as heavier weight.

Oxytocin "enhances the brain's reward system," Berciano noted. On the other hand, she said, lower oxytocin levels could boost chocolate cravings as a way to get that same reward.

Berciano was scheduled to present the findings Sunday at the American Society for Nutrition's annual meeting, in Chicago. The results should be considered preliminary until published in a peer-reviewed medical journal.

The study does not prove that any of those gene variants directly affect people's food preferences, Wright pointed out.

And even if they have an influence, she said, diet habits are much more than a matter of genes. Economics, culture and a range of environmental factors are at play, she added.

And, with help, people can change even long-standing diet habits. "We don't want people to think, 'I can't help bingeing on chocolate, it's in my genes,' " Wright said.

Still, Berciano said an understanding of the genetics behind food preferences could eventually prove useful in the real world.

"Understanding how genetic differences affect neural regulation of eating behavior means that we'll be able to predict the behavioral tendencies of the individual," she said.

That, she added, could help in creating diet plans that are "easier for the individual to adhere to."

For now, though, Wright said she is unsure how expensive genetic testing would enhance what dietitians already do. "We already look at the individual -- not just their food preferences, but their other lifestyle habits and their economic and social situations," she said.

That bigger context, Wright said, is critical in helping people make lasting diet changes.

More information

The U.S. National Institutes of Health has a list of resources for healthy eating tips.

SOURCES: Silvia Berciano, M.Sc., researcher, USDA Jean Mayer Human Nutrition Research Center on Aging, Tufts University, Boston; Lauri Wright, Ph.D., spokesperson, Academy of Nutrition and Dietetics, and director, doctorate in clinical nutrition program, University of North Florida, Jacksonville; April 22, 2017 presentation, American Society for Nutrition and Experimental Biology 2017 meeting, Chicago

Health Tip: Concerned About Your Child's Weight?

(HealthDay News) -- Overweight children are at risk for a number of health problems from childhood into adulthood.

Here are suggestions for discussing the subject with your doctor, courtesy of the American Heart Association:

Prepare a list of questions and concerns. Ask the doctor if you may phone or meet privately if you don't want to discuss in front of a child.
Before the visit, chat with your child about healthier living, and what that means for the family.
Bring up your child's weight, even if your doctor doesn't.
Focus on how the entire family can become healthier, rather than just on the child.

Get to Know the Mediterranean Diet

MONDAY, April 17, 2017 (HealthDay News) -- The diet followed by people who live in countries around the Mediterranean Sea has been shown to be more than just delicious. The so-called Mediterranean diet can help you limit daily calories so you can lose weight. Plus, it's a healthy long-term way of eating.

The main focus of the Mediterranean diet is on eating plant-based foods. That means including fruits and vegetables in every meal, and eating them for snacks and dessert, too.

Switch from refined to whole-grain foods, including breads, cereal, rice and pasta. Also add legumes like peas and beans. Try to __eat a vegetarian dinner one or two nights a week.

People who successfully lose weight while following a Mediterranean diet generally get about a third of their calories from healthy fats, including a small handful of nuts each day.

Other tips:

Switch from butter to olive oil.
Limit red meat to just a few times a month, and have smaller amounts than you're probably used to -- just a 3-ounce serving.
Eat more chicken and fish. In fact, have fish at least twice a week. Fatty fish like salmon and sardines are among the healthiest choices.
Choose low- or no-fat dairy products over high-fat ones to cut out more saturated fat.

As a bonus, if you like red wine, you can say cheers to one glass a day.

More information

The U.S. Department of Agriculture has a detailed portion chart to help you plan menus for the Mediterranean diet.

'Better Health' Argument Won't Always Work to Pass Soda Taxes

FRIDAY, April 14, 2017 (HealthDay News) -- Philadelphia lawmakers weren't able to get a soda tax passed on health benefits alone last year, researchers report.

Instead, the legislators had to sweeten the deal with a pledge to fund young children's education, the study found.

After two previous failed attempts, Philadelphia lawmakers last June approved a 1.5 cent-per-ounce tax on sugar-sweetened beverages, becoming the second city in the United States to do so.

The new study took a behind-the-scenes look at how the tax was passed.

"The tax was conceptualized and framed as a revenue-generation ordinance, not a public health ordinance," said study leader Jonathan Purtle. He's an assistant professor at Drexel University's School of Public Health in Philadelphia.

"Thus, it appears it was rather easy to avoid health messaging. Pretty much everything was focused on how the revenue from the law would be used -- not the potential health benefits," he explained in a Drexel news release.

The new tax could bring in $32 million for both Philadelphia and the state over the next five years, the study authors said. Last November, similar taxes passed in four cities: San Francisco, Oakland and Albany, Calif., and Boulder, Colo.

The hope is that the new Philadelphia tax will lead to a reduction in sugar-sweetened soda consumption that might help reduce obesity and type 2 diabetes rates. Money raised by the tax will be used to fund pre-kindergaten education, the researchers said.

Purtle said the strategy used to pass the Philadelphia soda tax could prove effective in other cities. But he added that a current court battle over the tax might affect such an approach.

"Other cities might want to consider how revenue will be used as opposed to potential health benefits when they're trying to pass a tax like this," he said.

The study was published recently in the journal Public Health Management & Practice.

More information

The U.S. Centers for Disease Control and Prevention has more on sugary drinks.

SOURCE: Drexel University, news release, April 10, 2017

A Healthier Weight May Mean Fewer Migraines

WEDNESDAY, April 12, 2017 (HealthDay News) -- Your weight just might influence your risk of migraine headaches, a new review finds.

"Those with migraine and [their] doctors need to be aware that excessive weight and extreme weight loss are not good for [migraine sufferers], and that maintaining a healthy weight can decrease the risk of migraine," said study corresponding author Dr. B. Lee Peterlin.

She is director of headache research at Johns Hopkins University School of Medicine in Baltimore.

"Healthy lifestyle choices in terms of weight management and diet and exercise are warranted," she added.

Migraines affect about 12 percent of U.S. adults, according to background information from Johns Hopkins. These debilitating headaches are often accompanied by throbbing, nausea and sensitivity to light and sounds.

Peterlin's team evaluated 12 previously published studies with nearly 300,000 people, a process known as a meta-analysis.

The investigators found that obese people were 27 percent more likely to have migraines than people who were at a normal weight.

And those who were underweight were 13 percent more likely to have migraines.

The researchers used the standard definitions of both obesity -- a body mass index (BMI) of 30 or higher -- and underweight, a BMI of less than 18.5. A person who is 5 feet 4 inches tall and weighs 175 pounds has a BMI of 30, while someone of the same height who weighs 105 has a BMI of 18.

In previous research, Peterlin's team found that the link between obesity and migraines was greater for women and for those under the age of 55. This new study reaffirmed those findings.

The new review found that the link between obesity and migraines is a moderate one, Peterlin said. It's similar to the link between migraines and ischemic heart disease, in which the heart doesn't get enough blood, she added.

Peterlin said she can't explain with certainty how body composition affects migraine risk. But, she speculated that fat tissue "is an endocrine organ and like other endocrine organs, such as the thyroid, too much and too little cause problems."

The change in fat tissue that occurs with weight gain or extreme weight loss alters the function and production of several proteins and hormones, Peterlin explained, changing the inflammatory environment in the body. This could make a person more prone to a migraine or it could trigger a migraine, she said.

However, the study only found an association, and not a cause-and-effect relationship, between weight and migraine risk.

The review was published April 12 in the journal Neurology.

Would weight loss or gain help? It's not certain, Peterlin said.

"Limited data in humans show that in both episodic and chronic [migraine sufferers] who are extremely obese and undergo bariatric surgery for other health reasons also have a reduction in headache frequency by over 50 percent," she said. Aerobic exercise has also been shown to decrease headaches.

"What is not yet clear is if it is the weight loss per se or other factors related to exercise that result in the improvement," Peterlin said.

One headache specialist who wasn't involved with the study lauded the findings.

The new analysis is "a valuable addition to the growing body of literature on migraine and body mass index," said Dawn Buse, director of behavioral medicine at the Montefiore Headache Center in New York City.

With her patients, Buse said, she has seen migraine frequency increase with weight gain. And she has also seen improvement in migraines after weight loss, she said.

Buse acknowledged that, while weight loss appears to help, losing weight can be challenging. Health care professionals should discuss with their patients the relationship with migraines, and help them by providing education and referrals for treatments that may help weight loss.

More information

To learn more about migraines, visit Johns Hopkins University.

SOURCES: B. Lee Peterlin, D.O., director, headache research, Johns Hopkins University School of Medicine, Baltimore; Dawn Buse, Ph.D., director, behavioral medicine, Montefiore Headache Center, New York City; April 12, 2017, Neurology, online

A Healthy Middle-Aged Heart May Protect Your Brain Later

TUESDAY, April 11, 2017 (HealthDay News) -- Healthy aging of the brain relies on the health of your heart and blood vessels when you're younger, a new study reports.

People with risk factors for heart disease and stroke in middle age are more likely to have elevated levels of amyloid, a sticky protein known to clump together and form plaques in the brains of people with Alzheimer's disease, the researchers said.

MRI scans revealed larger deposits of amyloid in the brains of seniors who smoked, had high blood pressure, were obese, diabetic or had elevated cholesterol levels when they were middle-aged, said lead researcher Dr. Rebecca Gottesman. She's an assistant professor of neurology at the Johns Hopkins University School of Medicine in Baltimore.

All of these risk factors can affect the health of a person's blood vessels, otherwise known as vascular health, leading to hardening of the arteries and other disorders.

"Amyloid is what we think, by leading hypotheses, accumulates to cause Alzheimer's disease. So this suggests that vascular risk in middle age may play a direct role in the development of Alzheimer's disease," Gottesman said.

Two or more risk factors nearly tripled a person's risk of large amyloid deposits. One risk factor alone increased the likelihood of amyloid deposits by 88 percent, the study found.

Obesity in particular stood out as a strong risk factor, on its own doubling a person's risk of elevated amyloid later in life, said Steven Austad, chair of biology of aging and the evolution of life histories at the University of Alabama, Birmingham.

"In terms of one risk factor by itself, that turned out to be the most important one, which is interesting," Austad said. "Twenty years ago obesity was not the problem that it is now, suggesting that 20 years from now things might be considerably worse."

Gottesman and her colleagues examined data from nearly 350 people whose heart health has been tracked since 1987 as part of an ongoing study. The average age of the study participants was 52 at the start of the study. Sixty percent were women, and 43 percent were black. The average follow-up time was almost 24 years.

When the participants entered the study, none of them had dementia. About two decades later, they were asked to come back and undergo brain scans to check for signs of amyloid.

The researchers discovered a link between heart risk factors and brain amyloid. The relationship did not vary based either on race or known genetic risk factors for Alzheimer's.

Heart risk factors that cropped up late in life were not associated with brain amyloid deposits. What a person does in their middle age is what apparently contributes to their later risk of elevated amyloid, not what happens later, Gottesman said.

The study did not prove a cause-and-effect relationship, but there are several theories why the health of a person's blood vessels might be linked to Alzheimer's.

Blood and spinal fluid contain amyloid, and some think that unhealthy blood vessels might allow amyloid to leak out of the bloodstream and into brain tissue, said Austad, a spokesman for the American Federation for Aging Research.

"The idea that the first injury to the brain is really an injury to the blood vessels of the brain has been around for a while, and this would support that, generally," Austad said. "The amyloid plaques, you're not seeing them inside the vessels. You're seeing them outside the vessels, in the brain."

Blood vessels also play a role in flushing out broken-down amyloid particles that naturally occur in a person's brain, said Keith Fargo, director of scientific programs and outreach for the Alzheimer's Association.

"You can imagine if there's something wrong with your brain's circulation, it could affect the clearance of this amyloid in some way," Fargo said.

Hardened arteries also can lead to strokes or mini-strokes that affect the ability to think and remember in some people as they age, which contributes to dementia and Alzheimer's, Gottesman said.

Based on these findings, people who want to protect their brain health should protect their heart health, and the sooner the better, Fargo said.

"You don't want to wait until your 60s to start taking care of yourself. It has to be a lifetime commitment," Fargo said.

The findings were published April 11 in the Journal of the American Medical Association.

More information

For more on Alzheimer's disease, visit the U.S. National Institute on Aging.

SOURCES: Rebecca Gottesman, M.D., Ph.D., assistant professor of neurology, Johns Hopkins University School of Medicine, Baltimore; Steven Austad, Ph.D., chair of biology of aging and the evolution of life histories, University of Alabama, Birmingham, and scientific director, American Federation for Aging Research; Keith Fargo, Ph.D., director of scientific programs and outreach, Alzheimer's Association; April 11, 2017, Journal of the American Medical Association

More Younger Americans Are Suffering Strokes: Study

MONDAY, April 10, 2017 (HealthDay News) -- Strokes are typically associated with the elderly, but new research suggests that strokes are increasingly happening to Americans under 65.

The study looked at a sample of data from some U.S. stroke hospitalizations. From 2003 to 2004 in this sample, more than 141,000 people from 18 to 65 were admitted to hospitals for stroke. By 2011 to 2012, that number had risen to more than 171,000, researchers found.

"Our results stress the importance of prevention of stroke risk factors in younger adults," said lead author Dr. Mary George. She's a senior medical officer with the U.S. Centers for Disease Control and Prevention's division of heart disease and stroke prevention.

"Young adults, ages 18 to 54, are experiencing a small but sustained increase in stroke and in the prevalence of traditional stroke risk factors, such as high blood pressure, diabetes, high cholesterol, tobacco use and obesity," George said.

Up to 80 percent of strokes are thought to be preventable, she said.

George said the study's findings "should prompt a sense of urgency to promote and engage young adults in practicing healthy behaviors, such as exercising, eating a healthy diet that includes plenty of fruits and vegetables, avoiding smoking, and maintaining a healthy weight."

The impact of a stroke is significant at any stage of life, she said.

But George added, "It is uniquely complex when younger adults in the midst of careers, serving as wage earners and caregivers, may suffer disability that can impact their lives and the lives of family members and loved ones."

Stroke is the fifth leading cause of death in the United States. Each year stroke kills more than 130,000 Americans. Stroke is also a leading cause of disability, George said.

To study trends in stroke, the researchers used a database of some U.S. hospital stays gleaned from billing records. The 2003-2004 data included more than 362,000 stroke hospitalizations. The 2011-2012 information included nearly 422,000 stroke hospitalizations.

There are two types of stroke: ischemic and hemorrhagic. An ischemic stroke, sometimes called a brain attack, is a stroke that occurs when a blood clot blocks the blood supply to the brain. Hemorrhagic strokes are caused by bleeding in the brain from a ruptured blood vessel.

Men between 35 and 44 years old saw a striking increase of 41.5 percent in hospitalizations from ischemic stroke over the two study periods.

The researchers found that the rate of hemorrhagic strokes remained basically stable during the study period. The one exception was in the 45 to 54 age group. There was a slight decline in hemorrhagic strokes for men and blacks in that age group, the study showed.

The researchers think an increase in stroke risk factors, such as high blood pressure, diabetes, high cholesterol, obesity and smoking, are behind the rise in strokes among younger adults.

During the study, the percentage of people with three or more stroke risk factors roughly doubled for all age groups.

"Preventing and controlling stroke risk factors among young adults can save lives, reduce disability, decrease health care costs and improve the quality of life for tens of thousands of people and their families," George said.

The study was published online April 10 in the journal JAMA Neurology.

One specialist questioned the use of billing data to uncover trends in stroke and isn't sure a real increase in strokes among younger adults is occurring.

"The systems for counting stroke in the United States are extremely limited," said Dr. James Burke, an assistant professor of neurology at the University of Michigan.

"Credible alternatives may explain what appears to be an increase in stroke among young men and women, but is not," said Burke, who co-wrote an accompanying journal editorial.

"MRIs are more widely used, which can lead to an increase in diagnosis of stroke," he said.

"MRIs are being used for all kinds of things, and so when you put lots and lots of people in MRI scanners, for example for headaches, we will find asymptomatic brain injury that is stroke-like, and how much classifying of these as stroke is not clear," Burke said.

In addition, the United States doesn't have extensive databases that track patients and medical conditions, he said.

"Our ability to make strong conclusions is surprisingly limited since we don't have national health data on everybody. When we are making these measurements, we are looking at a small chunk of the population," Burke said.

More information

For more information on stroke, visit the American Stroke Association.

SOURCES: Mary George, M.D., M.S.P.H., senior medical officer, division of heart disease and stroke prevention, U.S. Centers for Disease Control and Prevention; James Burke, M.D., assistant professor, neurology, University of Michigan, Ann Arbor; April 10, 2017, JAMA Neurology

Race May Play Role in Obese Teens' Blood Pressure

MONDAY, April 10, 2017 (HealthDay News) -- Obese teenagers are at increased risk of high blood pressure, but the effects of those extra pounds may vary by race and ethnicity, a new study suggests.

Researchers found that obesity had a bigger impact on blood pressure of Hispanic and white teens, compared to their black and Asian peers. It appeared to raise their risk of high blood pressure by four to six times.

Pediatric experts said the impact on Hispanic teenagers was striking.

Normal-weight Hispanic kids had a low rate of high blood pressure, at just over 1 percent. That shot up to nearly 8 percent among those who were obese.

"That's a little scary," said Dr. Joseph Mahgerefteh, a pediatric cardiologist at Children's Hospital at Montefiore in New York City.

Mahgerefteh, who was not involved in the research, said the study was well done, and gives pediatricians useful information.

High blood pressure at a young age can set the stage for serious health problems in adulthood, including stroke and heart disease.

All children should have their blood pressure checked at routine doctor visits, starting at age 3, said Dr. Joshua Samuels, the senior researcher on the study.

"But you may want to have your searchlight on a little brighter" when a child is obese, said Samuels, a professor at the University of Texas Health Science Center at Houston.

Doctors should also be aware that obesity can have a particularly strong effect on Hispanic kids' blood pressure, said Samuels.

Doctors have known for years that obese kids are at increased risk of high blood pressure, Samuels noted. But the role of race and ethnicity has been unclear, he added.

So Samuels' team studied a diverse group of more than 21,000 Houston adolescents who had their blood pressure screened at school.

Overall, almost 3 percent were diagnosed with high blood pressure -- after showing persistently high readings at three screenings.

Hispanic kids had the highest rate, at just over 3 percent. They also had the highest obesity rate, at 23 percent, the findings showed.

At the other end of the spectrum, Asians had the lowest rates of high blood pressure (1.7 percent) and obesity (10 percent).

In general, the study found, excess weight was linked to a raised risk of high blood pressure across all racial and ethnic groups.

But the impact of obesity was most clear among Hispanic and white kids: It raised their risk nearly sixfold and fourfold, respectively, compared to normal-weight students.

Weight-related differences were smaller among black and Asian students, the researchers said. Among black teens, 2 percent of those with a normal weight had high blood pressure, versus 4.5 percent of obese teens.

It's not clear why obesity affected kids differently, and the study only points to an association, not a direct cause-and-effect relationship.

Researchers do not fully understand the causes of high blood pressure in children, Mahgerefteh said.

He suspected, though, that some effects of obesity may have been "masked" in black kids.

Obesity was determined based on body mass index (BMI), a measure of weight in relation to height. It's an imperfect way to define obesity, Mahgerefteh pointed out, because it does not gauge body fat. A person who is larger-framed and muscular can fall into the "obese" category.

That's more likely to happen with blacks. So some black kids with a healthy body composition may have been deemed obese in this study, Mahgerefteh explained.

For parents, though, the bottom line is fairly straightforward, Samuels said. Be aware that kids can have high blood pressure, and that extra pounds are a risk factor.

The risk does not only rise once kids cross the obesity threshold, Mahgerefteh pointed out. Overweight kids in this study were more likely to have high blood pressure than their thinner peers, too.

"It's a continuum," Mahgerefteh said. "The more overweight you are, the higher the risk."

Once a child is diagnosed with high blood pressure, lifestyle measures -- a healthy diet and regular exercise -- are the go-to. "We have a higher threshold for using medication in kids," compared with adults, Mahgerefteh said.

If your teenager's blood pressure has not been checked in a while, it should be, Samuels said.

"Once kids move on to college, then young adulthood, they may stop going to the doctor," he noted. "Ideally, we want to catch high blood pressure when they're teenagers."

Samuels and his colleagues reported the findings online April 10 in Pediatrics.

More information

The American Heart Association has more on high blood pressure in children.

SOURCES: Joshua Samuels, M.D., M.P.H., professor, pediatric nephrology and hypertension, McGovern Medical School at the University of Texas Health Science Center at Houston; Joseph Mahgerefteh, M.D., pediatric cardiologist, Children's Hospital at Montefiore, New York City; May 2017, Pediatrics

'Yo-Yo' Dieting Does No Favors for Your Heart

WEDNESDAY, April 5, 2017 (HealthDay News) -- Yo-yo dieting -- quickly losing weight only to promptly regain it -- may raise the risk of heart problems, a new study suggests.

People who experience regular weight fluctuations of 8 to 10 pounds are much more likely to suffer from heart disease, heart attack, stroke and other heart-related maladies than people who only experienced shifts of 2 pounds or less, said lead researcher Dr. Sripal Bangalore. He is an interventional cardiologist with NYU Langone Medical Center in New York City.

In particular, yo-yo dieters had more than twice the risk of death, heart attack or stroke compared with people who maintained a relatively stable body weight, Bangalore said.

"For every 1.5- to 2-pound change in weight fluctuation, the risk of any coronary or cardiovascular event was increased by 4 percent, and the risk of death by 9 percent," Bangalore said.

Patients with heart disease are encouraged to drop some pounds if they are overweight or obese, but it is very hard to maintain weight loss, Bangalore said. Weight gain frequently follows weight loss, falling into a rhythmic pattern doctors call "weight cycling."

To see whether weight cycling had any effect on heart health, Bangalore and his colleagues analyzed medical data from 10,000 patients with hardening of the arteries in a clinical trial to test the effect of statin medications.

The patients were tracked over four years, with doctors regularly taking measure of their health and their body weight.

Researchers found that people whose weight cycled dramatically were more likely to experience heart disease, heart attack, cardiac arrest, blocked arteries, angina, stroke or heart failure.

Their risk of death was 124 percent higher, heart attack 117 percent higher, and stroke 136 percent higher, after accounting for other factors, the study said.

Bangalore thinks dramatic changes in weight likely place a lot of stress on the body, and also causes hormonal changes that affect the heart.

But yo-yo dieting might only be an indication of deeper medical problems affecting a person, said Linda Van Horn, a professor of preventive medicine at Northwestern University's Feinberg School of Medicine in Chicago.

Yo-yo dieters in the study were more likely to be heavier, smoke and have high blood pressure and diabetes, said Van Horn, a spokeswoman for the American Heart Association. Twice as many yo-yo dieters actually developed diabetes during the study.

"When you go down that list, some huge issues jump right out at you," Van Horn said. "Across all of the likely candidates for what contributed to illness or death, the yo-yo dieting in and of itself was not the culprit. Those who were yo-yo dieters, as much as they tried to lose weight to lower their risk factors, still succumbed to the very risk factors we know all too well."

Overweight or obese people should still try to lose weight, since dropping any excess pounds will improve their health, Bangalore and Van Horn said.

The key is to undertake weight loss as a long-term effort involving diet, exercise and other lifestyle changes you can maintain over the long haul, they said.

"This shouldn't deter anyone from losing weight, but this is all the more reason to say that once you've done the hard work of losing weight, it's really important to keep the pounds off for a long period of time," Bangalore said.

People can do that by avoiding fad diets, and instead focusing on healthy eating and regular exercise, Van Horn said. They also should give themselves a break if their efforts don't immediately pay off with dramatic weight loss.

"Maybe you don't lose quite as much as you could if you starve yourself, but the real trick is keeping it off over the course of your life," she said. "The only way that really is successful is adopting a lifestyle that includes the very things we all know that contribute to healthy weight."

The study was published April 5 in the New England Journal of Medicine.

More information

For more on yo-yo dieting, visit the Mayo Clinic.

SOURCES: Sripal Bangalore, M.D., interventional cardiologist, NYU Langone Medical Center, New York City; Linda Van Horn, Ph.D., R.D., professor, preventive medicine, Northwestern University's Feinberg School of Medicine, Chicago; April 5, 2017, New England Journal of Medicine

Fitness, Not Fat, Is Key to Post-Stroke Recovery

WEDNESDAY, April 5, 2017 (HealthDay News) -- People who were active and exercised regularly before their stroke were less likely to face disability after the attack, researchers say.

But the amount of body fat a person had did not seem to be tied to post-stroke disability, the study found.

Fitness was key, though.

"Being physically inactive before stroke predicts a higher risk of being dependent both before and after stroke," said study author Pamela Rist, of Harvard University. Her team's findings were published online April 5 in the journal Neurology.

The new study involved more than 18,000 people with no history of stroke who were followed for an average of 12 years. During that time, nearly 1,400 of the participants suffered a stroke but survived.

Three years after their stroke, those who had exercised regularly before their stroke were 18 percent more likely to be able to perform basic tasks -- such as bathing on their own, the researchers found.

The fitter individuals were also 16 percent more likely to be able to perform more complex tasks, such as managing money on their own, compared to those who did not exercise before their stroke, the findings showed.

"We also found that a person's body mass index was not a factor in predicting their level of disability after stroke," Rist said in a journal news release. Body mass index is an estimate of body fat based on weight and height.

Two experts in stroke care who reviewed the findings said the study highlights the importance of exercise.

The research "provides additional evidence that regular exercise has health benefits that last into a person's future," regardless of stroke, said Dr. Andrew Rogove. He directs stroke care at Northwell Health's Southside Hospital in Bay Shore, N.Y.

Dr. Ajay Misra is chair of neurosciences at NYU Winthrop Hospital in Mineola, N.Y. He said the study "provides insight into the fact that doctors should emphasize to their patients not only weight-reduction strategies for stroke and possibly heart attack prevention, but also the importance of leading a very active lifestyle to improve their chances of survival and recovery in case a stroke occurs."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on stroke rehabilitation.

SOURCES: Andrew Rogove, M.D., medical director, stroke, Northwell Health's Southside Hospital, Bay Shore, N.Y.; Ajay Misra, M.D., chairman, neurosciences, NYU Winthrop Hospital, Mineola, N.Y.; Neurology, news release, April 5, 2017

Race Plays Role in Heart, Diabetes Risk, Even at Normal Weight

MONDAY, April 3, 2017 (HealthDay News) -- Americans of South Asian and Hispanic descent who aren't overweight may be more at risk for heart disease, stroke and diabetes than normal-weight white people are, a new study finds.

"Clinicians using overweight/obesity as the main criteria for [heart disease and diabetes] screening, as currently recommended by the U.S. Preventive Services Task Force, may fail to identify [heart disease and diabetes] abnormalities in many patients from racial/ethnic minority groups," said study first author Unjali Gujral.

She is a postdoctoral fellow at Emory University in Atlanta.

The study was done by researchers at Emory and the University of California, San Francisco (UCSF).

The new research included nearly 7,000 people between 45 and 84 years old. More than 800 were of South Asian descent from India, Pakistan, Nepal, Bangladesh or Sri Lanka. The rest were identified as white, black, Hispanic and of Chinese descent.

The study included body mass index (BMI) information. BMI is a rough estimate of body fat based on height and weight. In general, a normal BMI range is from 18.5 to 24.9, according to the U.S. Centers for Disease Control and Prevention. This study used a narrower range for normal BMI for people of Chinese and South Asian descent -- 18.5 to 22.9, the researchers said.

The researchers also looked at four risk factors -- high blood pressure, elevated blood sugar, low levels of "good" HDL cholesterol and high levels of blood fats called triglycerides -- associated with heart disease, stroke and diabetes.

Those with two or more of the risk factors were considered to have heart disease or diabetes-linked (cardio-metabolic) abnormalities.

Among normal-weight people, those of South Asian descent were two times more likely to have heart disease or diabetes abnormalities.

Normal-weight people of Hispanic descent were 80 percent more likely to have these potential problems than whites, the study found.

And blacks and Chinese-Americans were 50 percent more likely to have these metabolic abnormalities at a normal weight, researchers said.

These abnormalities showed up at much lower BMIs for non-white people, the study found.

For example, for non-whites to have a similar number of heart and diabetes risk factors as a white person with a BMI of 25, someone of Chinese or South Asian descent had a BMI of 19.6. For a woman who's 5 feet 5 inches, a BMI of 25 is equivalent to 150 pounds. A BMI of 19.6 is 118 pounds, the researchers said.

"These differences are not explained by differences in demographic, health behaviors or body fat location," Gujral said in a UCSF news release.

Study senior author Dr. Alka Kanaya is a professor of medicine, epidemiology and biostatistics at UCSF. "We hope the results will enable patients and their health care providers to see that race/ethnicity alone may be a risk factor for cardio-metabolic health in minority Americans," she said.

The study was published April 3 in the journal Annals of Internal Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more on heart disease prevention.

SOURCE: University of California, San Francisco, news release, April 3, 2017

As Weight Goes Up, So Does Death Risk

MONDAY, April 3, 2017 (HealthDay News) -- Adults who become overweight or obese have a higher risk of dying from heart disease, cancer or other illnesses, a new study suggests.

Further, the risk of dying increases in proportion to the amount of excess weight you gain, the researchers found.

The results undercut the so-called "obesity paradox" -- a theory that obesity could protect the health of some people and even give them a survival advantage, said senior study author Andrew Stokes. He's an assistant professor of global health with the Boston University School of Public Health.

In the study, Stokes and his colleagues tracked the weight history of more than 225,000 participants in three large studies, gauging the maximum body mass index (BMI) of each person across an average of 16 years.

"We found that after considering weight history, the apparent paradoxical association between overweight/obesity and the risk of dying completely disappeared," Stokes said.

Morbidly obese people were twice as likely to die from any cause, more than three times as likely to die from heart disease, and 50 percent more likely to die from cancer compared with normal-weight folks, researchers concluded.

Previous studies with results supporting the obesity paradox have only checked participants' BMI at one point in time, producing a weight "snapshot" that might not reflect the person's actual excess pounds over their lifetime, Stokes said.

This can bias the results, when you consider that many people with a fatal illness frequently lose a lot of weight prior to death, he said.

"Some people have unintentional weight loss driven by the onset of a chronic disease like cancer or a heart condition," Stokes said. "When you just consider the snapshot, some people in the normal-weight category are those who developed a disease and are losing weight on the pathway to dying. That acts as a bias."

Tracking the subjects' weight every couple of years via questionnaires, researchers were able to categorize them based on the highest BMI they reached during the study period -- underweight (less than 18.5 BMI), normal weight (18.5-25 BMI), overweight (25-30 BMI), obese (30-35 BMI) and morbidly obese (greater than 35 BMI).

They then tracked participants an average of 12 years, noting which ones died and the cause of their deaths.

A person's overall risk of dying increased based on their maximum BMI, the researchers found: 10 percent increased risk for overweight people, 34 percent for the obese and 98 percent for the morbidly obese.

The same sliding scale held for risk of death from heart disease (23 percent increased risk for overweight people, 71 percent increased risk for the obese and more than triple for the morbidly obese) and cancer (5 percent for overweight, 20 percent for obese and 50 percent for morbidly obese).

Underweight people also had an increased overall risk of death (46 percent) and death by heart disease (77 percent) or cancer (7 percent).

However, the study cannot prove that the additional weight caused the increased death risk, and it can't say whether or not losing the weight would reduce the extra risk, Stokes added.

"That's a really important question, and it's a question I aim to address in future research," Stokes said. "In this paper, we have not distinguished between intentional and unintentional weight loss. We cannot say anything at this point about whether having a history of overweight and obesity sticks with you even after you lose the weight through lifestyle change."

Dr. Scott Kahan, director of the National Center for Weight and Wellness in Washington, D.C., said he's not surprised that the obesity paradox does not appear to stand up to close scrutiny.

"We have no biologically plausible reason to think that carrying excess weight would be protective in any way," Kahan said, noting that extra pounds place added stress on the body while larger fat cells produce harmful inflammatory chemicals and hormones.

At the same time, Kahan thinks ultimately it will be proven that overweight and obese people could reduce their risk by losing weight.

"Many, many other studies have shown that even moderate weight loss leads to improvement of a wide range of health problems," said Kahan, a spokesman for The Obesity Society.

Stokes agreed. "We have quite compelling evidence from trials of bariatric surgery that weight loss is hugely beneficial in reducing your risk of disease or dying," he said.

The study was published in the April 3 issue of the Annals of Internal Medicine.

More information

For more about body mass index, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Andrew Stokes, Ph.D., assistant professor, global health, Boston University School of Public Health; Scott Kahan, M.D., MPH, director, National Center for Weight and Wellness; Annals of Internal Medicine, April 3, 2017

Obesity in Early Pregnancy May Raise Child's Risk of Epilepsy

MONDAY, April 3, 2017 (HealthDay News) -- Kids are more likely to develop childhood epilepsy -- a seizure disorder -- if their mothers were overweight or obese early in pregnancy, a new study suggests.

The risk of epilepsy in children goes up as a mother's weight goes up -- reaching as high as 82 percent among kids of severely obese women, the researchers said.

"This means more severe grades of obesity correspond to increasingly higher risk," said study co-author Dr. Eduardo Villamor. He's a professor of epidemiology with the University of Michigan School of Public Health.

However, Dr. Steven Wolf, director of the pediatric epilepsy program at Mount Sinai Health System in New York City, pointed out that the overall risk of childhood epilepsy still remains relatively low, even if a woman is overweight or obese.

It's also important to note that this study wasn't designed to conclusively show a direct cause-and-effect relationship between a pregnant woman's weight and her child's risk of epilepsy.

About 50 million people worldwide have epilepsy, according to the study authors. In 60 percent of those cases, no known cause is found.

The current study included medical data for more than 1.4 million babies born in Sweden between 1997 and 2011. Of all those children, more than 7,500 kids were diagnosed with epilepsy between birth and age 16, the researchers said.

The investigators found that the odds a child would develop epilepsy corresponded to their mom's body mass index (BMI) at around 14 weeks of pregnancy. BMI is a rough estimate of body fat based on a person's height and weight.

A normal BMI is between 18.5 and 24.9. Someone between 25 and 29.9 is considered overweight. Anyone above 30 is classified as obese.

For someone who is 5 feet, 9 inches tall, a BMI of 25 to 29.9 (overweight) means a weight that's between 169 and 202 pounds. A BMI of 30 or more (obesity) is a weight above 202 pounds for someone of that height, the U.S. Centers for Disease Control and Prevention says.

This study also included separate classifications of obesity. From 30 to 34.9 was grade I obesity. From 35 to 39.9 was grade II obesity. And, grade III obesity included anyone with a BMI of 40 or more.

For childhood epilepsy, compared with normal-weight women, the researchers associated:

11 percent increased risk with overweight.
20 percent increased risk with grade I obesity.
30 percent increased risk with grade II obesity.
82 percent increased risk with grade III obesity.

Neda Razaz, the study's lead author, said, "Given that overweight and obesity are potentially modifiable risk factors, prevention of obesity in women of reproductive age may be an important public health strategy to reduce the incidence of epilepsy." She's a postdoctoral fellow at the Karolinska Institute in Stockholm, Sweden.

There are several potential ways a mother's excess weight could increase risk of childhood epilepsy, Razaz and Villamor said.

Excess weight increases the risk of preterm birth and birth defects, which in turn increase risk of epilepsy, the researchers said. The baby also is more likely to suffer from trauma or low oxygen levels during birth with an overweight or obese mother. These factors might raise epilepsy risk.

Overweight or obesity also spurs on general inflammation in the mother's body. This could possibly have an effect on their baby's developing brain, Villamor added.

Dr. William Bell is a neurologist with Ohio State University's Wexner Medical Center. He agreed that inflammation could be the culprit behind this increased risk.

"Pregnancy is already an inflammatory state, and so is obesity. When you add those two together, a lot of bad things can happen," Bell said. He wrote an editorial accompanying the new study.

However, Razaz said it's likely that excess weight interacts with other genetic and environmental factors that might contribute to epilepsy risk. These include smoking or drinking, vitamin deficiency, or problems related to a woman's social or economic status.

Wolf said the findings are fascinating, and mothers' weight hasn't been considered a risk factor for childhood epilepsy.

"We take care of a lot of kids with epilepsy, and that's not one of the variables that pop up," Wolf said.

However, Wolf thinks these findings need "a little more validation."

"A study like this makes us pause and stop and think, but my sense is this isn't a significant variable at this moment," he said.

But there are plenty of reasons women thinking about pregnancy might want to control their weight, including pregnancy complications, Wolf and Bell said.

The study was published online April 3 in the journal JAMA Neurology.

More information

For more about epilepsy, visit the Epilepsy Foundation.

SOURCES: Eduardo Villamor, M.D., M.P.H., Dr.PH., professor of epidemiology, University of Michigan School of Public Health; Steven Wolf, M.D., director of pediatric epilepsy program, Mount Sinai Health System, New York City; Neda Razaz, M.P.H., Ph.D., postdoctoral fellow, Karolinska Institute, Stockholm, Sweden; William Bell, M.D., neurologist, Ohio State University's Wexner Medical Center, Columbus, Ohio; April 3, 2017, JAMA Neurology, online

U.S. Thyroid Cancer Cases Continue to Rise

FRIDAY, March 31, 2017 (HealthDay News) -- The rate of Americans diagnosed with thyroid cancer has more than tripled over the past four decades, and continues to rise more than 3 percent a year, new research shows.

The rise can't be completely attributed to better detection or "overdiagnosis," said a team led by Cari Kitahara of the U.S. National Cancer Institute.

The findings "are consistent with a true increase in the occurrence of thyroid cancer in the United States," the researchers reported March 31 in the Journal of the American Medical Association.

The thyroid is a butterfly-shaped organ at the base of the throat. While the vast majority of thyroid cancers aren't life-threatening, the death rate for a particularly aggressive form of the disease -- advanced papillary thyroid cancer -- has increased, the study found.

One thyroid expert said the study helps clarify recent trends.

"Historically, thyroid cancer incidence has increased from overdiagnosis, due to more readily available technology such as sonograms and fine needle biopsy," explained Dr. Robert Courgi. But, he added, "the increase found in this study is greater than we expected."

Courgi is an endocrinologist at Northwell Health's Southside Hospital in Bay Shore, N.Y. He wasn't involved in the study.

According to the American Cancer Society, close to 57,000 new cases of thyroid cancer will be diagnosed in the United States in 2017. The disease strikes women more often than men -- more than 42,000 of those new diagnoses are expected to occur in females.

Luckily, thyroid cancer is one of the most curable tumor types. Still, the cancer society notes it will kill more than 2,000 Americans this year.

Numerous studies have suggested that thyroid cancer incidence is rising, but there's been debate on whether that's simply an artifact of improved detection methods.

To help settle the issue, Kitahara's team used detailed data from a major U.S. cancer database, looking at trends in thyroid cancer incidence and death from 1974 to 2013.

The researchers found that "thyroid cancer incidence increased, on average, 3.6 percent per year during 1974-2013," with rates for papillary thyroid tumors increasing at an even faster rate (4.4 percent annually).

The overall rate of new cases more than tripled -- a 211 percent rise -- over the study period.

Also, deaths from thyroid cancers rose steadily from 1994 to 2013 at just over 1 percent annually, with deaths from advanced papillary thyroid cancers rising at the fastest rate (nearly 3 percent per year).

Kitahara and her colleagues believe these increases can't be explained by better detection. They noted that certain known risk factors for thyroid cancer -- especially rising obesity rates -- may play a role.

"Obesity prevalence has increased threefold among U.S. adults between 1960 and 2012, with the fastest rate of increase between 1980 and 2020," the researchers pointed out.

Smoking is another potent risk factor. While fewer Americans smoke now than they used to, obesity and smoking together "have been estimated to be related to more than 40 percent of all new cases of thyroid cancer annually in the United States," the study authors said.

As for deaths linked to advanced papillary thyroid tumors, Kitahara's team believes there needs to be a "renewed focus" on aggressive management of this disease, including surgery, radiation and/or drug therapy.

Courgi agreed the study is a wake-up call for those concerned about this common cancer.

"This study suggests that the rate of thyroid cancer is increasing greater than we expected and we need to learn more in hopes of prevention," he said.

More information

Find out more about thyroid cancer at the American Thyroid Association.

SOURCES: Robert Courgi, M.D., endocrinologist, Northwell Health's Southside Hospital, Bay Shore, N.Y.; March 31, 2017, online, Journal of the American Medical Association

Sunday, April 30, 2017

Friday, April 28, 2017

Tuesday, April 25, 2017

Monday, April 24, 2017

Sunday, April 23, 2017

Tuesday, April 18, 2017

Friday, April 14, 2017

Thursday, April 13, 2017

Wednesday, April 12, 2017

Monday, April 10, 2017

Wednesday, April 5, 2017

Tuesday, April 4, 2017

Monday, April 3, 2017

Saturday, April 1, 2017

Follow me

Popular Posts

Blog Archive