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

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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.

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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.

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'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

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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

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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

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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

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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

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'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

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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

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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

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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

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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

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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

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Weight, Gender Appear to Play Part in Kidney Transplant Success

THURSDAY, March 30, 2017 (HealthDay News) -- Weight and gender differences between donors and recipients can affect the success of kidney transplants, a new study says.

Researchers reviewed data from more than 115,000 people in the United States who received a kidney from a deceased donor. The transplants took place between 2000 and 2014.

The average follow-up time was about four years. During that time, more than 21,000 patients developed transplant failure.

After accounting for other possible causes, the researchers concluded that weight was a factor in transplant failure. Specifically, if a kidney transplant recipient was more than 66 pounds heavier than the donor, there was a 28 percent higher risk of transplant failure, compared with recipients who weighed about the same as donors.

The researchers also noted a difference if the donor and recipient's genders were mismatched. The risk of transplant failure was 35 percent higher for a male receiving a kidney from a female donor. In women receiving a man's kidney, the odds of transplant failure were 50 percent higher.

That level of risk is similar to that faced by a recipient who receives a kidney from a donor who has diabetes, the study authors said.

The findings were published March 30 in the Clinical Journal of the American Society of Nephrology.

A kidney donor's weight and sex are not typically considered when choosing a recipient. These findings suggest that such factors may need to be considered, the researchers said.

"This study is extremely important because we have shown that when all else is considered, something as simple as the combination of a kidney donor's weight and sex is associated with a marked increase in kidney transplant failure," study co-leader Dr. Amanda Miller said in a journal news release. Miller is from Dalhousie University and the Nova Scotia Health Authority, Canada.

She said more research is needed before taking weight and gender into consideration when matching donors and recipients. But the findings suggest that current matching strategies may need to take other factors into account, she added.

However, matching donors and patients by weight and gender would be complex and could leave some potential recipients at a disadvantage, Dr. Bethany Foster and Dr. Indra Gupta, of McGill University in Montreal, said in an accompanying editorial.

"Restricting transplant options by prioritizing sex matching may also lead to longer waiting times," they wrote. "Females with a large body size would be particularly disadvantaged by an approach that favored allocation of sex- and body-size matched kidneys."

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on kidney transplant.

SOURCE: Clinical Journal of the American Society of Nephrology, news release, March 30, 2017

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